Tuesday, November 26, 2013

They Must Be Led

Childhood obesity is an epidemic that has short and long-term affects.  The dietary and physical activity behaviors of children and adolescents are influenced by many sectors of society, including families, communities, schools, child care settings, medical care providers, faith-based institutions, government agencies, the media, and the food and beverage industries and entertainment industries.

According to the Center for Disease Control and prevention obese youth are more likely to have risk factors for cardiovascular disease, such as high cholesterol or high blood pressure. In a population-based sample of 5- to 17-year-olds, 70% of obese youth had at least one risk factor for cardiovascular disease.  The numbers are even higher in African American and Hispanic communities, where nearly 40% of the children are overweight or obese.

With parents having busy schedules with work and other commitments it is less likely that a parent is preparing meals for their children like generations before them.  It is easier put something in the microwave or go to a drive thru.  Children’s free and leisure time is consumed with video games and television instead of physical activity.

The U.S. Department of Health and Human Services recommends that children and teens exercise at least at the intensity of a fast walk, about 5.6 kilometers per hour (3.5 miles per hour), for 60 minutes every day.

Recent research reported by The Children’s Obesity Fund, which has been reported in the Journal for Pediatrics, indicates that a lack of physical exercise is the big reason for the rise in obese children.
A recent study of 13,000 young people found that, on average, obese teens consumed fewer calories than their slim friends. According to Dr. Michael Omidi and his brother Julian Omidi and their non-profit The Children’s Obesity Fund, this finding underscores the importance of an active lifestyle.
The findings from The Children’s Obesity Fund complement the data from The Physical Activity Council which reported that in 2011, 170 million Americans – nearly 70% of the country -- were not active to healthy standards, i.e. 30 minutes of exercise at least three days a week.

For the past two school years I have worked with a nutritionist at middle schools in Montgomery County, MD in an after school Food and Fitness Program.  Every week after the exercise is completed they learn how to prepare healthy snacks and meals such as green smoothies, mixed green salads, grilled chicken and turkey burgers.  Each week they are requesting seconds and thirds.  Fitness activities have included relay races, kickball games, and introductions to exercises they can do on their own.

It is an example of when healthy options are presented to children there are foods they will eat and physical activities they can enjoy.  Recently I asked them to tell me what they had for lunch and the cost.  The next week they all received a handout with a shopping list and recommendations of what to purchase at school.  The list illustrated how a healthier lunch could cost $3.00/day with the right shopping choices and preparation.

It was refreshing to receive feedback from the students’ that their parents purchased items on the list and are helping them make better choices.

Children are dependent on adults to make decisions for them including what foods they are introduced to and activity levels.  At an early age foods that are high in sugar and fat are used as a treat or reward.  Parents have bad habits and they are passed down to their children.  Advertisers market specific foods for children that are high in fat and sugar.

 Dr. David Katz, Director, Yale University Prevention Research Center, Griffin Hospital recent editorial eloquently stated how adults view the nutrition and activity of their children:

“Most mammals seem to take the basic care and feeding of their offspring very seriously. Most mammals seem to recognize childhood as the time to cultivate the dietary aptitudes and attitudes that will shape a lifetime of sustenance. Our own species, or at least its currently prevailing culture, seems inclined to treat the feeding of our children as something of a joke. We seem inclined to confront the prominence of junk food in the diets of our children with a nudge-nudge, wink-wink, as if it were at worst cute—at best, a legitimate food group in its own right."

Parents can easily have the attitude toward feeding their children in the manner in which Dr. Katz stated because that is how they take care of their own temples.  With children their behavior is taught and caught.  Unintentionally parents condition their children to eating habits and activity levels.

Healthy and unhealthy school lunches.
Researchers have found adolescents are more likely to eat at least five servings of fruits and vegetables a day if their parents do. Contrarily, teens whose parents eat fast food or drink soda and are not active are more likely to do the same.
First Lady Michelle Obama Let’s Move Campaign is a comprehensive initiative dedicated to solving the challenge of childhood obesity.  It includes the first ever task force on child obesity and her championing of the Healthy, Hunger-Free Kids Act. A Congressional majority passed the legislation, which required meals in the National School Lunch Program (NSLP) to have fewer calories, more fruits and vegetables, fewer processed items and less sodium. And today the school lunches that 31 million kids eat are more likely to include a whole-wheat vegetarian pizza than sloppy joes.

The program has been scrutinized in some areas for being too rigid.  Districts in states including California, New York and Texas have dropped the program because their students simply weren’t eating the healthier foods and they were losing money on the lunches. 

The NSLP is still going through the trial and error process.  The program is making efforts to improve lunches, but breakfast, snacks, and weekend meal choices are up to parents.  The older children get the harder it will be for them to adopt a healthy lifestyle because the habits they develop now will become more engrained in them.

Environmental factors cannot be ignored.  Many communities are food deserts with limited options of healthy foods, walking trails, parks, and fitness centers. Low-income families are on reduced lunch programs and many children are stuck with the unhealthy choices at their schools.

In 2009 Robert K. Ross, president and chief executive officer of the California Endowment stated, "The research shows us that one of the keys to solving the teen obesity crisis starts with parents, but we must also improve the abysmal food environments in many low-income communities.  While parents are the primary role models for their children and their behavior can positively — or negatively — influence their children's health, it is also essential that local officials representing low-income communities work to expand access to fruits, vegetables and other healthful foods."

The private sector and government must do a better job of creating communities regardless of income that are more conducive for a healthy lifestyle.  The relationship between parents and children is perfectly designed to enable children to watch and learn.  Parents and caretakers must do a better job of setting the example for children and establishing habits while they are young.   Healthier parents will lead to healthier children; they are depending on the adults to step up to the plate for them.

Jamaal Piper is a Health and Wellness Consultant and Certified Personal Trainer

Tuesday, November 19, 2013

What's In Your Way?

Our entire society is struggling to find balance with work/school and family.  This impacts men, women, and children.  Some of the issues overlap, but others are very unique to the respective groups.  In this first installment of a three part series “Overcoming Roadblocks To Health”, I will focus on the unique challenges adults face to find balance with their personal responsibilities and maintaining a healthy lifestyle.

Men and women’s perceptions to being overweight or struggling to be healthy are different even though it is a concern for both.  The way it is internalized by men and women are different, but both sexes deal with the emotional and psychological contributors.

It has been documented that there are gender differences in eating habits. Specifically, a study conducted by Foodborne Disease Active Surveillance Network (FoodNet) found that men tend to eat more meat and poultry and women were more likely to eat fruits and vegetables. Additionally, the sexes find comfort in food, but approach this aspect of food in very different ways.

Dr. LeBel of Cornell University in a study conducted in 2005 Journal Physiology & Behavior (Vol. 86, No. 4) found that men were more likely to use food in celebration, and they will seek out higher protein foods such as steak. Whereas, women use comfort foods to cope with negative experiences and choose higher calorie sweet snack foods such as chocolate or ice cream.

Harvard Medical School’s Publication reported in 2012 research that suggested a gender difference in stress-coping behavior, with women being more likely to turn to food and men to alcohol or smoking. And a Finnish study that included over 5,000 men and women showed that obesity was associated with stress-related eating in women but not in men.
From my experiences as a personal trainer men have a more difficult time asking for help and if so they are usually older.  A woman is more inclined to seek help regardless of age.  Nutrition is always the biggest hurdle.  Body part emphasis varies between men and women.  Men mainly comment on their upper body and muscles.  Women on legs, it can be difficult for them to understand the importance of the entire body needing attention. 

Men and women have to keep their progress in perspective when attempting lose weight or just improve their health.  Men are larger and have more muscle than women due to the hormone testosterone. They are genetically designed to have a higher percentage of muscle and less fat -- which works in favor of keeping them fit and allowing them to consume more calories.

Weight is distributed differently between the sexes.  When men deposit fat, it most often goes to their mid section, while women's excess weight tends to settle below the belt and in the middle.

Leta Shy posed the question in 2011, “Does Your Beauty Routine Prevent You From Working Out?”  Shy stated how US surgeon general, Dr. Regina M. Benjamin spoke at a hair convention encouraging women to stop using their beauty routines as an excuse to skip exercise. "Oftentimes you get women saying, 'I can't exercise today because I don't want to sweat my hair back or get my hair wet," she said. "When you're starting to exercise, you look for reasons not to, and sometimes the hair is one of those reasons." The balance between maintaining your health and not having a bad hair day must be found.
1978 was the first year of the ABS standard Labour Force data series. Women accounted for only 35% of the workforce. After a massive surge during the 1980s and slower incline since then, women now account for just over 45%.  The three occupations with the strongest growth since 1996 for women are Professionals (91 %), Community and Personal Service Workers (83 %) and Managers (75 %).

These increases in responsibility add physical, emotional, and psychological stress.  "One of the biggest problems I see in my practice is women coming in with multiple physical signs of stress," says Nancy Molitor, Ph.D., a psychiatry professor at Northwestern University Feinberg School of Medicine. In fact, a new study found that stress and other negative emotions were consistently linked to poor physical health in more than 150,000 people in 142 countries.

Marcelle Pick, OB-GYN NP and co-founder of Women to Women’s Personal Program states that 80% of her patients have some form of issues with food.  Socioeconomic status is not relevant; rather what varies among these women is how they learn to respond to stress.

What must be distinguished is the difference between emotional and physical hunger.  When you’re physically hungry, healthy options such as fruits and vegetables sound good. But emotional hunger craves fatty foods or sugary snacks that provide an instant rush.

Obesity rates have skyrocketed in the United States over the last three decades.  In 1980 no state had an obesity rate over 15%, in 1991 not over 20%, 2000 not over 25%, but in 2013 41 states have an obesity rate over 25%.  Men and women have virtually identical obesity rates today (35.8% and 35.5% respectively). Ten years ago there was a difference of 6 percentage points (women 33.4% - men 27.5%).

Since 2000, male obesity rates have been rising faster.

Even reaching a goal for weight loss can present challenges.  "It's a fantasy, that when we lose weight, everything wrong in our lives is going to be right — that means our relationships are going to be right, we're going to feel completely differently about ourselves," says Geneen Roth, a New York Times bestselling author of books on eating who also leads retreats and workshops, and who herself lost between 60 and 70 pounds in her late twenties. "People are shocked to find out that this thing that they've been longing for and waiting for and working for is not what they thought it was."

Have you ever watched The Biggest Loser on NBC?  The emotional and psychological drain the contestants go through illustrates how impactful weight gain and loss can be.

Attempting to adapt a healthy lifestyle is an emotional and psychological process for men and women.  Habits become ingrained in our minds to the point where you cannot live without some of them.  That can be your favorite meal or lying on the coach instead of exercising.  It is disheartening to see people content with being unhealthy. 

Education, career pursuits, family, hair maintenance, time management, extra curricular activities are just a few examples of what can impede a healthy lifestyle.  Regardless of a negative doctors report, that favorite outfit not fitting anymore, or the displeasure with the reflection in the mirror, many would rather stay in the comfort of their current habits than make the necessary changes. 

Obesity rates continue to rise with a marketplace over saturated with tools to assist.  There are home video systems, publications, websites, personal trainers, nutritionist and other health professionals.  Even after getting professional assistance and learning and experiencing what is required to become healthier and in better shape the sacrifice of changing their eating habits, the fatigue and soreness after an intense workout is overwhelming.   Returning to the status quo just feels better.  What has to be recognized is that men and women are faced with responsibility and stresses.  Taking care of yourself will help you cope with the inevitable, the trials and tribulations of life.  Get healthy, be healthy, stay healthy, it will be worth it!

Jamaal Piper is a Health and Wellness Consultant and Certified Personal Trainer

Thursday, November 14, 2013

You Can't Pick A Spot

In my experiences in the health and wellness industry I have done many consultations with clients and had friends and family ask questions regarding them reaching certain goals.  A question that is raised on many occasions is, “how do I lose weight here or tone up there? ”, usually pointing to a body part they are not pleased with.  It is usually the gut with men and with women it can vary from dangling triceps, back fat, or  legs.  Areas to lose fat cannot be targeted, but targeting an area to build muscle can.

Fat and muscle are totally different body tissues.  The fat visible is sitting on top of muscle.  Age, gender, genetics, physical activity, and nutrition are factors that contribute to where the fat is stored.  When you lose weight, you are unable to choose the area in which the reduction will occur. Your body predetermines which fat stores it will use. For example, someone can do sit-ups that will strengthen their core, but will not take the fat off of their stomach.

Bat Wings
Bat wings are a common complaint amongst women.  Bat wings are the flabby skin hanging along the triceps.  With age, our skin gets thinner and less resilient, which means our parts just hang differently. Women in particular are subject to this because their skin is thinner to begin with.  To tone up the triceps area include compound exercises in your regiment that work the chest, shoulders, and triceps, such as push-ups and dips. 

With age symptoms of sarcopenia can develop.  Sarcopenia is when your muscles are deteriorating due to aging and neglect.  According to WebMD people who are physically inactive can lose as much as 3% to 5% of their muscle mass per decade after age 30. Even if you are active, you will still experience some muscle loss.

Dr. Oakley Jordan, a Memphis Internal Medicine physician associated with Methodist Hospital, stresses to his patients to be aware of sarcopenia (sarco for "muscle" and penia for "deficiency") and how to battle muscular deterioration.
Oakley is 62 and does cardio every day and resistance training every other day. He says sarcopenia is "normal attrition." Muscles regenerate slower and slower as we age, but working out, particularly with resistance training, turns regeneration up a notch.
"Women particularly need to work out with weight training because they carry more body fat. They have to hang on to their muscles."
All of these factors are why it is important to focus on overall fat loss and increase of strength.  Problem or target areas can be addressed with exercises to build muscle.  Losing body fat requires a combination of cardio vascular exercise, strength training, and a clean diet.   Cut processed foods from your diet.  Avoid sugar in all its many forms and very common in beverages. Try to eat only one-ingredient foods - in other words, eat foods in their most natural state, and combine them when you're cooking, instead of buying foods that have already been prepared. This is the same prescription for all fitness goals and that “spot” you want to address.