One of my favorite snacks - Veggie Booty - is being pulled from the shelves because of concerns about contamination. All lots and sizes of Veggie Booty are being recalled following a report of 51 cases of salmonella that may be associated with the product. Check out this link to read more about the recall.

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This post was actually in response to another question from David!

When you walk into a pharmacy or health food store, you are bombarded with bottles of vitamin supplements. How do you know which one is best for you?

Here are some tips to help you select a vitamin/mineral supplement:

1. First, keep in mind that food comes first and supplements are not a substitute for a poor diet. Our bodies need a balance of vitamins and minerals to function at an optimum level. Real food provides this balance, whereas supplements do not. So while it is not a bad idea to take a supplement, the major focus should be on making your diet as healthy as it can be. Real food also provides disease fighting phytochemicals - which are not found in supplements.

2. I would recommend that you buy a general multivitamin / mineral supplement that contains 100 % of the RDA (or 150% at the most) for vitamins and minerals. This is a better bet than buying individual vitamin or mineral supplements (unless you were prescribed the individual supplement by your doctor for a specific condition such as iron or Vit. B12 for anemia). A general supplement is adequate for most people - however some people may need an additional calcium supplements if they are not consuming 1200 mg of calcium from food. Some of my clients have 15 bottles of individual vitamins and minerals where they could most likely be better off  with a general multivitamin supplement along with a calcium supplement.

3. Avoid megadoses. Read the label and look for a supplement that has 100-150% of the RDA for vitamins and minerals. Some supplements contain megadoses (over 1000 times the RDA). More is not necessarily better. On the contrary, it can be harmful. Taking in too much of one vitamin or mineral can decrease the absorption of other vitamins or minerals. In addition, excess amounts of certain vitamins or minerals can actually create health problems.

4. There are no federal standards that tell exactly how supplements must be manufactured. Therefore I would recommend that you look for USP (United States Pharmacopeia) on the label. This ensures that the supplement meets standards for strength, purity, disintegration and dissolution.  So basically when you buy a product with USP on the label, you know you are getting a product that contains what it claims to contain and has met standards that prove it actually dissolves in your body.

5. Look for expiration dates. Vitamins can lose potency over time, especially when kept in a hot and humid climate.

6. Avoid paying extras for ingredients (i.e. bee pollen, echinacea, coenzyme Q 10, lecithin, PABA, bioflavanoids) that have not been proven to be essential for health. The same goes for added herbs, amino acids or enzymes.

7. Ignore marketing gimmicks. It does not matter whether Vitamin C is derived from organic rose hips or synthesized in a lab.  And unless you are allergic to wheat, rice or lactose, there is not need to buy allergen-free products.

8. “Natural” vitamins are not necessarily better than synthetic vitamins but they cost a lot more! Generally, synthetic vitamins are just as good as natural ones. The one exception could be Vitamin E. Natural Vitamin E (d-alpha tocopherol) appears to be slightly better retained and used by the body. As long as the E in your supplement is labeled as International Units (IU), you need not worry as any amount of IU of synthetic Vitamin E will be just as potent as natural Vitamin E.

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Question from David: Why do I get muscle cramps? Are they linked to a mineral deficiency?

Answer from Martha: Thanks for writing David! Another question from a guy. I should change the name of this blog to “City Guys” where are all the city girls?

Muscle cramps can be occur for several reasons, including:

1. Overexertion or working a muscle to the point of exhaustion can cause cramping.

2. Dehydration can be another cause. It is important to stay fully hydrated prior to, during and after exercise.

3. Electrolyte imbalances (especially sodium and potassium) can cause muscle cramping. Potassium and sodium help maintain fluid balance in the body. The electrical charges they carry help trigger muscles to contract and relax. A potassium-sodium imbalance can lead to muscle cramps.

a. Your best bet against muscle cramps is to consume potassium rich foods including oranges and orange juice, bananas, dried fruit, legumes, milk, yogurt, potatoes, tomatoes, spinach, etc.

b. It is also important to consume adequate sodium in  your diet. Salt your food and consume salty foods such as pickles,pretzels, soup, baked chips, etc. Of course, you may need to limit your sodium somewhat if you have high blood pressure.

c. Consume a sports beverage that contains sodium and potassium when exercising, especially in the heat.

4. Although not as common, a calcium deficiency may be blamed for muscle cramping. Increase your calcium intake or take a calcium supplement to see if the cramps disappear.

5. If all else fails, make an appointment with a physical therapist to see if there is a biomechanical cause of your muscle cramps.

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Do you find yourself in and out of the gym everyday, same routine, same treadmill, and no results? This is a common problem and while the gym is a great place to remain healthy there are ways through nutrition and modifying our routine to make us see a few more results and get us more excited about working out.

Exercising does not give you the green light to gorge!
First off, many of us go to the gym to lose weight, but still aren’t seeing the scale drop. The bottom line is…. in order to lose weight we must burn more calories than we take in - it’s as simple as that! Going to the gym does not enable us to gorge on sweets, and high fat foods just because “we worked out today.” We need to be smart about how we work out, and what we put in our bodies before and after our workouts. I have seen many a client grab an extra cookie or two thinking they were entitled just because they went to the gym. Not to depress you, but have you ever noticed how many calories you burn off in your workout? Maybe 300? 400? And this is assuming the calorie counters on the machines are correct - many seem to overestimate your caloric burn in my opinion. In order to burn off one pound of fat, you will need a deficit of 3500 calories. That is a lot of exercise. Check out my calorie calculator on this blog to see how many calories you burn in your workout.

Fuel  your workouts
Prior to: In order to last throughout a long workout (over an hour) it essential that we stay hydrated and eat a balanced snack before. High intensity workouts over an hour will require a snack with carbohydrates in order to keep us going, but we don’t want to eat high calorie snacks that we won’t be able to burn off. Snacks such 1 or 2 rice cakes, or a piece of fruit or some low fat yogurt might be a good option 30 minutes before getting to the gym. This will give some energy to burn and will last us for a while. I think you will find you have better energy levels for your workout and will be able to push yourself more if you have a light snack before working out. This is especially true if you exercise after work and have not eaten anything since lunch. The amount of carbs you will eat prior to your workout will really depend upon your body size and the type of workout you will be doing. If you plan on going for a 50 mile bike ride, you will obviously need to eat more than if you are going to do a 4 mile run.

During: If you are exercising over 60- 90 minutes, it is recommended that you consume some carbohydrate during your workout session. This will give your blood sugar a boost and provide energy for you to keep up the pace. It is recommended you aim for 30 - 60 grams of carbs per hour. If you are running, you might want to try a powergel type of supplement. It contains 26 grams of carbs per pack. You can “eat” it during your long run. If you are biking, you could try an energy bar high in carbs (or a gel) such as a Cliff or Power Bar. Again, check the label for carb content. Another option would be to drink ~ 16 oz of a sports drink like Gatorade. This will provide 30 grams of carbs. You will need to experiment to see which option works best for you.

Staying hydrated is key!
Being hydrated is essential for making sure we are able to last through a workout. Proper hydration is key to muscle functioning and a dehydrated athlete can reduce performance by up to 3%. Thirst is not a good measure of hydration; because once you are thirsty you are already dehydrated. Keeping hydrated will make you less likely to suffer that afternoon slump, and will give you a better chance of making it the gym post your 9-5 job. When you are working out, consistently sip on your water bottle and finish a 20 oz water bottle within an hour.

There are sometimes questions regarding whether water or a sports drink is best. Sports drinks can be high in calories and sugar, which are unnecessary if you are not working out very hard or for less than an hour. Sports drinks are appropriate when you are sweating a lot and working out for long periods of time  (an hour or longer). The carbohydrates in sports drinks will keep you going for long periods of time. The sports drink will also replenish the electrolytes you lose when you sweat. However, if you are not sweating for long periods of time, then a carbohydrate containing sports drink will just add excess calories. If just working out for a small amount of time, a reduced calorie (less than 10 calories per serving) sports drink or regular water will keep you properly hydrated without adding extra calories.

Here are some tips for fluid replacement:

1. Drink 17 oz (2+ Cups) of fluid 2 hours before exercise.

2. Drink approximately 3 - 6 oz every 10 -15 minutes during exercise.

3. Keep drinks cooler than air temperature & close at hand (a water bottle is ideal).

4. If you exercise for more than 60 minutes or exercise less than 60 minutes very intensely (i.e. interval training or hill repeats), you may benefit from a sports drink containing carbohydrate (not greater than 8% concentration, though). Gatorade is an example (Look for ~ 60 calories per 8 oz and you will know you have the concentration right!)

5. To determine the concentration of carbohydrate in your favorite sports drink, divide the number of grams of carbohydrate in an 8 oz serving by 240 and multiply by 100. For example, fruit juice is not a drink to consume while exercising as the concentration of carbohydrate is too high. This will actually draw water into stomach and can cause cramping. In addition, it makes it more difficult for the exercising muscles to get the fluid they need.

Refueling after workouts
Lastly, after your workout it is important to refuel your body with the proper nutrients. After a long run, or an intense spin class your muscles will need all of a nice balance of carbs, fat, and protein to help them recover. It is essential to consume this meal / snack within one hour of exercise for the body to utilize it most efficiently. Our bodies are in need of these nutrients and will use them to replete glycogen stores (these are energy stores that will help you in your next workout) and to rebuild / repair muscle breakdown that occurs during a workout.  Some great ideas for post workout meals include lean protein like turkey, chicken, cottage cheese, egg whites along with some complex carbs like whole wheat pasta, whole grain bread, sweet potato or fruit. These foods are loaded with vitamins and minerals which will fuel your body to get stronger and will speed up recovery time without having consumed high fat, low nutrient dense foods.

So the next time you are feeling in a slump about your gym routine, remember that little changes make a big difference! So grab a bottle of water, have a smart snack, and this time add some speed and 5 more extra minutes to your routine, and perhaps in no time at all those skinny jeans will be all you will want to wear.

Information for this article was contributed by
Erin Merrit,
Dietetic Intern at New York Presbyterian Hospital in NYC

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The Enviromental Working Group (EWG), a not-for-profit consumer activist organization, evaluated government data on 43 fruits and veggies to assess pesticide residues. The EWG estimates that you can cut your pesticide exposure risk by as much as 90% if you concentrate your organic dollars on the most contaminated products. Check out their  website for full details on the ranking system.

Here are the Top 12 Contaminated Fruits and Veggies:

peaches
apples
sweet bell peppers
celery
nectarines
strawberries
cherries
pears
grapes
lettuce
potatoes

Here are the 12 Least Contaminated Fruits and Veggies:

onions
avocados
sweet corn (frozen)
pineapples
mangoes
asparagus
sweet peas
kiwifruit
bananas
cabbage
broccoli
papaya

Whether you choose to purchase organic foods or not, it is recommended that you follow the following tips to reduce your risk of contamination:

1. Always wash your hands before and after handling raw products

2. Rinse produce thoroughly under running water

3. Do not place any produce near uncooked meat, fish or poultry

4. Remove the outer leaves of lettuce or greens

5. Consider cutting up your own fruits and vegetables instead of buying them already cut

Taken from Enviromental Nutrition Newsletter, June 07

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One my new favorite books is Mindless Eating by Brian Wansick, PHD. He is a researcher who has made it his mission to understand why people eat (and overeat!). His book is full of interesting and entertaining research regarding human behavior associated with eating.

Here is one of his more amusing experiments on regarding guys, food and what they perceive as “manly” eating behavior.

Dr. Wansick wrote out 2 identical scripts on a hypothetical movie - dinner date with “Brad and Barb”. The scripts described the date in detail including the movie and dinner (and supposedly other juicy details which were not revealed in the book). The 2 scripts only differed in one area - one script described Brad as eating his own large order of popcorn at the movies and the other script described him as having a “few handfuls” of Barb’s popcorn. Otherwise the scripts were identical.

These scripts were given to college guys to read and then answer a questionnaire. Here is the amusing part. The guys perceived Brad who ate the large serving of popcorn to be more manly, assertive, studly and aggressive and able to bench press 20% more than the Brad who just ate a few handfuls of popcorn. The women who were presented with the 2 scripts did not report any difference between the 2 Brads.

In Dr. Wansick’s words “There are a lot of things men do to try and impress women. Eating a whole bucket of popcorn is not one of them”. So the next time your date has his hands wrapped around a jumbo bacon cheeseburger with fries or orders a large popcorn with butter tell him it is not a turn-on!

Is this how all men think - or just college age guys??

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I belong to a public speaking group toastmasters. It is a great program that helps you improve your public speaking. Here is one of the speeches I did at toastmaster’s on insomnia: (the sound quality is not that great… do I really sound like that?)

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You may have seen the Alli brochures on display at your local pharmacy. Alli is the newest diet pill on the market and the first FDA approved over the counter diet pill. There is a major difference between this pill and the hundreds of other diet pills out there alli does not promote itself as a magic bullet, but rather as an adjunct to a healthy diet and exercise regimen. It even has you take a quiz before buying the pills to make sure you are ready to make lifestyle changes that are recommended. After you purchase alli, you are entitiled to sign up for free online nutritional counseling. It also comes with a starter pack that provides diet and exercise guidelines.

How does alli work?
It is taken with a meal and blocks 25% of the fat calories consumed from the meal. The clinical trials on alli showed that the people using alli lost an additional 2-3 pounds for every 5 pounds lost through diet and exercise. So what this means is that you can lose about 50% more weight by taking alli along with a low fat reduced calorie diet than by dieting alone.

The down side…
About ½ of the people in the clinical trials taking alli experienced gastrointestinal side effects including anal leakage, gas and oily discharges. Basically, the more fat you eat, the more side effects you will experience. These side effects will be lessened if you stick to the low fat diet plan.

Restrictions
Alli is not intended for anyone under the age of 18  or people with certain medical conditions or on certain medications. Check with your doctor prior to taking it.

My thoughts on alli:
1. Overall, I am not a huge fan of diet pills as I believe that many people who use then are looking for a crutch and do not put in the hard work that is needed to lose weight and keep it off. There are no magic pills for weight loss. Bottom line, you will need to learn how to change your eating and exercise habits.

2. However, as far as pills go, I like that fact that alli does not promote rapid weight loss, and stresses the importance of eating healthy and exercising. It also provides guidance on making behavior changes. It may provide an adjunct to losing weight for those people who feel they need an extra “edge” and are willing to be very compliant with the low fat diet.

3. If you already follow a low fat diet, this pill will likely not help you as it only blocks some calorie from  fat, not from protein or carbs.

4. The unpleasant potentially embarrassing side effects may be too much for some people. You may want to avoid those white pants until you test it out!

5. If you decide to take alli, I would recommend that you also take a multivitamin with mineral supplement.

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Who wakes up feeling refreshed and energized on a daily basis? Who experiences some trouble sleeping several nights a week? I do! (I am the insomnia queen). If so, you are not alone. A study done by the National Sleep Foundation reported that only about 50% of adults say they get a good night’s sleep almost every night. Women report even more trouble sleeping. A recent poll done by the National Sleep Foundation reported nearly 70% of women have trouble sleeping on some nights of the week. 29% of the women surveyed reported taking a sleep aide at least a few nights a week. 

I have had “sleep issues” for as long as I can remember. I starting taking Nyquil to help me sleep in my 20’s. It then progressed to Unisom. That stopped working after a while. I tried natural alternatives like accupuncture (along with sleep herbs), melatonin, valerian, meditation nothing worked. I then got a prescription for ambien from my doctor. Worked great for a while - then stopped (actually causes me to sleep great for 2 hours but then I feel WIDE awake after 2 hours so sleep is impossible). I am now seeing a sleep specialist at Columbia Presbyterian Hospital Sleep Disorder Center (more about this in another post!).

So why do we have so much trouble sleeping? Look at our lifestyles. We work put in long hours at work, get home late, watch tv, get on the computer late at night and then expect to fall asleep. We are wired! And other culprits include caffeine, nicotine, alcohol, eating late at night and stress.

There are numerous consequences to inadequate sleep, including:
 Impaired memory and thought processes. The National Sleep Foundation Study found that over 25% of working adults said they had missed work, events and activities, or made errors at work because of sleep-related issues in the previous three months. I know that I personally have made mistakes at work and sometimes have trouble remembering the simplest things.
 Depression
 Decreased immune system response

These sleep deficits can lead to poor work performance, driving accidents, relationship problems, and mood problems like anger and depression. In addition, health problems like increased risk of diabetes, heart disease and obesity have been linked to inadequate sleep. Also, when you do not sleep well, your motivation to eat healthy, exercise or even have sex goes down.

How much sleep do you need?
It really depends upon the person, however sleep experts say that most people need between 7-8 hours to feel refreshed and alert. This can vary as some people function fine on less and others need more. 1 in 6 people polled in the survey reported sleeping less than 6 hours a night.

What can you do about inadequate sleep?
Most people can improve their sleep by making some lifestyle changes.  Here are 10 tips to improve your sleep:

1. Keep a regular sleep schedule. This will help to keep your biological clock steady.
2. Develop a soothing sleep ritual prior to going to bed. Avoid any activities that stimulate your mind such as watching tv or getting on the computer.
3. Limit caffeine and nicotine. These are stimulants that can remain in the body for up to 12 hours. I would recommend stopping caffeine intake by 3 pm.
4. Limit alcohol. While alcohol may initially cause you to feel sleepy, it can cause you to wake up in the middle of the night.
5. Avoid taking naps during the day.
6. Limit the time you spend in bed. If you can not fall asleep after 15 minutes, get up and do something else like reading.
7. Associate your bed only with sleep and sex. Avoid watching tv or doing other activities on in bed.
8. Exercise to relieve stress, but avoid heavy exercise for several hours prior to bedtime.
9. Avoid eating heavy meals or drinking large amounts of fluid prior to going to bed. This can cause you to feel uncomfortable or make you have to get up to urinate.
10. Create a pleasant sleep environment. Cool temperature work best. Get a white noise  machine if you have noisy neighbors, etc.

If you are still having trouble sleeping despite trying these tips, you will need to consider your emotional state. Are you feeling very stressed out or depressed? If so, you may benefit from meeting with a therapist. Other options would be to meet with a sleep behaviorist who can help you to change your negative thoughts and expectations that may worsen your insomnia. Lastly, there are medications that can help you sleep. Some of them are short term while others can be used on a more long term basis - under the care of a doctor.

Bottom line, insomnia is a common and annoying condition that  potentially serious consequences.  It is important to know that it can be treated. You do not have to live feeling chronically exhausted - there are effective treatments to improve the quality of life for anyone who has a sleeping disorder

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Question from Bob: If diet soda has no calories, why is it bad to drink it?

Answer from Martha: Glad to see that guys are also reading this blog! You have posted a great question that my clients frequently ask me.

 Here are some of my thoughts on diet soda:

1. I would not tell you that you have to totally avoid diet soda. My concern is for people who are drinking several a day - and drinking little or no water. In general, we drink too much soda and too little water. In 2005, Americans consumed 2 1/2 servings a day of soda (regular and diet). Regular soda contains approximately 9 teaspoons of sugar. While diet soda obviously does not contain sugar,  it contains other ingredients including artificial sweeteners, sodium, phosphoric acid and other preservatives.

2.  While artificial sweeteners have been approved as safe for human consumption by the FDA, many health experts still recommend consuming them in moderation.  While the majority of people consume these ingredients without any problems, a small percentage of people have reported symptoms when consuming these sweeteners, especially aspartame. I think the key word is moderation. I personally consume artificial sweeteners - but try to limit my servings to about 2 a day. This is just my opinion because as I said previously, they are approved as safe by the FDA.

3. Some studies  have suggested that artificial sweeteners may actually contribute towards weight gain. The suggested mechanism for this is that the body may learn to predict caloric intake by the taste and texture of certain foods. When artificial sweeteners are consumed, our body sends the appropriate sweet signals to the brain but never receives the sugary calories (as would be predicted by the sugary taste of the diet soda). So the body then sends out signal increasing the appetite in search of higher caloric foods. However, this theory is not agreed on by all health experts.

4. Have you ever poured soda on a car (probably not!) ? When I was a child, this was a common prank from kids in my neighborhood. The soda actually erodes the enamel on the car. While I do not recommend you pour soda on your car to test this theory out, here is another experiment to try.  Put a nail in a glass of soda and in a few hours, the soda will erode the nail. Think what it is doing to your gastro-intestinal tract. Personally for me, soda is the worst culprit in terms of bringing on pain from my reflux.

6.  Lastly, dentists are concerned about the acid in regular or diet soda wearing away at the enamel of your teeth.

Bottom line, an occasional diet soda is fine, but make water your beverage of choice.

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