JoAnn:
The thyroid gland produces hormones, which control the metabolism. According to the American Association of Clinical Endocrinologists, over 27 million Americans suffer from a thyroid disorder and only about half of these people have been diagnosed. This is because the symptoms of thyroid disorders run the gamut—from weight fluctuations to mood changes—and these indications can often be confused for other conditions.

Hypothyroidism is an under-active thyroid, meaning that not enough of the thyroid hormones are being produced. This imbalance has a direct effect on the rate your body burns calories, as well as, your heart rate and body temperature. The following symptoms vary for each individual case:

− Weight gain (usually does not exceed 20-30 pounds)
− Fatigue
− Muscle weakness or pain
− Increased blood cholesterol
− Dry, pale or puffy skin
− Depression
− Constipation
− Heavier menstrual periods

Many people discount the symptoms as just a part of life or getting older. In other cases, the combination of certain symptoms could be misdiagnosed; for example, weight gain, hot flashes, fatigue and irritability are signs of both hypothyroidism and menopause.

But if hypothyroidism goes undiagnosed, symptoms increase, the thyroid gland (located at the nape of the neck) can become enlarged, the risk of a heart attack nearly doubles and the condition can develop into an advanced form, which is life threatening. If you are concerned that you may have hypothyroidism, speak with your doctor about the symptoms you are experiencing. If he or she is concerned, they will most likely start by testing your blood—with a TSH test and/or T4 test.

Treatments include thyroid hormone replacement or natural alternatives.

In good health,
Dr. Tabor

The body’s response to negative and/or threatening experiences is sometimes referred to as “fight-or-flight” and is an essential survival mechanism in many instances. But, over-exposure to stressful situations can wreak havoc on your mental and physical health.

Effects of frequent stress run the gamut—headaches, stomach issues, high blood pressure, chest pains, fatigue, depression, diabetes, obesity, skin conditions, anxiety and sleep disorders.

In stressful situations, the pituitary gland (at the base of the brain) releases an increased amount of the hormone adrenocorticotropic (ACTH). The ACTH hormone activates the release of other hormones, like cortisone and adrenaline, into the bloodstream. These hormones act to sharpen your focus, provide you with extra strength and help you quickly react to danger.

Hormones return to normal levels after the situation subsides. However, if these hormones are triggered frequently and over a long period of time, you can be at risk for serious health conditions.

Here are some pointers for re-shaping your lifestyle to avoid stress:

− Reflect/relax: find an activity that helps you relax, whether it be yoga, meditation, listening to music, etc.

− Healthy diet: eat foods like protein, whole grains, fresh fruit/vegetables, which keep blood sugar levels consistent and avoid sugar and caffeine that cause energy spike-and-crash reactions.

− Sleep: seven to nine hours of sleep per night will restore your body and mind and help you avoid illness.

− Stay active: exercise helps relieve stress and promotes production of endorphin hormones, which improve mood.
− Talk/share: express your emotions and thoughts to friends or to a therapist. Keep a personal journal.

− Time for yourself: take the time to engage in a hobby, volunteer, pamper yourself or just have “me” time.

It is important for us to listen to what our bodies and minds are trying to tell us so we are aware of our stress levels. There are ways to take control of such experiences and tailor our lives to avoid situations that might trigger anxiety.

What’s wrong with this scenario?

For 13 hours, your body has been fasting. How can you expect to run efficiently throughout the day if you haven’t fueled up? You wouldn’t expect to take a road trip by running on empty. When you go without eating for an extended period of time, the brain reacts by sending signals to the body that you are “starving”—the metabolism slows to conserve energy. Then when you finally eat again, the body thinks it needs to reserve energy in preparation for more food deprivation. Therefore it stores calories in the form of fat. So, not eating can actually lead to weight gain

Besides the common excuse of simply not having time or forgetting to eat breakfast, some people think that they actually eat more on the days that they consume a morning meal, than on days that they don’t eat. Research, reported in the February 2005 issue of the American Journal of Clinical Nutrition, debunks this belief. The study examined how eating and then skipping breakfast altered the participants’ daily caloric intake. During the two-week interval when participants skipped breakfast, they consumed 100 more calories than during the two weeks when they ate breakfast.

Studies have also shown that people who eat breakfast:

• Are less likely to be overweight


• Eat more nutrients and less fat and cholesterol


• Have more energy and better concentration throughout the day


• Have healthier cholesterol levels

To keep you fuller, longer, your morning meal should provide a combo of carbohydrate, protein and fat. Also, aim for at least 5 grams of fiber. Dodge the doughnuts, croissants and high-sugar cereals, which provide little nutritional benefit. Although your body physically needs calories, optimizing the health impact of the calories you eat will have a positive result on your health, energy and weight goals.

A 2005 poll conducted by the National Sleep Foundation shows that Americans average 6.8 hours of sleep per night—falling short of the recommended 7-8 hours. To make the situation even worse, some of us try to compensate for our lack of sleep on weeknights by getting extra sleep on the weekend. This inconsistent pattern can lead to sleep deprivation.

Signs of deficient sleep are both mental and physical. It can impair your cognitive ability, concentration, coordination and reaction time, while making you moody, depressed or anxious. In addition, lack of sleep is associated with obesity, diabetes and impaired nervous and immune systems.

Two hormones that signal the appetite, in opposing methods, may explain why we overeat when we under-sleep:

1. Shortage of sleep lowers levels of leptin, a hormone that suppresses the appetite. When leptin levels are depleted, the body thinks it needs food, when in fact, adequate amounts of food may already have been consumed.
2. Another hormone, ghrelin, sparks the appetite. Research has shown that insufficient sleep elevates levels of ghrelin, making you hungry.

The reactions of these hormones suggest a correlation between obesity or weight gain and habitual sleep deprivation. When you don’t get enough sleep, leptin (appetite suppressor) dips and ghrelin (appetite inducer) rises, resulting in a signal to the brain to eat. Recurrent overeating leads to weight gain.

If you have trouble maintaining a consistent sleep schedule of 7-9 hours a night, here are some tips to get on track:

• Create a routine—plan a common time to fall asleep and awake
• Relax before going to bed and create a soothing sleep environment
• Eat only light foods—heavy meals and spicy foods can hinder sleep and induce indigestion
• Avoid caffeine, especially later in the day
• Avoid alcohol prior to sleep, it can prevent you from reaching a state of deep sleep
• Check drugs and supplements for suggested intake times—some herbs and medications, such as decongestants, can increase the heart rate or activate brain activity, making it difficult to sleep

Don’t just dream about a full night’s sleep. Establish a healthy sleeping habit and your mind and body will feel the effects.

Dear Vikki:

Good question! Water is needed for every bodily function and it constitutes about 70% of your body weight. Conventional wisdom has advised us to drink at least eight glasses of water a day, but this isn’t entirely true. To start, we all have different water requirements, based on varying factors in our lives. The average male should intake about 13 cups-worth of water a day and women should aim for closer to 9 cups.

Many people don’t realize that drinking water isn’t our only source of hydration—foods and other beverages count towards our water intake. And contrary to popular belief, we do not need to consume extra water to make up for moderate consumption of coffee or other caffeinated beverages.

Influences on water requirements:

1. Physical activity—replenish fluids lost through sweating
2. Illness—fluid excretion often increases, requiring your intake to increase as well
3. Climate—hot, humid weather promotes sweating, as well as cold climates when we may be transferring between extreme temperature changes from inside to outside
4. Pregnancy/nursing

Juices, milk, coffee and alcoholic beverages DO contribute water content to our bodies. Foods also hold varying water amounts. Here are some examples of the water content we receive from various foods and beverages*:

1 cup of water = 236 ml of water
1 cup of 1% milk = 219 ml of water
1 cup marinara sauce = 206 ml of water
1 cup raw strawberries = 151 ml of water
1 raw apple = 118 ml of water
1 sweet potato, baked in skin = 111 ml of water
1 cup cooked, whole wheat spaghetti = 94 ml of water
1/2 cup chocolate frozen yogurt = 46 ml of water
1 cup raw spinach = 27 ml of water

Drinking water may assist in weight management/weight loss. Some people misinterpret signs of thirst as hunger. If you feel hungry, but have recently eaten, you may want to try drinking some water and waiting a short time to see if the feeling subsides. Also, water has zero calories. You can easily reduce your caloric intake by substituting water for some of the other beverages you typically consume—like sodas and juices—throughout the day.

In good health,
Dr. Tabor

A 2005 study, conducted at Cornell University, suggests that it may not be the isolated weeklong overeating that leads to a sustained weight gain, but the retrained appetite that follows it.

During this small-scale study, 12 normal-weight men and women were asked to overeat for two weeks, after which they were to revert to their usual diets. The researchers discovered that in the time following the increased consumption period, participants ate as much or more than they did during the two-week mandatory binge.

It appears that our bodies adjust to the high calorie diet and continue to crave more food than what it needs for energy. Simply put—your body wants to eat more calories than it will burn, leading to weight gain.

Although the smartest approach is to resist the temptation to ‘pig out’, if you do decide to overindulge over a period of time, resume your normal eating habits as soon as possible. Trying to reverse to, or compensate with, a calorie-restricted diet—much lower than your usual intake—may backfire and lead you back to over-consumption.

How can you determine the real deal from the imitators? If you read the labels and know what to look for, you can optimize the nourishment you receive from some of your favorite foods.

Yogurt
People have been making and consuming yogurt for centuries. In 1916, the first packaged yogurt was introduced in Europe, and in 1940 it made its way to the US. Yogurt is known for its live and active cultures, which keep your digestion system healthy and support the immune system, but it also provides calcium, protein, magnesium, Vitamins B-6 and B-12 and more.

The popularity of yogurt has created a plethora of added options, such as blended flavors, bright colors and granola, candy or sprinkle mix-ins. To please calorie counters, many yogurts use aspartame instead of sugar, while others add too much sugar in order to appeal to the American palate. In addition, some yogurts don’t even contain live and active cultures because they’ve been heat- treated to extend shelf-life.

Here is what you should look for when choosing yogurt (most of which is sold in either 6 oz or 8 oz sizes):

− Live and active cultures
− Low fat or skim milk
− 3% calcium per ounce (equals at least 18-24% of your RDA for calcium)
− No more than 5 grams of sugar per ounce (that’s 30g for a 6 oz and 40g for an 8 oz)
− 30 calories or less per ounce (160-240 calories)

And avoid:

− Aspartame
− Colorings
− Mix-in toppings
− Heat-treated

The ideal way to enjoy yogurt is by using low-fat or fat-free plain mixed with your own toppings—like fresh fruit or cereal—but, there are healthy flavored-varieties in the dairy aisle.

Katz points to research to back-up his premise. Medical evidence has suggested that eating certain basic foods trigger different appetite centers in the brain. So if you eat something salty and sweet within the same meal, both appetite centers are stimulated and signal you to continue eating until satiated.

Katz theorizes that the fewer appetite centers we activate, the less we’ll be prompted to eat. The reverse is also true—the more centers we trigger the more food we need to feel satisfied. This may explain why buffets and dining situations, such as Thanksgiving, can lead us to overeat. You fill your plate with a ‘little of this’ and a ‘little of that’ and next thing you know you’re craving more, although you feel full.

Even if you attempt to limit the flavors you eat at one time, fast food and conventional snacks could be unforeseen pitfalls. Katz points to popular items like salty chips, which may also contain sugar, and sweet cereals, which may contain salt. Our taste buds only detect the prominent flavor, but our brains recognize both. Is this why you can’t stop at just one chip?

The saying goes, “variety is the spice of life.” In this case, could variety be the downfall of America’s waistline?

Marilyn:
A fiber-rich diet has many health benefits. Besides helping you maintain a healthy weight, fiber has been linked to heart health, a reduced risk of type 2 diabetes and more. The Institute of Medicine recommends that, depending on age and sex, you should consume between 21 and 38 grams of total fiber each day. Most Americans, however, barely reach half of this quota. Women under the age of 50 should aim for 25 grams, while men in this age range should try for 38 grams. Women over 50 years should strive for 21 grams and men who are 50 plus need about 30 grams.

Fiber is a carbohydrate found in plant-based foods such as whole grains, legumes, vegetables and fruits. It cannot be digested, has no calories and keeps you feeling fuller, longer. There are two categories of fiber, soluble and insoluble.

Insoluble fiber acts as a bulking agent in the digestive tract. It helps move waste along in the digestive process so that you remain regular.

Soluble fiber becomes gel-like as it dissolves in water. This allows for it to bind to fatty acids and carry them out of the digestive system, thus contributing to lower cholesterol levels. Soluble fiber also limits the absorption of glucose from the intestine, helping to control blood sugar levels.

Both forms of fiber have merits. Currently, there is no consensus on the proper ratio of soluble to insoluble fiber, in relation to your total daily fiber intake. You will get the most benefit by including the two types in your diet, through consumption of various food sources. Many food labels divide fiber content into the two categories, which can help you keep a tally.

If you don’t already consume the target 21 to 38 grams of fiber, slowly increase your consumption over a few weeks to avoid bloating and abdominal discomfort. Food sources of fiber are optimal. Be sure to spread intake throughout the day and drink plenty of water.

In good health,
Dr. Tabor

Your total metabolism has three components:

• Basic body functioning (or basal metabolic rate) - this is the energy needed for your vital organs, such as the heart and lungs, to work; rate decreases with age.


• Food processing (or thermic effect of food) - a relatively consistent rate, its the energy needed to process food.


• Exercise - energy needed for any physical activity; you have total control over this rate; the more frequent and intense your activities are, the more you will burn.

The most effective way to alter your metabolism is to increase your physical activity. Activities should include an exercise routine, but incorporate lifestyle changes that keep you moving—vacuuming, taking stairs and shopping. Expand your workout routine beyond just aerobic exercises. Also, engage in anaerobic exercise, which is resistance training, such as weight lifting. This will help you build lean muscle mass.

Avoid the trap of supplements and drugs that claim to increase your metabolism and burn fat. Many of these products create little or no results and may have unwanted, and even serious, side effects.

Don’t skip meals. When you go for an extended period of time without eating, your body thinks it’s starving. It kicks into survival mode. Your metabolism slows to conserve energy. Then when you eat again, the body stores calories as fat in preparation of future food deprivation. To avoid a metabolism dip, eat small meals, consistently, throughout the day.

Incorporating minor and easy-to-adopt habits into to your daily routine will avoid loss of stamina and weight gain due to metabolic slow-down. Simply packing nutritious snack foods in the morning, eating a healthy breakfast and avoiding sedentary behavior whenever possible will ensure you are feeling energized and help to manage weight.

To get to the bottom of this dilemma, the American Council on Exercise (ACE) commissioned the University of Wisconsin, La Crosse, to examine various exercises used to work the gluteus muscles—the three muscles that form your butt.

Researchers chose eight popular gluteal exercises to test—traditional squats, single-leg squats, vertical leg press, quadruped hip extensions, horizontal leg press, step-ups, lunges and four-way hip extensions. All eight were evaluated by how much they activated each of the three glute muscles.

The result…there wasn’t one dominant winner. While two exercises, the horizontal and vertical leg presses showed mediocre results, the other six produced similarly strong outcomes.

The researchers did highlight the traditional squat and quadruped hip extension as possibly having the greatest toning affect.

During testing, participants conducted the quadruped hip extension without any weight. Researchers predict that the potential for better results may increase by adding ankle weights. To do this exercise:

1. Get onto all fours.
2. Your back should be straight and parallel to the floor, eyes looking down, arms straight, palms forward.
3. Lift one leg, while keeping the knee at 90 degrees.
4. Stop when the foot is pointed towards the ceiling.
5. Return the knee to the floor. Do up to 12 reps.
6. Repeat with the other leg.

All eight activities can help you strengthen and tone. The best routine should include a combination of various exercises, in order to prevent injury or boredom.

Women around the world may soon have the answer. Dr. Lisa Macintyre, Professor at Scotland’s Heriot-Watt University, and a team of researchers, are on a mission to determine which styles, colors and types of fabric best flatter the female butt. The goal—to provide information that will help clothing designers create body-enhancing attire.

Female volunteers are photographed, from behind, in hundreds of different types of garments. Participants view the photos and evaluate how big or small the models’ backsides appear. The volunteer models are of varying sizes and shapes in order to collect findings that represent the greater population.

Rachele:

As many of us have learned from repeated dieting pitfalls, there is no effortless or short-term way to drop unwanted pounds and sustain weight loss. The most successful route is to adopt good eating behaviors that become a long-term way of life.

Originally developed 25 years ago to help diabetics measure blood sugar, the glycemic index (GI) measures the rate at which carbohydrates are released into the body after food consumption. High GI foods cause a rapid spike in blood sugar, whereas low GI foods create a gradual rise in blood sugar, allowing your body to control insulin production.

When you eat carbohydrates, they are metabolized into glucose in the bloodstream, which raises your blood sugar levels. Then your body produces insulin in order to offset glucose levels. Excessive levels of insulin overwhelm the body. This insulin is forced into fat cells, resulting in weight gain.

Concurrently, repeated overproduction of glucose, caused by extreme blood sugar levels, not only poses health risks, but can also cause your body to become insulin-resistant. High glucose levels and insulin resistance have been associated with obesity, type 2 diabetes, heart disease and some cancers.

The GI uses glucose as a benchmark on a scale of 100 points for ranking foods according to how they affect blood sugar levels. Low GI foods are those that score 55 or less on the index. These foods help to curb the appetite and sustain energy levels since your blood sugar is not on a spike-then-crash pattern. In many studies, shifting to lower glycemic foods aids in blood sugar control for diabetics, lowers LDL (bad) cholesterol levels and raises HDL (good) cholesterol levels.

High GI foods are those that score 70 or higher. These foods lead to a destabilization of blood sugar levels, increased appetite and inadequate fat breakdown in the body.

The GI ranking of foods, however, should not be the only factor one considers when dieting. There are low GI foods filled with empty calories and fat—potato chips and candy bars. Certain high GI foods, furthermore, are nutritious and should not necessarily be eliminated from your diet—watermelon, pineapple and potatoes.

To optimize the GI ranking system for long-term weight loss, you should integrate other healthy actions, such as limiting the consumption of animal fats, saturated fats and calories.

Recommendations for following a low GI diet:

− Whole wheat/whole grain breads and cereals (also breads containing millet, flaxseed)
− Brown rice, basmati rice
− Oatmeal
− Barley, buckwheat
− Legume products (hummus, baked beans, lentil soup)
− Unsweetened dairy products (milk, yogurt)
− Soy foods and beverages
− Fruits and vegetables
− Foods high in fiber and protein that metabolize slower than sugary, processed foods

Avoid:

− Processed sugars
− White Flour (pasta, rice, breads)
− Saturated and trans fats

Following the framework of a low GI diet in order to promote overall nutrition and lasting weight management can be very effective as long as you remember to think comprehensively. To sustain your dieting accomplishments, continue to consume wholesome foods and maintain an active and healthy lifestyle.

In good health,
Dr. Tabor

Here are some of the newest trends in exercise and health clubs, which may help motivate you or invigorate your current workout regime.

2006 Predictions from the American Council on Exercise:

− More classes that offer a fusion of Yoga and Pilates with traditional forms of exercise in order to focus on the mind-body aspect of physical fitness.
− Balance training—utilizing wobble boards, Bosu balls, Pilates, Tai Chi, etc.
− Employer-funded wellness programs that encourage physical activity and provide nutrition and lifestyle education.
− Fitness programs designed for seniors, which focus on overall conditioning and injury prevention.
− Small group training classes will gain in popularity—these are a cross between large group classes and personal training, you get more attention than in the larger classes, but at a lower cost than 1-on-1 time with a trainer.

New fitness fads from across the country include:

− The Action Hero Workout, from NYSC, will keep you active with stunt techniques—combining gymnastics, martial arts, strength, endurance and agility.
− International flair—African, Indian and Caribbean dance-based classes keep you moving and entertained.
− Forza—a samurai sword training class, developed by Ilaria Montagnani, burns about 500 calories a class and tones the upper and lower body.
− Stiletto Strength, offered at Crunch (a chain of gyms) and developed by dancers, works on strengthening your body’s core along with feet, ankles and calves.
− Gliders—roller devices placed under each foot and used during an aerobic workout—force you to stabilize your body to maintain motion. Gym-classes are already using them or you can purchase a set to use at home.

So if you’ve had one too many walks around the block to keep you on track with exercising, look for some of the new options from local studios and gyms to get you back in motion.

Causes of Weight Gain
During menopause and perimenopause, there is a decrease in estrogen and a rise in the hormone, cortisol. Studies have shown that increased cortisol in a woman’s body contributes to weight gain.
Testosterone hormone levels, however, remain steady, causing an imbalance in the presence of estrogen vs. testosterone. This uneven ratio triggers the development of body fat, especially around the waist.
Reduction in physical activity frequently associated with midlife is also to blame for increased body weight.

Resulting Health Conditions That Put You at Risk for Heart Disease
•  Elevated blood pressure
•  High cholesterol
•  Insulin resistance, which can lead to type 2 diabetes

Strategies for Preventing or Reversing Weight Gain
Get Moving: aerobic/cardiovascular exercise minimizes fat storage and speeds metabolism, which slows between 10% and 15% during this time.
Pump Iron: weight-bearing activity helps to maintain muscle mass and speeds up metabolism.
Cap Calories: smaller portions and a nutrient-rich, balanced diet help to maintain weight, improve mood and increase energy levels.
Eat Right: consuming high protein and high fiber foods such as whole-grains, fruits, vegetables, soy and mixed nuts which will keep you satisfied longer.
Reduce Stress: meditate, exercise and talk with friends/family/therapist since pent up stress can cause an increase in fat storage around the waistline.
You may not be able to control hormonal fluctuations that accompany midlife and cause changes for your skin, body and mood, but you can determine how you manage these changes by prioritizing your overall health.

Fad diets don’t work, you need to adopt a healthy lifestyle in order to achieve weight management, maintain wellness and FEEL good about yourself.