Everyday exercises help improve mobility after stroke

Making everyday tasks such as getting dressed or walking up stairs a type of focused, repetitive exercise may improve mobility and function after a stroke, according to a study in the Oct. 17 issue of The Cochrane Library. In an analysis of 14 studies with 659 participants, people who had undergone "repetitive task training" had improved walking distance and speed and were better able to go from sitting to standing.

(Training involved three or five hours a week of repeating tasks such as reaching for items on shelves or buttoning clothes.) Activities of daily living such as bathing improved as well. Upper-limb functions such as reaching were not greatly improved, however. Overall, the authors state there was "modest improvement" in lower-limb function, even in people who had experienced a stroke in past years.

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Many factors protect women against heart disease

Exercise alone does not prevent heart disease in women, according to a study in the Oct. 22 issue of Circulation. Researchers measured levels of hemoglobin A1c (HbA1c, which detects blood glucose levels over time), cholesterol, and inflammatory "biomarkers" such as C-reactive protein (CRP) in 27,055 healthy women.

They also tracked participants' physical activity, blood pressure, and weight. After a follow-up of up to 12 1/2 years, the risk of heart disease decreased in women with higher levels of activity. However, women with lower inflammatory biomarkers had the lowest risk of heart disease, followed by those with lower blood pressure, cholesterol levels, body mass index, and HbA1c. The researchers explain that factors other than physical activity, such as CRP and blood pressure, appear to play a role in heart disease in women.

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Obesity, acid reflux, smoking increase esophageal cancer risk

Obesity increases the risk of esophageal cancer, regardless of whether a person has other risk factors such as gastroesophageal reflux disease (GERD) or smoking, according to a study in the November issue of Gut. Among 800 people with esophageal cancer who were compared to 1,600 people without the disease, obese people were six times more likely to have esophageal cancer than people who were not obese.

Esophageal cancer is known to be more common in people with GERD, but this is the first study to indicate that obesity alone could increase the risk. As expected, smokers in the study had a higher incidence of both GERD and esophageal cancer. The investigators recommend that obese people lose weight, and if they smoke, quit. Medications to reduce GERD symptoms also should be considered.

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Energy drinks may increase blood pressure

"Energy drinks," which usually contain caffeine and other additives, may be harmful to people with heart problems, according to a study presented at the American Heart Association's 2007 annual meeting. In 15 healthy adults who drank two cans a day of a popular energy drink, systolic blood pressure (the upper number) rose by as much as 9.6 percent, and diastolic blood pressure (the bottom number) increased by as much as 7.8 percent.

Heart rates increased five to seven beats per minute after consuming the drinks. Although the increases did not reach dangerous levels, the cardiac changes could be problematic for people with existing hypertension or heart disease. The researchers advise people with high blood pressure or heart disease to avoid energy drinks.

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Chew your way to a slimmer waistline: study shows sugar-free gum can help you cut calories and shed pounds

Chewing gum offers more benefits than fresh, minty breath; gum may also help you whittle away your waistline. Chewing gum before an afternoon snack can help reduce hunger, diminish cravings, and promote fullness among people who try to keep their calorie intake down, according to a new study presented at the 2007 Annual Scientific Meeting of The Obesity Society in October.

Conducted by researchers from the Glasgow Caledonian University in Scotland, the study included 60 participants ages 18-54 who were asked to consume a sweet and salty afternoon snack either after chewing a sweetened gum or not chewing gum at all. The results from the study indicated that chewing gum reduced caloric intake by 25 calories and specifically reduced sweet snack intake by 39 calories. It was also discovered that chewing gum suppressed hunger and desire for food after lunch, as well as reduced anxiety and stress.

The good news about gum's potential role in weight loss is spreading quickly. It is being promoted as one of many facets in some weight-loss programs because it can replace a high-calorie snack. This strategy was recently highlighted in the NBC weight-loss reality TV show, The Biggest Loser. It makes sense that if you chew a stick of sugar-free gum containing about five calories per serving and forego a bag of chips at the vending machine, you've probably saved yourself 220 calories or more--a tactic that can help you lose weight.

"Sugar-free chewing gum as a snack could help us take in fewer calories at a time when we might not truly need a snack. It might satisfy the need to chew, and because it's basically free of calories, it won't add calories to your day. If gum does the trick, then that would help to avoid excess calories that your body doesn't need," says Heather

Bainbridge, RD, dietitian at the Comprehensive Weight Control Program at New York Presbyterian Hospital/Weill Cornell Medical Center.

Bainbridge notes that it's important to choose sugar-free chewing gum to cut down on calories and to promote dental health. The bottom line--if you turn to gum in order to cut out a 220-calorie trip to the vending machine every day, this habit can chew up almost 23 pounds per year.

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Eating plans reduce risk of colorectal cancer

Current U.S. dietary recommendations do help prevent colorectal cancer, according to an analysis of three major eating plans in the November 2007 issue of The Journal of Nutrition. Researchers evaluated the U.S. Department of Agriculture Food Guide recommendations, the Dietary Approaches to Stop Hypertension (DASH) Eating Plan, and a Mediterranean diet (which is not an official U.S.plan) in more than 51,000 patients aged 55-74 who were screened for colon cancer. All three eating plans feature high amounts of produce and whole grains and reduced saturated fat and meat intake. The risk of colorectal cancer was found to be reduced by 18 to 33 percent in patients who had followed one of the three dietary plans.

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Physical activity linked to better cognitive performance

People who have been more physically active in their lives have much better cognitive functioning, according to a study in the October issue of Aging Clinical Experimental Research. In the study, 364 people in their 80s were questioned about past and present physical activity. Forty-three percent had a history of high-intensity physical activity during their youth, although it was lower during adulthood and old age.

Nevertheless, people with a history of high-intensity physical activity at any time in their lives had a much lower cognitive performance study (CPS) score (indicating better performance) than participants who did not have a history of high-intensity physical activity.

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Why cross-training is crucial: add variety to your workout by balancing endurance, strength training, and flexibility exercises

Does the thought of doing the same exercises every day prevent you from starting a fitness program? Are you tired of your current workout? Do you want to move up to a higher level of fitness? If you've answered yes to any of these questions, consider cross-training.

Cross-training is a way of adding variety to your exercise program. It started out as a prevention strategy for athletes who were committed to one sport--usually running--who experienced overuse injuries from the jarring impact of that sport. Cycling or swimming a couple of days a week allowed them to continue to build endurance while reducing stress on their joints and using their muscles in different ways, explains John Cavanaugh, MEd, PT, ATC, a senior physical therapist at the Sports Medicine and Performance Center in the Weill Cornell Medical College-affiliated Hospital for Special Surgery.

Cross-training is used more broadly now to encourage new or moderate exercisers to incorporate all the components of fitness into a weekly workout. The recently updated American College of Sports Medicine/American Heart Association recommendations highlight the importance of following an exercise program that includes endurance exercises, resistance training, flexibility, and--for those who need it--balance exercises.

Cross-training also adds variety and structure to your workout, says Cavanaugh. But if you have arthritis or other conditions that might limit your ability to move, work with a physical therapist or other fitness professional to make sure the exercises you choose don't aggravate your condition.

Mix it up

The American Academy of Orthopaedic Surgeons provides a sample program built on cross-training principles. It includes the following:

* Three times a week: 30 minutes of aerobic exercises, alternating activities such as walking, swimming, and stair-climbing.

* Twice a week (not consecutive days): 30 minutes of strength training, working each major muscle group.

* Daily: 5 to 10 minutes of stretching. Additional aerobic options include dancing, tennis, cycling, or rowing. You can do strength training with gym machines, free weights, resistance bands, or your own body weight. Yoga, Pilates, and tai chi emphasize flexibility as well as strength, so adding a class to your weekly workout could help.

Regardless of what you choose, start slowly and build up gradually, Cavanaugh advises. If you're new to exercise or haven't worked out in a while, keep it simple: walk a couple of blocks, and gradually build up to a mile; swim one lap and then set your sights higher. Try to follow the "10 percent rule"--increase the frequency, duration, or intensity of an activity by no more than 10 percent each week. And be sure to get medical clearance first.

CROSS-TRAINING EXERCISES FOR A BALANCED WORKOUT

Strength: Seated chest press

This exercise strengthens the shoulders, chest, and back of the upper arms (triceps). Sit in a chair with your arms at your sides, elbows bent, and palms down. Inhale, then push your arms straight out in front of you as you exhale. Keep your wrists level with your arms; don't lock your elbows. Return to the starting position.

Repeat 8 to 12 times.

[ILLUSTRATION OMITTED]

Flexibility: Seated overhead stretch

This exercise improves range of motion in your shoulders. Sit in a chair with your arms at your sides and palms of your hands facing in. Inhale; turn your palms outward, lift your arms out to the sides and up over your head, and bring your palms together. Keep your shoulders relaxed and down and your chest lifted. Exhale and lower your arms back to the starting position. Repeat 3 to 8 times.

[ILLUSTRATION OMITTED]

Balance: heel-to-toe walk

This exercise improves your balance. Walk by putting one foot in front of the other, with the toes of the back foot touching the heel of the front foot. Stand next to a wall as you walk so you can put your hand on the wall for support if needed. Start by walking heel-to-toe for 15 seconds, and slowly work up to 1-2 minutes (you may need to turn around and go the other way if the wall isn't long enough).

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Preserve your health at any age: whether you're 50, 60, 70 or beyond, you can improve your health and cut your risk of disease

Simple measures can be "extremely effective" in boosting health and reducing the risk of chronic illnesses, even if you're older and your lifestyle until now hasn't been the healthiest. That's the good news from Richard Rivlin, MD, a professor of medicine at Weill Cornell Medical College and attending physician at NewYork-Presbyterian/ Weill Cornell Medical Center.

In the November issue of The American Journal of Clinical Nutrition, Dr. Rivlin reports that his review of the scientific literature (more than 100 studies over the past 20 years) showed proof of the health benefits of simple and realistic lifestyle changes. For example, adults age 65 and older who followed a low-calorie diet and regular exercise and program lowered their risk of cancer by about one-third; those with heart disease who lowered their cholesterol reduced their risk of a future heart attack or other cardiac event by up to 45 percent.

Change your mindset

Before attempting to change your lifestyle, "You have to believe that doing so can help," says Dr. Rivlin. "Too often, older people say, 'Eating right and exercising is good advice for my children and grandchildren, but it's too late for me.' That's simply not true. For example, one study showed that lowering blood pressure through diet and exercise had the most dramatic health benefits for older adults compared with all other age groups, cutting the risk of heart disease by 30 percent in women and 20 percent in men."

Adjust your diet

During menopause, women often gain weight and body fat and lose fat-free mass (muscle and bone). But these changes in body composition composition are not an inevitable part of aging. "You can do a lot to improve and even reverse these harmful changes," Dr. Rivlin stresses.

Start by cutting calories if you're overweight, and pay attention to what you're eating. Choose foods with high-quality protein such as lean meat and fish, poultry, nuts, and legumes; limit your intake of saturated fats; and replace simple sugars (e.g., table sugar, honey, canned fruit) with whole grains and other foods such as oatmeal and sweet potatoes that contain complex carbohydrates and high amounts of fiber.

If you're tempted by high-fat, high-calorie "junk" foods, remind yourself that such foods can cause you to pile on unwanted pounds; you also miss out on important nutrients that you would get from eating more healthful alternatives, such as vegetables and fruits.

Boost your activity level

For maximum health benefits, your exercise program should include aerobic activities, such as walking or jogging; resistance training with light weights or elastic bands; and flexibility exercises such as stretching or yoga, Dr. Rivlin says.

Take advantage of daily opportunities to increase your activity level by breaking established habits. If you're accustomed to driving to work or to the store, try walking instead, or at least park far enough away from your destination that you are compelled to walk a block or two to get there. Similarly, use the stairs instead of the elevator, at least for a couple of floors. Walking up stairs is one of the best exercises you can do for cardiovascular fitness, according to Dr. Rivlin. Walking down stairs is also good because it puts weight on the spine and can help protect bones.

Get medical clearance before starting an exercise program, and work with a professional who is knowledgeable about fitness programs for older adults, Dr. Rivlin advises. "If you have arthritis, consider taking an anti-inflammatory an hour before exercising to make moving around more tolerable. One of the biggest dangers is not doing anything--that's when muscles atrophy and you lose function."

What's more, you get the most benefits by going from no exercise to a little, rather than from a little to a lot. "Instead of looking at the elite athlete who completes a marathon in just over two hours, look at how many complete the marathon, period. That's really amazing," Dr. Rivlin concludes.

WHAT YOU CAN DO

* Remind yourself that you can improve your lifestyle and health at any age.

* Exercise regularly; include cardiovascular activity, weight training, and stretching.

* Cut calories by eating more protein, whole grains, vegetables, and fruits, and avoiding high-fat, high-calorie "junk" foods.

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Cracking the confusion about eggs: eggs are packed with protein, folate, and other nutrients and back on the "healthy foods" list for most people

In recent years, the number of egg varieties in your supermarket has been growing: eggs with more omega-3s, eggs with less cholesterol, eggs with reduced saturated fat, and so on. But are these new varieties worth buying? And perhaps more importantly, should you be eating eggs at all?

"My motto is, 'An egg a day is okay,' assuming you do not have a history of heart disease or high blood cholesterol," says Sari Greaves, RD, a dietitian at NewYorkPresbyterian/Weill Cornell's Cardiac Health Center. "One egg is packed with essential nutrients vital for good health."

Are "enhanced" eggs healthier?

The claims on egg cartons range from "more omega-3s" and "more lutein" to "lower cholesterol" and "less saturated fat." While these statements may seem impressive, you're paying more money for relatively small differences, Greaves says. For example, an Eggland's Best egg has 4 grams of total fat and 180 milligrams (mg) of cholesterol compared to a "regular" egg that has 4.5 grams of total fat and 213 mg of cholesterol.

Remember that eggs are only one element in your diet, which should include vegetables and fruits; whole grains; highfiber foods; lean meats, poultry, and fish; and fat-free or low-fat dairy products. "Don't worry about getting your omega-3 fats from eggs because you can naturally consume them in foods such as oily fish, flaxseed, walnuts, soybeans, and canola oil," says Greaves.

Update on cholesterol

For many years, eggs were virtually banned from healthy eating plans due to their cholesterol content (about 213 mg per egg). However, a study published last year in Medical Science Monitor concluded that eating one or more eggs per day did not increase the risk of coronary artery disease or stroke in healthy adults. Experts no longer consider it necessary for healthy people to limit their intake of egg yolks to a specified number per week.

If you have high cholesterol or heart disease, "It's a good idea to limit egg intake to two to three yolks per week," says Greaves. The yolk contains all of the egg's cholesterol. The American Heart Association recommends limiting dietary cholesterol to less than 300 mg per day. If your LDL ("bad" cholesterol) is high and/or you're taking cholesterol-lowering medication, aim for less than 200 mg a day.

Eggceptional nutrition

Eggs offer a big nutrition bang for their calorie buck: one 75-calorie egg contains protein, folate, iron, zinc, lutein, zeaxanthin, choline, and vitamin D. Folate contributes to the development of red blood cells and nerve tissue. Iron is needed to transport oxygen throughout the body. Lutein has been shown to help protect the eyes from macular degeneration. And vitamin D helps protect against colon cancer, osteoporosis, heart attack, and stroke. "The high-quality protein in eggs helps you to feel full longer and stay energized, and it plays an important role in muscle strength, repair, and preservation," says Greaves.

Cooking method is key

Don't overlook preparation style when calculating the fat and calories in your egg dish. "Prepare eggs using a fat-free cooking spray or one to two teaspoons of a heart-healthy oil, such as canola or olive oil, to cut down on calories and eliminate saturated fat," advises Greaves.

Fill omelets with nutritious vegetables such as onions, tomatoes, spinach or peppers. Cheese can give you a calcium boost, but use only one ounce (1/4 cup shredded) of low-fat or fat-free cheese.

The bottom line: Eggs can be part of a healthy diet. "Eggs are economical, easy to prepare, and deliver a bundle of important nutrients," says Greaves.

EASY CHEESY EGG MELTS

     4 slices whole-grain bread
     4 large eggs (or 2 whole eggs
       & 4 egg whites)
1 Tbsp. reduced-fat milk
1/4 tsp. basil
1/4 tsp. oregano
1/2 cup (2 oz.) reduced-fat
       cheddar cheese, shredded
       Nonfat cooking spray
       Black pepper to taste

Lightly toast bread.

Whisk together eggs, milk, herbs, and pepper in a small bowl. Lightly
coat a medium skillet with cooking spray. Cook egg mixture in skillet
over medium heat, stirring gently but frequently, until mixture is
set and eggs are firm.

Spoon 1/4 of egg mixture onto each bread slice. Sprinkle 2 Tbsp. of
cheese over each egg/bread slice. Place slices on baking sheet in a
350-degree oven until cheese is melted. (Or place slices in the
microwave and cook at full power for 20-30 seconds to melt cheese.)
Serve immediately.

Yield: 4 servings.

Nutrition information per serving (whole eggs/2 whole eggs plus 2 egg
whites): 165/137 calories, 7/3 g fat, 2/0 g saturated fat, 215/109 mg
cholesterol, 268/260 mg sodium, 13/12 g protein, 12/12 g carbohydrates,
2/2 g fiber.

NUTRIENT CONTENT:
WHOLE EGG VS. EGG WHITE

                    Whole Egg   Egg White
Calories                     72          17
Total fat                4.97 g       .06 g
Saturated fat            1.55 g         0 g
Protein                  6.29 g       3.6 g
Folate                   24 mcg       1 mcg
Iron                     .92 mg      .03 mg
Zinc                     .56 mg      .01 mg
Lutein & Zeaxanthin     166 mcg       0 mcg
Vitamin D                 18 IU        0 IU

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