Dr. Kracker

Although three recent newspaper articles (two in the Wall Street Journal and one in the New York Times) cited the link between exercise and long-term health, none of them included diet in the equation, which seemed a huge omission to me. What and how much we eat, along with how physically active we are, are the variables that determine our body weight and mass index. As our knowledge and understanding of what optimum health is increases, it becomes more and more evident it is that diet should always be part of the discussion.

In “Hidden Benefits of Exercise” (online WSJ, 1/5/2010), Laura Landro begins with the lesser-documented benefits of exercise. “Regular workouts may help fight off colds and flu, reduce the risk of certain cancers and chronic diseases and slow the process of aging,” she writes, and, “Medical experts say inactivity poses as great a health risk as smoking, contributing to heart disease, diabetes, hypertension, cancer, depression, arthritis and osteoporosis.” Landro quotes physicians who have some strong beliefs about the link between well-being and regular exercise: “No pill or nutritional supplement has the power of near-daily moderate activity in lowering the number of sick days people take.” (Dr. David Nieman) “We need to refocus the national message on physical activity, which can have a bigger impact on health than losing weight … If there were a drug with the same benefits as exercise, it would instantly be the standard of care.” (Dr. Sollis) The emphasis is on physical activity instead of weight loss, but weight loss, if it is needed, will almost automatically follow from increased activity. And the activity level recommended can be “as simple as a brisk 30- to 45-minute walk five times a week.”

Landro’s article suggests exercise and activity are especially meaningful for women, and can reduce the risks of some cancers. Multiple studies, when taken together, link activity levels to the immune system. Exercise lowers estrogen levels, and lower estrogen results in lower incidences of cancers.

Then there are the anti aging effects for both sexes: “The study concluded that physical activity has an anti-aging effect at the cellular level, suggesting exercise could prevent aging of the cardiovascular system.” The benefits of a youthful heart pay large dividends for us both emotionally and physically, in terms of our outlook on life and ability to get up and go!

This same week, New York Times ran an article that looked at weight and overall health. (”Can You Be Overweight and Still Be Healthy?” by Gretchen Reynolds). While most of us would like to believe that good health is still possible in spite of the few extra pounds we might have put on over the years, the evidence is to the contrary. The studies, which focused primarily on men, concluded that “although being fat and having healthy blood work puts you at less risk of cardiac disease than someone who is thin and has lousy metabolic parameters, the extra pounds still leave you with at least a 50 percent greater risk of developing heart disease.” Professional football players are a good example of the combination of bulk and brawn. Although we may think their great conditioning protects them from the excess pounds that are their power and strength, research shows the metabolic dangers this elite group suffers for their chosen career.

Women do not fare much better, according to another study. “Women with a higher B.M.I. (body mass index), even if they were active, had an elevated risk of coronary heart disease compared with women engaging in an equal amount of activity who were normal weight. Being fit, for the thousands of women under consideration here, lessened but did not fully mitigate the health problems associated with being fat.” Reynolds goes on to explore the complex relationship between fitness and extra pounds. “Being overweight, even if you have sterling blood-cholesterol levels or a firm commitment to exercise, does increase your risk of heart disease, and you should probably try to lose the extra pounds.” Here the message has changed from the above: exercise and activity are not enough; maintaining ideal weight must be part of the plan. It’s easy to think that if one’s exercise level is above average, the other markers (like blood cholesterol or high blood sugar levels) will be balanced out and care of. We pick and choose the info we hear or ignore, but we do so at our own risk.

The second WSJ article on the subject (”Why You Should Step Up Your Workout” by Kevin Helliker), describes the work of Doctor Paul Williams. An avid runner, Dr. Williams used a Runner’s World magazine subscription list to create a database of 55,000 runners (which by now has grown to over 100,000). His research is easy to sum up: the key is “more.” “An early study … found that male distance runners gained weight with age unless they added mileage. Two others, one published in the New England Journal of Medicine in 1996, found that risk factors for coronary heart disease steadily improved with greater doses of exercise, up to 50 miles per week. Too few runners surpassed that number to determine whether such improvements would have continued, says Dr. Williams.”

Wow! This is an awfully intimidating message for sedentary people who’ve been thinking of starting an exercise program. And it’s precisely for this reason that other doctors and cardiologists resist including Dr. Williams and his work as part of the public health plan. The Helliker article mentions the “fragile motivation to exercise” that may characterize the mindset of those wanting to transition from sedentary to active. At some point most of us would say “enough is enough, already!” and give up on the idea of improving our lives with exercise if it seems impossible to ever be successful.

But what was missing from all of these examples was the idea of combining a better diet with increased physical activity. From the articles and information reviewed in past newsletters, we know that diet, especially the plant strong diet, can reverse weight gain and rejuvenate the heart muscles. (And by the way, Dr. Williams’ research also reaffirms the strong link between exercise and reducing the risks of stroke, heart attack, glaucoma, diabetes: “There is no gene or drug discovery that comes close.”)

Ideally, when the topic is optimum health, exercise and diet should be discussed together — and by “diet” I mean more than reducing the number of calories consumed in an average day. It is the quality of the natural nutrients and fiber contained in the food we eat that matter as much, if not more, than how many calories per serving. What real benefit is there in a long work out followed by greasy pizza and chocolate chip cookies?

In past newsletters, we’ve looked at taking control of what we eat by cooking more and eating out less. Cooking requires more time, it’s true. (Maybe we can cook and exercise at the same time? Watch for the next self-help video series: “Vigorous Cooking!”) I don’t have the answer to finding more time in busy lives, but I do count myself as blessed: the flexibility of my profession, my interest in cooking and food and my enjoyment of exercise and physical activity help me make time for all of the above. That is to say, because all are a source of enjoyment, I find the time. And the solution could be as simple as planning and scheduling — cook on the days that you don’t exercise! I know I simplify dinner if I am returning late from a long bike ride. And maybe the key here is to find those activities that are truly fun even if they can’t be measured in miles per week. Dancing, gardening and plain walking are not competitive, powerful cardio activities, but they do burn calories, stretch muscles and foster the sense of well being. And when we combine these activities with a good diet that regenerates the coronary system, the youthful heart is not so difficult to find.

It’s strange to read articles that recommend either diet or exercise, as if the two were mutually exclusive. Some doctors may be reluctant to recommend exercise if they think their patients will begin too exuberantly and create more damage than good. And in the case of diet, too few doctors have studied nutrition; they may hesitate to go beyond their sphere of expertise, feeling that diet is more a question of public health than their specific discipline. In this light, Dr. Caldwell Esselstyn’s (a phyician I’ve cited in previous newsletters) move from heart surgeon to nutritional enthusiastic is even more admirable. Dr. Esselsyn’s son, Rip, has followed the nutritional path and written Engine 2 Diet, and he is a spokesperson for Whole Foods Market’s plant strong dietary initiative as well as being an accomplished triathlete.

The articles in the WSJ and NYT will not move many people from the couch to the bike spin class at the gym. And they shouldn’t. Abrupt changes can result in injuries or worse and permanently damage that “fragile motivation.” However, the spark of knowledge, awareness, and self reflection may motivate more walking, gardening, dance classes and fun. All are purposeful first steps. They may also lead to more cooking and to a less meat-heavy diet. Small changes prepare the mind and body for more momentous things.

Two Heroes of the Month for this shortest month of the year! The first is a friend I caught up with in January who told me that he’d joined Alcoholics Anonymous. In his words: “I didn’t have a drinking problem; I had a behavioral problem.” Hats off to him and all who find the strength to initiate change!

The second is nutritional yeast (not to be confused with brewer’s yeast). This super food is a phenomenal source of the B-Vitamin complex. It has a nutty, savory flavor reminiscent of rich chicken broth and adds a layer of complexity to sauces, soups, and dressings. Moreover, as a fermented food, it tickles the umami taste receptor. Our family uses it on salads and pasta as a great replacement for Parmesan cheese. And while I prefer my popcorn plain, the rest of the family insists on eating it with nutritional yeast — if you haven’t tried it yourself, get some now! (It’s available at most natural foods stores, usually sold in the bulk section.)