Yeshiva World News

It all makes sense.  Sugar is the enemy!  It is high in calories and short on nutrition.  And in this generation of type two diabetes, who wants the white powdery stuff around anyway?  The perfect solution would be to find a substitute for sugar and use it to sweeten beverages, desserts, yogurts and puddings.  It cuts the amount of calories you consume per food item and it should go a long way to solving the epidemic of overweight and obesity.  Sounds good, right? But guess what? It isn’t working! 

Artificial sweeteners not only aren’t helping people lose weight; a study conducted at Harvard Medical School using the Framingham Heart Study shows that consuming diet drinks may actually increase the risk of heart disease.  Ravi Dhingra, M.D. and her colleagues looked at nearly 6,000 middle-aged men and women who had medical examinations every four years.  Those who consumed more than one diet or regular soda per day experienced a 25% increased risk of impaired fasting glucose and high triglyceride levels.  They had a 31% greater chance of becoming obese, a 32% higher chance of low HDL levels (good cholesterol), and a 44% increased risk of metabolic syndrome.   

So the question is: how does something that has less calories cause you to become obese and put your cardiovascular health at risk?  Several theories abound, but the overall consensus is that artificial sweeteners may actually encourage you to partake of more servings of food or drinks than would sugar.  It appears from studies conducted on animals, that sugar substitutes may interfere with the body’s natural ability to count calories based on the food’s sweetness.  Additionally, many foods containing sugar substitutes may still be high in fat and total calories.  But because we see that it is sugar-free, we eat more of it.  In short, at the end of the day, it encourages our sweet tooth, causing us to consume more calories. 

What are these sweeteners and just how sweet are they?  Aspartame, commonly known as NutraSweet, is 200 times sweeter than sugar.  Saccharin, which is marketed as Sweet ‘n Low (among others brands) is also 200 times sweeter than sugar. One of the more popular sweeteners today is Sucralose, which we see on the shelves as Splenda. It is 600 times sweeter than sugar.  Although all of these sweeteners have been approved for use and have been determined as safe by government authorities, their continued use has been shown to be problematic.  It should be noted that the Center for Science in the Public Interest, citing a study done by the National Cancer Institute, still maintains that saccharin in heavy amounts causes cancer of the bladder.  Some of these sweeteners are known to cause bloating and stomach discomfort as well as rashes/flushing, panic-like agitation, dizziness and numbness, diarrhea, swelling, muscle aches, headaches (migraines), intestinal cramping, bladder issues, and stomach pain.  This is particularly true of people that have food sensitivities and allergies to begin with.  
 
Many people have chosen to use a more natural product as a sweetener.  Stevia is a genus of about 240 species of herbs and shrubs in the sunflower family. As a sweetener and sugar substitute, stevia’s taste has a slower onset and longer duration than that of sugar, although some of its extracts may have a bitter or licorice-like aftertaste at high concentrations. With its steviol glycoside extracts having up to 300 times the sweetness of sugar, stevia has garnered attention with the rise in demand for low-carbohydrate, low-sugar food alternatives. Because stevia has a negligible effect on blood glucose, it is attractive as a natural sweetener to people on carbohydrate-controlled diets. 

In all, what we DO know is that eating real food is a better way to lose weight.  Whole foods, such as whole grains and breads, tend to fill you up more and lengthen the amount of time before you feel hungry again.  Diet products almost always tend to leave you wanting more, and if you want more, you will take more, because after all, it’s meant for people who are dieting!  So remember: just because a certain food is marketed as a “diet” product doesn’t mean it will help you lose weight. If anything, the complete opposite might be true.  

The bottom line: consuming wholesome, healthy foods as opposed to those containing artificial sweeteners will more likely keep you thin, help you avoid heart disease and will “add hours to your day, days to your year and years to your life.”   

Alan Freishtat is an A.C.E. CERTIFIED PERSONAL TRAINER and a LIFESTYLE FITNESS COACH with over 15 years of professional experience. He is the co-director of the Jerusalem-based weight loss and stress reduction center Lose It! along with Linda Holtz M.Sc. and is available for private consultations, assessments and personalized workout programs. Alan also lectures and gives seminars and workshops. He can be reached at 02-651-8502 or 050-555-7175, or by email at alan@loseit.co.il 

Check out the Lose It! website at www.loseit.co.il. US Line: 516-568-5027

Someone recently asked me if it is really so terrible to be overweight.  This person mentioned her grandmother, who live to age 91 and was always pudgy.  And so I got to thinking about her question.  And the bottom line is that it is hard to argue with statistics all of which indicate that for the general population, being overweight diminishes your quality of life and even shortens your life.  There are people who live long who are overweight, but how is the quality of their life? 

Being overweight is known to cause heart disease, various cancers, digestive problems, fatty liver disease, type 2 diabetes, high cholesterol, sleep apnea, and osteoarthritis.  It also shortens your lifespan. So, maybe you happened to be one of those handful of lucky people who have great genes.  Well, even that will only get you so far, because when it comes to sleep apnea and osteoarthritis, that won’t help you too much. 

We live in a prosperous society.  Even during the recent financial crises, nobody had to wait in line to receive handouts of bread as in the great depression.  Food abounds everywhere and fast foods are relatively cheap and quick.  There is hardly an establishment today that doesn’t deliver and burger places and pizza shops are on every corner, or at least relatively close by.  And for a working person, taking out is easier than cooking.  And most of all, we have lost our awareness of true hunger and of what feeling full is.  Even those that try to eat healthy food, tend to eat too much of it.  In the United States alone, Americans pay 400 billion dollars a year just on cardiac related illness and the costs of health care are soaring.  

What is normal weight?  This is not as easy a question as it seems.  Most people measure weight by a number on a scale.  And you can certainly access normal weight charts online.  The most common and easiest way to ascertain normal weight today is the Body Mass Index, or BMI.  BMI is determined by calculating the individual’s body weight divided by the square of his or her height using meters for height and kilograms for weight. Using a BMI chart simplifies this process.  A reading of 18-24 indicates that your weight should not affect your health.  In addition, your percentage of body fat plays a key role in assessing a healthful weight.  The best way to determine your body fat is to have measurements taken of skin folds at certain locations on your body.  This should be done by a professional with experience.  

There will always be people who can “get away with being overweight.”  But as we get older and carry around weight that our body is not really built to be lugging around, we WILL begin to experience soreness in the knees, ankles and lower back.  Summer weather will cause us to feel several degrees warmer than others.  So even if you are fortunate enough to have those protective genes against the numerous ailments caused by overweight, somehow you will still feel these effects. 

Keeping a normal weight, within the realm of good and nutritious eating and exercise, is integral to your health and quality of life.  It is another way to “add hours to your day, days to your year, and years to your life.” 

Alan Freishtat is an A.C.E. CERTIFIED PERSONAL TRAINER and a LIFESTYLE FITNESS COACH with over 14 years of professional experience. He is the co-director of the Jerusalem-based weight loss and stress reduction center Lose It! along with Linda Holtz M.Sc. and is available for private consultations, assessments and personalized workout programs. Alan also lectures and gives seminars and workshops. He can be reached at 02-651-8502 or 050-555-7175, or by email at alan@loseit.co.il 

Check out the Lose It! website at www.loseit.co.il. US Line: 516-568-5027

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Chaim is 46 years old and goes to see his doctor for his yearly physical examination.  After checking him thoroughly and doing standard blood work, we find that Chaim has blood pressure of 144/92 and his cholesterol, particularly his LDL (the bad stuff) is borderline high.  The physician prescribes drugs to lower his blood pressure and begins 10mg of a statin drug to control his cholesterol levels, thus dealing with two risk factors for heart disease and stroke through drug intervention.  But this is far from the full picture.   

We have all heard about the risk factors for heart disease and coronary artery disease.  There are about 20 together, and we can certainly control most of them (although some are beyond our control).  Every hour of every day, we are all aging; we can’t turn back the chronological clock or change our family history. And if we were born with a low birth weight, there isn’t much we can do about that either. We can do something about most risk factors, and not necessarily with drug intervention. Case in point: a smoker can stop smoking. But there are many misconceptions when it comes to risk factors, and often, those things that really matter the most are not necessarily diagnosed through a blood test. Consequently, the underlying issue is that we have don’t always have accurate information as to what those risk factors actually are.   

Dr. Michael Mogodam of the George Washington University School of Medicine and Associate Professor of Medicine at Georgetown University Medical School has studied the effects of the different risk factors extensively.  Let’s look at his top four risk factors. 

• Number One – the first and foremost risk factor – is diabetes.  Twenty-two million Americans have diabetes and another 20 million have insulin resistance and pre-diabetes.  Aside from the many other complications of diabetes, we know that 80% of diabetics will eventually die of cardiovascular complications.  Yet, this is a risk factor that can be prevented, dealt with, and even reversed.  By eating properly (you should see a registered dietician and learn what constitutes proper eating for a diabetic), eating small amounts more often and beginning a formal and balanced exercise program, you can, in the majority of cases, control your diabetes.  You may need medication as well until you can gain control.  Staying generally active in addition to your planned exercise is also important.

• Risk factor number two is being obese – particularly abdominal obesity.  The Body Mass Index (BMI) is the most widely used gauge for measuring obesity.  A reading of 30 or above would indicate obesity.  Because the BMI has some inaccuracies built into it, a better way to determine your risk, is to measure your waist-to-hip ratio as abdominal obesity is more of a risk factor than overall weight.  Take your waist circumference and divide it by your hip circumference.  Look for a reading less than 0.9 for men and 0.75 for ladies.  Higher readings would indicate heart risk. 

But remember… There are tangible steps you can take to reverse this situation. Including 5 serving of vegetables, 3 servings of fruit per day and exercising 30 minutes per day would be a great way to get started in reducing your weight. Cut your overall calories but don’t eliminate entire food groups.  Include monounsaturated fats in your diet such as nut and olive oil.  Proceed slowly and methodically with your weight loss, as rapid weight loss will almost always result in a rapid return of the weight.  

• Risk factor number three is leading a sedentary lifestyle.  Our lives are different today than they were 40 and 50 years ago.  The workplace is now a sedentary setting in which most of us sit by a computer all day, we use cars or public transportation to get places, and elevators transport us between floors of apartment buildings or office buildings.  According to the Center for Disease Control and Prevention, sedentary life style accounts for more than 250,000 deaths annually – more that the total deaths from colon, breast, and prostate cancers combined.  One 8-year study of 3,120 healthy women showed that being physically fit had an age-adjusted 900% advantage in the death rate from cardiovascular disease than sedentary women.  The nurses’ study showed that those who engaged in moderate exercise had a 54% lower combined risk of heart attack and stroke.  No one has to be sedentary.  Start with some simple walking and build up from there

• Risk factor number four is simply the diet – what we eat.  Food need not be the enemy.  And we don’t have to entirely eliminate foods we like.  However, we know that including an abundance of fruits and vegetables and using whole grains will help keep all the western diseases away and will add years to your life.  Typical western diets have too many trans fats and saturated fats, lack vitamin D, don’t include enough sources of Omega 3 and have inadequate fiber and healthy fats.  And we certainly have the power to change what we eat and how much we eat.  Keeping the daily caloric intake to the amounts we need for maintaining a normal and healthy weight is also essential. 

So there you have the first four risk factors.*  Remember Chaim and his high cholesterol and high blood pressure?  They are in the top 20, but not the top four.  Physicians are great at prescribing medication for these conditions, but are they prescribing active living and exercise, normal, healthy eating and even stress management?  Most likely, if you get serious and do the work to mitigate risk factors 1-4, you will end up solving most of the other ones, too. Taking positive steps to reduce the risk factors for heart disease (and other risk factors as well) is an excellent way to “add hours to your day, days to your year and years to your life.”   
 

* If you would like to learn more about these risk factors, email me at alan@loseit.co.il and I will gladly send you the complete list.   
 
ALAN FREISHTAT is an A.C.E. CERTIFIED PERSONAL TRAINER and a LIFESTYLE FITNESS COACH with over 15 years of professional experience. He is the Co-Director of the Jerusalem-based weight loss and stress management center Lose It! along with Linda Holtz M.Sc. and is available for private consultations, assessments and personalized workout programs. Alan also lectures and gives seminars and workshops. He can be reached at 02-651-8502 or 050-555-7175, or by email at alan@loseit.co.il. You can also visit the Lose It Website at www.loseit.co.il

U.S. Line 516-568-5027

The two most common excuses people give for not exercising and taking care of their general health are lack of time, and finances. In previous articles, I have addressed the time issue, but I would like to add the following: If you don’t make the time to exercise, you won’t have much time to do anything. Eventually, as we age and don’t make the time to compensate for its effects, we end up with one or more debilitating condition. But what is just as shocking is how much it actually costs us to be out of shape and in an unhealthy state. Many people say they just can’t afford to go to an exercise specialist, or they can’t afford the health club and gym fees. But let’s look at the alternative.

We all have heard about the cost of obesity in and of itself.  Medical bills are quite a bit higher.  But researchers at George Washington University took the expense equation a step higher.  They added in things such as employee sick days, lost productivity, even the need for extra gasoline – and calculated that the annual cost of being obese is $4,879 for a woman and $2,646 for a man.  Now, if you are only overweight, the cost is less — $524 for women and $432 for men.  And why the difference between the genders? Studies suggest larger women earn less than skinnier women, while wages don’t differ when men pack on the pounds – a big surprise, said study co-author and health policy professor Christine Ferguson.

Obesity is linked to earlier death. While that’s not something people usually consider a pocketbook issue, the report did factor in the economic value of lost life. That brought women’s annual obesity costs up to $8,365, and men’s to $6,518.

In addition to the direct costs of being overweight and obese, let’s look at a person with heart disease. Cardiovascular disease is the leading cause of death, and multiple medications are often needed to control symptoms and risk factors. In a recent study following 104 people with ischemic heart disease, average monthly costs were $104.77 for cardiac medications and $115.54 for non-cardiac medications, for a total of $220.31. In addition, the cost of heart disease and stroke in the United States was $368 billion in 2004, including health care expenditures and lost productivity from disability and death. 

If you are an employer, you may want to insist that your employees exercise. In 1995, Nicolaas Pronk, director of HealthPartners’ Center for Health Promotion, surveyed nearly 6,000 HealthPartners members over age 40 about their lifestyle and health status, and then looked at 18 months’ worth of their medical claims. In a report based on that data, published in the Journal of the American Medical Association (JAMA), he compared people with poor habits to those with healthy ones and found that:

• Those who engaged in some kind of physical activity at least once a week cost the company 4.7% less than those who are sedentary.
• Smokers cost the company 18% more than nonsmokers.
• Each unit increase in body mass index (a measure of body fat) raised costs by 1.9%.

Those who suffered from the chronic illnesses that are often the result of unhealthy lifestyles – particularly diabetes and heart disease – were the costliest of all. Diabetics cost 137% more than non-diabetics, and those with heart disease cost 150% more than those without, the study found. 

Obesity and sedentary lifestyle are escalating global epidemics that warrant increased attention by physicians and other health care professionals. These intricately-linked conditions are responsible for an enormous burden of chronic disease, impaired physical function and quality of life, at least 300,000 premature deaths, and at least $90 billion in direct health care costs annually in the United States alone. Couple all this with the rising premiums for solid, comprehensive health insurance and it becomes obvious that it pays to work out and be healthy.

Now, back to obesity.  At a time when we are all trying to figure out how to lower our transportation costs, higher now because of the high cost of oil and gasoline, a different study calculated that nearly 1 billion additional gallons of gasoline are used every year because of increases in car passengers’ weight since 1960.  You can do the math of 1,000,000,000 times the price per gallon or liter of gas. 

Yes – it CAN be costly to take on a trainer, join a health club or enroll in the Lose It! program, but it’s definitely money well spent. Investing in staying in shape and improving your overall lifestyle habits may, in the long run, be less costly to your health AND to your wallet. 

EXERCISE, EAT RIGHT and LOWER YOUR STRESS! It will “add hours to your day, days to your year and years to your life.”   

Alan Freishtat is an A.C.E. CERTIFIED PERSONAL TRAINER and a LIFESTYLE FITNESS COACH with over 15 years of professional experience. He is the co-director of the Jerusalem-based weight loss and stress reduction center Lose It! along with Linda Holtz M.Sc. and is available for private consultations, assessments and personalized workout programs. Alan also lectures and gives seminars and workshops. He can be reached at 02-651-8502 or 050-555-7175, or by email at alan@loseit.co.il 

Check out the Lose It! website at www.loseit.co.il. US Line: 516-568-5027

Long life, Arichus Yomim, has been said as a bracha (blessing) from one Jew to another for thousands of years.  We also say L’chaim!, to Life!, as a blessing to each other as we take a drink.  Two blessings we give, but very different in their ramifications. 

According the the Harvard School of Public Health, beginning in the year 2012, 10,000 people a day will start turning 65.We are aging differently than previous generations, however. Physically and mentally, the health of today’s 70-year-old now equals that of a 65-yearold in the 1970s. In that period, deaths from heart disease and many cancers have dipped. And while most older adults have at least one chronic health problem, disability has slowly and significantly declined.  It is interesting to note, that the United States has been slipping in its longevity ratings compared to other countries. Israel, on the other hand has been climbing. 

When the numbers are added up more carefully, though, there are obvious differences between men and women and people of different races. A newborn boy born in 2004 or after can expect to live a bit more than 75 years, while his sister can expect to live to slightly more than 80.  As you grow older, your average life expectancy stretches. For example, while the life expectancy of a newborn in the United States is nearly 78, a 65-year-old can expect to live 19 years longer, and a 75-year-old for another 12 years.  What is just as important as Long Life, is the L’chaim part of it—living life and how to maintain not only longevity but quality of life until 120. 

Why did life expectancy increase so much in the 20th century in developed nations? Whether individuals develop a particular disease is usually determined by three things: their lifestyle (including diet and exercise), their environment (such as exposure to infectious microbes or toxins), and their genes. Increased life span surely has nothing to do with genes: our genes today are the same as they were a century ago. Instead, changes in lifestyle and environment are responsible. Changes in the environment—such as better sanitation, the use of antibiotics, and many other improvements in medical care—can claim much of the credit. As for lifestyle, in developed nations, nutritional deficiency diseases largely were eliminated in the last century. Still, not all nutritional changes have been entirely for the better. In the United States, at the turn of the 20th century, most Americans lived on farms or in rural communities. We ate fresh, unprocessed food every day, and we worked hard physically. Today, our diets are less healthful in many ways, and we exercise less.  And that leads us to the second blessing—L’chaim!

The doctors can definitely help us live longer with all of the great advancement in medical care and medicines that we have today.  But there is so much that we can do that will extend and enhance our lives.  And we all understand the value of every second of life.  So it is incumbent upon us to take our wellbeing into our own hands.  The Be’er HaGolah at the very end of Choshen Mishpat tells us there is not bigger Hefkerus than not taking care of one’s self and the Rambam in Hilchos Daos 4:1, 14 writes very clearly: “Because for the body to be healthy and wholesome is among the ways of Hashem… therefore a person must distance himself from those things that cause his body damage… And they stated another rule relating to the health of the body: As long as a person engages in physical activity (= exercise) and works hard… no illness will attack him and his strength will increase.”

So what are some practical measures we can take to both extend life and be able to server the Ribono Shel Olam well during that time?  Again, Harvard Medical School gives us some practical tipsto do to the best of our ability:

1. Don’t smoke.

2. Include  physical and mental activities into daily life.

3. Eat a healthy diet rich in whole grains, vegetables, and fruits, and substitute healthier monounsaturated and polyunsaturated fats for unhealthy saturated fats and trans fats.

4. Take a daily multivitamin, and be sure to get enough calcium and vitamin D.

5. Maintain a healthy weight and body shape.

6. Challenge your mind.

7. Build a strong social network.

8. Protect your sight, hearing, and general health by following preventive care guidelines.

9. Floss, brush, and see a dentist regularly. Poor oral health may have many repercussions, including poor nutrition, unnecessary pain, and possibly even a higher risk of heart disease and stroke.

10. Discuss with your doctor whether you need any medication—perhaps to control high blood pressure, treat osteoporosis, or lower cholesterol—to help you stay healthy. 

Most of your health and longevity is in your hands.  Hashem has given us all the tools at our disposal in order to maintain health.  Let’s use them.  Be active, exercise, eat right, stay positive, manage and reduce stress. Following these tips can “add hours to your day, days to your year and years to your life.” 

ALAN FREISHTAT is an A.C.E. CERTIFIED PERSONAL TRAINER and a LIFESTYLE FITNESS COACH with over 15 years of professional experience. He is the Co-Director of the Jerusalem-based weight loss and stress management center Lose It! along with Linda Holtz M.Sc. and is available for private consultations, assessments and personalized workout programs. Alan also lectures and gives seminars and workshops. He can be reached at 02-651-8502 or 050-555-7175, or by email at alan@loseit.co.il. You can also visit the Lose It Website at www.loseit.co.il

U.S. Line 516-568-5027

(Last week, we explored our poor eating habits and the some of the options available to us for improving our diets and our overall health. That discussion continues.)

Last, but certainly far from least on the list of foods to avoid is trans fats.  I don’t know if anything man-made, as opposed to grown or raised, truly constitutes food to begin with.  If you are my age or older, you certainly remember when the “health experts” declared margarine to be far more healthy than butter.  Even as early as the 1950s, when we didn’t understand as we do today the ways in which cholesterol is absorbed, the margarine manufacturers figured out that they could market their product as healthy. Well, here we are 60 years later and we know that trans fats such as margarine, hydrogenated oil and shortenings for deep frying are twice as bad for you as saturated fats.  And 0% trans fats listed on a label or no trans fats doesn’t mean NO TRANS FATS. Check the label; if you see the word “hydrogenated” in the ingredients, put it back.   

It is important to remember that the more processed a food, the less nutritious it is for you.  Preserving a food’s shelf life is more important to the manufacturer than making sure you are healthy.  Try whenever possible to stick with a plant-based diet, unprocessed foods and when given a choice, always go for what is better for you.  It is important to look at what NOT to eat as well as what we

NEED to eat.  Now the question becomes which types of food to eat, and how much.

We can break down our foods into 3 main categories: Carbohydrates, Proteins and Fats.    The latest general recommendation (a good Registered Dietician can figure your exactly what you need) are for 45% -65% of the daily food intake to be carbohydrates (that includes whole grains, vegetables and fruits), 10%-35% protein (preferably plant based, fish, or skinned fowl) and 20%-35% fats – mostly monounsaturated.  What is just as important in order to maintain a healthy weight while at the same time getting your basic nutrition, is to know how much food to consume on a daily basis. To make this determination, it is necessary to calculate your resting metabolic rate and then factor in the amount of exercise and activity you do daily.  A sedentary person is not able to consume as many calories daily as an active person who exercises.  Again, a qualified Nutritionist or Registered Dietician can assist you in these calculations. 

Food is needed to sustain life. We can take pleasure in eating, and eating meals together as a family is a positive experience, especially in today’s hectic world.  It can be one of the key ingredients in leading a healthy and high-quality life into old age, as eating a balanced diet rich in fruits, vegetables and whole grains can extend your years. Consuming the right foods in the proper amounts is another way to “add hours to your day, days to your year and years to your life.”  

ALAN FREISHTAT is an A.C.E. CERTIFIED PERSONAL TRAINER and a LIFESTYLE FITNESS COACH with over 15 years of professional experience. He is the Co-Director of the Jerusalem-based weight loss and stress management center Lose It! along with Linda Holtz M.Sc. and is available for private consultations, assessments and personalized workout programs. Alan also lectures and gives seminars and workshops. He can be reached at 02-651-8502 or 050-555-7175, or by email at alan@loseit.co.il. You can also visit the Lose It Website at www.loseit.co.il U.S. Line 516-568-5027

As we age, getting out there for that basketball game, jog or tennis game can begin to take its toll on our joints.  Minimally, our joints may feel a little bit achy, but if you have real pain, swelling and/or limited movement lasting for more than two weeks, you may very well have arthritis.

There are two main forms of arthritis – osteoarthritis and rheumatoid arthritis.  Rheumatoid arthritis, the second most common form, is an autoimmune disease. The most common form of arthritis, and the form that commonly affects active and athletic people, is osteoarthritis.

A normal joint is enclosed in what is known as the joint capsule.  An inner lining, called the synovial membrane, releases synovial fluid into the space between the bones.  The ends of the bones are covered with cartilage, which acts as a shock absorber.  However, in a joint with osteoarthritis, this cartilage breaks down, causing the bones to rub together.  If the bone ends begin to thicken, painful growths known as spurs will form.

Although not a fatal disease, osteoarthritis is not curable.  Pain and stiffness can persist for long periods of time, which can make simple activities such as walking, getting up and down from a chair, or lifting and carrying, very difficult to accomplish.

Therapy for arthritis has four major goals: 1) easing pain; 2) decreasing inflammation; 3) improving function and 4) lessening joint damage.  Treatment includes medication, exercise, rest, use of cold and heat, joint protection, and on occasion, surgery such as knee or hip replacement.  The American College of Rheumatology states that treatment should include the following:

Lifestyle Changes:  Exercises to strengthen muscles, weight loss to take stress off joints, and the use of assistive devices like canes where needed 

Pain Management:  Physical therapy, drugs and surgery for more severe pain

Patient Education:  Informing patients about the disease, providing tools to help overcome pain, and helping them adjust to their situation

Although rest remains important during flare-ups, inactivity can lead to weak muscles, stiff joints and reduced range of motion. Numerous studies have concluded that regular exercise, including stretching, aerobic and resistance training, are all effective in improving the fitness of patients with osteoarthritis or rheumatoid arthritis. The potential benefits include improving joint function and range of motion, mood elevation, increased muscular strength, and aerobic fitness to enhance the activities of daily living. (ADLs).

Experts recommend a comprehensive exercise program to improve joint range of motion and flexibility, muscular strength and endurance, and aerobic endurance. As exercises should be tailored to the patient’s specific needs, a supervised program is recommended. For people experiencing arthritis, maintaining a balanced exercise program can “add hours to your day, days to your year and years to your life.”

Alan Freishtat is an A.C.E. CERTIFIED PERSONAL TRAINER and a LIFESTYLE FITNESS COACH with over 12 years of professional experience. He is the co-director of the Jerusalem-based weight loss and stress reduction center Lose It! along with Linda Holtz M.Sc. and is available for private consultations, assessments and personalized workout programs. Alan also lectures and gives seminars and workshops. He can be reached at 02-651-8502 or 050-555-7175, or by email at alan@loseit.co.il  Check out the Lose It! web site – www.loseit.co.il

US Line 516-568-5027

In last week’s column, we defined metabolism, discussed the benefits of raising one’s resting metabolic rate and highlighted the ways in which having a higher muscle mass boosts metabolism. Below are some tips which can help us achieve that goal, and increase our overall health and well-being.

Tips for Raising Your Metabolism

1. Build lean body mass. As mentioned in last week’s column, metabolism slows as we age, by as much as 2% a year! But there is something you can do to counterbalance nature. “Muscle is the single most important predictor of how well you metabolize your food, how well you burn calories and burn body fat,” insists Shari Lieberman, author of Dare to Lose. Strength training with dumbbells or resistance bands at least twice a week is essential to boosting your metabolism. Repeat – essential. And here’s the really good news: Your metabolism stays pumped for many hours after you finish your workout.

2. Get moving. You’ve heard it before, but here’s a reminder. At least 30 to 60 minutes of walking, jogging, cycling, swimming or some other form of aerobic exercise, a minimum of three times a week, is the other half of the exercise equation. “People don’t like to hear it, but you have got to exercise,” says Lieberman.

3. Eat. It may sound crazy to those trying to lose weight by severely restricting their daily caloric intake, but the problem with this old school of thought, explains Michigan dietician Julie Beyer, is that it actually slows metabolism. “Every cell of the body is like a flashlight bulb,” she explains. “When our bodies don’t get enough food, or fuel, every cell burns less brightly.” Recent studies indicate that eating smaller meals every three to four hours aids metabolism and weight loss.

4. Cut down on sugar. Of course, you still have to make good choices about what you eat. “When you eat sugar, you throw your metabolic switch into fat storage mode,” says Lieberman, who suggests a predominately low glycemic index diet, meaning foods that, unlike sugars, are broken down gradually to help maintain an even blood-sugar level.  Remember that whole grain foods are broken down slowly compared to refined grains.

5. Don’t skip breakfast. It’s a fact that people who eat a healthy breakfast are skinnier than people who don’t. And try to think outside the cereal box. A breakfast bowl of vegetables and brown rice is a great way to kick-start your metabolism for the day.

6. Include hot foods. If Mexican and Thai are favorites, you’re in luck. “Spicy food that has hot peppers in it appears to boost metabolism,” Lieberman says. 
 
7. Drink green tea. “There are unhealthy things that can boost your metabolism, like a really strong cup of coffee, or nicotine, but I would never say ‘Go have a cigarette!’” says Michelle Streif, a personal trainer in Nebraska. Don’t overdo it on caffeine, which also has undesirable side effects. Instead, go for green tea, says Lieberman, which is known to stimulate metabolism longer and more effectively than coffee.

8. Don’t forget H2O. Staying well hydrated is essential to flushing the body of toxic byproducts that are released when fat is burned. Cold water may be best since it gives your metabolism at least a small boost because energy is required to heat the body.

9. Reduce stress. At all costs. “Stress can actually cause weight gain, particularly around the tummy,” says Lieberman. Why? Because physical and emotional stress activates the release of cortisol, a steroid that slows metabolism.

10. Sleep. Research shows that people who don’t sleep for seven to eight hours a night are more prone to weight gain. Additionally, we now know that lean muscle is regenerated in the final couple of hours of sleep each night, says Beyer – which takes you right back to tip number one!

Measuring Metabolism

One of the most accurate ways to measure metabolism is through indirect calorimetry. This is where a person fasts for 12 hours and then enters a metabolic chamber. The amount of oxygen consumed by a person is measured and that tells us how many calories are burned.  Obviously, this is not a very practical option for most people.  An easier, although less accurate way, is to find a metabolic calculator on the Internet and plug in your height, weight and activity levels.  It will calculate the number of calories you need to consume per day to sustain your present weight. 

The Weight Loss Factor

Many people have come to me over the years, particularly people over the age of 40, who are already exercising and eating less, but they just can’t lose weight and reach their desired goals.  In almost each case, I have found three factors that stand out from amongst the rest.  First, in almost every case, there is not enough exercise time spent on resistance training, either with weights or bands.  Second – and this is primarily true of middle-aged women, they are trying to lose weight by consuming too few calories.  Besides slowing down their metabolism, it also prevents them from meeting their daily nutrition requirements.  And third is the sleep factor. Lack of sleep can also activate the hormone cortisol, which both slows your metabolism and can cause you to reach for sugary and fatty foods, defeating the whole purpose of the weight loss goal. 

Incorporate as many of the above tips as possible into your daily habits, and you’ll begin to see changes – some subtle and some more pronounced – almost immediately. Remember: keeping your resting metabolic rate high is another way to “add hours to your day, days to your year and years to your life.”

ALAN FREISHTAT is an A.C.E. CERTIFIED PERSONAL TRAINER and a LIFESTYLE FITNESS COACH with over 15 years of professional experience. He is the Co-Director of the Jerusalem-based weight loss and stress management center Lose It! along with Linda Holtz M.Sc. and is available for private consultations, assessments and personalized workout programs. Alan also lectures and gives seminars and workshops. He can be reached at 02-651-8502 or 050-555-7175, or by email at alan@loseit.co.il. You can also visit the Lose It Website at www.loseit.co.il

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I’m sure that you’ve probably been to a wedding or Bar Mitzvah and stood at the reception with your mouth wide open in amazement and watched as someone who is as skinny as a beanpole downs three pieces of cake.  You say to yourself, “If I did that, my clothes wouldn’t fit anymore.”  What’s the difference between that person and yourself?  It’s your metabolism.

The word metabolism is used quite frequently, but what does it mean and how does it affect us?   According to the standard definition, metabolism is the chemical processes occurring within a living cell or organism that are necessary for the maintenance of life. Some substances are broken down to yield energy for vital processes while other substances, necessary for life, are synthesized.  Essentially, metabolism is an all-encompassing word that relates to the breakdown of food and its transformation into energy.  In practical terms, the rate at which we are processing our energy source (food) has a great effect on our body mass, and how we look and feel.   

Although we all know that exercise, particularly aerobic exercise, uses calories and helps us to lose weight, it is less well known that certain types of exercises can, over the long term, raise our metabolism and help us keep our caloric burn a little higher all the time, even while at rest.  The way that we measure energy consumption is through the unit of measure called calories.  One calorie represents the amount of heat required to raise the temperature of one gram of water one degree Celsius. 

Your Resting Metabolic Rate 

Everyone is born with a rate of metabolism.  This is known as the resting metabolic rate (RMR) or basal metabolic rate (BMR).  Your resting metabolic rate (RMR) is the minimum number of calories your body needs to support its basic physiological functions, including breathing, circulating blood and all of the numerous biochemical reactions required to keep you alive. Your RMR is generally 60-70% of your total daily caloric expenditure.  Additionally, a second component of energy expenditure is called TEF, or the thermic effect of food. When you have a meal or snack, calories are needed to digest and store the nutrients. This accounts for up to 10% of caloric expenditure.  According to Eric Poehlman, a Professor of Medicine with the University of Vermont, these are the calories used above your resting metabolic rate due to meal ingestion.  He terms the RMR as the calories burned to maintain life.  The rest of your calories are burned off with activity and exercise.

The average person is burning about one calorie per minute at rest.  Needless to say, this varies greatly amongst people, depending upon size and build.  However, imagine adding 0.2 calories per minute to your resting metabolic rate.  That could increase the amount of calories you burn by approximately 288 more per day.  That is slightly more than 2,000 per week.  At 8,000 calories per month, you will be losing an extra kilo (2.2 pounds) per month, or 12 kilo per year (26.5 pounds).  Keep in mind that this is all at rest.  Let’s see how we can accomplish this feat.   
 
 

The Muscle Factor

Muscle tissue has a high-energy requirement to sustain itself.  Therefore, the more muscle you can build, the higher your RMR will stay.  The average person begins losing about 1% of their muscle mass per year in their early 30’s, so as we age, our RMR gets slower and slower – that is, unless you are working in manual labor or doing resistance training exercise.  Since today, only a very small percentage of jobs in the western world are in manual labor, the only practical way to fight this trend is through muscle-building exercise.  Exercise physiologist Rich Weil with the Van Italie Center for Weight Management at St. Luke’s-Roosevelt Hospital in New York explains metabolism this way: “Let’s say you have a little Toyota and a large Cadillac idling in the driveway. When you put your foot down and rev the engine, the big Cadillac burns more gasoline because it has a bigger engine.”  And so it is with our muscles.  The bigger our muscles are, the more energy they burn.  That in turn can, over time, raise your metabolism.

There are other forms of exercise that do indeed boost your metabolism.  For instance, an intense aerobic session, like running, biking or swimming, will also boost your metabolism; however, usually within an hour of your workout, your metabolic state returns to its previous rate.  Cardiovascular exercise is important for weight loss because of the amount of calories you use during the session, and is therefore an important ingredient in weight loss. However, it will not raise your RMR for more than a short time.   When you build muscle, even though it is a long-term process, as long as you keep your muscle mass at a larger level, the RMR stays higher, even when you are sleeping, resting, sitting at work, or driving your car. 

In addition to raising your metabolism, keep in mind that being stronger and more functional is also very important. Stay tuned for next week’s column, which will focus on ways to raise your metabolism. In the meantime, remember that maintaining a high resting metabolic rate high is another way to “add hours to your day, days to your year and years to your life.” 

ALAN FREISHTAT is an A.C.E. CERTIFIED PERSONAL TRAINER and a LIFESTYLE FITNESS COACH with over 15 years of professional experience. He is the Co-Director of the Jerusalem-based weight loss and stress management center Lose It! along with Linda Holtz M.Sc. and is available for private consultations, assessments and personalized workout programs. Alan also lectures and gives seminars and workshops. He can be reached at 02-651-8502 or 050-555-7175, or by email at alan@loseit.co.il. You can also visit the Lose It Website at www.loseit.co.il

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