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FAQ (6)

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How Fattening are Soft Drinks?

Q: How fattening are soft drinks and other sweetened beverages?

A: More fattening than I realized, according to a panel of experts organized by Barry M. Popkin, PhD, head of the Center for Obesity at the University of North Carolina. Popkin talked with consumer oriented Nutrition Action Health Letter and is featured in the June 2006 issue.

Professor Popkin says soft drinks are a major culprit in the ongoing obesity epidemic. The basic problem is that our bodies are not designed to consume calories in liquid form. “When you consume calories from beverages, you don’t compensate by eating less food later on,” Popkin told the Health Letter. “Liquid calories don’t register with our appetite controls.”

Paleolithic man got his calories from food. The only beverage our ancient ancestors consumed was water (and breast milk for babies). From an evolutionary survival-of-the-species standpoint, “it would be dangerous if people were no longer hungry after drinking water, because they wouldn’t consume enough food,” Popkin explained. “We were built to have separate thirst and hunger mechanisms because the body needs both fluids and calories from food. Throughout evolution, fluids had no calories.”

After World War II, when soft drinks came on the scene in a major way, we were in a “new world when it came to beverages.”

According to a 1999-2002 government survey, the average American reported drinking 2 ½ servings of soft drinks and fruit drinks, about 210 calories a day. That adds up to 1470 unregistered calories a week, or almost one-half pound of fat (3500 calories in one pound of fat). Extra calories at that rate, over time, can become a major problem.

“An ideal diet would include no beverages other than water,” says The Beverage Guidance Panel. Acknowledging that that’s not going to be acceptable to many people (or healthy for some), they say it’s okay within limits to have unsweetened tea or coffee (a teaspoon of sugar in a cup is considered unsweetened), non-fat or 1% milk, plain soymilk, 100% fruit juice, and diet drinks.

The most important change is to eliminate regular soft drinks and fruit drinks.”

The panel’s advice is new, of course, but it turns out that Carol and I have been in voluntary compliance for years. We both drink mainly water. I add skim milk, plain soymilk, a cup or two of coffee and a little red wine. She drinks some soymilk, plus tea. We both use artificial sweeteners, which the panel says is okay in moderation. “We didn’t think there was much evidence against the safety of any of the FDA-approved sweeteners,” Popkin told Nutrition Action. “But we were cautious about the possibility that diet drinks condition people to prefer sweets.”

So drink up, but make it mainly water.

You’ll find many more interesting details on beverage choices in the June 2006 issue of Nutrition Action Health Letter (www.cspinet.org).

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Vitamin-Mineral Supplements, Good or Bad?

Q: A Wall Street Journal article by health writer Tara Parker-Pope (March 2006) says that some experts now believe that vitamin-mineral supplements may do more harm than good. What do you think?

A: I read the same article. There does seem to be an assault on the mega-buck supplement industry, and some of it is probably justified. A doctor friend of mine, a sports medicine specialist, told me recently that he doesn’t take supplements of any kind and that he discourages his patients from taking supplements, including multi vitamins & minerals. That’s a bit “far out,” however, and I don't think it's the consensus view.

Not everyone buys the recent negative research on vitamin-mineral supplements. As Parker-Pope observes, industry representatives and others say the people studied were already sick.

“Most doctors and health experts now suggest that consumers interested in taking vitamins stick to a multivitamin rather than concocting their own cocktails of high-dose vitamins,” Parker-Pope writes. That’s probably good advice. I’ve always taken a multiple vitamin and mineral supplement—but only for insurance.

The Multivitamin Maze, the cover story in consumer-oriented Nutrition Action Health Letter (March 2006), presents that view: “It’s worth taking a multivitamin, just for insurance.”

Harvard professor Walter C. Willett, MD, says the same thing in his highly regarded book Eat, Drink, and Be Healthy (Simon & Schuster 2001). “I use the term insurance for good reason,” he writes. “A multivitamin can’t in any way replace healthy eating. It gives you barely a scintilla of the vast array of healthful nutrients found in food. It doesn’t deliver any fiber. Or taste. Or enjoyment. The only thing it can do is offer a nutritional backup or fill in the nutrient holes that can plague even the most conscientious eaters.”

Both Willett and Nutrition Action suggest steering clear of mega-dose formulations. “A good multi should supply roughly 100 percent (or more) of the Daily Value (DV) for most vitamins and minerals,” says the Health Letter. In short, the formulation should not contain too much or too little of anything.

Dr Kenneth Cooper, founder of the Cooper Clinic, recommends that hard training athletes take higher dosages, but not too high. For example, his formulation for elite athletes includes 2,000 mg of vitamin C and 800 IU of vitamin E, while his “basic” formula contains 200 mg and 200 IU, respectively.

The variations can be mind boggling. Nutrition Action Health Letter lists more than 100 multivitamin-and-mineral products it considers adequate (meets their "basic criteria"), including 25 “Best Bites” based on sex and age (men or women over or under 50). If in doubt, ask the pharmacist or other knowledgeable person to recommend a formula suitable for you.

[The NSP Fitness & Endurance Pack offered on our Products Page includes packets containing eight identical sustained release tablets, which allows you to spread the dosage over one or more days, as you see fit.]  

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New Tanita Body Fat Scales

Q: In Challenge Yourself, I enjoyed your explanation of how you use the Tanita electrical impedance scale to monitor your body weight and fat at home; you also weighed yourself on the Tanita scale in The First Ripped DVD. In shopping for Tanita scales online (Tanita.com), however, I notice that in addition to bodyweight and fat percentage, the new models measure total body water, visceral fat, muscle mass, bone mass, and daily calorie intake (DCI). What’s the value, if any, of these additional measurements? Is body weight and fat percentage adequate for tracking purposes?

A: The old model Tanita (measures only weight and % fat) has served me well for almost nine years. Your query aroused my interest, however, and I am now the proud owner of a new top-of-the-line Tanita InnerScan Body Composition Monitor, model BC-533. Thanks to the wonders of technology and our growing economy, the new model with all the bells and whistles cost less than we paid for the old one. 

One factor that complicates the comparison and evaluation, of course, is the metal in my new hip (Miracle in Houston, article 161, Health and Fitness category), which the new scale interprets as part of my body. It is, of course, but I’ve gone from bone and cartilage in my hip to metal and plastic. Fortunately, the excellent FAQ section on the Tanita web site addresses this issue: “Any metallic implant could affect the body fat reading, giving a slightly lower than normal reading.” That’s not a problem, however, because the implant will now be a constant; it won’t change. “You can still use the monitor to successfully track relative change in body fat over time.” As I explained in Challenge Yourself, “The body’s response to diet and exercise is more important than absolute accuracy. The critical factor is whether the measuring device shows progress or lack thereof.”

Based on readings before and after the surgery (before on the old scale and after on both), my new hip makes about 2 % difference. From now on, I’ll simply make a mental note to subtract 2 % from my readings when absolute accuracy is important. So, my new hip is nothing more than a minor complication, easily handled.

A more significant change is that the new monitor asks for your age, along with height, sex and whether you are an athlete; the old monitor didn’t consider age in the body fat calculation. The FAQ section explains why age was added. I don’t buy it, however, at least for an atypical person like me. 

“Research has determined that as we age there is a tendency to increase body fat [especially visceral fat] and decrease muscle mass,” says the Tanita FAQ section. My fat readings over the last nine years show that that did not happen in my case. “This is a natural progression,” says Tanita, “unless you increase exercise as you age.” That’s probably correct, but training intensity is what counts most, not volume. I maintained my training intensity, and didn’t gain fat or lose muscle over the last nine years. My first and last fat percentage readings on the old scale, as well as the average of the first 10 readings and the last 10, are almost exactly the same.

To see how age affects the readings on the new scale, I weighed myself using both the default age (30) and my actual age (68). The fat percentage and muscle mass were the same on both age settings, but when my actual age is entered, Tanita’s proprietary formula moved part of the fat to my belly. On a scale of 1-59, my visceral fat rating is “1” on the default setting, and “7” using my actual age. Both ratings are healthy, according to Tanita; 1 to 12 is healthy and 13 and above indicates an excess level of visceral fat.

Since I can’t improve on a rating of 1, I’ve decided to monitor my visceral fat on both age settings. Maybe I can bring the 7 down, using my actual age..

For the average person, however, especially those who have not been training, I suggest using your actual age—and not changing it over time. That way you’ll know what’s actually happening. If you change the age setting every year, you’ll be accepting, as a fact of life, that you will get fatter with each passing year, at least in the belly. The choice is yours. (See article 2, “The Metabolism Myth,” Age Factor category, which explains why there's no physiological reason to gain fat with age.) 

The new Tanita literature also does a better job explaining the “Athlete” mode. On both the old and new scales, you are offered a choice of Male or Female or Male/Athlete or Female/Athlete. If you select Athlete, you are automatically given the highest setting for activity (another new feature), which means you are involved in intense physical activity.

Tanita defines athlete as someone who exercises for at least10 hours a week and has a resting heart rate of 60 or lower, which is basically the same as before. But they’ve expanded the category to include “lifetime of fitness” individuals who’ve been fit for years but “currently exercise less than 10 hours per week” They also  specific that it does not include “enthusiastic beginners,” whose bodies have not yet changed to require the Athlete mode.

“Athletic body types are physiologically different than standard adult body types,” Tanita explains, “due to muscle mass and hydration differences. Athletes generally have greater muscle mass and tend to be more dehydrated. These differences would skew [an athlete's] body fat reading high, when taken with the standard Adult mode.”

As I recall, the dehydration factor wasn't explained when our first scale was purchased. Hydration is very important, because the basic assumption of Bioelectrical Electrical Impedance (BIA), the method used by Tanita scales (old and new), is that “lean muscle has more water than fat tissue and allows the [electrical] signal to pass more easily.” Fat causes more “impedance” or resistance than muscle. That means the Adult mode short changes athletes on muscle mass two ways. First, it assumes less muscle (and more fat) than athletes typically have, and second, it compounds the error by interpreting dehydration as a permanent muscle deficiency, rather than a temporary condition. That’s why I usually suggest that our readers (most are active trainers) use the Athlete mode from the beginning, and stick with it. That will give a more accurate initial reading and show changes in response to diet and training.

As you might expect, Tanita's formula assumes that body water decreases with age. When using my actual age, the new scale calculated my total body water at 62 percent, versus 68 percent using the 30 default age. It's unclear what Tanita's formula did with the decrease in water when I enter my actual age. As noted above, my muscle mass is the same on both age setting. Again, it seems clear that my body does not jibe with their proprietary formula.

None of what I’ve said, however, is meant to discourage you from buying a new Tanita scale with all the bells and whistles. By all means, buy one of the new models. Just don’t obsess over all the new information; use what applies to you and helps you achieve your goals, and ignore the rest. Remember that body weight and body fat % are still the most important variables for tracking your progress.

I love the space-age looks of my new scale, and I'm fascinated by all the added variables. In addition, the FAQ page on their site and the literature that comes with the new scales are very informative. Buy the best model your pocket book allows. And read everything—I did.     

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New Muscle-Health Connections

Q: What are the health benefits of strength training?

A: That’s a very broad question, too broad to be answered here. For a comprehensive look at the importance of muscle mass, strength and body fat percentage in health and aging, read the book Biomarkers by William Evans, PhD, and Irwin Rosenberg, MD; you’ll find it on our Products Page under recommended books. You’ll, however, be interested in three recent studies reporting exciting new details on the connection between muscle and health. Let’s take them one-by-one.

 Syndrome X

The first study, reported in the November 2005 Medicine & Science in Sports & Exercise, examined the association between muscular strength and metabolic syndrome, a cluster of risk factors for heart disease, stroke and diabetes (high insulin cholesterol and blood pressure; see our article 46, Syndrome X, Health & Fitness category on this web). For six years, the study tracked 3233 men (20 to 80) initially free of metabolic syndrome who had two or more health and fitness examinations at the Cooper Clinic between 1980 and 2003, including muscular strength as measured by body weight-adjusted one-repetition max for the leg- and bench press. Cardiorespiratory fitness was also assessed by maximal treadmill test.  

A total of 480 men developed metabolic syndrome during the 6-year period. After adjusting for age, smoking, alcohol intake, family history and cardiorespiratory fitness, those in the highest strength category were found to be 44% (39% for overweight) less likely to develop metabolic syndrome than those in the lowest strength category. “Muscular strength was inversely associated with metabolic syndrome incidence,” the researchers concluded. “Potential benefits of greater muscular strength presumably through resistance exercise training should be considered in primary prevention of metabolic syndrome.”

The other two studies provide examples of the mechanism by which strength training and muscle create health.

Blood Pressure

The second study, reported in the American Journal of Hypertension, November 2004, looked at the connection between lean body mass and the ability to regulate blood pressure (BP) during and after a stressful event. Interestingly, they did it by measuring BP and sodium, a key factor in BP control. Sodium, of course, causes the body to hold water and excess water is associated with high BP. That’s why diuretics or water pills are often prescribed for people with high BP. One of the ways your body controls BP is by raising and lowering the level of sodium in the blood. When the level of sodium in the blood goes up, water is drawn into the blood stream and BP goes up; the reverse is also true. Excess sodium is excreted in the urine. Natriuresis is the medical term for the excretion of greater than normal amounts of sodium in the urine. This happens when people take diuretic drugs or, as we see in this study, the body is in the process of restoring BP to normal.

In the words of the report, “The purpose of this study was to examine the influence of body composition on stress-induced pressure natriuresis.”

The study was probably fun for the 127 youths, boys and girls average age 16, who participated. After measuring their lean body mass (LBM), fat mass (FM) and body fat percentage (%BF), the youths were put through the following stress protocol: 2-hour baseline period, 1-hour stress period (playing video games for money), and 2-hour recovery period. Urine samples were collected hourly and BP was taken every 15 minutes.

As would be expected, BP and urinary sodium excretion increased (which means sodium in the blood was elevated) from baseline to stress, and returned to pre-stress levels during the recovery period. The critical finding, however, was the response of those with high LBM compared to those with high FM. “The BP levels and changes were positively correlated with LBM,” the researchers reported. “In contrast, levels and changes in sodium excretion were inversely correlated with FM and %BF.” In other words, those with a greater proportion of LBM exhibited better control of their BP. In contrast, those with a higher percentage of fat responded less well to stress; their BP went up less but stayed up longer.

“Greater LBM was associated with higher BP during stress,” but that’s “appropriate to meet the…demands of the stressor.” It indicates an increase in blood flow to prepare the body for fight or flight. Within limits, that’s good, especially if accompanied by greater ability to restore BP to normal after the stressful situation passes. Greater body fat means “slower natriuretic response to stress” and less natriuresis after. In short, more fat means less sodium response to stress and less clearance afterward.  

“Lean body mass was the strongest predictor of BP response to stress,” the study concluded. Keep your fat down and weight train, and you’ll have a healthier BP response to stress. And don’t forget aerobic training. It’s also an important factor in stress control.     

Blood Flow

Recognize the name Izumi Tabata? With the Japanese National Institute of Health and Nutrition in Tokyo, he was the lead author of the study which reported the amazing effectiveness of very brief 20s/10s (work/rest) interval training, AKA the Tabata Protocol (see our article 10, Forget the Fat-Burn Zone, Aerobic Exercise category on this web). He’s also one of the authors of our third study, which is reported in the October 2005 Journal of Applied Physiology. Motohiko Miyachi, the lead author, is also with the National Institute of Health and Nutrition in Tokyo. Hirofumi Tanaka, Department of Kinesiology, University of Wisconsin-Madison, was the American collaborator. The study deals with the effect of resistance training on blood flow in the legs, another factor implicated in syndrome X.

Here’s the problem being addressed, as stated by the researchers: “Basal (basic) whole leg blood flow decreases progressively with advancing age in healthy men and women, which is related to corresponding reductions in leg fat-free mass and estimated leg oxygen demand.” Aerobic exercise does not appear to remedy the problem, according to the researchers. “The lack of influence of regular aerobic exercise is presumably due to the fact that leg fat-free mass decreases similarly with advancing age in both sedentary and endurance-trained healthy men.” Aerobic exercise does not retard muscle loss. In view of the proven ability of resistance training to prevent or slow the loss of muscle mass and function that typically occurs with aging (sarcopenia), Miyachi and Tabata et al. undertook to test the hypothesis that resistance training also enhances “leg perfusion in aging humans through its impact on leg skeletal muscle mass.” It does so impressively, but not quite the way you might expect.

The study involved 104 healthy (normal BP and body weight, and free of chronic disease) men age 20-34 (young) and 35-65 (middle age), who were classified as sedentary or resistance trained. The sedentary subjects had not participated in regular exercise for at least two years. Resistance-trained men had been “performing moderate- to high-intensity full-body resistance exercise involving large muscle groups.” To isolate the effect of resistance exercise, cross-trainers who had also been doing regular aerobic exercise were excluded. Smokers and those who had ever used anabolic steroids were also excluded.

Leg blood flow was measured by ultrasound in all subjects. Body composition was determined using “dual-energy X-ray absorptiometry (DEXA),” which not only measures total muscle and fat mass, but also the precise location of both. “The measurement of leg muscle and fat mass using DEXA has been well validated against other standards,” the researcher stated.

Three salient findings emerged. First, leg blood flow was “not significantly different” in the sedentary and resistance-trained young men. Second, blood flow was 35% higher in the resistance-training middle-age men than in their sedentary peers. The men who trained with weights did not experience the decline in blood flow that usually comes between youth and middle-age. Third (here’s the surprise), there was no age-related difference in leg muscle mass. (Emphasis added)

Confused? Me too. Here’s the researcher’s explanation:

Consistent with the initial hypothesis, in the pooled population of 104 subjects, “leg muscle mass was significantly related to whole leg basal blood flow.” This suggests that increased leg blood flow in resistance-trained men is, “at least in part,” associated with larger muscle mass. “In the present study, however, there were no obvious differences in leg muscle mass between young and middle-aged men, and the magnitude of age-related reductions in leg muscle mass was similar between sedentary and resistance-trained men.” [#]

Resistance training may induce “not only quantitative but also qualitative changes” in muscle components, the researchers suggest. Resistance training may stimulate increased “muscle turnover and basal metabolic demands in older subjects, which may have acted to preserve leg blood flow independent of leg muscle mass.”     

Whatever the explanation, the end result was greater blood flow. This lab had previously reported that repeated increases in blood flow due to endurance exercise “is associated with” expansion and remodeling of the major artery in the legs. “In the present study, resistance-trained men had enlarged femoral arterial diameter compared with sedentary counterparts. Taken together, these results suggest that both aerobic and resistance exercise appear to cause arterial enlargement” and increased blood flow, they conclude.

That says it all. If you’re doing both weights and aerobic, keep it up. If not, start now—and never stop.        

[# CB: The resistance-trained middle-aged men had been lifting an average of 52 minutes 4.6 times a week for 18.3 years. Could overtraining have been a factor in their loss of muscle mass?]

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