Archive for January, 2012

Should I Take Melatonin?

“What are your thoughts on taking Melatonin.  I’ve met a few people who take it to help them sleep.  I don’t have problems sleeping but wanted to get your thoughts.”

What is melatonin?

We naturally produce melatonin, a hormone involved in the sleep-wake cycle (to learn more about the cycle, read this post about circadian rhythm).  As it gets darker, levels of melatonin increase; when it gets lighter, melatonin will drop.  Thus, this hormone (recall, which we naturally produce) can regulate sleep patterns.

Who should take melatonin?

For those who have a clinically-diagnosed sleep disturbance (a.k.a., not self-diagnosed), melatonin is a proposed treatment to help normalize sleep patterns.  According to Web MD, sleep disturbances include insomnia, delayed sleep phase syndrome (DSPS) and mental anxiety (again: diagnosed by a doctor).  In short, I recommend melatonin only if a doctor has diagnosed the problem.  It should not be used to self-treat random sleep disturbance.

Side effects?

According to Web MD, melatonin can cause some side effects: headaches, acute depression, irritability, stomach cramps, sleepiness during the day and dizziness.   I find the “do not drive or use machinery” warning quite obvious (bordering on comical), but suppose that would be an important point to bring up, for the ambitious crowd.

Effectiveness of use

Numerous studies have suggested that melatonin is useful in treating chronic sleep issues.  Dosing will vary based on gender, age, size and condition (but it seems that 0.3-5 mg at bedtime is the typical dose).

Some reports (still equivocal) have shown effectiveness to treat jet-lag, reduce anxiety pre-surgery, and reduce nicotine withdrawal symptoms.  Again, (just in case I haven’t fully driven this point home yet) to use melatonin for any circumstance it is best to consult your doctor first!

Safe supplements

If a doctor suggests melatonin and prescribes a dose, here are some of the safe and effective brands out on the market (this is according to consumerlabs.com, leader in independent test results for thousands of products).

  • Bios Life Melatonin (2.5 mg melatonin per tablet, once per day)
  • CVS Pharmacy Melatonin 3 mg (3 mg per tablet, once per day)
  • Origin Melatonin 5 mg (5 mg per tablet, once per day)
  • Puritan’s Pride Melatonin 3 mg (3 mg per tablet, once per day)
  • Solgar Melatonin 10 mg (10 mg per tablet, once per day)
  • Spring Valley (Walmart) Melatonin 3 mg (3 mg per tablet, once per day)
  • Vitamin World Melatonin 3 mg (3 mg per tablet, one to three per day)
  • Nature’s Bounty Triple Strength Melatonin 3 mg (3 mg per tablet, once per day)

Understanding METS

Understanding METs

If you think this post is about my hometown’s baseball team, think again… (Although that would be fun).  “METs” is an abbreviation that refers to “Metabolic Equivalents of Task” — commonly seen on cardio machines and heart rate monitors.

Level of Effort

Cardio machines and heart rate monitors will tell you the amount of calories you are burning during an exercise session (most accurate when you tell the machine and/or monitor your correct age and weight).  But calories alone cannot express how hard you’re exercising (i.e., exercise intensity).  On the other hand, metabolic equivalents (METs) can help quantify the level of effort you put in.

What’s a metabolic equivalent (MET)?

More specifically, METs are a unit of measurement that calculates how much oxygen the body is taking in per minute.  METs are a useful measurement since they allow you to compare the amount of oxygen consumption used during exercise versus at rest.  The harder your body works, the more oxygen you will have to take in (and the higher the MET level).

At rest, the amount of oxygen your body needs to take in is equal to one MET.  Two METs equal any activity that requires two times the amount you require at rest.  Nerijus’ p3 class (circuit training) is about 8.0 METs.  This means you are generally using eight times the amount of oxygen per minute that you would typically use at rest.

Explicit MET values     

MET values haven’t appeared out of thin air.  One MET = 3.5 ml of oxygen per kilogram of body weight per minute (1 kg = 2.2 lbs).  Since no one (at least here at the company) cares to measure the rate at which you’re consuming oxygen, the 2011 Compendium of Physical Activities assigned numerical values based on the energy costs of activities.  This list (described in more detail below) shows how intense certain activities are over others.

MET values in the compendium

Since one MET is considered the “resting metabolic rate” or energy cost of a person at rest, that is the baseline we use to determine how many METs you are working at.  0.9 is for sleeping and 23 METs is for running at 14.0 mph.

Sedentary behavior = 1.0-1.5 METs

Light-intensity = 1.6-2.9 METs

Moderate intensity = 3-5.9 METs

Vigorous intensity = > 6 METs

One Met = 51.3 kcal/hour

Two Met = 102 kcal/hour

Here is the 2011 Compendium: click on the “Activities Categories” tab and choose your exercise.  Here is a full list PDF.

Summary

Metabolic equivalents (METs) calculate the “metabolic cost” of doing a certain activity per minute.  It is a great measurement to use when building a routine that will add more intensity.

Sources

Compendium of 2011 Activities

Ainsworth et al. 2011 Compendium of Physical Activities: A Second Update of Codes and MET Values.  American College of Sports Medicine. 2011.

https://sites.google.com/site/compendiumofphysicalactivities/

Misconception: “B-vitamins Give Me Energy”

Vitamins don’t give me energy?  Say it ain’t so!  Sorry Joe, vitamins and minerals do not provide energy (physical or caloric) to the body.  Here is why B-vitamins have an energy-misconception.

B-vitamins: what’s the energy link?

B-vitamins are responsible for playing an integral role in the production of ATP (your energy currency).  Thus, B-vitamins can sometimes be misconstrued as providing energy.  But they do not…

Most functions in the body require enzymes.  Although the body is able to endogenously make these enzymes (meaning, your body produces them on its own), enzymes require a catalyst to render them biologically active.  Remember from high school biology how enzymes are inactive until they have a coenzyme and substrate (cofactor)?  Well, B-vitamins act as coenzymes.

Coenzymes are the catalysts that help the body create energy from food.  Coenzymes are derived from vitamins – which is why B-vitamins aren’t coenzymes, but act like them in the case of producing ATP.  This educational video on how B-vitamins act as a coenzyme is pretty awesome in describing how it all occurs (just in case you aren’t convinced yet).

Should I take a B-complex vitamin?

Likely, you are getting enough B from your diet (especially since most foods are now fortified with vitamin B: breads, cereals, pastas, drinks, bars, protein shakes, etc).  If you are eating a whole food diet most of the time (or if you are a vegetarian), then it might be a good idea to focus on foods that are high in vitamin B and/or take a B-complex.  Leafy greens, eggs, cheeses, whole grains and meats will offer the best sources.

All About Vitamin D

“How serious is vitamin D deficiency (especially in the winter months)?  Should I be concerned, and what can I do to overcome it?”

Be concerned. Vitamin D deficiency is serious.

Here are some of vitamin D’s functions, and risks of being deficient.  I will also describe ways to overcome deficiency (it is possible!)

Functions of Vitamin D 

Vitamin D has been shown to be responsible for many different functions in the body.  Nowadays, we never hear about calcium without its friend, vitamin D.  This is because bones require both in order to be healthy and strong.  Specifically, vitamin D promotes calcium to be absorbed in the GI tract, and subsequent reabsorption in the kidneys.  By absorbing more calcium, vitamin D works to help stimulate bone remodeling.  Without D, calcium wouldn’t be able to strengthen bones all alone.

When exposed to sunlight or UV radiation, the skin can produce vitamin D (known as vitamin D3).  Since vitamin D is synthesized in the body, it acts like a hormone and sends chemical messages in the bloodstream from one organ to the next.  The Institute of Medicine (IOM) has now assessed 1000+ studies to look at how vitamin D may be beneficial beyond bone health.  These data suggest that vitamin D might have protective effects against diabetes, internal cancers, multiple sclerosis, hypertension and immunity.

 

 

How to Get Vitamin D Naturally

The Beatles say, “here come’s the sun,” and Marissa agrees, “it’s all right,” since being in direct sunlight without sunscreen for just 10-15 minutes can produce up to 10,000 IU per day of vitamin D. (1)  When skin is not exposed in the winter months, there are a few natural ways to consume D through food, most of which are high in fat.  These include fatty fish and eggs, predominantly. Some foods are fortified with vitamin D, such as cow’s milk, orange juice, some soy and rice milk and breakfast cereals.  In supplemental-form, vitamin D can be obtained from multivitamins, as a calcium combination with D or as a separate vitamin D supplement.

Below are the IOM recommendations per life stage on how many International Units (IU’s) to consume.

Deficiency

In children, vitamin D deficiency causes rickets.  In adults, a deficiency can cause osteomalacia (bone cancer), osteopenia (bone mineral density that is lower than normal) and eventually, osteoporosis (the most common bone disease, aka, “the disease of brittle bones”).  Osteoporosis is characterized by a severe loss of bone mass, strength and susceptibility to fracture.

Vitamin D deficiency has been defined by the Institute of Medicine and an Endocrine Society practice guideline as a level of serum 25-0H vitamin D less than 20 ng/mL (2, 3).  The Endocrine Society went on to further define vitamin D insufficiency as a level between 21 and 29 ng/mL (3).

Prevention

There are a few ways to prevent and reverse a vitamin D deficiency.

#1 Blood test at your doctor’s office.  Ask for a vitamin D test to find out if your blood levels are within normal range.  A normal vitamin D level will show a blood range between 30-100 ng/mL.

#2 Look at your current sunlight exposure.  In the summer it is usually not a problem.  In the winter, it might be time to get some from your diet and/or supplements.

#3 Diet and supplements.  From the diet, vitamin D comes in the form of fatty fish, milk, eggs and in supplemental form, through D alone, a multi or a combination of calcium with D (sometimes will also include magnesium).  Supplements are great ways to get in enough vitamin D.  Look at the IOM’s guidelines above for how much you need to consume per day.  Although the IOM states a minimum of 600 IU’s per day, many supplements will offer upwards of 2,000 IU’s per day.  I take this amount and have been able to reverse a Bone DEXA diagnosis of osteopenia to normal.  So long as you are not exceeding the 4,000 IU’s per day Upper Level Intake, ranges in 2,000 IU’s per day seem to be effective.

#4 Exercise.  If you have yet to read a previous post of mine on Exercise’s role in building bone, now is the time.  Weight-bearing activity puts lots of (good) stress on the bones, which in turn produces more bone cells to strengthen the bone!  If you are not currently weight training at least 1-2x per week, fit it into your schedule to help solidify strong bones.

Sources

(1) http://www.ajcn.org/content/69/5/842.full.pdf

(2) IOM (Institute of Medicine). 2011. Dietary reference intakes for calcium and D. Washington DC: The National Academies Press.

(3) Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. JCEM. 2011 Jul; 96(7):1911-30.

Corporate Athlete 101: Cortisol & Stress

Here is the fifth question in a series I’ve received from Jeremy Jauncey.  The following Q&A will be used in the nutrition series for our corporate athlete NJU classes.

“When tired and stressed is it true that the body generates cortisol, which suppresses the immune system and raises blood pressure?

As usual, I will break down your question into parts.

What is cortisol?

Cortisol is one of the major “glucocorticoids” (a class of steroid-hormones produced by the adrenal cortex, see graphic above).  The adrenal glands lie just above of the kidneys, and are responsible for mediating the body’s stress response.  The way the adrenal glands do this is by pumping out glucocorticoids, one of which is cortisol.

“Fight or flight”?

When in a super charged state, known as “fight or flight” mode (a survival response that keeps the body alert and functioning during stressful situations), the body stimulates the release of cortisol in conjunction with the hormones, epinephrine and norepinephrine.  The entire function of all these hormones acting together is to increase blood glucose levels (to give body extra energy to push harder), increase red blood cells (to deliver extra oxygen to the body’s tissues), vasoconstrict blood vessels (constriction of blood vessels to retain body heat and vascular resistance), speed up pulse (speeding heart beat allows more blood to flow throughout body), increase blood pressure (also increases blood flow to body) and slow digestion (stops blood from being shunted to the center part of the body and instead, focuses the blood flow to the extremities: legs, arms, fingers, feet, in order to fight or run away).

When tired and stressed is it true that the body generates cortisol?

Yes — and it is helpful to generate cortisol so that the body is able to push harder through the stressful activity and perform better.

… which suppresses the immune system and raises blood pressure?

Yes to both.  The downside to production of cortisol (especially chronic production) is that several inflammatory cytokines (such as C-reactive protein or CRP, a major inflammatory marker) get elevated.  As a result, both cortisol and inflammatory cytokines (there are more other than CRP) have been implicated in contributing to many diseases, such as heart disease, diabetes, obesity, and cancer.

How to avoid physiological effects of chronic stress?

(1) Reduce stress: The first step is to reduce stress (but that might be difficult to do).

(2) Diet: The next step is to look at your current diet.  Scientists have been researching how specific nutrients can thwart the effects of high cortisol.  The most notable one is the omega-3 fatty acid.  Omega-3’s come from fatty fish, fish oil pills and algae pills (for vegetarians).  Omega-3’s are a great way to reduce total inflammation in the body.

(3) Exercise: the role of physical activity should not be overlooked.  Exercise has positive effects on anxiety, depression, insomnia and energy.  Exercise promotes the release of serotonin (a neurotransmitter) that is important for the regulation of mood, appetite and sleep.

(4) Social network: no not facebook 🙂  Investing energy toward friendships, both old and new, revitalizes the soul and reduces chronic stress.

New Startup, Fitness-Buffet

Fitness-Buffet is a startup gaining traction in the corporate wellness space.  Read on to learn more.

Why Fitness-Buffet …

The company launched six months ago, listing 119 countries to redeem Fitness-Buffet offers.  According to a Reuters article published on Monday, Fitness-Buffet sells “downloadable fitness offers,” which include various activities at a flat fee of $99.  The premise of the program is that users can take advantage of fitness activities at a $1,000 value (e.g., zumba, kick-boxing and touch rugby) at a much cheaper rate.  Additionally, users mention that they would have never thought to try out many of these classes if it were not for the offer.

A two month long buffet!

Since users only have a two-month window to take advantage of the offers, they might have more reason to increase gym attendance (and thus, get fitter).  The teaser video under the “how it works” tab reminds users that they can recapture their youth by having fun again while getting fit.  I specifically enjoyed the undertone about finding a soul-mate during your course of trying random activities 🙂

Viewing the buffet

To browse over some “buffet samples,” go to the homepage and click on the (hardly noticeable) black link under the orange continue button.  I was intrigued to find “nutrition counsel” as part of the buffet offerings, but suppose that would make sense (in a “punny” sort of way).  In an attempt to locate some offers in the Next Jump vicinity (NYC, BOS, SF and UK), I could not seem to find (any) results in the “Buffet Samples.”  I imagine there is more to be had once you sign up.  But since we already have a gym and awesome classes … Meh.    

Break Out of a Snack Rut

Do you have poor snacking habits?  Read on to find out the most common snack ruts…

#5 You eat when not hungry

Why it’s a problem: this is the best way to ingest excess calories.

The fix: are you hungry? If not, wait until sounds rumble from the tummy.  If yes… read on to learn some new better snack foods.

#4 You don’t include fresh fruits or veggies

Why it’s a problem: restricting fresh fruits and veggies to meal times will limit every chance of consuming enough servings per day (at least 5-9).

The fix: have a serving of a fruit or a vegetable as your snack (or as part of it).  One serving of fruit is the size of your fist.  One serving of veggies is a half cup of cooked veggies or one cup raw.

#3 You go for salty stuffs

Why it’s a problem: high sodium snacks contribute to overall excesses in total sodium for the day.  High sodium diets lead to hypertension in the future.  2,400 mg is the current recommended daily allowance (RDA) for sodium.

The fix: read how much sodium (salt) is in your snack — per serving.  If there is 140 mg or less per serving, that is considered low-sodium.

#2 You avoid protein and fat

Why it’s a problem: protein and fat satiate (tide your body over) because those macronutrients are not as readily absorbed as carbohydrates.

The fix: keep your body fuller for longer by choosing a snack with a small amount of protein and/or fat.  Some examples include adding a piece of cheese to your apple or having a handful of almond butter with celery sticks.

#1 You grab juice, a high-calorie coffee or regular soda

Why it’s a problem: these types of beverages are high in sugar (bad for your teeth, waist and focus).  Drinking empty calories will help to store some extra fat on your body.

The fix: beverages with calories should be consumed for a specific reason (e.g., a supplement pre or post workout).  Choose water or seltzer in between meals (or a tea/coffee without the whip, mocha frocha, and packets of sugar).

Guide to prepping a good snack

My recommendation is that you make yourself something easy, healthy and tasty by following these steps.

One: choose a fruit or a veggie of choice

Two: add in 1-2 handfuls (4-8 oz) of lean protein (fat is usually found in most protein sources)

Three: add 1 serving complex carbohydrate (optional)

Examples:

– Banana with 1-2 tablespoons peanut butter (add a slice of whole wheat toast)

– Carrots with hummus and rice or whole wheat crackers

– 1/2 cup fage yogurt with 1/2 cup berries

– Apple with string cheese

– 2 eggs with 1/2 cup cooked spinach

– Kashi TLC or KIND bar