A lot of attention is given to men and heart attacks because they’re so sudden and dramatic. The health attention given to women by the media is usually in the area of breast and cervical cancers. We want to turn up the volume on women’s heart health awareness. This is not to scare you but to show you ways to prevent heart disease so you can enjoy your golden years.
Facts You Probably Never Knew About Women and Heart Disease
Heart disease kills more women than men each year in the U.S.
Heart disease kills ten times more women per year than breast cancer in the U.S.
Most women don’t even realize they’re having a heart attack, the symptoms are much more subtle than men’s
Sadly, many medical professionals don’t properly diagnose heart attacks in women
Heart disease does not have to be an inevitable part of aging
As Dr. Miriam Nelson explained in our 2007 interview below, the first step is learn, then take control and then challenge medical authority when they ignore your symptoms.
“I am woman, hear me roar In numbers too big to ignore And I know too much to go back an’ pretend ’cause I’ve heard it all before And I’ve been down there on the floor No one’s ever gonna keep me down again”
— Helen Reddy
In recent years, heart disease has claimed the lives of more women than men. Yet it remain a little known fact, why? Mostly because perpetuated myths about women and heart disease still stand in the way of prompt, effective diagnosis and treatment. Sad but true.
According to Miriam Nelson, Ph.D., and Alice Lichtenstein, D.Sc., the way to change the perception that heart disease is a “man’s problem” is by empowering women to take charge of their own heart health. The two women teamed up to write Strong Women, Strong Hearts a groundbreaking guide that every woman should read.
Backed by cutting edge research, the book combines diet and exercise guidelines, stress reduction techniques, and more practical advice in a workable, effective life plan. Its proven strategies help women assess their risk for heart disease, choose foods wisely, lose weight sensibly, and nurture their emotional health.
Here is that 2007 conversation with Miriam Nelson…
FitCommerce: What’s the biggest misconception about heart disease with respect to women?
Dr. Nelson: The biggest misconception is that heart disease is mainly a man’s problem. Not true. Almost 500,000 women die from heart disease each year. Another 8 million women are living with heart disease.
FitCommerce: More women than men die from heart disease, a statistic that seems to be a well-kept secret. Why? And why has that fact stayed under wraps for so long?
Dr. Nelson: One reason is that historically, women have been under-represented in studies. Also, a lot of the spotlight has been on breast cancer rather than heart disease, at least in part because breast cancer tends to strike women at a younger age. But 10 times as many women die of heart disease as of breast cancer. It’s not that breast cancer isn’t a devastating disease. But you can’t deny the numbers. Still, knowledge often lags behind perception. Shifting the knowledge in the culture takes a while.
For whatever reason, the media wasn’t picking up on heart disease prevalence in women, so the facts have stayed largely under wraps. Also, women’s diagnoses are often delayed, so the presence of heart disease is not always clear.
“I believe all women can be what I call ‘agents of change’ for other women.”
FitCommerce: How are women’s symptoms different from a man’s?
Dr. Nelson: When a man is having a heart attack/it’s typically as though a Mack truck is
running over his chest. Women’s symptoms are often much more subtle – mild indigestion-like feelings, sometimes some jaw pain, fatigue, feeling winded. Also, men often have no symptoms before the heart attack; it just strikes.
Women often feel lousy up to a month before – fatigued, indigestion, etc. That’s a silver lining. If a woman doesn’t feel great, she can get to the doctor, get intervention, and avoid the heart attack.
FitCommerce: What are the emotional factors that elevate the risk of heart disease, particularly for women?
Dr. Nelson: While type A personality appears to be a risk factor for men, it’s women who repress anger, etc., too much that appear to be at increased risk. That is, women who bottle up their negative emotions too much might be at increased risk.
FitCommerce: What’s the most misinterpreted sign of heart disease in women? What signs should women be on the alert for?
Dr. Nelson: Women should be on the alert for feeling more fatigued than usual in the course of their daily activities. They might also feel that tasks requiring exertion, such as carrying a suitcase or doing yard work, are more difficult than they used to be.
There can perhaps tie some jaw pain, too, along with a persistent feeling of mild indigestion. Finally, there might be a general feeling lousy, but it doesn’t go away the way a cold does. It just keeps lasting. None of these symptoms automatically mean you’re having a heart attack, but it does mean you should get to the doctor.
FitCommerce: What tests should every woman have to assess her risk?
Dr. Nelson: Blood tests should be done to check for total cholesterol, “good” HDL-cholesterol, and “bad” LDL-cholesterol, along with testing for blood pressure and blood sugar. Body mass index (a measure of weight for height) should be determined, too, as well as waist circumference. If any of these numbers are outside the healthy range, the doctor will probably order further tests.
FitCommerce: What about a treadmill test?
Dr. Nelson: A treadmill test is rarely called for, but still, women do not get them often enough. Ironically, recent research has found that treadmill testing is more predictive for women’s heart disease risk than men’s. It appears women’s fitness, as measured on a treadmill test, is much more a part of the equation than has been realized.
FitCommerce: It seems that every week the prevailing opinion on certain foods changes. Fish is healthy/fish is contaminated. Fat-free is best/fat-free is bad. Abstain from alcohol/drink in moderation. How can women make sense of all the conflicting nutrition information out there?
Dr. Nelson: A woman should think more about food patterns than this or that food. There is an ever- growing body of research that gives a much clearer picture than ever of what that pattern should look like- plenty of vegetables and fruits and whole grains; low- or nonfat dairy every single day; fish at least twice a week; modest portions of other protein-rich foods like meat, poultry, beans, and soy; use of the right types of oils; sweets and other treats now and then; and of course, calorie control. Look at the big picture.
FitCommerce: What advice would you give someone who’s been sedentary for years?
Dr. Nelson: Someone who has been sedentary for years should start out very gradually with what I call decreasing sedentary living rather than plunge into a structured exercise program. Really do take the stairs rather than the escalator, really do park away from the supermarket entrance, and really do walk two bus stops and then get on.
These little steps will acclimate you to moving your body. After a couple of weeks, you will feel ready to walk 15 minutes at a time just for exercise’s sake, etc. But before that, simply fold more activity into your life here and there wherever you can find places to tuck it in. It won’t feel so onerous then. It’ll get you started at the right pace on a step-wise, lifelong activity pattern.
“What’s best, though, is eating better and becoming physically active at the same time. They work synergistically.”
FitCommerce: Why is it important to include strength training in your program?
Dr. Nelson: Strength training does four things to reduce heart disease risk:
It increases muscle strength, which allows you to do aerobics better (a good thing because aerobics directly target the heart and the rest of the cardiovascular system to get stronger). But strength straining also has independent effects.
It decreases high blood pressure.
It decreases fat around the abdomen.
It keeps down blood sugar.
FitCommerce: We once thought that hormone replacement therapy protected women’s hearts. Now it seems that it increases your risk of heart attack. Would you demystify the research?
Dr. Nelson: A very large, rigorously controlled study that came out just a couple of years ago showed that, contrary to previous research, HRT increases a woman’s risk for heart disease within the very first year of use. The risk is small but significant. It doesn’t mean that if a woman’s hot flashes are intolerable, she should not take low-dose HRT for a very short time to help her over the hump. But it does mean that no women should take HRT for the purpose of reducing heart disease risk. That thinking is over.
FitCommerce: Why isn’t diet alone is not enough to reduce your risk of heart disease?
Dr. Nelson: There’s evidence that diet alone can reduce your risk of heart disease, and there’s evidence that being physically fit also reduces risk. What’s best, though, is eating better and becoming physically active at the same time. They work synergistically.
FitCommerce: If you could distill a heart healthy lifestyle down to 2 or 3 principles, what would you say?
Maintain or move toward a healthy body weight.
Follow a dietary pattern that’s low in saturated and trans fatty acids and high in fruits, vegetables, and whole grains.
Be physically active most days of the week.
Be good to yourself – take time to nurture yourself every day, even for just 15 minutes, make medical appointments even if your life feels rushed, say “no” when you need to, etc.
FitCommerce: It seems that the health care delivery system needs more training on treating women with respect to heart disease. Is there anything women can do or should do to spread the word about this important issue?
Dr. Nelson: I believe all women can be what I call “agents of change” for other women. The more women speak up about this – take care of themselves, urge their women friends and family and colleagues to take care of THEMselves, the more the word will spread. If a woman speaks up at the doctor’s office, the hospital, and to all her healthcare providers, the more inclined those providers will to pay attention to the heart of the next woman who walks through the door.
About Miriam Nelson:
Dr. Miriam E. Nelson is currently the University of New Hampshire deputy chief sustainability officer and director of the Sustainability Institute.
Nelson is the author of 10 books, including the New York Times bestselling “Strong Women Stay Young” and eight others in the “Strong Women” series.
In August 2001, Dr. Nelson appeared in her own PBS special entitled Strong Women Live Well, which focused on the benefits of exercise and nutrition for women’s health. She has been featured on many television and radio shows, including The Oprah Winfrey Show, The Today Show, Good Morning America, CNN, Fresh Air, and the Discovery Channel.
Dr. Nicholas Perricone, MD is a board certified clinical and research dermatologist and is regarded as the Father of the Inflammation Theory of Aging. Amazingly, he is the author of 3 New York Times #1 Best Sellers: The Perricone Promise,The Perricone Prescription, and the Wrinkle Cure. Here is our 2004 original interview which is still apropos to those wishing to feel and look younger.
FitCommerce:Good afternoon, Dr. Perricone. You are noted for your leading work in anti-aging and advanced skin care, what events in your career prompted you to zero in on this particular field?
Dr. Nicholas Perricone: I had just been discharged from the army, I felt kind of fatigued, so I went to see a physician and he said, “You’re in perfectly good health”, and I thought, “Gee, I don’t feel that great”.
So I started reading some nutrition books, such as [those] by Adele Davis, and I started following some of her programs and I felt terrific. So, I continued reading more about nutrition. By the time I went to medical school, I actually had a good solid nutrition background.
Whenever I would observe a disease process, I would ask, “How would altering the nutritional status work in this case in addition to traditional medications?”
Then I discovered the inflammation-aging-disease theory, which means that inflammation is at the basis of aging and a lot of diseases. I knew that I could actually decrease inflammation through nutrition.
So, utilizing all of that in my practice for close to 12 years, I had a lot of information about overall health and wellness and how it affects the skin. The skin is a perfect reflection of what’s going on inside of us: it’s a barometer.
Since my patients were doing so well, I thought I should start telling others about it. The first book I wrote, The Wrinkle Cure, discusses how beauty is really from the inside out.
FC: In your books you’ve gone into detailed explanation about the harmful effects of “free radicals” as forming chain reactions in cell damage. Where do free radicals come from and how can we combat them?
NP: First of all, free radicals are generated by many things; one of the ways is by metabolizing our food for energy. Free radicals are also generated by smoking, alcohol consumption, stress, sunlight and a number of other things.
Free radicals are very reactive, and they tend to react with other chemicals, they can also react with our cells in our bodies and cause damage. Free radicals only exist for only a short period of time, for a nanosecond, but they trigger a cascade of inflammation that goes on for hours or days.
So, I like to interfere with the process of inflammation. Because trying to hit a bullet with another bullet is difficult for a fraction of a second. But the results of free radicals can actually be treated. So, we look at inflammation here. One of the best ways to decrease inflammation in the body is through what we eat.
We can eat foods that are pro-inflammatory like sugar or things that are converted to sugar, or we can eat foods that are anti-inflammatory, which is a diet consisting of a lot of fresh fish, fruits and vegetables, and so on.
“Our skin is a reflection of what’s going on inside of us.”
If we cut out the pro-inflammatory foods and add the anti-inflammatory foods, there will be a tremendous impact on our health and well-being. It will decrease the risk of all of the age related diseases like cancer, heart disease, diabetes and all the rest. At the same time, it also improves our appearance, remember, our skin is a reflection of what’s going on inside of us.
I can show people that within 3 days of eating an anti-inflammatory diet, they can look entirely different. They can walk into a room and people will be astounded by how well they look.
FC:You just mentioned how you would like to prescribe good nutrition with classic medicine. Also, you were one of the first to associate disease being caused by inflammation instead of necessarily vice versa. Do you recall when you had that epiphany about the connection between inflammation and disease?
NP: When I was in medical school. I took a course where I looked at everything under a microscope. Students had to study all disease processes by how they looked to the naked eye, then you had to look at the disease process under the microscope.
It’s called histopathology; you’d have a full course just looking at microscopic slides of heart disease, of cancers. I was looking that these cancer cells and they were surrounded by inflammation. I thought that was rather intriguing. I was taught that cancers existed because they avoided immune systems.
So, I went to my professor and asked, “Is it possible that this cancer is somehow mediated by inflammation rather than just being a side effect of the cancer.” My professor said, “No, it’s just the immune system being activated”.
But then I went on to look at sections of arteries of people with heart disease and there was inflammation there. I was looking at sections of the pancreas of people with diabetes and there was inflammation there. It just went on and on.
“If skin was aging, it had inflammation in it. If it wasn’t aging, it had no inflammation.”
I really felt that inflammation was at the basis of a number of disease processes. Then when I started my dermatology residency, we did the same thing, we looked at every skin disease, including aging skin, under the microscope. If skin was aging, it had inflammation in it. If it wasn’t aging, it had no inflammation.
So, I put together this inflammation-aging-disease theory. I was convinced from medical school and from my residency that inflammation is the bad guy, that we should be treating it. So, I started looking at ways to decrease inflammation and found that nutrition was huge; the right foods can actually decrease inflammation.
We can take nutritional supplements in the form of capsules that also have anti-inflammation activity. And as a dermatologist, I was doing extensive research in applying things to the skin to try and stop the aging process and try to improve aging skin and found that anti-inflammatories had a tremendous benefit to the appearance of skin.
“All anti-oxidants have anti-inflammatory activity.”
So, this is really a 3-tiered program. There’s the anti-inflammatory diet, as the first and most important portion. The second tier is taking nutritional supplements, usually anti-oxidants, that have anti-inflammatory activity. (All anti-oxidants have anti-inflammatory activity). The third tier was putting anti-inflammatories directly on the skin, once again, natural substances found in foods and things like that.
“All fat cells produce inflammation chemicals.”
This is my 3-tiered program. It’s what I write about. My approach to beauty and wellness is definitely a holistic approach. We also know that a bad lifestyle creates inflammation, [things] like not drinking enough water, not getting enough sleep, and emotional stress causes tremendous inflammation in the body. Also being overweight, because all fat cells produce inflammation chemicals.
FC:Our readers understand that there’s a connection between regular exercise and general health, but is there also a connection between fitness and better health, successful aging and healthy skin?
NP: First of all, my approach to everything is moderation. The diet is moderate, the lifestyle is moderate, and I think exercise should be moderate. I certainly see the health benefit to regular exercise.
I recommend 3 kinds of exercise. I recommend an aerobic cardiovascular type of workout, some weight resistance, we need to have extra muscle mass, it helps to decalcify bones. I believe in some flexibility exercises. These are all important because exercise reduces stress, decreases body fat, improves circulation, all those things are anti-inflammatory. However, I do have a problem when people exercise too much because that becomes a pro-inflammatory process.
“I believe you can improve your [sports] performance with extended exercise, but not necessarily improve your health.”
When we exercise for over an hour, our endogenous anti-oxidants get used up, and the metabolites produce inflammation in the body. So, once again, look to moderation.
So, if you’re doing some cardiovascular activity, I’m recommending 20-30 minutes 3-4 times a week. I’d recommend some weight resistance training, 20-30 minutes maybe 2-3 times per week, and some flexibility training, maybe 4-5 times per week. And that’s it.
Certainly there are marathoners out there. I believe you can improve your performance with extended exercise, but not necessarily improve your health.
FC:You’ve also spoken in the past how exercise stimulates the formation of HGH (“human growth hormone”) and that HGH is beneficial to other parts of the body, can you please expand on this?Another topic of interest to the boomer generation is this whole notion that HGH helps to foster youthfulness and weight control, etc. Obviously taking HGH injections could carry some risk, however, there are some theories that some forms of exercise can elevate the natural HGH. If that were possible, would that have a positive effect on successful aging?
NP: Yes, I think certainly we want to maintain youthful levels of hormones, but we also know that hormone supplementation hasn’t worked out for us in many cases. We know for a fact that exercise on a regular basis gives you elevated levels of growth hormone. That’s good, because growth hormone will increase your muscle mass, will increase bone density, increase skin thickness, boost your immune system, maintain the normal size of your organs, your heart, your kidneys, liver, all that.
So, we want to maintain youthful levels of growth hormones as best we can, and certainly exercise is one of the strategies. Another strategy is getting enough sleep. Reducing stress, and even eating the right foods can actually enhance growth hormone production. When cortisol is high, growth hormone production goes down, so we want to lower cortisol by lowering our stress.
FC:Just a follow up question to exercise, clearly exercise helps to build muscle which is good, but there are also facial muscles, just kind of a wild question here, if one could build the muscles in their face, would that be a good thing for better appearance?
NP: That’s a great question because I’ve spent years on this particular problem, and I actually have a device in front of the FDA specifically to exercise facial muscles. Now my experience has been the following: when I started seeing superstars, super-models, actors, and actresses, as patients, they’re genetically gifted because they’re extremely beautiful. I thought that beauty was coming from perfect bone symmetry.
And looking at them, they didn’t necessarily have perfect bone symmetry; they did have a lot of soft tissue symmetry, and a lot more soft tissue in the face – that is more musculature.
So, if you look at a young Michael Douglas, or Michelle Pfeiffer, you’ll see the extra musculature in the cheekbones, in the jaw line, in the chin with the cleft, it’s all musculature with a good amount of subcutaneous fat there.
”Anything that accelerates muscle loss is a disaster and that’s why I think Botox is dangerous. “
So, let’s take a picture of Michelle Pfeiffer 20 years ago, and put her picture up now. What you’re going to see, is that she’s going to go from a lot more musculature, from round to a little flatter. So, that loss of convexity is interpreted as aging. So, the best strategy for the face would be to increase muscle mass and increase subcutaneous fat.
So, the worst thing we could do for a face would be anything that would decrease muscle mass, like Botox injections which atrophy muscles because they’re paralyzed.
When you look at a person, you’re processing the convexities, not the wrinkles. I have 25-year-old patients, blond hair, blue eyed, with a lot of wrinkles, but they still look 25 because they have convexities. Those people that atrophy their facial muscles look older and you’re interpreting them as older. I don’t care if they don’t have a line or a wrinkle; you’re going to say “old”.
FC: What about good nutrition for good health, beauty and successful aging?
“That’s the key, once we control blood sugar and insulin, then we control inflammation, and if we control inflammation, we control the onset of disease and the onset of aging.”
NP: I know that the key to maintaining low levels of inflammation in the body by carefully controlling blood sugar and insulin. If you’re eating a lot of starches, your blood sugar and insulin are going to be elevated, that’s a fact.
Now I certainly don’t believe in no carbs. That’s disastrous because what you do is produce ketosis, and ketosis produces inflammation. People should have balance. A red flag should go up when people say ‘no carbohydrates’, or ‘low fats’, anything that isn’t balanced should be a red flag to the consumer.
But your carbohydrates should come from fresh fruits and vegetables, legumes – and it should be balanced. That’s the key, once we control blood sugar and insulin, then we control inflammation, and if we control inflammation, we control the onset of disease and the onset of aging. It’s a simple formula and the formula is always based on moderation.
FC: Can you expand a little bit on why there are “good fats” and “bad fats”.
NP: Sure, first of all, the bad fats are fats that are not natural. [In] trans fatty acids, the hydrogen bonds are kind of reversed, so our body can’t deal very well with them and they can actually cause a rapid increase in body weight, [and] inflammation within the arterial walls. [They] also make the cell membranes stiff so that the receptors don’t work as well. So, we get increased insulin insensitivity by having a lot of bad fats in our diet.
Good fats are the essential fats, certainly the omega 3’s and the omega 6’s, we’re aware of the omega 9’s, those are ‘essential.’ I even believe you should have some saturated fats in your diet, because it helps to strengthen the cell membrane.
Fats serve many functions. You need fat to burn fat, you need fat to maintain a supple cell membrane, you need fats for storage of energy, and you need fats for a health immune system and for beautiful skin.
Low fat/no fat diets are disastrous. The brain is extremely sensitive to not having good fat, when you have trans fatty acids, cell membranes become stiff, you’re not going to think as clearly, you’re going to age more rapidly. The brain is 70% fat by weight; if you starve those brain cells of fat, it’s a set up for mental depression.
“…The point is that low fat, no fat is disastrous, it’s bad for our immune system, bad for our skin, bad for our brain”
I don’t think it’s any coincidence that in the late eighties and early nineties, when the no fat, low fat diet took off, that we had the onset of a lot of mental depression and therefore the development of products like Prozac and all the others.
In fact, there’s an interesting study that was done in Massachusetts. A group of patients who had clinical mental depression were evaluated by a group of psychiatrists and they were given a numerical score based on depression. The group was broken in half, half was given the traditional SSRI (Serotonin Specific Reuptake Inhibitor) like Prozac and Paxil, the other half was given salmon every day or fish oil supplements or both.
And the end of 8 weeks with the evaluation, those people in the group eating salmon or taking fish oil capsules had greater elevation of depression than those taking the SSRIs.
So the point is that low fat, no fat is disastrous, it’s bad for our immune system, bad for our skin, bad for our brain, and therefore we have to be very careful, we have to have enough fats.
Now, you can get some saturated fats as long as they’re not trans fats, because saturated fats strengthen the cell wall. If you have too much essential fat, like omega 3s and omega 6s, you end up with the cell wall being too supple and not being strong enough. Again, it’s just moderation.
FC: In addition to our good nutrition taken by foods that we eat, etc., a lot of older people are big on supplementation. From a general health and good skin standpoint, is supplementation important even if we’re eating a healthy diet?
NP: Yes, I’m a great believer in supplements because, remember the battle is against inflammation, and many supplements provide an extra layer of protection against inflammation or extra ability to decrease inflammation in the body.
Let’s face it, we don’t have a perfect lifestyle. We don’t get enough sleep, we’re stressed by a number of things, both psychological and chemical, toxins in the environment, we go through the long list. So I think supplements are important to bring down inflammation and detoxify our bodies.
“The most important step here is a good diet”
I also believe that as people get older, they should probably take some supplements like branch chain amino acids, because we’re not as efficient in terms of metabolizing our protein. So, if you look at a range of supplements, I think they all help with the battle, but I want to emphasize to everybody I talk to that the most important step here is a good diet. I still recommend, as a second level of protection, supplements, and the third level would be the topical anti-inflammatories and topical neuropeptides.
But the whole approach here once again is holistic. Beauty is released from the inside out and we have to understand that, and know what the most important steps are. However, I can say that when people do all three steps and add lifestyle changes, they get the most benefit of anybody.
FC:O.K. So if a patient were on a tight budget and had a balanced diet, what would be the 2 or 3 ‘must take’ supplements?
NP: I would suggest they take fish oil capsules, alpha lipoic acid, and Coenzyme Q10. And then a multiple vitamin, which is very affordable, along with that.
FC:And the fish oil, is that for the omega 3s?
NP: Yes, the omega 3s, DHEA and EPA have tremendously powerful anti-inflammatory effects. CoQ10 is a tremendously powerful anti-inflammatory, as well as alpha lipoic acid. Because inflammation, once again, is the key here, I want to recommend those 3 along with a multiple [vitamin].
But certainly everybody has a budget. I want to emphasize one thing, I believe that you can have a good diet, a good healthy diet and it’s cheaper than having a junk food diet. I wish it wasn’t as expensive eating fish and fresh fruits and vegetables. And you know what? I’m pretty sure I can challenge anybody to have a really good diet, look at what they spend on a fast food meal, and what they spend on other processed foods in the supermarket, and show them that they will actually save money while at the same time saving their health and their beauty.
FC:And not to mention, perhaps over a lifetime, the medical costs related to that junk food diet.
NP: Of course, we can’t even begin to calculate the difference in having a healthy life where you’re independent and you’re going to accomplish your mission in life.
FC: As you peer over the horizon, what do you see coming out as products or what have you observed that can affect our successful aging and beauty?
NP: I think we’re going to get more sophisticated in terms of nutrition and supplements, we’re going to understand that a lot better. I thing we’re also going to perhaps start having administered to us, hormone supplementation in a safe way.
I also believe that we’ve done enough work now with the genetic map that, hopefully, that maybe not in the next half decade, but maybe in a decade, we’ll have some gene therapy to slow the aging process down and regenerate our major organs.
About Nicholas Perricone, M.D.
Nicholas Perricone, MD, FACN, is a board-certified clinical and research dermatologist. He completed his internship in Pediatrics at Yale Medical School and his Dermatology Residency at Ford Medical Center. Dr. Perricone is regarded as the Father of the Inflammation Theory of Aging. He is the author of the three New York Times Best Sellers, The Perricone Promise (Warner Books 2004), The Perricone Prescription (HarperCollins 2002), and The Wrinkle Cure (Warner Books 1998).
There’s a lot of anecdotal-based advice out there on how we should or should not eat, how to exercise, etc. But we really want good advice to be evidence-based, founded by sound scientific methods. So, we asked an expert researcher on female health, Dr. Miriam E. Nelson for her insights.
Dr. Nelson is currently the University of New Hampshire deputy chief sustainability officer and director of the Sustainability Institute. But while previously at Tufts University she was the Director of the John Hancock Center for Physical Activity and Nutrition. She’s written several books on the theme of “Strong Women”. These books and the work she performed at Tufts have helped women to shed the shackles that aging has to be a normal process of physical decline, osteoporosis and other forms of mental and physical deterioration. With proper exercise and nutrition, some of the deteriorating processes of aging can be mitigated or even reversed.
Leading by example, Dr. Nelson is the quintessential strong woman. In addition to rigorous research; book writing; speaking engagements, appearing on TV shows such as Oprah, The Today Show, and Good Morning America ; she is an avid mountain climber, and mother of 3 children, and a marathon runner.
We originally interviewed her back in 2004, but those pearls or wisdom are as true today as they were then, here are excerpts from that original interview.
“…we’re all going to age, but let’s do it in positive way.”
FitCommerce: Dr. Nelson, you have distinguished yourself in the field of exercise and nutrition, especially as it pertains to women, of all the career choices out there, how did you happen onto this one in the early days?
Dr. Nelson: My interest in the general filed of physical activity and good nutrition were fostered at a very early age, I was always interested in health and physical activity, I was physically active myself and I had parents that fostered it. I also always loved good food.
There was a freshman undergraduate nutrition course at the University of Vermont where I attended that was everything. It was science, health, and real world and extremely interesting and that was what got me going.
As for specific work with women, strength training and the like, that was fostered through the graduate work that I started at Tufts University. A lot of it was serendipity with some early projects where my mentor suggested that nobody has really looked at exercise, bone and women. All of that got me going in a new field. I’ve been very fortunate.
The title of several of your books include the words “Strong Women”, the central theme is strong, which implies physical strength, was there an epiphany in your professional life where you observed a correlation between strength and better women’s health?
I’m not sure it was an epiphany as much as it is good, solid scientific thinking, and building upon previous studies, looking at the literature, taking some risks in doing some research in an area that no one had thought about before with women that are 50-70 doing high intensity strength training. So, the epiphany came when the results bore out what we had thought. That is, women can get very physically strong, get much healthier, gain muscle, lose body fat, and gain bone, through a simple intervention. The epiphany came with the results, I’d say.
You’ve focused on both physical fitness and nutrition, the diode. This implies an important connection between the two, are there observable synergies between physical fitness and nutrition?
Very much so, they really go hand in hand, one without the other makes the glass half empty instead of being completely full. If you eat well, but you’re a total slug, totally sedentary and not fit, you’re going to be at risk for many of the chronic conditions that are out there. Mind you, you’re going to be better off than if you ate poorly and you’re a slug.
If you also exercise and eat really poorly, you’re not going to be maximizing the impact of the hard work that you are doing. When you add the two together, they both mutually feed off of each other. A body that’s exercising needs to be well nourished and a body that’s well nourished can exercise well, and then you’re going to be so much healthier.
“So, we have gathered more information about the importance, especially as you grow older, of strength training for older adults.”
When you looked at nutrition, how did you select what food groups to look at? Did you make assumptions about their health benefits and seek corroborative evidence? Or was it purely serendipitous?
The work we did was more large scale population work, so we’re not dealing with food groups or individual nutrients, it’s more, we wanted to know how can we, within a community, or a town, or a state, actually get people to change their eating habits, their behaviors, so that they’re eating more fruits and vegetables, more whole grains, and less processed foods, so it’s more at the macro level.
Dr. Nelson, we were hoping you could weigh in on fad diets that have become so popular in the U.S., are they beneficial or harmful?
Where these general diets are helpful is that they really bring up the fact that a lot of the carbohydrates that people are eating right now are poor. They’re highly palatable, really cheap, and very caloric. We’re talking about juices, drinks, and snack foods, pretzels, chips, cookies, and convenience foods and highly processed grains.
We, in the nutrition community, have known that these foods are really contributing to the increase in caloric intake. The plethora of these foods that have been produced, have never been there before. These popular diets have rightfully brought that up.
However, they have vilified all carbohydrates — whereby fruits, vegetables, and whole grains are really good for you. People now are very confused to the point where they don’t know what a carbohydrate is. They don’t realize that oranges and broccoli are carbohydrates. So, there’s a good part about elucidating the problems with refined carbohydrates, but they throw the ‘baby out with the bath water’ and that’s problematic.
There needs to be a better understanding so people realize for long term health, like cancer prevention, heart disease, eye health, you need fruits and vegetables. You cut those out and, yes, you may lose weight and even you cholesterol might go down, your Triglyceride level definitely will go down, but, it’s at the point where, long term, if you don’t have the fruits and vegetables, and whole grains, you may be increasing your risk of colon cancer, breast cancer, and many others.
Did Tufts do any research in regard to successful aging?
Yes, in fact that’s what most of the research was about. Whether you call it “successful”, or “optimal”, or other terms with the exception of “anti-aging”. That term is just awful, we’re all going to age, but let’s do it in positive way. Both exercise and nutrition play a large role.
Your department at Tufts has made positive statements about the value of exercise and in particular, resistance training, can you expand on the benefits you’ve observed?
We’re one piece of the research that’s been done in the field of aging. So, it’s just one piece of the puzzle. Where we have contributed, not just myself but other colleagues, is that we have been the first to show the real importance of muscles as we grow older and it seems so obvious now, in the early 1980’s there wasn’t a lot of focus on muscles as we grow older.
“Both cardiovascular and strength are critical because heart disease is the number one killer of women, so we want to be working their heart as well as their muscles.”
It really came about by colleagues in our lab doing work in long term care facilities and realizing that these people were frail and weak and that’s one of the reasons they were so dependent on others’ care. When you start thinking about frailty and weakness, you then start thinking about combating that which leads you to start thinking about resistance training and strength training. Through a series of research studies, we’ve looked at the effects of strength training on body composition, muscle, bone, strength, frailty, function, type II diabetes, depression, sleep, osteoporosis, congestive heart failure, and arthritis.
So, we have gathered more information about the importance, especially as you grow older, of strength training for older adults.
Resistance training takes many forms, there is gravity-created, such as free weights and selectorized machines, and there are stretch bands, and there are pneumatic and hydraulic resistance machines. From your view of the data, does it really matter what type of resistance one gets to derive benefit?
I think it doesn’t really matter in the end. By far the greatest impact is just doing it regularly and having a good program and then also making sure that you’re targeting most of the major muscles groups, and that you’re doing at an intensity that is high enough so that you get benefits and that you’re doing it in proper form.
There are a lot of machines out there which older adults, because of range limiting issues, because of initial weakness, they have difficulty on some machines, not all. The better machines within any category are really fine.
“Both cardiovascular and strength are critical because heart disease is the number one killer of women, so we want to be working their heart as well as their muscles.”
Dr. Nelson, if you had a deconditioned, sedentary women that was only willing to commit a few minutes each day to improve her health, what are the top 2 or 3 must do exercises you would have her do?
I would first want to know what her goals are and expectations that she is willing to commit to. Then I would try to get her, at least twice a week, maybe 20 minutes of strength training, to get at perhaps 5 different muscle groups: core, arms, and legs.
Then I would try to get her to do some brisk walking so she gets cardiovascular. Both cardiovascular and strength are critical because heart disease is the number one killer of women, so we want to be working their heart as well as their muscles.
We’ve talked a lot about women, does any of your research spill over to men’s health?
They’re completely applicable to both men and women. It’s just that men have a larger base of muscles and strength to begin with, so it’s not as critical for men as it is with women. It becomes critical for men 10-15 years later than it does for women. Issues around bone, frailty, falls, are issues that affect more women than men. 20% of men are going to get osteoporosis compared to 50% of women. It’s important to both groups, it’s a matter of relativity.
About Miriam Nelson:
Dr. Miriam E. Nelson is currently the University of New Hampshire deputy chief sustainability officer and director of the Sustainability Institute.
Nelson is the author of 10 books, including the New York Times bestselling “Strong Women Stay Young” and eight others in the “Strong Women” series.
In August 2001, Dr. Nelson appeared in her own PBS special entitled Strong Women Live Well, which focused on the benefits of exercise and nutrition for women’s health. She has been featured on many television and radio shows, including The Oprah Winfrey Show, The Today Show, Good Morning America, CNN, Fresh Air, and the Discovery Channel.
Did you just grunt getting out of that chair? Probably. Can you really bend over and pick up that pin off the floor? No, you had to stoop down, right?
As we age, our body’s water content in connective tissue, such as ligaments and tendons, decreases, resulting in reduced elasticity and flexibility. In other words, we move around like old people.
Not to worry, these are early signs of natural rigidity setting into our joints but with dedicated routines, they can be reversed and you can be flexible and supple deep into your older years for added juice in your life.
Why Flexibility is Important as we age
Today, middle-age to senior people are aware of the importance of aerobic exercise, they may even incorporate regular strength training. But most people are unaware of the incredible importance of flexibility training, especially as we age.
If one does absolutely nothing in regard to flexibility they will lose over 30% of their range of motion by the age of 60. So What? Well, this leads directly to poor posture, more pulled muscles, and loss of balance. Plus you want to be able to squeeze into that tiny sports car, right?
Stretching reduces the risk of falling
The risk of falling is a major concern for older adults. Each year one out of three older adults will fall and need treatment in emergency facility. Research as show that regular sessions of stretching are critical to balance and stability helping prevent against such falls.
When to Stretch
Don’t have the time to incorporate stretching into your day? Then, how about the time you may spend lying flat in bed with a back spasm? Didn’t plan on that, right? It’s all about the ounce of prevention.
Make stretching a daily habit but break it up into chunks. Upon waking in the morning make a big yawn and stretch. Build in triggers in your day to remind you to stretch. We recommend doing about 4-5 stretch poses just before your morning meditation, what a way to jump start your mind-body connection.
First, we recommend highly that you visit a gym or YMCA and enroll in a formal class to get proper stretching techniques down. Perhaps you can ask them to test your current range of motion so you have goals to strive for.
With that said, you can started right now with these simple to use stretches that cover the important muscles and joints:
While regular stretching is a great way to help manage low back pain and arthritis, improve posture, reduce falls, and increase energy levels, there are additional exercises that will aid in healthy aging.
The 500 lb. gorilla of healthy flexibility is yoga. This remarkable form of fitness not only incorporates full body flexibility, but it also directly improves strength, balance, breathing, and calmness of the mind, it doesn’t get any better than this.
In addition you can advance your flexibility with other classes:
Lotte Berk Method
In conclusion, don’t delay, get started on your stretching program today to maintain vigor as you age.
Oops, you’re not far away from retirement, you looked at your IRA balance… meager. So how are you going to pull it off? Paradoxically, working just a little during your retirement, can be the answer to achieving all that you ultimately wished for in retirement: time freedom, travel, stress-free. Here are some basic principles for you to develop a strategy and a proper attitude.
The Halcyon Days are Gone
Since you were very young, you heard your parents talk about “retirement” and how great it was going to be. Your mom might have stayed at home to raise you kids, and kept the home. Your dad may have been a middle manager at a firm that offered a pension. And when your parents turned 65 years of age they probably did retire, the house was paid off, there was a pension and social security, and those weeks in Florida during winter…life was good.
Is that what you’re expecting, boomer? That same scenario? Forgetaboutit. Why? Well, there have been a couple of seismic shifts from our parents’ generation to ours, just to vamp on three:
The demise of pensions
The elimination of decent salaried middle management jobs
Longer life expectancies
The Demise of Pensions
The burden of securing funding for retirement has shifted from companies that offered pensions to either IRA’s or 401(k)’s where the employee is now solely responsible. It’s a sad fact, but most boomers simply haven’t saved enough in their personal retirement funds. Yes there will be social security but that won’t be nearly enough.
In your father’s era, large corporations offered pensions that were carefully managed by highly educated and highly trained financial managers who could invest properly to fund the disbursements. Plus, the new young hires would finance the old retiring employees, and it worked great for a while. But it turned out to be a Ponzi scheme that wasn’t sustainable in the long run, and it’s thus it’s gone. Poof.
The Elimination of Middle Management a/k/a Downsizing
In the post-World War II era, the world was economically ravaged by war. Because the factories were bombed out over there and not on U.S. soil, we were able to jump start a powerful peace time economy. It was so powerful that families only needed one income and we could have that “Ozzie and Harriet” family lifestyle.
However, when the other economies finally recovered, the world flattened and it became globally competitive. Cars were made in Japan, IT jobs moved to India and a new management surgical procedure was implemented – downsizing.
Many boomers, perhaps yourself, faced job losses at a later stage in life. Most never got the salary they were accustomed to and had to tighten the belt. With no pension, they just weren’t making the deposits to their retirement accounts.
Longer Life Expectancy
The good news, and bad, is that if you’re still alive at age 51, statistically speaking, you could live another 30 years to the age of 81 and even beyond. That means if you retire at say age 66, you will have to self-finance about 20 years of living.
Contrarily, if your parents were born around the 1930’s their life expectancy, statistically speaking, was to age 60. So, you’ll statically have an extra 20 years of life over them, but where’s all that money going to come from?
There’ also another big gotcha, how are you going to exit this world? Will you be stricken down by a massive heart attack and be buried 3 days later? (Sad, but not an excessive financial burden.) Or, will you and/or your spouse be stricken with a stroke or Alzheimer’s and require expensive assisted living for years and years gobbling up all your finances?
It’s a sheer lottery as to when our last day on earth will be, and how expensive health care and assisted living will be those last weeks or months.
You’ll Need a Contingency Fund for End of Life
This part is going to be really unpleasant, but better to realize it now rather than when the day comes.
According to US News, a semi-private room in a nursing home runs on average $222 daily, or more than $81,000 per year! And the average nursing home stay is 28 months. So, doing the math, if you’re average and require nursing home care you will need $185,000 per spouse, or $370,000 in reserve for this contingency alone. Will you have it? Or, pass the burden to your children?
Standard Retirement Income Streams
Keeping it simple, there are three standard income streams for retirees:
IRA Draw Downs
If you started your career in the public sector, congratulations, you probably have a pension to fall back on. The rest of you in the private sector enjoyed more income during our working days, but there’s no federal annuity coming. So, nothing coming in from the pension channel.
Thank FDR for our social security benefits. But can you really live on $1,400 per month? That’s what the average payout is to over 40 million recipients. Hopefully, yours is much more.
The 3rd factor and most variable is your IRA balance when you retire. Most middle-agers don’t have nearly enough. According to the Employee Benefit Research Institute, most Americans in the 55-59 age group average about $122,957 in their IRAs.
Sounds like a lot right? Wrong.
At age 55, if you’re socking away 10% of your $60,000 per year salary into your IRA, and maintaining a 5% compounded return, you will have about $295,000 in your IRA by age 66. If you start withdrawing 4% of your balance each year (the formula most financial advisors agree upon) that gives you slightly less than $12K per year. There goes your plans for a vagabonding through Europe.
Wait, what if you could add another income stream for that “fun” money in retirement?
Semi-retirement, the Magic Bullet
What if there was a way of adding another income stream without adding stress or minimizing your time freedom, or getting in the way of extended trips? There is, it called semi-retirement.
Imagine adding an income stream of up to $2,000 per month or $24,000 per year on top of your IRA draw down and social security, how much is that worth to you?
Well, if you do the math, at 5% yield and not touching the principal, you would comparably need $480,000 in savings to yield that amount. Amazing, more than you have currently saved up, right?
O.K., I hear you, “I’m tired of work, I don’t want a boss hovering over me, I want to fish more, I want to spend more time with my grandchildren, I don’t want to be hemmed in.”
I get it. So, let’s set some ground rules for the what we’ll need out of this semi-retirement job
It truly has to be “part-time”, 20 hours per week or less. The hiring firm has to realize that if they mess up they can’t expect you to work more than this amount.
Build in long vacation times and sabbatical. Your job can’t be so mission critical that you can’t take off for 6 weeks for a European trip if you wanted to.
Your ideal wage would be between $20 – $25 per hour so that you can achieve your goal of an extra $2,000 per month.
As for the stressful boss issue. Most companies are so grateful to get seasoned mature workers that they treat them like princes and princesses. And if they don’t, you walk.
Ideas Jobs for Part Time Work
O.K. where are you going to find that ideal semi-retired job?
You’re only limited by your own imagination, but let’s give you some fertile ground to explore:
If you did good work for a previous company, the may be willing to discuss bringing you back in at a scaled down level – give it a shot.
If you were highly skilled in your field, you could hang your shingle out as a consultant, choose your clients and choose your hours.
Or, if you were a decent business person, you can hang your shingle out as a business coach. There are a plethora of young entrepreneurs that need mature business guidance.
There are a host of products and services to be sold. Many companies are willing to offer commission only deals, but pick up expenses. This could be selling via the phone in a business to business scenario. Or, merely generating appointments for field reps to follow up on. You can spend as much or little time as your wish.
If you’re a little more entrepreneurial, you can become a sub-agent in merchant services (credit card processing) or work under a realtor.
Until Amazon sells everything on the planet, there are many independently owned retailers just dying for reliable in-store sales associates.
With more and more retail sales occurring over the web, all those packages need to get delivered. That means seasonal hires but the big package delivery firms like UPS, FedEx and others. A good way to earn income in a few weeks and take the rest of the year off.
Start Your own Sales Business
Hundreds of thousands of people earn a living reselling stuff on eBay. If you’re good at finding value at flea markets or peoples’ attics, this may be good for you. All you really need is a smartphone camera and the ability to write accurate descriptions of products.
If you’re good at design and making your own clothing, jewelry, etc. then Etsy may be for you.
Excess Capacity Opportunities
If you own a halfway decent car you can set your own hours and work for Uber of Lyft.
Similarly, if you have a decent apartment or home in area where people like to visit or vacation, and have another place to crash, you can rent your home on AirBnB, Home Away, and the like.
Do you like to teach? You can put your master’s degree to use and become an adjunct professor at a nearby college. Or, how about a teacher’s aid in your local public school, a great way to get summers off.
Home Based Jobs
If you already know how to build websites, web development is ideal for part time work out of your home. You’ll have to get out and network to pick up customers.
There’s a growing field for virtual assistants that can work from home. This may be helping a self-employed entrepreneur to focus on the core of their business while you handle the mundane of staying on budget, answering email, booking appointments, handling phone calls and the like.
With the aging population there is high demand for at-home non-medical senior care. With the high expenses of resident assisted living, the more affordable solution is at-home senior care. If you’re a care giver and enjoy intermingling with seniors, this may be an opportunity for you.
Pets are prolific, another freelance opportunity is to be a dog walker, or pet sitter. Pet sitting usually involves overnight stays which doubles up as house sitting. Most pet owners don’t like to place their loved pets in the kennels, so pet sitting is a growing field.
Multi-level marketing is portrayed as a pyramid, but it need not be. If you find a product that you truly love, whether it be Amway, Avon, health juices, go for it and sell the product to everyone you know. If you happen to build a sales force under you than you’ll make additional passive income.
This is only a partial list. With heightened awareness, you can create your own par time job or business.
It’s up to you
Remember, the quality of your (semi) retirement lies solely with you, there’s no one else to blame. Get started now.
Depression affects people of all ages, even teenagers. It affects over 19 million Americans a year, and unfortunately the condition is twice as common in females as in males.
But there are certain factors that can increase depression as we age. According to Johns Hopkins you’re “more likely to develop depression if you are between ages 45 and 64, nonwhite, or divorced, and if you never graduated high school, can’t work or are unemployed, and don’t have health insurance.”
The entire boomer generation will experience events that can trigger depression: the loss of a spouse, partner or close friends, financial calamity, deteriorating health, loss of independence…the list goes on.
Unless one wants to have a Prozac crutch the rest of their life, a little bit of awareness and a little change in diet and lifestyle could level off your mood, abate depression, and get you a whole lot healthier. It’s a natural neurotransmitter in our system called serotonin.
What is Serotonin?
Serotonin is a neurotransmitter that dramatically affects our moods. It’s formed in the brain and primarily found in three parts of the body – the brain, the lining of the digestive tract, and in blood platelets. In the brain, serotonin’s main effects include improving mood and giving you that “satisfied” feeling from food. It’s also thought to help promote sleep and relaxation.
“So what’s the big deal about eating pasta to chase away the blues? The big problem is…there is also a spike in insulin which could cause weight gain if done consistently, and guess what? Something else to get depressed about.”
It is believed that serotonin levels that are too low can cause depression. Depression affects 19 million Americans a year, with the condition twice as common in females than in males.
It turns out that women are more susceptible to depression caused by lowered serotonin. According to noted author Dr. Nicholas Perricone MD, because of their unique brain chemistry, women naturally have lower levels of serotonin, and this important “feel-good chemical” drops even lower during menstrual cycles. Without consciously knowing, in order to raise levels of serotonin rapidly, women tend to eat carbohydrates, which boosts blood sugar resulting in a rise of serotonin levels.
So what’s the big deal about eating pasta to chase away the blues? The big problem is. In addition to that serotonin elevation, there is also a spike in insulin which could cause weight gain if done consistently, and guess what? Something else to get depressed about.
Through more beneficial foods, one can elevate their serotonin level without spiking their insulin levels. Try turkey, black eyed-peas, black and English walnuts, almonds, sesame or pumpkin seeds, and cheddar, gruyere or Swiss cheese.
Exercise and Increased Serotonin Levels
Another way to maintain a consistently appropriate level of serotonin is to exercise regularly. It is impossible to overdose on serotonin, or any natural body chemical, brought on by exercise.
Researchers at Duke University demonstrated several years ago that exercise can be an effective antidepressant. Putting aside for the moment, that cardiovascular exercise can produce endorphins otherwise known as a “runner’s high”, it is also an effective remedy for depression.
Animal studies have found that exercise increases levels of serotonin, dopamine and norepinephrine. All of these neurotransmitters have been associated with elevated mood, and it is thought that antidepressant medications like Prozac also work by boosting these chemicals.
“You don’t have become a gym rat and spend endless hours at a health club to combat depression, just a little will go a long ways.”
Exercise has also been found to increase levels of “brain-derived neurotrophic factor” (BDNF). This substance is thought to improve mood, and it may play a role in the beneficial effects of exercise. BDNF’s primary role seems to be to help brain cells survive longer; so this may also explain some of the beneficial effects of exercise on dementia.
You don’t have become a gym rat and spend endless hours at a health club to combat depression, just a little will go a long ways. Consider joining a local express gym where you could get benefit from three one-half hours sessions a week, and gain both strength and cardiovascular health at the same time and drop a few pounds to boot.
At the very least, walk. You can start off slowly and increase your distance and pace over time. Find something, anything, that you enjoy, that will elevate your heart rate, and make it a weekly habit. This will benefit both your body and your brain.
Sometimes Diet and Exercise Just Are Not Enough
Chronic depression is something that should not be taken lightly. If altering your diet and increasing your exercise don’t snap you out of it, you should seek medical help.
Some cases of depression are influenced by reduced quantities or activity of serotonin in the brain. Certain medications like selective serotonin re-uptake inhibitors (SSRI) work to balance serotonin levels in the brain. For some people, SSRIs, such as Prozac, may be helpful.
However, the causes and solutions might be more involved than unbalanced serotonin levels alone. A medical professional can help determine the best course of action.
Good boomer health requires regular exercise to stay strong, flexible and to keep excess weight off. But, can too much of a good thing be harmful to your health in the way of elevated blood pressure?
The Mayo Clinic actually advises at least 30 minutes a day of aerobic exercise as a natural way to lower blood pressure. They state that daily exercise so can lower your blood pressure by 4 to 9 millimeters of mercury (mm Hg).
O.K. that’s aerobic exercise, but what about weight lifting? Older men and women, more so than younger adults, face muscle loss due to sarcopenia. The antidote to sarcopenia is to keep a regular regiment of resistance training to mitigate loss of lean muscle mass. The added benefit is muscle eats fat 24/7. But can all that straining during resistance training actually raise your blood pressure?
To get the answer we asked Dr. Wayne Westcott, PhD, who has authored or co-authored 22 books on fitness including Strength Training Past 50, Strength Training for Seniors. He conducted no less than 5 major studies on the topic of weight training’s effect on blood pressure.
Here’s what he told us:
The most pervasive misconception in the field of exercise is that strength training raises blood pressure (both resting and exercise readings) to dangerous levels, and is, therefore, a contraindicated physical activity for many middle-aged and older adults.
Although it is true that people with certain medical conditions should not perform resistance exercise (e.g., uncontrolled hypertension, aneurism). It is also true that certain resistance training actions can elevate blood pressure beyond recommended exercise readings (e.g., breath holding, isometric holding, and extreme heavy weight load).
The conclusions of all his studies was that when sensibly applied, weight training does not elevate resting blood pressure. In fact, properly performed resistance exercise can produce beneficial blood pressure adaptations in as little as 2 months of regular strength training.
So, get to the gym and keep your weight training in place. Just don’t hold your breath while you exercise.
Her are Dr. Westcott’s guidelines for sensible strength training:
Never hold your breath when performing resistance exercise.
Use weight loads that can be performed with correct exercise technique for at least 8 controlled repetitions.
Keep the weight load moving throughout each exercise set, taking about 2 seconds for the lifting actions and about 4 seconds for the lowering actions. Never hold your weight load in a static muscle contraction.
Keep breathing throughout each exercise set, exhaling during the lifting actions and inhaling during the lowering actions.
Use relatively loose hand grips whenever possible.
Keep your face and neck muscles as relaxed as possible throughout each set of exercise.
Beyond Diet and Exercise: Alternative Approaches to Lowering Cholesterol
For some people, diet and exercise just won’t be enough to lower their cholesterol. But there’s one more step before moving on to prescription medication. There’s a lot of scientific evidence that certain alternative approaches can successfully improve cholesterol.
Niacin is actually a B vitamin that has been shown to not only lower LDL and triglycerides, but also to raise HDL. When taken in doses in the area of 1,500 to 3,000 mg per day, LDL levels are usually reduced by about 5% -15%, and up to 25% in some patients.
Also called nicotinic acid or vitamin B3, it decreases production of particles in the liver that are necessary for carrying cholesterol and fat in the bloodstream. Although it is a B vitamin, the high dosages required to affect cholesterol should be taken only under a physician’s supervision.
Such high doses are considered “pharmacologic” and must be prescribed by a qualified healthcare practitioner. The practitioner will instruct you on how to increase the amount of niacin slowly, over the course of 4 to 6 weeks, and to take the medicine with meals to avoid stomach irritation.
Phytosterols are naturally occurring plant compounds that block the body from absorbing cholesterol. Their chemical make-up is similar to cholesterol, so that they fool the body and block the absorption of cholesterol. Phytosterols are benign and not absorbed by the body.
Food sources highest in phytosterols:
Wheat germGood secondary sources of phytosterols:
Plant Stanols and Sterols
Plant stanols and sterols occur naturally in small amounts in many plants. Those used in certain food products are taken from soybean and tall pine tree oils. Plant stanols and sterols help block the absorption of cholesterol from the digestive tract, which therefore helps to lower LDL. Studies show that a daily intake of about 2 grams of either stanols or sterols reduces LDL cholesterol by about 5% – 15% often within weeks.
Stanol and sterol esters can be found branded margarines. The product, Benecol contains stanol ester while Take Control contains sterol ester. Both Benecol and Take Control are low in saturated fat and trans fat and are considered healthy margarines.
Turmeric, the spicy yellow ingredient found in Indian food, contains the active ingredient, curcumin. Recent research suggests that curcumin may reduce cholesterol by interfering with intestinal cholesterol uptake, increasing the conversion of cholesterol into bile acids, and increasing the excretion of bile acids. Curcumin has powerful antioxidant and anti-inflammatory properties and may help prevent the oxidation of LDL cholesterol to a more dangerous form that is more likely to end up in your arteries.
Medical authors such as Dr. Andrew Weil and Dr. Nicolas Perricone advise copious amounts of turmeric in your diet for a host of health reasons, not to mention the flavor – Bon Appetit.
Red Rice Yeast Extract
Originating in Asia, red rice yeast extract derives from the activities of red yeast on rice and the byproduct has been proven to lower cholesterol. It contains the same ingredient found in prescription statin drugs, and statin drugs have a physiological effect on the liver. Consequently, the use of red rice yeast extract should be considered risky and not taken without consulting your physician.
The Indian Guggul
Guggulipid is extracted from guggul and also contains plant sterols. Guggul is a yellowish resin produced by the mukul mirth tree, a small, thorny plant that grows throughout northern India. Several studies suggest guggul and guggulipid lower cholesterol levels. However, the jury is still out on this one and more evidence may be needed.
When All Else Fails: The Use of Statin Drugs
If all diet, exercise and alternative measures fail, then a prescription route may need to be followed. Again, remember all those sorcerer’s brooms building up cholesterol in your arteries year after year, you don’t want to let this go.
The advent of powerful cholesterol-lowering drugs known as statins (with brand names such as Crestor, Lipitor, Zocor, and the like) has made it possible for virtually anyone to safely slash total and LDL cholesterol. Discuss this option with your family doctor.
Unfortunately, statins are costly and have side effects. And worst of all, once started you’re on them for life. According to the NIH, “Statins stop an enzyme that controls the rate at which the body produces cholesterol. They lower LDL levels more than other types of drugs-about 20% -55% -and also moderately lower triglycerides and raise HDL.
Heart Disease is the number one killer in the U.S. Science to date attributes the depositing of plaque on artery walls via excess cholesterol as a major contributor. Control this substance now and you can mitigate the risk of heart disease later in life. Extreme cases will require prescription medication and close monitoring by a physician.
As always, prevention is best. However, the simple, but permanent, lifestyle changes outlined in this piece can cut it off at the pass.
Should you discover that you have elevated LDL cholesterol and a low HDL factor, your doctor will most likely insist that you immediately go on a statin drug. Forgive her. It’s not her fault, that’s the training doctors get in Western medicine — a system that only reimburses for drugs and surgery and not diet and lifestyle changes.
But we also live in an era of the educated patient, and you have the right to collaborate with your doctor to try alternative means before going on statin drugs for the rest of your life. So discuss the natural route first to see if you can get your numbers in the healthy range.
But also realize that your doctor probably has received no training in nutrition or exercise to help prescribe a program to you. She will most likely tell you to eliminate red meat and dairy products and walk or exercise more. For some, this may be enough, but for many it will not and bigger changes in diet and exercise will need to be implemented to affect improvement.
The Value of Aerobic Exercise
Exercise is a proven way to improve cholesterol. It sets off a series of enzymatic reactions in the body that increase HDL and lower triglycerides.
Probably the person most credited for launching the aerobics craze of the eighties, was Dr. Kenneth Cooper in his landmark book, Aerobics.
According to Dr. Kenneth Cooper, regular aerobic exercise will contribute to increasing HDL and lowering triglycerides.
He’s also written sequel books on exercising for better health, including improving one’s cholesterol. In his book Controlling Cholesterol The Natural Way, Cooper advises:
“We’ve known for a long time that exercise – especially aerobic exercise done over a sustained period of 20 to 30 minutes or so at least 3 days per week – can raise the level of “good’ HDL cholesterol by 5-10%… another fact that we have known for a while is that exercise can lower levels of blood triglycerides… [this] involves the release during exercise of an enzyme known as lipoprotein lipase, or LPL, which breaks down the triglycerides for use as body fuel.”
Therefore regular aerobic exercise, walking, jogging, biking, say 3 times per week for 30 minutes even at only 50% of aerobic maximum will burn up triglycerides while stimulating more HDL…not to mention how good it will make you feel.
A Healthy Story…
James is a walking testament that exercise and nutrition can improve HDL.
He exercised off and on his entire life, mostly running, biking and strength training.
But last May his total cholesterol count climbed to 208, well into the borderline range. he wasn’t that worried about it since his HDL factor was 3.2, below Dr. Cooper’s 3.5 prescribed threshold for health risk.
He went on Lipitor briefly, but quickly got off because he was experiencing side effects. So he committed to stepping up his nutrition and exercise regimen even more to improve his HDL factor the natural way.
Although he kept his ongoing strength training routine using a mixture of free weights and Nautilus machines, he added a twice-per-week racquetball routine to the mix — something that he enjoys and doesn’t even realize that he’s exercising.
By the following January his HDL level improved by another 30 mg/dL, and that improved his HDL factor to an even healthier 2.72.
Only time will tell if he can stay in the healthy zone strictly through exercise and nutrition, but he figures that every year that is drug free is a good year.
Stress Management Through Yoga, Pilates or Tai Chi
Daily stress raises your cholesterol levels. Therefore any form of stress-management technique may help lower it. All forms of exercise will relieve stress and keep you in the “present moment.” In particular, mind-body exercise that emphasizes concentration on breath, such as yoga, Pilates and tai chi, are exceptional forms of stress management.
Specific Dietary Changes to Lower LDL
One could write books on all the various foods that affect some component of cholesterol. One basic concept to understand is that cholesterol comes from two sources, the food you eat and your own body. The cholesterol in your system from diet is only about 20%. That means 80% is manufactured by your liver.
There is much inconclusive discussion on whether eliminating dietary cholesterol has any affect on health at all. But again, based on current science, it is recommended that the intake of dietary cholesterol be minimized. This underscores the importance of reading those food labels.
The elimination of high cholesterol items such as milk products and egg yolks is healthier anyway. Milk products are high in saturated fats and egg yolks are high in arachidonic acid, and their reduced intake is good for overall health.
Limiting Dietary Cholesterol
The National Heart Lung and Blood Institute advise that you limit dietary cholesterol to 300 milligrams per day. Certain foods with high concentrations of dietary cholesterol should be limited. Beef, pork and bacon have anywhere from 80 to 90 mg. of cholesterol per 3 ½ once serving. Lamb has 122 mg. and veal 128 mg. Fried chicken with the skin on is an unhealthy 167 mg., while roasting it with the skin off is a healthier 85 mg., the same as turkey. Boiled shrimp tops the list with 195 mg. per serving.
Limit Daily Intake of Saturated Fats
Saturated fat raises your blood cholesterol more than anything else in your diet. Americans eat an average of 11% of their total calories as saturated fat. Your liver uses saturated fat to make LDL cholesterol.
Saturated fat is identifiable as a solid at room and refrigerator temperatures. It is found in the greatest amount in foods from animals, such as fatty cuts of meat, poultry with the skin on, whole-milk dairy products and lard, as well as in some vegetable oils, including tropical oils like coconut and palm oils.
Eliminate All Trans Fats
Trans fats are bad for a number of reasons, only one being that it increases cholesterol. Although the package for margarine may say 0% cholesterol, the bad news is that it stimulates the liver’s production of cholesterol.
Trans fatty acids are formed when liquid vegetable oils go through a chemical process called hydrogenation. Common in a range of food products – biscuits, chips, doughnuts, crackers – the hydrogenated vegetable fat is used by food processors because it is solid at room temperature and has a longer shelf life.
So, as you read those food labels, eliminate all foods that contain the phrase hydrogenated or partially hydrogenated.
Eat Fewer High Glycemic Foods
High glycemic foods turn to glucose very quickly in the bloodstream and are generally bad for health for a number of reasons . You should eat fewer simple carbohydrates such as sugar, white flour, white rice, and high-fructose corn syrup, which can markedly increase your triglycerides. These should be offset with lower glycemic foods like unrefined, complex carbohydrates such as fruits, vegetables, whole grains, legumes and soy products.
Foods That Improve Cholesterol
O.K., now that have a list of items to either eliminate or reduce in your diet, there are others that you should try to increase in your diet to improve your cholesterol make-up.
Soluble Fiber Inhibits the Absorption of Cholesterol
In addition to reducing the intake of dietary cholesterol, another remedy is to block your absorption of cholesterol in the first place and that’s where soluble fiber does the trick nicely.
Soluble fiber dissolves into a gel-like substance in the intestines. The substance helps to block cholesterol and fats from being absorbed through the wall of the intestines into the blood stream. Research shows that people who increased their soluble fiber intake by 5 – 10 grams each day had about a 5% drop in their LDL cholesterol. The NIH recommends that you get at least 5 – 10 grams of soluble fiber a day-and, preferably, 10-25 grams a day, which will lower your LDL even more.
Brussels sprouts, pinto beans, navy beans, lima beans, kidney beans, black beans, pears (with skin), whole citrus fruits (not juice), and psyllium are high sources of soluble fiber.
The Value of Oats
Oats should be part of your daily diet to control cholesterol. Oats contain Beta-glucan, which has also been shown to lower LDL. Scientists from the U.S. Department of Agriculture’s Agricultural Research Service have developed a new oat variety containing higher levels of beta-glucan. This variety may soon allow food manufacturers to offer smaller portions of whole oat products that will pack the same health benefits as ordinary oats. Also on the horizon is “HiFi”, which is not a stereo system but a new strain of oat that lowers LDL even further.
According to Dr. Shela Gorinstein of Hebrew University, one red grapefruit a day will keep the cholesterol away and help prevent heart disease. Her team’s study published in the March 2006 issue of Journal of Agricultural and Food Chemistry found that red grapefruit (more so than white grapefruit) was effective in lowering cholesterol, although it is not yet clear as to why.
Cholesterol levels tend to rise as we age, but when should one reach for a statin drug for presumably the rest of their life?
The matter should not be take lightly, it is a forerunner to heart disease — the No. 1 killer in the US, responsible for 37% of all deaths.
According to Louisiana State University AgCenter nutritionist, Beth Reames, one out of every two men and one out of every three women will develop heart disease sometime in their lives. That’s a big percentage and the philosophy of wellness is to proactively address health risks before they become medical conditions.
As with all health issues, we can only respond to the science that is available at the moment. There are conflicting theories. Some suggest that rising LDL is not a threat, per se, but is a player in a biological conspiracy. Alternate theories label inflammation as the chief culprit. But until links between heart disease, C-Reactive Protein and Homocysteine (measures of inflammation) are more readily used, we must stick with the cholesterol yardstick, know our numbers and take proactive measures.
The Sorcerer’s Apprentice – Cholesterol Keeps Rising Over Time
Remember the Disney story of the Sorcerer’s Apprentice? The brooms kept carrying buckets of water and, over time, an unmanageable ocean was formed.
The same phenomenon happens with cholesterol deposits; they keep building year by year and cause a narrowing of our artery walls. In some cases this leads to a coronary block and either angina or a cardiac arrest.
As children we start out with a low total cholesterol reading somewhere in the 30-70 mg/dL range. (The yardstick for measuring cholesterol and all its subcomponent parts is milligrams per deciliter). As maturing adults that number trends upward for most of us and breaks into the 200s by middle age.
If you haven’t had your cholesterol measured in a while, it’s high time, because it’s probably gone up. Aging boomers are having an impact on total population numbers. A recent report in the Journal of General Internal Medicine revealed that an estimated 63 million U.S. adults have high LDL cholesterol levels, and as a consequence, 38 million are at increased risk for heart disease.
Regardless of your age, you should begin to make lifestyle and dietary changes now that will keep this beast in its cage. Even the young should make adjustments, because they can more easily adopt lifelong dietary and lifestyle changes that will stave off a cholesterol problem later. First of all, it’s not all bad. Cholesterol is an odorless, white, waxy, powdery substance that is found in every cell of our bodies. We actually need a certain amount of it to sustain life. It is an important building block for cell membranes, hormones and vitamin D. It also aids in the digestion of fat into caloric energy.
Cholesterol consists of lipoproteins. A lipoprotein is a combination of fat (lipid) and protein that wraps around the individual fat molecules in our bodies, transporting them throughout our bodies and aiding in the digestion of fat.
But too much of a good thing turns into a bad thing. Many factors in modern society cause cholesterol to elevate as we age. Evolution never addressed the problem of too much cholesterol in our bodies because we never used to live this long. Therefore we have to take control, get smarter and take preventive measures. According to the National Institute of Health, the recommended cholesterol test is called a ‘lipoprotein profile.’ It measures the levels of total cholesterol, LDL, HDL, and triglycerides in the blood. The lipoprotein profile is calculated from a small sample of blood after a 9 to 12-hour fast.
Know Your Numbers
The 3 numbers that are most closely monitored are HDL, LDL and triglycerides — the good, the bad and the ugly. LDL is singled out as the real bad guy and triglycerides are his general accomplice.
Think of HDL as Clint Eastwood. It actually sops up the harmful LDL which needs to be removed from the system. So, you want more HDL and less of LDL. Actually LDL is not in itself bad, it’s excess LDL that is bad. In fact without some LDL you could not survive. Aristotle’s “everything in moderation” rules.
Triglycerides are fats that, as the name implies, consist of three fatty acids attached to a molecule of glycerol. The role triglycerides play in heart disease is conflicting. But generally speaking, it is a good idea to have low triglyceride levels. O.K., so we want to keep our LDL number nice and low, but what’s the acceptable range? And when should we be concerned? According to the American Heart Association, adults age 20 or older should have their cholesterol levels checked minimally every five years. Unfortunately many people ignore this and walk around with elevated cholesterol levels without knowing it.
Here Are The Ranges For The Various Components:
200 – 239
41 – 60
HDL Factor — Men
3.6 – 5.4
HDL Factor — Women
3.1 – 4.1
Sources: American Heart Association and Dr. Kenneth Cooper’s book: Controlling Cholesterol the Natural Way.
In the old days there was a simple decision process, doctors only monitored the total cholesterol count and when that got above 200, they would write a prescription for a statin medication to bring it down. Recent scientific advances now look at the interplay between the component parts
A New View on Cholesterol
New thought on cholesterol does not focus on the “total cholesterol count” but gives strong consideration to the ratio of its subcomponent parts — particularly the relationship between HDL and total cholesterol. Recall that HDL is the good stuff that actually removes LDL from our blood vessels.
Think of LDL and HDL as transport vehicles. LDL transports cholesterol to your arteries and deposits it there. HDL retrieves cholesterol from your arteries and expels it through the liver. So, if your HDL and LDL are in balance, if you are retrieving as much as you are depositing, theoretically you’re at less risk even though you may have a high total cholesterol count.
As an analogy, imagine that you have a crew of workmen dumping 100 wheelbarrow loads of dirt per hour into a pit, and another crew of workman removing dirt from that very same pit at the same rate of 100 wheelbarrow loads per hour. Dirt will never accumulate in that pit. Similarly, the same holds true for cholesterol. For example, let’s say you’re male with a total cholesterol of 200. According to our chart above, you would be categorized as borderline. But let’s say your HDL level is 60. Then the HDL ratio is calculated as follows:
HDL Factor = Total cholesterol / HDL
HDL Factor = 200/60=3.3
When we refer to the chart above, the 3.3 number is in the healthy zone for men. This is significant because there are many natural ways to elevate your HDL number.
Unfortunately, many schooled MD’s are still only looking at the total cholesterol number when they advise treatment, especially the prescription of statin drugs. You should discuss the HDL factor with your doctor and see if she agrees that your risk is lower and therefore you don’t need medications.