Tuesday, December 4, 2007

Blog 020 - telling stories

Medicine is supposed to be a “scientific” endeavor, and it mostly is. But practicing medicine means also being a bit of a philosopher, a friend, a parent, an advocate, a teacher, a student, and, most important, a listener.

Telling stories is how we humans bond with one another and understand the world around us. Stories reach us in a way that other forms of communication cannot. Stories can teach us, inspire us, and either strengthen our convictions or invite us to reconsider our beliefs.

Somewhere in my medical training and practice I learned that if I listened to the stories that patients told me long enough, they would tell me what was wrong with them, and what to do about it.

I believe in the power of telling stories, and the power of listening to them.

This week on Fitness Rocks I interviewed a remarkable woman. She tells a wonderful story of strength and courage and determination to change a set of bad lifestyle habits into good ones.

Listen to what she has to say. I know you’ll find something in it that will touch you, and maybe even change you, no matter who you are, or whom you think you are.

For all of us our life is our story. We can write it better if we listen to the one’s that other people are telling.

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Monte Ladner

Monday, November 12, 2007

Blog 019 - should I weigh myself?

A lot of people send me e-mails asking about the importance of weighing regularly as part of a fitness program. They often ask “As long as I’m fit, isn’t it OK to be overweight?” Here is my typical answer:

Weight does matter, so don't completely ignore it. It does seem true that one can be "Fit and Fat" as Dr. Steven Blair has said many times in his research articles on fitness.

If you’re overweight and trying to lose weight my advice has always been to focus first on the basics of a healthy lifestyle - healthy eating with an emphasis on fruits, vegetables, whole grains, nuts, beans, healthy fats from olive oil, canola oil, and fish, and combine this with a regular exercise program. If you do these things really well, I believe that your weight will find its way to exactly where it should be. Remember, a big part of healthy eating is to avoid consuming excess calories.

Good health is a multifaceted phenomenon – and everything matters. Luckily, the formula for success is pretty simple, at least in concept – eat right, exercise, maintain a healthy weight, don’t smoke, don’t drink excessively, and manage stress as best as you can.

These days we have a lot of good evidence that chronic stress is an important area to pay attention to as part of an overall fitness program. Chronic stress has a negative impact on our physiology and increases the risk for chronic disease.

We talked about Transcendental Meditation for stress relief in podcast 071. There appears to be good medical evidence that a regular meditation practice can help to lower blood pressure and even improve insulin resistance.

If you need to lose weight then it is a good idea to step on the scale at least once a week to monitor your progress, and to catch any slips in the wrong direction. But don't focus only on your weight. Yes, an optimal weight with a BMI under 25 has consistently been associated with reduced risks of chronic disease. But, fitness is about more than just weight.


Monte
www.fitnessrocks.org

Tuesday, October 30, 2007

Blog 018 - a wake up call

I came across an article in the associated press today about how so many young people are taking medication to lower cholesterol and blood pressure. There has been a 68% increase in the number of people between the ages 0f 20 - 44 taking drugs to lower their cholesterol over the past 6 years.

Astonishing.

I made a video blog in which I discuss the article. Send me your comments.

Monte
www.fitnessrocks.org





video

Monday, October 22, 2007

Blog 017 - thinking

The first really chilly fall weather blew through our coastal New England town a few days ago. It was a good chill, the kind that makes me feel giddy and full of energy. I had an irresistible urge to pull on a sweater and go for a walk outside, and maybe afterwards have a cup of coffee and a conversation at the kitchen table.

I followed Old Dock Road to the harbor where a few boats are still waiting for one last chance to go out into the bay before being pulled out of the water for dry storage until next summer. Ducks were paddling around in the water and seagulls were waddling around on the boat ramp. It isn’t much of a ramp, just a narrow concrete driveway that slopes down into the water. On either side of the boat ramp there is wet, squishy sand where trailers get stuck if their wheels veer off the side.

Scallops were dangerously exposed on the muddy banks of the harbor because of the low tide. Seagulls love scallops.

I’ve seen the occasional seagull eat a scallop before, but this evening there were lots of seagulls eating scallops – it was a feast in progress.

Before a seagull can eat a scallop it has to open the shell, and that is what makes watching the whole thing so fascinating. It would seem that the only way a seagull could eat a scallop is if it happened to come across one that had already been opened by another animal with nimble fingers and maybe a pocketknife. But they don’t need any help at all. They have figured out a way to open the scallops all by themselves.

The birds have recognized the difference between the hardness of the concrete boat ramp and the squishy sand on either side of it. The first time I saw a seagull drop a scallop on the boat ramp I thought it was just a quirky chance event. After all, it’s just a dumb seagull, how could it know that a boat ramp would be a better place to drop a scallop than the squishy sand?

But, this evening the seagulls were dropping scallops on the boat ramp over and over until finally the shells popped open and the birds could get at the prize inside. They never dropped a scallop on the squishy sand.

The seagulls have figured out how to use the concrete to their advantage. A real biologist would probably have a different explanation for this behavior, but to me it is clear that they are thinking at a level that is higher than what I had given them credit for being able to do.

Seagulls were flying in over the water clutching a scallop in their beaks. As they approached the boat ramp they would swoop up high and circle around making sure there were no other birds nearby that could steal their cargo and then with laser guided precision they would drop the scallop on the concrete and chase it down to the ground to see if it had cracked. They repeated this process as long as it took.

Amazing.

We humans live in our artificial world and scarcely even acknowledge the millions of other creatures with whom we are sharing this planet and this life. It is to their detriment that we behave so arrogantly, and to ours as well.

If a seagull can figure out how to open a scallop what else might it be thinking about? Do seagulls feel giddy and full of energy on brisk fall days, like me? Because we can’t speak to them we assume they have nothing to say, and no stake in the future of this planet.

Turn off the television that is streaming nonstop garbage into your brain and go outside for a walk. If you look around you will almost certainly be amazed at what you see.

It’ll make you think.

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Monte Ladner
www.fitnessrocks.org



video

Wednesday, October 10, 2007

Blog 016 - an inflammatory response

In medical school a professor once told me that I would forget half of what I was being taught, and the other half would ultimately be discovered to be untrue. It was a bleak and discouraging perspective. Hopefully, it was an exaggeration.

But, since I started medical school in 1981 there have been some big changes in the way we think about a lot of important issues. One of these is heart disease.

Back in the day, we believed that coronary heart disease was a consequence of eating too much cholesterol with all of the excess cholesterol being deposited onto or into the inner lining of the arteries to our heart. The metaphor often used to describe the process was “corrosion accumulating inside a pipe.” It was an overly simplistic point-of-view that led to the “obvious” mechanical solution of coronary artery bypass surgery – “putting in new plumbing” as a heart surgeon once joked to me and my peers while on rounds one day.

Coronary artery bypass surgery has extended the lives of many patients, but bypassing the clogged blood vessels does absolutely nothing to change the underlying disease process that got the patient into trouble in the first place.

We used to think that a heart attack was a consequence of a coronary artery getting progressively more narrow because of cholesterol accumulating in the artery wall until it was finally swollen shut, thereby obstructing blood flow to the heart muscle. Now we think that a non-obstructing plaque inside the lining of a coronary artery breaks open and causes a blood clot to form inside the coronary artery, thus acutely obstructing blood flow and causing a heart attack.

We are beginning to recognize that our fundamental understanding of what causes coronary artery disease was not exactly right. It is more complicated than corroding pipes and globs of fat accumulating inside blood vessels. Now we are talking about “oxidative stress” and “chronic systemic inflammation” as the underlying causes of heart disease.

The phenomenon of oxidative stress and chronic systemic inflammation are consequences of our modern, unhealthy lifestyle. And, these phenomena cause more than just heart disease. It’s beginning to look like oxidative stress and chronic systemic inflammation play a role in most of the chronic diseases that afflict us today.

Here’s the good news – oxidative stress and chronic systemic inflammation can be largely prevented or reversed with a healthy lifestyle.

I’m not even going to pretend that I understand the nuances of oxidative stress and chronic systemic inflammation. The more I read about them, the more confused I become. But, I am fascinated by the cellular biology involved. Over the next few weeks on the Fitness Rocks Podcast I will be sharing my efforts to understand these complex processes that are at the origin of so much sickness.

While you’re waiting for me to get a handle on this stuff you should be eating your fruits and vegetables and exercising every day. And, if you smoke – quit.

Have a great workout.
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Monte Ladner, M.D.
www.fitnessrocks.org

Sunday, September 23, 2007

Blog 015 - sunsets

Over twenty-five years ago I was sitting in a lecture in medical school listening to a professor talking about something. I don't remember what the subject was. But, I’ll never forget that in the middle of the lecture he put up a slide of a fragile, yellow flower poking up from a city street. The brightly colored little flower was in stark contrast to its barren concrete surroundings.

The professor asked us to look at the picture and consider that there is beauty all around us in the world, even if sometimes we have to try hard to find it. He pointed to the flower and said "See, here through a crack in the asphalt in this urban jungle, a tiny flower struggles to press its face against the sun - beautiful!"

He was right. It's easy to forget these days that we live in such a wonderful world - there is so much ugliness and despair that one can become overwhelmed. Seeing the good things sometimes takes an effort.

I live 3 minutes from the ocean by bicycle. You might think that means I'm at the beach every day, but I'm not. I often find that I just “can't find the time.” This translates to “I don't always make the effort.”

When I’m feeling gloomy I find the time for a bike ride to the beach. I sit on the sand and listen to the sound of the waves; I watch the sea birds swooping and soaring over the water, and I marvel at how the setting sun paints the sky in brilliant red and orange hues.

It doesn’t make the troubles in my life or the world go away, but the experience helps to restore me. It gives me the strength and the will to go on trying. It reminds me of the eureka moment I had when a professor showed a picture of a simple yellow flower stretching its petals so hopefully toward the sky.

This weekend I thought I’d share my bike ride to the beach with you by capturing some of it with my video camera. I've posted a compressed file on this blog and at youtube. It’s also on the video page of the Fitness Rocks website. I'll be sending it out as a podcast later this week. Some of the detail was lost in compressing the file to upload it, but I think it’s still pretty. I call it "Sunsets." Send it to a friend who’s feeling down.

I hope it brightens your day.


Monte Ladner
www.fitnessrocks.org

video

Wednesday, September 19, 2007

Blog 014 - what's your HEART score?

On Saturday September 22, 2007 on Fitness Rocks Podcast 064 I will have an interview with medical researcher Dr. Arch Mainous from the Medical University of South Carolina. We will be discussing his work in developing the HEART score which is a simple scoring system designed to assess ten year risk of coronary heart disease based on self-reported data. I have reproduced the HEART score for men and women in this blog post so you can get your own score. This is not intended as medical diagnosis, advice, or treatment. Regardless of the results you get with this test, you should discuss them with your personal doctor.

HEART Score for women:

RISK FACTOR - POINTS
Age (years)
45 - 49 - 0
50 - 54 - 2
55 - 59 - 2
60 - 64 - 2
History of Hypertension - 2
History of High Cholesterol - 2
History of Diabetes - 4
Smoking Status
Never - 0
Former - 0
Current - 3
Body Mass Index
<30 - 0
>30 - 1

Estimated 10-year risk - Total Points
<10% - 0 - 6
10 - 20% - 7 - 9
>20% - 10 - 14


HEART Score for men:

RISK FACTOR - POINTS
Age (years)
45 - 49 - 0
50 - 54 - 0
55 - 59 - 2
60 - 64 - 2
Family History of Heart Disease - 2
History of Hypertension - 1
History of High Cholesterol - 2
History of Diabetes - 2
Smoking Status:
Never - 0
Former - 0
Current - 2
Physical Activity:
Often or very often - 0
Sometimes - 0
Seldom or never - 1

Estimated 10-year risk Total Points
<10% - 0 - 2
10 - 20% - 3 - 5
>20% - 6 - 12

MAKE SURE YOU DO THE HEART SCORE THAT IS CORRECT FOR YOUR GENDER.

Do not draw any conclusions about your individual risk of having a heart attack or developing heart disease from this score without first discussing the results with your personal doctor. I encourage you to print out this blog and take it to your next doctor's visit. Check out Fitness Rocks Podcast 064, Saturday, September 22, 2007 to listen to an interview with Dr. Mainous, the medical researcher who developed the HEART score.

An abstract of Dr. Mainous' article can be found by clicking this link to the American Jounal of Cardiology.

Monte Ladner, M.D.
www.fitnessrocks.org

Saturday, September 1, 2007

Blog 013 - the deadly burger

In 2007 the number of Americans who are obese kept going up, according to the Trust for America’s Health. I’m not surprised.

My oldest son graduated from college last May with a degree in Math – 3.87 GPA in the Dean’s Scholar Program at the University of Texas at Austin. He’s a really smart kid, and I’m very proud of that.

I bring up my son in this discussion of obesity because his next stop in life is culinary school at the prestigious Culinary Institute of America in Hyde Park, New York. He is not, by the way, overweight. My enthusiasm for fitness has been embraced by all of my kids. I’m very proud of that, too.

He spent this summer living at home with us and working as a chef at a local restaurant in our hometown on Cape Cod. He works a shift from around 2:00 PM until close to midnight five days a week. He is home during the day and he watches cooking shows on television. I normally never turn the television on, so this is a new thing for me to have this background noise. I don’t like it.

Yesterday, I was walking through the living room and stopped briefly to see what he was watching. A woman who I recognized as one of the more popular cooking stars was preparing something she called “Butter Burgers.” I felt compelled to watch.

Two beef patties with a huge dollop of butter mixed with herbs smeared between them, wrapped in bacon and then slathered in mayonnaise. The television audience was wild with enthusiasm for this lethal burger.

Every year Americans get fatter. Being obese is associated with significantly higher risks for all chronic diseases, including hypertension, type 2 diabetes, heart disease, and cancer. The Trust for America’s Health claims that in a public opinion survey 85% of Americans stated that they believed we do, in fact, have an epidemic of obesity. So, there is a real public health problem, and people apparently know about it.

But, you can still become rich and famous in America teaching people how to make Butter Burgers. What am I missing?

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Monte Ladner
www.fitnessrocks.org

Wednesday, August 22, 2007

Blog 012 - link to the department of family medicine at the medical university of south carolina

Here’s something pretty cool: Fitness Rocks has entered into a link partnership with the Department of Family Medicine at the Medical University of South Carolina (MUSC). Some of you may recall that recently I had a great interview with Dr. Dana King who is a Professor in the Department of Family Medicine at MUSC. Dr King and his colleagues are involved in a lot of current research on the relationship between lifestyle and the risk of chronic diseases. So, it’s a perfect relationship for Fitness Rocks.

Dr. King and the Department of Family Medicine at MUSC have offered to do at least six interviews with Fitness Rocks relating to their research over the next year.

The link to the MUSC website is on the Fitness Rocks Home Page and you can follow it to some really terrific health information. Be sure to check out the Health Assessment Tools link.

This is an incredible honor and opportunity for me and my little podcast, and a tremendous resource for you – the Fitness Rocks listeners.

So, take advantage of the good news here at Fitness Rocks World Headquarters.

Monte
www.fitnessrocks.org

Thursday, August 16, 2007

Blog 011 - falmouth road race

Summer vacation. Visiting friends and relatives. Falmouth Road race. These are my excuses for not writing more frequently.

The Falmouth Road Race was this past Sunday, August 12, 2007. It is a seven mile race along the roads of my town - Falmouth, Massachusetts on Cape Cod. The race route includes some of the most picturesque scenery in the country. There are quaint New England lighthouses, beaches, and views across Vineyard Sound toward Martha's Vineyard. Just running the race makes me happy that I live here.

This year my whole family entered the race - including my daughter who turned 15 the day after the race. It was her first race. Since I have been struggling with a stress fracture in my foot and wasn't able to run for most of the past year (I do a spinning bike for my aerobic exercise) I decided to run with her - to make sure she didn't get trampled.

At the last minute it occurred to me that I could carry my video camera with me during the race and capture it on video. So I did.

Editing the video was nauseating because of the erratic motion of the images filmed while I was running. I had to stop multiple times to recover from the headache and upset stomach caused by watching the bouncing video. But, I did it. And then I decided to post the video on YouTube!

You can watch the video by going to the Fitness Rocks website (www.fitnessrocks.org) and clicking on te video button. Or, you can click this direct link: Falmouth Road Race

Let me know what you think.

Monte
www.fitnessrocks.org

Sunday, August 5, 2007

Blog 010 - tomatoes

This is a story I wrote a couple of years ago and posted on a blog that nobody ever read. I decided to recycle the story after I discovered a rogue tomato plant growing where the tomato plant in this picture was two years ago. It came back to visit and remind me that every day we have a chance to examine our lives and start over.

Tomatoes will always remind me of a date I had in college. She was pretty and smart and it had taken months for me to get up the courage to ask her out. We were having dinner at a small cafĂ© popular with students. Conversation between us was going along swimmingly when our salads arrived. Perched on the top of my salad was a plump, ripe, shiny red cherry tomato. The tomato was so inviting that I was distracted from our dialogue and went straight for my fork, spearing the fruit and popping it into my mouth with great expectations for the savory experience to follow. Biting into the tomato caused an eruption of tangy juice and succulent seeds that squirted out of my mouth like a popping pimple and shot across the table onto my horrified date’s white button-down shirt.

I don’t know what became of that girl; oddly, she never returned my calls. Fortunately, this traumatic experience did not diminish my love for tomatoes. And that’s a good thing. Tomatoes, it turns out, are fabulously healthy to eat in a multiplicity of forms including cooked and fresh.

The American Institute of Cancer Research reports that diets with lots of tomatoes on a regular basis are associated with lower risks for developing prostate cancer, stomach cancer, and pancreatic cancer.

One of the nutrients in tomatoes that may account for their cancer-fighting strength is lycopene. Lycopene is a carotenoid compound. Other carotenoids in tomatoes include phytoene and phytofluene. Tomatoes also contain fiber – about 2.5 grams per medium tomato. They are rich in vitamin C, with a single medium tomato supply 66% of the recommended daily allowance. B-vitamins, potassium, and alpha- and beta- carotene are additional nutrients found in tomatoes that are health-promoting.

Cooked tomatoes are actually better than raw tomatoes. Cooking makes the nutrients, especially the lycopene, more available for absorption by your body. So here’s an irony – canned tomatoes, tomato sauce, and tomato paste seem to be great choices, evidently better than fresh. Although it’s probably a good idea to have fresh raw tomatoes several times a week as well. When selecting canned tomatoes read the label carefully – most are loaded with excess sodium. Buy low-sodium or no-sodium-added tomatoes.

A friend of mine recently told me that she had been advised not to eat tomatoes because they would worsen her osteoarthritis. Tomatoes are a member of the “nightshade” family of vegetables which includes potatoes and peppers as well. The idea that nightshade vegetables aggravate osteoarthritis is as unfounded as it is old. There is simply no evidence to support this assertion. Tomatoes won’t make your arthritis worse and they may well help prevent cancer – you should eat them.

Here’s another useful tip – you can’t get the good-for-you benefits of tomatoes in a pill, you have to eat them. Supplement manufacturers have already started marketing lycopene supplements. Lycopene is only one of the good things in tomatoes; there are many others, and it is this nature-perfect combination of nutrients in tomatoes that gives them their cancer fighting ability. Single nutrient supplements like beta-carotene, or vitamin E have been consistently shown to be unhelpful compared to eating the whole foods from which they come. Skip the pills and eat your tomatoes (along with your broccoli, spinach, beans, zucchini, blueberries, apples, etc.)

Finally, eat your tomatoes with your mouth firmly closed.

Wednesday, August 1, 2007

Blog 009 - careful what you say, or at least how you say it

This week I have been going to selected discussion panels at the Woods Hole Film Festival here in my little town on Cape Cod. It’s been a lot of fun, and another example of how cool it is to live where I do.

Woods Hole is an interesting place where world-renowned scientists do Nobel Prize winning research at the Marine Biological Laboratories and the Woods Hole Oceanographic Institute. The Film Festival is held every year in some of the old, historic buildings of Woods Hole. Woods Hole (part of my town of Falmouth) is a postcard-perfect New England coastal town with stunning views across Vineyard Sound toward Martha’s Vineyard. Martha’s Vineyard is where they made the movie JAWS.

People who are passionate about making films come here from all over the world to show their movies and to talk, excitedly, about their “next projects.” The very coolest part of the whole deal is that I live close enough that I can ride my bicycle to the festival on a bike path with no cars!

Anyway, today I was at my third discussion panel. There were only about ten or twelve people attending the panel. The moderator had us sit in a circle and have an open discussion. The discussion was about media literacy and how to interpret the new media and the role of the Internet in spreading ideas around the world. There were old guys, like me, and some young kids (eighteen years old and going to start film school in the fall).

I spoke more than I should have and shared some of my views on how I see the internet, podcasting, blogging, and video blogging evolving. At one point one of the young, refreshingly idealistic kids spoke about how the conference had really opened his eyes to the possibilities of using the Internet to find an audience for his future films. He was genuinely excited and optimistic about his future as a filmmaker.

Evidently, my responses to his comments were received by the group, and the young man, as harsh, cynical, and frustrated – basically too negative, too bitter. He had expressed his enthusiasm for the power of the Internet to spread his message. I had responded by saying that it could indeed, but the stories that had been shared by others during previous discussion panels were probably exaggerated, and that he would still need to expend a great deal of effort in marketing his films beyond simply posting a few clips on YouTube.

I also expressed my concern that as the “new media” gains a larger audience the business leaders of the “old-media” will be waiting to move in and capitalize on this new source of revenue – and they will have the money and the power to do it much more effectively than a guy like me. I argued that the romantic ideal of a level playing field where every individual can share the stage with media superpowers is probably destined to become little more than fantasy.

Okay, I was, without intending to be, a bitter, frustrated old man throwing cold water on the newfound passion of a young kid who’d found what he wanted to do with his life.

Shame on me!

But, the stories that others had told (in previous conferences) about posting clips of their movies and having “half-a-million downloads in one weekend” were equally destructive, in my mind, because they are stories that probably weren’t true or were misleading. My thinking was that the kid should be encouraged, but not led to believe that the Internet was going to make him famous overnight.

The bottom line, I think, is that my intention was good, but my delivery sucked!

I continue to run head on into the reality that words matter, and what we say to other people can be powerfully uplifting, or terribly defeating.

Hopefully, this kid will grow up to be the next superstar movie director and be able to tell his own kids how lucky it is that he didn’t listen to the angry old man at the Woods Hole Film Festival.

Be careful what you say – someone might be listening.


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Monte Ladner
www.fitnessrocks.org

Sunday, July 29, 2007

Blog 008 - how should we discuss obesity?

Dick Cavett wrote a scathing editorial on obesity that appears in the Sunday July 29th New York Times.

Here is a link: http://cavett.blogs.nytimes.com/2007/07/25/is-bigger-really-better/

I agree that something needs to be done to "shock" Americans out of their denial about the harsh consequences of the "poor lifestyle" epidemic (most visibly distinguished by the increasing size of people in our country).

However, I have to believe that the lashing out that Dick Cavett does in his article will only serve to stimulate indignation among obese people, and drive them to become even more entrenched in their denial of their poor lifestyle habits.

Furthermore, I fear that the food industry marketeers will capitalize on the words of people like Mr. Cavett and use their "unfair attacks on obese people" as a reason for obese people to "exercise their freedom to eat and behave as they choose - regardless of the consequences."

Obesity is a major public health issue and the discussion on what to do about it needs to be based less on emotion and more on cold, hard science. And the cold, hard science indicates that being obese is bad for your health - period.

Eating poorly, not exercising, and steadily gaining weight is bad for you as an individual, but also, because of escalating health care costs associated with obesity and poor lifestyle habits, it is bad for our country - very bad!

We should be very careful not to let this discussion degenerate into a "Fat versus Thin" debate with the food industry and their lobbyists acting as the cheerleaders.

I say let's keep the discussion grounded in the facts that are readily available, and keep our personal feelings of loathing or persecution to ourselves.

But, I could be wrong.

Let me know what you think.

Monte

Monday, July 23, 2007

Blog 007 - e-mail from Catherine

Listeners to the Fitness Rocks podcast send me some wonderful e-mails sharing their ideas and enthusiasm for living a fit lifestyle. Catherine sent in a list of tips for starting an exercise program that I would like to post in this blog so that others can benefit from her experience getting hooked on working out.

Thanks for your wonderful podcast!  It has helped me finally commit to an exercise routine after (literally) years of being sedentary.  I am a 44-year old mother of two, and am now running (jogging, really)approximately 20 miles each week.

I have some tips that I would love to pass on to your listeners:

*Find a good time to exercise. The time that works for me is 6:00 a.m. I feel like I have already accomplished something at 7:00 a.m.

*Find a good route, if you're running or walking. I find that following the same route every day allows me the psychological satisfaction of knowing how far I've gone and how close I am to home.

*Find a way to make the exercise enjoyable. I look forward to listening to my downloaded podcasts (especially yours!); I try to download podcasts that are approximately 45 minutes long so I don't have to stop my run to reset my ipod. I wish the word could get out about the wonderful variety of free podcasts available on the web.

*If you're walking or running, choose a route that gets you at your furthest point from home at the midpoint of your exercise session. That way, you can't "give up." Even if you walk slowly all the way home, you're still getting exercise.

*Spend some money on your exercise clothes as you begin your new exercise program. In my previous attempts to exercise, I threw on old t-shirts and was constantly trying to roll up the sleeves as I walked or ran. The stopping interrupted my momentum, and I also got very hot. I now have tank tops specifically designed for running, with mesh insets to allow air flow. I can't tell you how much more comfortable I am. I can go further!

*Finally, reward yourself when you're finished. I sit down, read the paper, and drink two large glasses of sugar-free iced tea.

I hope others might benefit from these tips.
Thanks from one in the exercise/fitness trenches--

Catherine
Great advice - and thanks to everybody who sends me e-mail.

Monte
www.fitnessrocks.org

Sunday, July 15, 2007

Blog 006 - new york city

The funny thing about vacations is how happy one is upon returning home. This immediately brings up the question “why did I want to go on vacation in the first place?”

I don’t mean to say that we didn’t have fun in New York – we did. We stayed with relatives who took us all over town. We visited the Metropolitan Museum of Art, the Museum of Natural History, Central Park, 5th Avenue (shopping), and we ate at fabulous restaurants.

My aunt has an apartment in the west village – very posh! We had a whole floor of their apartment to ourselves. There was a great gym just a few blocks away and a grocery store where I could buy fresh fruit. It was almost perfect.

But here’s the deal: first, New York City is a dirty place. I would guess that breathing there is just about as bad for one’s health as smoking – maybe worse. That is a problem that is tough to overlook for a guy who spends his time talking about fitness. I also found that I have become intolerant of unruly crowds of people swarming around me.

New York City is a showplace for what is great about our culture and what is dreadfully wrong with it. Art, architecture, academia, music, theatre, towering buildings that stand as monuments to American business success, it’s all in New York.

But New York is also a place where tourists step over homeless people sleeping against sparkling shops selling diamonds. The mentally ill roam the streets muttering to imaginary listeners and casting wild-eyed paranoid glances at random pedestrians. The smell of roasted nuts and hotdogs mixes with automobile exhaust and the putrid stench of trash. On a corner a hapless man with an infected foot oozing pus onto the sidewalk holds out his hand to the tinted window of a limousine, unable to see if the passenger inside even notices his suffering.

New York City is a conundrum. Should I just stay focused on all there is that is exciting and wonderful, or should I fret and wring my hands about the picture it paints of the growing gap between the very wealthy and the desperately poor in our country?

This morning I woke up in my quaint Cape Cod town. I walked my dog on the quiet street in front of my house while the sun was rising on another beautiful day at the beach. The air was clean and filled with the sounds of birdsong – no deafening roar of traffic here. Less than a three-minute bicycle ride away there were people boarding boats in the harbor anticipating a leisurely day sailing in the pristine water between the Cape and Martha’s Vineyard.

The busy streets of New York could easily be forgotten – but not the haunting image of the old man struggling to push a shopping cart missing one wheel along the uneven sidewalk, or the empty dark eyes of the woman begging for money on the subway platform.

New York City screams the question: “What is my obligation to my fellow human beings, and how do I fulfill it?”



Monte Ladner
www.fitnessrocks.org
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Sunday, July 8, 2007

Blog 005 - vacation fitness

I’ll be leaving for a week of vacation in New York City in a few days. I am looking forward to the museums, some concerts, and just walking around the city.

Of course, there is the downside of travel – staying with a fitness program. Finding a good place to workout and a way to eat healthy food when you’re stuck eating most meals in restaurants can be difficult. But, I have a pretty good system for this.

I’ve already located a gym near where I’m staying. There is a great little store just around the corner that is well-stocked with fresh fruit that I can eat for breakfast and lunch every day. So I’ve got a plan.

The trick to maintaining a fitness program is to make it a priority without making it an obstacle to having fun. Yes, it takes effort, and yes, in the past, I have let the anxiety over missing a workout get in the way of doing other things. I’m much better about that these days. I still workout while I travel, but I look at these workouts as “maintenance workouts” designed to be quick so that they don’t interfere with other plans.

I also look at the week of vacation as a time to “rest.” By rest I don’t mean “do nothing.” I mean ease up on the intensity. It turns out that this is a good thing to do now and then.

There is a line between fanaticism and healthy living – a line that is not always easy to see. Most people would label me a fanatic. I counter this allegation with something I read a long time ago about the amount of physical activity done by an average person living just 50 – 60 years ago in a less mechanized culture.

The article said that the more physically demanding lives of people just a few generations back was about like running a marathon (26.2 miles) every week, or 3.7 miles a day. Were they fanatics? No. They were doing what had to be done to survive, and it required physical activity.

We evolved over many millennia to eat a diet of whole foods and to move around – a lot. Today we are simply out of synch with our genes and the consequence is obesity and chronic disease. Our modern artificial environment does not require the same physically active life that our ancestors faced, even our fairly recent ancestors. This same modern environment confronts us with an abundance of unnaturally poor quality food that we find hard to resist.

To stay fit, therefore, requires that we add an additional layer of artificial living on top of our artificial world. That means we have to make time to run when there is nothing to chase after, and nothing chasing after us. We have to lift heavy objects overhead repeatedly, even though we ultimately intend to leave them on the ground. And we have to look for the quaint little stores that sell food that our ancestors would recognize as food.

I’m not a fanatic. I’m just trying to live the life we evolved to live.

Now, what book should I bring on the trip?

Monte
www.fitnessrocks.org
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Wednesday, July 4, 2007

Blog 004 - independence day

Today Americans will gather with friends and family to celebrate our nation’s independence. We will have picnics, go to the beach, barbecue, ponder what it means to be a member of a free society, give thanks to those who have served and sacrificed to protect that freedom – and, for tens of millions of Americans, it will be another day to swallow a handful of pills.

Pills to make their blood sugar go down, to make their blood pressure go down, to make their cholesterol go down, and, for a lot of men, pills to make things go up.

People who know they will have a hard time resisting all the food laid in front of them at parties will take pills to make them think they aren’t hungry, or they will succumb to the urge to eat more than they should, but first take a pill that prevents the absorption of the fat they eat – now available without a prescription.

Tonight, after a full day of care-free celebrating, eating too much, and drinking too much, the anxiety of another day back at the office will start to creep into our psyches making slumber seem impossible, and so many of us will pop a pill to fall asleep.

Medical studies assessing the health habits of Americans reveal that today, like all days, only about three percent of us will do all of the following four things to keep us healthy: Eat five or more fruits and vegetables, be careful to maintain our weight in a healthy range, exercise, and avoid smoking. It is because we don’t do these things that we need all the pills.

I propose that we add a new dimension to Independence Day. Why don’t we make it a day to also consider what we can do to become independent and free of the chronic diseases that plague our society, kill more of us than all the wars we have fought combined, and lessen the quality of our lives? This is a remarkably achievable goal.

Living free of chronic disease is possible, very possible. And, sorry Big Pharma, it doesn’t require a pill. The millions of pills swallowed today by millions of Americans, costing billions of dollars could largely be rendered unnecessary if people would only eat healthier, exercise regularly, achieve and maintain a healthy weight, and avoid smoking. The medical evidence for this assertion is absolutely overwhelming. You don’t have to be sick or die prematurely from chronic diseases.

Talk to your doctor about the benefits of changing your lifestyle.

What do you think? Why not make this your Independence Day?

Monte
www.fitnessrocks.org
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Sunday, July 1, 2007

Blog 003 - 365...thousand!

Browsing the Sunday papers and news programs this morning I was confronted with an overwhelming array of seemingly insurmountable problems facing our country and the world today. Car bombers, suicide bombers, famines, civil wars, and for the past six years Dick Cheney has apparently been secretly rewriting the Constitution to make the office of the Vice President a separate and omnipotent branch of the government, unaccountable to anyone.

It’s all just too much to bear for one Sunday morning.

Pondering the state of the world I couldn’t help but wonder if I’m not wasting my time spending every week podcasting about diet and exercise. Shouldn’t I be focused on a more pressing issue?

But then the number 365,000 came to mind. Three hundred and sixty-five-thousand!

Why that number?

Three hundred and sixty-five-thousand is the number of Americans who die EVERY YEAR as a consequence of poor diet and lack of exercise. That’s a lot of preventable premature deaths. And the estimate of 365,000 is considered to be very conservative – in other words, it’s probably a lot higher.

I heard an interview this past Friday with a science writer who has just written a book about obesity. I won’t write her name, or tell you the name of her book. I will just tell you that she would like us all to believe that the obesity epidemic is mostly just a “myth” and that we really aren’t eating ourselves to death. Everything this science writer said in her interview offended me, but the thing that really got to me was this quote: “If all it took to cure type 2 diabetes was a healthy diet and regular exercise don’t you think every type 2 diabetic would happily do that rather than take drugs and insulin for the rest of their lives?” That’s my best recollection of what she said.

The answer is that type 2 diabetes can be prevented by a healthy diet, regular exercise, and maintaining a healthy weight – and in people who already have the disease it can be brought under control to the point that fewer drugs, or maybe no drugs, are needed to treat it. But few people will actually take this message to heart and act on it. And here she comes saying it’s all a myth anyway.

The reality, I concluded, is that healthy eating and exercise are, in fact, very important topics that aren’t being discussed enough. And sometimes when pseudoexperts posing as science writers discuss the topic of lifestyle the information is outrageously mangled so as to mislead the public.

I’ll keep podcasting. With a little luck next year the number might be 364, 999.

Monte
www.fitnessrocks.org
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Thursday, June 28, 2007

Blog 002 - intensity of exercise and calories burned

I received an e-mail from a listener of my podcast (www.fitnessrocks.org) yesterday. He had several questions about exercise and weight loss. The first question was whether the intensity of exercise affected the amount of calories burned? Specifically, he wanted to know if there would be any difference in calories burned if he walked, or jogged, a mile at different speeds? This is a common question and I thought it would be good to include the answer in my blog.

Here is an excerpt of my response:

I think I can best answer that question with some calculations:

Assume, for the math, that we are talking about a man who weighs 322 pounds (146 Kg). He wants to cover a mile every morning.

If he walks at 3 miles per hour (20 min/mile) he will burn 168 calories over the course of the mile in the 20 minutes he is walking.

If he jogs at 5 miles per hour (12 min/mile) he will burn 263 calories over the course of the mile in the 12 min he is jogging.

If he jogs at 5 miles per hour (12 min/mile) for 20 min he will have exercised for the same amount of time that he spent walking, but will have covered a greater distance. He will burn 438 calories.

This example shows that intensity of exercise is related to energy expenditure. I used formulas from the American College of Sports Medicine to perform these calculations. I double-checked, and I'm pretty sure I got the math right.


Monte
www.fitnessrocks.org

Wednesday, June 27, 2007

Blog 001 - a new medium

After podcasting for a full year I thought I would add a blog. Why not?

My podcast, Fitness Rocks (www.fitnessrocks.org), is posted every Saturday and covers recent medical research regarding the relationship between lifestyle habits and health or disease.

This blog will be a venue in which I can address whatever I want to, including fitness and health, but also random thoughts and observations.

I’m retired from medicine because I reached a point at which there was more I disliked about going to work each day than I liked. The technical term for that is “burned-out.” So, to say I am retired is really saying “I’ve gotten lost in this life and I’m trying to find my way again.” I suspect I’m not alone.

Monte
www.fitnessrocks.org