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For October 15, 2018

  • Breakfast: The essential meal
    Breakfast: The essential meal
    By Elizabeth Somer, R.D.

    (WebMD) -- Your mother was right: Breakfast is the most important meal of the day. People who skip breakfast tend to struggle more with weight problems and suffer low energy later in the day when compared to those who take the time to eat.

    If you're a seasoned breakfast skipper, change your ways and start eating breakfast -- even if you aren't hungry. It takes two to three weeks to reset the appetite clock. After that, you should notice a boost in energy and fewer problems with overeating later in the day.


    The eight or more hour time span between dinner and breakfast is the longest span between any of the three meals of the day. In the hours since dinner, and even while sleeping, the body still needs fuel to keep the heart beating, nerves transmitting, eyes blinking and cells dividing. Much of that fuel comes from the readily available stores of glucose in the blood, liver and muscles.

    By sunrise, the body is essentially in a fasting mode, with more than half of the body's glucose usually drained by morning and needing the jump-start that comes from eating a carbohydrate-rich meal. That first meal of the day literally breaks the fast.

    Energy drop

    If you skip breakfast, you might feel fine, full of energy and ready to go for the first few hours after you wake up. That burst of energy typically comes from a mind and body refreshed after a good night's sleep. But this initial burst of energy wears off as the morning's demands add stress to a body already running on empty.

    If you allow even four hours to pass between meals, blood sugar levels drop, resulting in fatigue, poor concentration, irritability and lethargy. Double the time to eight or even 12 hours and you can imagine the energy-draining effects of failing to refuel.

    By afternoon, even if you eat a relatively good lunch in an effort to boost lagging energy levels, it's difficult to regain an entire day's worth of energy that you would have had if you had taken five minutes to eat breakfast.

    A breakfast primer

    What should and shouldn't you eat for breakfast? Avoid high-sugar breakfasts, such as doughnuts and coffee, which provide a quick boost, but leave you feeling drowsy within a few hours. Instead, choose meals with a mix of protein and starch. This will help you to maintain blood sugar levels throughout the morning.

    Some good morning choices include:

    -Whole-grain cereal and milk

    -An English muffin with low-fat cheese and orange juice

    -Nontraditional breakfast foods, such as leftover pizza, soup and toast, or a sandwich

    -Egg substitute and toast

    -whole-wheat toaster waffle topped with fat-free sour cream and fresh blueberries

    -A flour tortilla filled with cottage cheese and fresh fruit, warmed in the microwave

    -A low-fat whole-wheat bran muffin topped with applesauce and yogurt

    -An English muffin topped with one ounce of fat-free cheese and broiled until bubbly, served with a glass of orange juice.

    Elizabeth Somer, R.D., is the author of several books, including "Nutrition for a Healthy Pregnancy," "Food & Mood," "Nutrition for Women: The Compete Guide" and "The Essential Guide to Vitamins and Minerals." She is editor in chief of "Nutrition Alert!" a newsletter that abstracts current nutrition research from more than 6,000 journals.

    Copyright 1999 webmed, Inc. All rights reserved.
  • Fish Oil May Help Unclog Diseased Heart Arteries
    Fish Oil May Help Unclog Diseased Heart Arteries


    In a fat-fearing world, fish oil is emerging as one fat even a cardiologist can love. Adding to evidence that the omega-3 fatty acid promotes heart health, German researchers have found that a daily dose of fish oil may help slow or even reverse the hardening and narrowing of arteries in patients with heart disease.

    In the current issue of the Annals of Internal Medicine, researchers from the University of Munich report that a fish- oil capsule a day may ``modestly'' improve blood flow to the heart and bolster traditional therapy in patients with atherosclerosis, or hardening of the arteries.

    In a study of 223 men and women, those who took a dose of fish oil per day for two years had fewer atherosclerosis complications such as heart attack and stroke. Two fish-oil patients had complications, compared with seven patients on a placebo pill that contained other fatty acids similar to those of the ``average European diet.'' Most patients were also on cholesterol- lowering drugs, and many had previously had surgery to unclog their arteries.One of the ``good,'' polyunsaturated fats, fish oil has widely been thought to have important heart benefits. Found in fish such as salmon, it is a key component of the low-saturated-fat Mediterranean diet that has been linked to the lower incidence of heart disease in that area of the world.

    Just how fish oil bestows its benefits has been unclear, but researchers have suspected that it somehow helps clear clogged heart arteries. The German team, led by Dr. Clemens von Schacky, used X-rays to peer into the patients' heart arteries at the beginning and end of the study. They found that after two years, the arteries of the fish-oil patients, on average, offered more room for blood flow.

    The improvements were not dramatic, however; the fish-oil capsules failed to reverse the disease course in most patients. In the fish-oil group, 14 patients did show a mild reversal of artery clogging, compared with seven in the placebo group. Two fish- oil patients showed moderate reversal, while no placebo patients did. For 35 in the fish-oil group, atherosclerosis progressed slightly, and for four, artery narrowing progressed moderately _ results that were almost identical to those of the placebo group, in which 36 worsened slightly and five showed moderate disease progression.

    Still, von Schacky's team concluded that the benefits found in this study are significant enough to warrant including fish oil as part of traditional heart-disease treatment. Taking a daily capsule or dining on fish twice weekly would fulfill the prescription, according to the researchers.

    Dr. Robert Vogel, a cardiologist at the University of Maryland in Baltimore, agreed that the omega-3 fatty acid, in the form of food or pill, is a wise addition to heart-disease therapy. But he pointed out that fish oil has been shown to have greater effects on factors other than atherosclerosis in treating heart-disease patients. Other research, said Vogel, has revealed that fish oil may help correct heart-rhythm disturbances and that it has a blood-thinning effect. It also appears to spur chemical changes in blood vessels that help them dilate.

    ``As a supplement, fish oil has fairly dramatic benefits,'' Vogel said. ``This is an area of research that has been consistent.''

    Annals of Internal Medicine (1999;130:554-62)

  • Interval training.
    Interval training.

    Interval training is a special training technique that involves periods of higher intensity exercise interspersed with periods of rest or light activity. These intervals, which can be used to enhance competitive performance in a specific sport or to improve general fitness can vary in the following ways:

    1. Intensity and duration of the exercise period.
    2. Intensity and duration of the rest period.

    Depending on how the workout varies an athlete can train the specific energy system necessary to develop his or her specific fitness goal.

  • Some alcohol good?
    Some alcohol good?

    DALLAS (CNN) -- Consuming two to six alcoholic drinks per week can greatly reduce the risk of sudden cardiac death, according to a new report from researchers at Harvard Medical School.

    The Physicians' Health Study used data from 21,537 men over a 12-year period. Researchers found that men who had two to four drinks per week lessened their risk for sudden cardiac death by 60 percent. Those who had five to six drinks per week lowered their risk by 79 percent.

    Though some alcohol is good, more may not be better. Rates of sudden cardiac death increased among people who had more than two drinks per day, the study found.

    The research did not look at drinking patterns. However, it is generally agreed among scientists that binge drinking, or drinking large amounts of alcohol in brief periods, can cause abnormal heart rhythms that can lead to sudden cardiac death.

    Though the study's findings are considered significant, its authors are not recommending that people start drinking.

    "Based on the data, I wouldn't recommend that non-drinkers start drinking," said Christine M. Albert, M.D., lead researcher. "One has to consider all the risks and benefits of drinking alcohol. You don't know how likely a person is to become addicted to alcohol, and there is also the risk of cancer to consider."

    Previous studies have found that heavy alcohol consumption may increase an individual's risk of certain types of cancer.

    "Consuming two or more drinks per day has been associated with an increased breast cancer risk in women. This study was done only in men, so we can't be sure if our results would apply to women as well," said Albert.

    Sudden cardiac death (SCD) is responsible for about half of all deaths from heart disease, the nation's biggest killer. SCD is usually caused by irregular heart rhythms. Heart attack, the death of heart muscle due to loss of blood supply, rarely causes SCD.

    Prior studies have pointed to a similar beneficial effect of alcohol when consumed in moderate amounts. This study, however, is the largest to date. It is published in the American Heart Association's journal, Circulation.

  • Types of Exercise
    Types of Exercise

    From John Hopkins Health

    Fitness is most easily understood by examining its components--cardiovascular endurance, muscular strength, muscular endurance and flexibility.

    Cardiovascular endurance is the body's ability to do large muscle work, i.e. moving the body over a period of time. This ability is dependent on the cardiovascular system's ability to pump blood and deliver oxygen through your body. Cardiovascular endurance should be a central component of your overall fitness program. Improving cardiovascular endurance increases your supply of oxygen and energy to your body. It also decreases your risk of heart disease, stroke, high blood pressure and other life-threatening diseases.

    When a heart is well-conditioned, it is like any other muscle--it becomes stronger and more efficient. A normal heart beats at a rate of approximately 70 beats per minute at rest or about 100,000 beats a day. The well-conditioned heart can actually beat as few as 40 times a minute at rest or approximately 50,000 beats per day. A well-conditioned heart conserves energy, and can supply oxygen-rich blood to the rest of the body with half the effort.

    Strength is the ability of a muscle or group of muscles to exert an amount of force, typically in a one-time burst of effort. Weight-lifting (or "resistance training") is a classic example of strength-training because it increases muscle strength and mass, as well as bone strength, by placing more strain on muscles and bones than they are used to. When you lift weights, muscles are forced to meet that challenge by generating more force-generating proteins to feed the "fibers" that grow during exercise.

    Most muscles have a combination of two types of fibers that are challenged during strength-training activities: Fast-twitch fibers provide the explosive force needed for weight-lifting or activities such as sprint racing. Slow-twitch fibers are for endurance, such as the ability for muscle to withstand fatigue. Most muscles have a 50-50 blend of fast-and slow-twitch fibers, but others have an advantage one way or the other. When you make muscles work harder, you actually tear these fibers. As they rebuild, they get stronger and bigger, resulting in harder, tighter and larger muscles.

    Muscle Endurance is the ability to resist fatigue and continue to exercise over long periods of time. While strength-training is needed to maintain muscle strength, endurance training is required to achieve stamina. Muscular endurance is the ability of muscles to continue working strong without rest, such as the ability of a quarterback to throw long pass after pass.

    Flexibility is the ability of joints and muscles to achieve a full range of motion. This results in the preventing injuries and helps keep your body feel comfortable after exercise. Despite popular opinion, there's no evidence that you should lose flexibility as you build muscle.

    Unfortunately, there is truth that the natural aging process can rob you of muscular strength, endurance and flexibility--if you don't maintain them. That's why a regular fitness regimen becomes increasingly important as you age.

  • Hopkins Insider: Cold Prevention: Is Zinc Worth Its Weight In Gold?
    Hopkins Insider: Cold Prevention: Is Zinc Worth Its Weight In Gold?

    By Paul G. Auwaerter, M.D.

    Cold remedy makers seem to think so. But the evidence is still slim.,/p>

    BALTIMORE (Johns Hopkins Health Insider) � In the past few years, Americans have swallowed countless zinc lozenges � along with unproved claims that the mineral helps fight the common cold. Now a new zinc product, Zicam, is poised to hit cold viruses where they live: up your nose.

    Gel-Tech of Woodlands, Calif., developed the gel-based nasal spray, convinced that it would work even better than lozenges, supposedly because the zinc would stay in the nasal passages long enough to interact with cold viruses. The company says its research suggests the zinc gel prevents infection by blocking viruses from binding with cells in the nasal cavity.

    A study supporting those claims is scheduled to be published in the February 2000 issue of the American Journal of Infection Control. But this fall, Gel-Tech released data early to take advantage of the budding cold season. The company says researchers at the University of Southern California tested the zinc spray against a placebo in 104 cold sufferers and found that symptoms ended several days sooner in the Zicam users.

    While those results may sound promising, it remains to be seen whether they will hold up. Other researchers won't have a chance to analyze the study until after it's published. Even if the data look good, a single study � especially a relatively small one � is never enough to support firm conclusions about the safety and efficacy of a new therapy.

    Zinc lozenges, on the other hand, have been the subject of several studies � with decidedly mixed results. For every study that shows the lozenges can shorten the duration of the common cold, another shows no effect. An analysis of six major studies of zinc lozenges, published in the Archives of Internal Medicine in November 1997, failed to find any clear benefit. An update by the same researchers last year reached the same conclusion.

    Proponents of zinc lozenges say the studies that failed to show any benefit used inadequate doses, while skeptics say the studies that showed a benefit did not adequately "control" for the placebo effect. Both sides may be right. But for now, the jury's still out on zinc lozenges and sprays, pending further research.

    Proven Cold Prevention

    Meanwhile, if you want to avoid a cold this winter, your best bet is to practice a few habits that are known to help keep the viruses at bay:

    • Wash your hands often, for a full 15 seconds, preferably with soap. (The type of soap isn't important.) Viruses can survive for as long as three hours on such surfaces as telephones and keyboards.
    • If it's not too inconvenient, use an alcohol wipe to kill viruses on potentially contaminated surfaces.
    • Keep your hands away from your face. You're unlikely to become infected unless the viruses you pick up on your hands come in contact with your eyes, nose or mouth.
    • Avoid excessively dry air, which can increase your vulnerability to cold viruses by drying out the mucous membranes in your nasal passages. Drink plenty of water and, if you're in a dry environment (such as an airplane), skip dehydrating drinks containing alcohol or caffeine. Use a humidifier at home.
    • Shop off-hours and avoid busy restaurants and other crowded spaces when possible.

    Paul G. Auwaerter, M.D., is an infectious disease specialist and assistant professor of medicine in The Johns Hopkins University School of Medicine.


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