Monday, March 24, 2008

Weight loss after 40: Goodbye Fat, Goodbye!

After the age of 40 a woman's accrued stress of a lifetime, declining metabolism and the onset of perimenopause takes a physical toll. Deposits of fat begin to settle in a disappearing waistline. Energy levels may decline. Women over 40 are spending their time juggling a career, caring for aging parents, spouses and teens.

Middle-age hormones begin to flood the body unpredictably resulting in mood swings, muscle fatigue and intense food cravings. The physical and emotional changes that result in long-term stress can cause self-destructive eating behaviors. This stress can make us frazzled and overweight. How we respond to stress determines appetite, body composition and overall fitness level.

Stress releases ravenous brain chemicals to help the body handle its responsibilities and also triggers the appetite. Food has easily become our anesthesia to numb the pain of chronic stress. Fat that accumulates around the waist is the result of stress. This stress makes us more vulnerable to colds, flu, infections and fatigue. Women with a thick middle section (35 inches or larger) are at higher risk of high blood pressure, high cholesterol, stroke, diabetes and cancer.

Perimenopausal weight gains in women over 40 result from not burning calories as effectively as we did a decade ago. Hormones change as we lose muscle mass and become more sedentary. Steps can be taken to turn the process around. Develop a stress-resilient lifestyle to take off fat and stop overeating at the kitchen counter. Make a few simple changes that will result in a healthy lifestyle. First realize we cannot eat the way we did when we were 20. Learn how your over-40 body operates and why your metabolism hormones are different now than at any other time in your life. Make yourself more important than food. Learn how to eat again. Savor and taste the food rather than over-consuming to overcome the day's stress. Curb the guilt and anxiety about paying attention to yourself. A beautiful body emanates from a healthy mind. Rebalance your mind and body. No longer allow eating to be a stressful torment but a nurturing pleasure. Use your body to neutralize the stress of the day. Trade unsatisfying rewards of stress eating for rewards that are more fulfilling. Make positive, lasting changes in your relationships, careers, etc., and finally come to peace with your body. Achieve a balanced state of mind and body through regular physical movement and appropriate eating. Allow yourself to enjoy the rich and rewarding experiences of the second half of your life.

Balance physical and mental fitness. Develop a stress resilient personality. Take the time to care for yourself. Create peaceful times to relax. Learn to keep stress hormones in check. Navigate food choices around the most dangerous time of the day, which is mid-afternoon to evening. Some women anesthetizing pain confess to eating until they are physically sick. Stress overeaters never feel completely full. When reward systems are not operating correctly, the response is inappropriate eating. Bingeing quenches the need for reward and fulfillment, yet never brings a feeling of total satisfaction. Food numbs the pain. A stress-driven appetite is imbalanced and can lead to addictions to cigarettes, alcohol and other self-destructive behaviors.

Sometimes just getting on the scale can ruin a perfectly good day. Nothing can boost a women's confidence or send her self-esteem plummeting like the numbers on the scale or a glance in the mirror. Concern about body image is a real anxiety among women. Many equate having the perfect body with having the perfect life. By age 40 most women's closets resemble department-store retail racks with sizes ranging from small to large. We go through perimenopause with elastic waistbands that have replaced belts. It is not really about losing 20 pounds for a special event or squeezing into a size six. It is about negotiating through the maze of everyday challenges. Sadness, worry and anxiety suffocate the feelings of self-care. Learning to control stress hormones will reduce the tendency toward self-destruction and ultimately improve the quality of life. This means doing the best we can working through the daily hassles without mindless eating. No more standing in front of the fridge in a trance ready to stuff all the problems down with food. Calories are not the answer.

For healthy nutrition eat carbohydrates. Minimize or avoid foods with processed, refined sugars such as table sugar, candy and pastries, as well as processed white starches such as pasta, rice and bread. Maximize exposure to unprocessed starches as well as fruits and vegetables. Choose smaller portions to avoid overeating the good choices at meals. Stress hormones peak early in the morning usually between 6 and 8 a.m. This is when we are most energetic and able to concentrate. Mid-morning stress hormones slowly decline, and by mid-afternoon there is a drop in energy and mental concentration. Stress hormones are the lowest levels during sleep to allow full relaxation. Overeating in the late afternoon and evening is one of the biggest culprits behind stress-induced weight gain in women over 40. From 3 p.m. to midnight the stress hormone levels plummet. Mindless, unfocused, stress-driven eating dominates guaranteeing weight gain especially in women over 40. Carpooling, project deadlines, business travel, help with kids homework and endless domestic errands fill the mid-afternoon phase of the day. By dinnertime many women feel like rewarding themselves for surviving yet another day. The only real time they have to themselves may be after the rest of the family has retired to sleep. Late-night, after-dinner eating is a common habit of exhausted and over burdened women. Many seek peace and solace of enjoying a momentary pleasure and relief of their favorite anesthetic -- food.

Learn to successfully navigate the daily routine around the temptations of food. Arm yourself with daily eating plans as well as ways to blow off stress. Know what to eat for mid-afternoon snack and dinner. Keep the plan easy and simple. Stress eaters seek food as pleasure to help neutralize mental pain of stress they must continue to endure. Stock up on low-stress foods such as tofu, fresh fruits, vegetables, low-fat canned soups, pita bread, cottage cheese, low-fat cheeses, rice cakes, low-fat tortillas, canned tuna, chicken or salmon, high-protein cereal, oatmeal, string cheese, frozen fruit sorbet, reduced-sugar canned fruit or veggie burgers. Consume at least 65 percent of the daily carbohydrates before 5 p.m. Breakfast, mid-morning snack, lunch and mid-afternoon snack should constitute the majority of the calorie intake for the day.

Enjoy the benefits of protein by eating fish, beans, peas, chicken, eggs and peanuts. Protein is necessary for the growth and repair of body tissues such as muscles, blood, bones, hair, skin, and nails. Soybeans and soy-based products are rich source of phytoestrogens, which are the weak estrogens found in plants. These phytoestrogens protect against breast cancer in perimenopausal women. Additional sources are soymilk, tofu, soy flour, soy protein powders, soy energy bars, chickpeas, lentils, clover, onions and apples.

Adapt to this sample daily routine. Have a healthy breakfast no later than 9 a.m. Have a small, mid-morning snack of fruit, low-fat yogurt or a piece of string cheese. Eat lunch no later than 1:30. Include a healthy balance of protein, fat and carbohydrates. Mid-afternoon snack is for energy. Choose protein and carbohydrates such as low-fat yogurt, or cottage cheese and fruit. Dinner should be eaten between 6 and 7:30 p.m. Good choices are soup, salad, poultry, fish, legumes, veggie burgers and mixed fruit. Have dinner over by 8 p.m. Remember if you have dinner after 8 you gain a lot of weight. Also drink 64 ounces of water per day. Many times when we think we are hungry we are actually thirsty. Water has many functions in the body. It transports nutrients to the cells, regulates body temperatures, lubricates joints and provides moisture to the skin. The lower estrogen levels during perimenopause make water intake even more critical.

Perimenopausal Symptoms and Solutions:

Fatigue -- iron-rich foods such as meats and poultry
Irritability, memory loss, depression -- vitamin B complex
Indigestion -- small, frequent meals, low-fat foods. Avoid fried foods, lunchmeats
Hot flashes -- soy products, vitamin E, wheat germ, whole grains
Sweating -- Soy products
Water Retention - Consume majority of calories and carbohydrates before dinner
Headaches -- Magnesium, nuts, tofu, leafy green vegetables, wheat germ
Constipation - High-fiber foods (whole grains, vegetables, beans, peas), plenty of water, exercise

After the age of 40 the female body experiences changes in metabolism, bone structure, skin, hair and appetite. The appetite is closely linked to culture. Food is loving, nurturing and a pleasurable substance. Just the smell of something warm and familiar can trigger all sorts of pleasant memories. Think of turkey basting in the oven on Thanksgiving Day. Imagine the smell of hot cinnamon-laced cider on a snowy Christmas day. Smells that waft over us can trigger pleasant associations. The key to enjoying food is not to let it be in control. Make peace with food. It is not the enemy. Keep the eating process simple. There will be less mental stress about eating when other areas in life are in control.

Feelings of sadness, worry and anxiety will suffocate thoughts of self-care. The stress cycle snowballs when food is routinely used as comfort. Plan ahead to make time for yourself. Realize that you deserve joy just as much as the people you continue to serve and please. Women over 40 need all the solace they can get. Incorporate a variety of stress-reducing physical activities into the daily routine. Plan to escape and take a walk whenever you can. An immediate improvement of energy will be seen in addition to the stress reduction. Create a support system. Enlist the help of a buddy to help keep each other encouraged. Enjoy a laughter workout at least 10 minutes a day. Laughter will reduce stress hormones and boost the immune system. Another great tool for improved mental health is journaling. Writing your thoughts down daily is a great way to express emotions and get to know your inner self better. Find some private space to relax and record your thoughts. Write freely and note what you were feeling that day.

Getting fit and healthy after 40 is not a destination but a journey filled with trials that test our abilities to live healthfully. Planning and determination will give a sense of control. Learn to enjoy this season of life to the fullest.

Osteoporosis: A guide to bone health

Osteoporosis, which literally means “porous bone,” is a disease characterized by low bone mass and structural deterioration of bone tissue. Low bone mass leads to fragile bones and an increased susceptibility to fractures. Since you can lose bone mass without realizing or feeling it, it is often referred to as the “silent disease.” Often when an elderly person falls and breaks their hip, there is a possibility that the hipbone actually broke first and caused them to fall down. While osteoporosis is often thought of as an older person's disease, it can strike at any age. The first step in preventing the development of this disease is to determine whether you are at risk or not. Here are some common risk factors:
  • Age – As part of the natural aging process, the older you are, the weaker your bones tend to be.
  • Gender – women are at greater risk than men.
  • Family History – young women whose mothers have a history of vertebral fractures also seem to have reduced bone mass.
  • Race - Caucasian and Asian women are more likely to develop osteoporosis, however, African American and Hispanic women are also at significant risk.
  • Bone Structure and Body Weight –Small-boned frame or if you are thin, your chances increase.
  • Menopause/Menstrual History - Normal or early menopause, brought about naturally or because of surgery. In addition, women who stop menstruating before menopause because of conditions such as anorexia or bulimia, or because of excessive physical exercise, may also lose bone tissue and develop osteoporosis.
  • Lifestyle - Cigarette smoking and/or drinking too much alcohol increases your risk. Other lifestyle factors include consuming an inadequate amount of calcium or performing little or no weight-bearing exercise such as walking or weight training.
  • Medications/Chronic Diseases - Medications to treat disorders such as rheumatoid arthritis, endocrine disorders (i.e. an under-active thyroid), seizure disorders and gastrointestinal diseases may have side effects that can damage bone and lead to osteoporosis. One class of drugs that has particularly damaging effects on the skeleton is glucocorticoids.
Use of the following drugs can also cause bone loss:
  • Excessive thyroid hormones
  • Anticonvulsants
  • Antacids containing aluminum
  • Gonadotropin releasing hormones (GnRH) used for treatment of endometriosis
  • Methotrexate for cancer treatment
  • Cyclosporine A, an immunosuppressive drug
  • Heparin
  • Cholestyramine, taken to control blood cholesterol levels.
Many of the above mentioned drugs are life-saving or life-enhancing drugs, and their use may be the only way to achieve a better quality of life. Always be sure to discuss the use of these medications with your physician before you alter or stop your medication doses.

Speaking of medications…PREVENTION is the best medicine! If you feel you are at risk for developing osteoporosis, talk to your doctor about whether or not you should have a bone mineral density test done to test the strength of your bones. This is a painless procedure that can sometimes be done right in the doctor's office.

In the meantime, work on building a strong skeleton. Establishing strong bones, especially before the age of 30, can be the best defense in preventing this disease.

Here are some recommendations to help prevent osteoporosis:
  • Include weight-bearing exercise into your day such as walking, dancing, jogging, stair-climbing, racquet sports and hiking. If you have been sedentary most of your adult life, be sure to check with your healthcare provider before beginning any exercise program.
  • Avoid smoking or excessive alcohol use. It is never too early or too late to start your prevention program.
  • Choose a balanced diet rich in calcium and vitamin D. Calcium-rich foods include low-fat milk, cheese, broccoli and others. Many foods are fortified with calcium and are readily available and affordable such as orange juice, cereals and breakfast bars.
  • Another easy and economical way to boost the calcium content of many meals is to add nonfat powdered dry milk to puddings, homemade cookies, breads or muffins, soups, gravy, casseroles and even a glass of milk. A single tablespoon of nonfat powdered dry milk adds 52 mg of calcium, and 2 to 4 tablespoons can be added to most recipes. You may add:
    -3 tablespoons to each cup of milk in puddings, cocoa or custard
    -4 tablespoons to each cup of hot cereal before cooking
    -2 tablespoons sifted into each cup of flour in cakes, cookies or breads
  • Take a calcium supplement. If you have difficulty getting enough calcium from the foods you eat, a calcium supplement will make up the difference.
Vitamin D is needed for the body to absorb calcium. Vitamin D comes from two sources: through the skin following direct exposure to sunlight and from your diet. The major food sources of vitamin D are vitamin D-fortified dairy products, egg yolks, saltwater fish and liver.

A few things to consider when taking a supplement :
  • Calcium, whether from the diet or supplements, is absorbed best by the body when it is taken several times a day in amounts of 500 mg or less, but taking it all at once is better than not taking it at all.
  • Calcium carbonate is absorbed best when taken with food.
  • Calcium citrate can be taken any time.
  • Calcium also interferes with iron absorption, so a calcium supplement should not be taken at the same time as an iron supplement. The exception to this is when the iron supplement is taken with vitamin C or calcium citrate.
  • Any medication to be taken on an empty stomach should not be taken with calcium supplements.
  • Avoid calcium from unrefined oyster shell, bone meal or dolomite without the USP, as these historically have contained higher lead levels or other toxic metals.
If you have questions about osteoporosis, healthier eating or other health concerns, consult a Registered Dietitian for an individual assessment.

The Milk Myth: Calcium Source and Osteoporosis

Most people reach for a glass of milk or wedge of cheese to meet their calcium needs, but dairy products do not necessarily contain more calcium than plant-based foods, and may actually inhibit your body's absorption of calcium. Surprised? Read on.

What is Calcium?

Calcium is a major mineral, necessary for healthy bones and teeth. There are several minerals known to be essential to the human body that must be obtained from food: calcium, magnesium, phosphorus, sodium, chloride and potassium. Minerals make up the skeleton, help control the composition of body fluids and aid the action of many enzymes and other proteins. Our bones contain large amounts of calcium that helps to make them firm and rigid.

The Milk Myth

The advertising barrage surrounding cow's milk would make anyone think it is an absolutely essential and natural product for humans. However, whole cow's milk is only suited to the nutritional needs of calves that double their weight in 47 days and grow to 300 pounds within a year. Human milk, by contrast, is designed by nature to meet the needs of a child during her most rapid growth period. It has only 80 mg. of calcium per cup, compared to the 288 mg. of cow's milk.

In fact, human beings are the only species to drink the milk of another species, and the only species to drink milk beyond infancy. About 90% of the world's adult population lacks the lactase enzyme needed to digest milk properly. Lactase is present in infants for digesting their mother's milk, but levels decline after the age of five years. Adults who lack the enzyme suffer from bloating, cramping, gas and diarrhea if they drink milk.

Even before his death, child-care expert Dr. Benjamin Spock joined several doctors in questioning milk's nutritional value and warned of a possible link to juvenile onset diabetes and allergies. Dr. Frank Oski, director of pediatrics at John Hopkins University and Dr. Neal Barnard, president of the Physicians' Committee for Responsible Medicine. Dr. Oski both supported Dr. Spock stating that cow's milk is overrated as a source of calcium, is often contaminated with traces of antibiotics, can cause allergies and digestive problems and has been linked to juvenile diabetes.

What About Osteoporosis?

Osteoporosis is the major cause of bone fractures in the elderly. It is better prevented than treated and prevention includes an adequate intake of calcium throughout life, but especially in childhood and young adulthood. However, recent studies have shown that diets high in protein, particularly animal protein, and in salt (sodium chloride), actually increase calcium loss and may contribute to the cause of osteoporosis.

The dairy industry spends hundreds of millions of dollars promoting the notion that high calcium intake is critical to developing strong bones and preventing osteoporosis. They have even convinced the USDA to raise the Recommended Daily Allowance for calcium, with ringing endorsements that dairy products are optimal calcium sources. Unfortunately, there is a lack of credible research showing that a deficiency in calcium may be to blame for the osteoporosis epidemic currently raging in the Western world.

Osteoporosis is more common in Westernized countries where calcium intake and consumption of dairy products is high compared to the rest of the world. It is comparatively rare in rural subsistence cultures, even though calcium intakes are much lower. Lifestyle factors such as physical activity, lower protein intake, little alcohol consumption and the rarity of smoking may offer protection to people in these populations.

An interesting study published in the July 2000 Pediatrics, the medical journal of the American Academy of Pediatrics, is entitled "Adult Female Hip Bone Density Reflects Teenage Sports-Exercise Patterns But Not Teenage Calcium Intake." (PEDIATRICS Vol. 106 No. 1 July 2000, pp. 40-44)

The study tracked 81 girls for six years, from ages 12 to 18. Adolescence is a critical period for bone health because the average woman gains 40 to 60 percent of her skeletal mass during those years. Researchers controlled calcium intake via supplementation, and concluded "Time-averaged daily calcium intake, which ranged from 500 to 1500 mg/day in this cohort was not associated with hip Bone Mineral Density (BMD) at age 18 years or with total body bone mineral gain at age 12 through 18 years."

In other words, consistent with previous studies, none of the girls with low calcium intake had any different bone development than girls with high calcium intake. Contrary to the dairy-industry propaganda, getting that extra calcium didn't make a difference.

The average daily calcium intake for South African blacks is 196 mg whereas the daily calcium intake for African-Americans is more than 1,000 mg. Yet the hip fracture rate for African-Americans compared to South African blacks is nine times greater! (California Tissue Institute 1992; 50:14-18) Those countries with the highest calcium consumption turn out to be the same ones with the highest rates of osteoporosis.

The Role of Protein - Animal, Vegetable

A high protein diet, especially derived from animal foods, causes calcium loss in the body. The higher sulfur-to-calcium ratio of meat increases calcium excretion, and a diet rich in meat can cause bone demineralization. A report published in 1988 that compared the amounts of calcium excreted in the urine of 15 subjects showed that the animal-protein diet caused greater loss of bone calcium in the urine (150mg/day) than the all-vegetable protein diet (103mg/day). These findings suggest that diets providing vegetable rather than animal protein may actually protect against bone loss and hence osteoporosis. In one study, adults on a low-protein diet were in calcium balance regardless of whether calcium intake was 500mg, 800mg or 1400mg a day.

Calcium Needs Balance

Calcium needs a balance of potassium and magnesium to work effectively in building bone. Potassium can be found in bananas, prunes, raisins, spinach and white potatoes; magnesium is found in dark-green leafy vegetables, brown rice and black beans. Vitamin D, the sunshine vitamin, is also vital for the absorption of calcium and helps prevent it from being lost in the urine.

Good Sources of Calcium

Calcium is abundant in dark leafy greens such as collards, kale, turnip, mustard greens, parsley, watercress and bok choy. Dark leafy greens are far richer in calcium per calorie than is cow's milk. Broccoli, almonds, chickpeas, carob, sea vegetables, dried figs and molasses also provide calcium. Numerous other vegetarian foods, such as tempeh, corn tortillas and oranges make respectable calcium contributions too.

Drinking hard water can provide 200mg of calcium daily but soft water contains almost none.

Tofu is commonly recommended as a good source of calcium, but the amount of calcium depends on the coagulating agent used in the process of making tofu. Calcium sulfate and nigari (magnesium chloride) are two commonly used agents. Tofu prepared with calcium sulfate will contain more calcium than tofu made with nigari. When you realize that there is as much calcium in 4 ounces of firm tofu or 3/4 cup of collard greens as there is in one cup of cow's milk, it is easy to see why people who do not drink cow's milk still have strong bones and teeth.

What To Do?

Although the calcium intake of adult vegans tends to be lower than the optimal recommendation, it is close to the Estimated Average Requirement.

The same things that protect against heart disease, cancer, and a host of other diseases can help protect against osteoporosis: limit your animal-protein intake, including red meat, chicken, fish, eggs and cheese, all of which leech calcium from your bones. Cigarettes, salt, caffeine and a sedentary lifestyle are also related to poor bone health. Eat a balanced diet and exercise!

Exercise: A Handicap Is No Excuse

I have this same problem every time I walk into some sort of physical training or sports-oriented group and tell them I'm interested in signing up. Maybe it's the limp that shows off the two-inch difference in length between my legs, or the brace I wear to support my right ankle that does a good imitation of Robocop when I'm in motion. Or maybe it's the cane I lean on when it's been a bad day and I'm more tired than usual. Who can say?

"Are you sure you want to try this?" they ask, looking at me with a mixture of surprise and fear of liability suits.

I'm a polio survivor. I was one of those hundreds of thousands of people caught in the epidemics that swept this country in the early 1950's, before Dr. Salk perfected his multiple-hypodermic vaccine and before the Sabin vaccine with the sugar cubes. In fact, I was in the field tests of Dr. Salk's vaccine. They figured if I already had contracted polio, there wasn't much chance of me getting it again and maybe the vaccine would do some good. Even if there was no benefit, I could tell them if the vaccine was safe to use on other people. It may have been a bit of a cold-blooded approach, but I was too young to argue at the time. If you asked me today, I'd tell them to go ahead and give it a shot, no pun intended. I know what polio did to a lot of people and I wouldn't wish that on anyone if there were a way to avoid it. A lot of kids I met in the hospital never made it home. Sometimes they haunt me and remind me to try harder.

I grew up watching the other kids play sports. It's tough to run with a heavy metal brace on your leg, and the chance of injury or damage to an expensive piece of equipment made my parents leery of giving me free rein of activity. Hey, I was still a kid, with a lot of chances to get in trouble. So I spent my formative years watching the antics of doctors, nurses, interns, hospital aides, therapists and an occasional psychiatrist, who wanted to know if I felt any anger for people who could do what I couldn't do. Of course I was angry. But I learned that everybody has limits. I just needed to learn to work with what I had and do as much as I could. It was those ghosts haunting me, telling me to keep going.

I tried martial arts when I was in grade school. At the time, my body was still growing and having the usual problems with changes in balance, muscle control and coordination. When you also consider the atrophied muscles left over from polio and the special shoes I had to wear on a daily basis, trying to work out barefoot was a whole new experience, with painful results. Learning martial arts wasn't working for me. Like any other kid, I got into my share of confrontations. Add to that the normal adolescent habit of picking on the strange and the weak in any group and I was a perfect target. I wanted a way to keep my skin in one piece, but so far, martial arts wasn't doing the job. I learned to avoid fights as much as possible, which may have been better for me anyway.

Fast-forward a few years in time. I grew up. My body settled down into something I could learn to live with that wasn't changing every day. I began to learn to work with what I had. I began to take part in sports. I'll never be much of a basketball player, I found out. There is just too much running back and forth. I'm a fair hand at volleyball since I can judge the trajectory of the ball and move far enough to get there, most of the time. But some part of me still wanted to study combat styles. After all, I was still a target, and these days it pays to be prepared.

Having grown up on stories of King Arthur, swashbuckler movies with Errol Flynn and Tyrone Power and the ever-popular Zorro serials, I was drawn to the sword. I found a local school that taught fencing and paid it a visit. After a long talk with the head instructor and a couple of lessons, I was hooked. Fencing is a sport that demands as much from you mentally as physically. My instructor told me I'd never be Olympic material, but there was no reason I couldn't do well at tournaments with some practice. I started, as most students do, with the study of the foil. This is a very light weapon, weighing about two pounds, with no edge and a covered point. The target area is limited to the upper body, minus the head and arms. You stand with your side toward your opponent, arm out and holding your foil, and try to keep your opponent from hitting you while trying to hit him or her with the point of your weapon (okay, it's a lot more involved than that, but let's keep it simple for now).

Since I had limitations to my movements, being shy a leg that worked, I concentrated on my hand movements and reflexes. I didn't use the fancy moves that called for running or jumping at your opponents, like the ballestra or the fleche. My instructor told me I'd have to fence like an old man. After he laughed, and ducked, he explained that younger fencers enjoy the fancy movements that make fencing look so flashy. They tend to use their physical skills at their foremost tactic. But older fencers, and smart fencers, use their ability to draw an opponent close, rather than try to run after them. I must use feigns and planned attacks to draw an opponent in range. Once the attacker was close enough, a parry/lunge combination, done quickly, would finish the match. It wasn't flashy, but it won me a lot of points in tournaments.

Studying fencing was fun. I learned all three competition weapons: foil, epee and saber. Each has its own target areas and rules for scoring a point. My personal favorite soon became the epee. The epee is the sport weapon most like real combat. The point alone is used, but the target area is the entire body. In addition, in both foil and saber, you must begin an attack and carry it through in order to score a point. This is called establishing right-of-way. If your opponent attacks you, his attack must be deflected before you can riposte and score on your own. In epee, it is possible for both fencers to score at the same time, a double-touch. With the entire body as a target and no need to establish right-of-way, you could wait for your opponent to move, then strike into his attack. If you touched first, the point was yours. Since most people give up some level of defense when they focus on their attacks, this was an effective tactic to use. All it required was speed and a good eye (and sometimes a lot of luck, but that's another story).

After about six or seven years of fencing, I moved to another city and was looking for something else to keep me in shape. Once more, martial arts beckoned. Looking into several dojos, I found one with an instructor willing to work within the boundaries of my physical limitations, in a style that didn't require running laps and jumping over obstacles. I learned the basic moves: punches and kicks, blocks and stances. Each lesson in the early days was as much trying to find something that worked for me as it was learning the style of the school. But I learned and progressed. My right leg can't kick worth spit, but my left, overdeveloped from years of compensating, is pretty deadly. My punches and blocks are as good as any other student in the school.

Years of learning how to deal with my own limitations gave me an unusual perspective on trying to find your own abilities. This insight comes in handy with some of the new students. And when a parent comes in with a special child, sensei points to me and says, "If he can do it, so can your child. We'll find a way."

I've made it to brown belt so far. Not as fast as some other students, perhaps, but I'm satisfied with the progress. I'll probably never take any trophies or win any sparring bouts at a tournament, but a while back sensei came up to me after sparring in the dojo and stated he wouldn't mind having me defend his back in a fight. High praise from a fifth dan. I know I'm not the best student around, but I do work hard. One day I may even make black belt. Then I can truly start learning the martial arts.

Until then, I'll just work with what I've got and ignore the handicap.

Eating Disorders: Definitions, Symptoms and Treatment

Eating disorders plague many young women, men and families around the world. Sometimes the symptoms are obvious, sometimes they are not. Eating disorders should not be ignored. They are symptoms within themselves that may hint of a psychological problem which, if not treated, will remain for life.

Anorexia Nervosa

Characterized by over-dieting and the need for perfection. They appear to want to please all, all the time. They have a distorted self-image. Even at 90 pounds, an anorexic will look in the mirror and see fat. These people are usually over-achievers, always willing to help everyone else except him or herself. They do not realize that there is a problem.

Some of the symptoms include: weight loss, becoming withdrawn, excessive exercising, symptoms of Raynaud's syndrome (hands and feet always cold), tiredness, weakness of the muscles, obsession with food and caloric intake, depression with mood swings, fainting, dizziness, missed periods or amenorrhea (no period). When questioned, the person (usually a child or teenager) will become very defensive and angry; this is a common symptom.

It is noticeable that they will surround life with food, not the consumption of it, but its avoidance. They may prepare a meal for the family and busy themselves with cleaning up while making an excuse to eat later and never actually eating. They noticeably cut food into very small portions or may take predetermined (two to three) bites of any food choice. They become obsessed with food and become defensive if their obsessiveness is brought to their attention. Again, an anorexic does not see that there is a problem. Some may start wearing oversized clothes, hiding the effects of the excessive dieting. The scale becomes their friend, and you will find them weighing themselves daily. Anorexics feel they have failed not only themselves but also others when they don't eat. In striving for perfection, they have lost sight of reality.

With proper counseling and nutritional training, they can recover; but they may relapse, so ongoing treatment is a must. The need for counseling cannot be stressed enough. People suffering with this disease have a high relapse rate. Family counseling is also suggested due to the high stress levels that develop from fear of losing your child, or lack of understanding the disorder.

Bulimia Nervosa


Bulimia is characterized by excessive bingeing and purging. Put in more common terms, it's eating and either vomiting or taking excessive amounts of laxatives to remove what they have just put into their system. The logic behind this behavior, regardless of how it sounds, is to remove the calories before they are absorbed into the system. They have a fear of weight gain; weight gain means failure. Most people who do not understand this condition think that purging is simply vomiting, but this is not true. Bulimics have been known to use things such as enemas, diuretics and laxatives to rid themselves of the over-abundance of calories they feel they have ingested. For some, a simple ice-cream cone is bingeing; others may eat many calories by eating a box of cookies, Twinkies, candy, cakes or any other food source.

Some symptoms of Bulimia are: binge eating, secretive eating, hiding to eat or eating during the night when everyone is sleeping, weight fluctuations, broken blood vessels usually in face or eyes from forced vomiting, bathroom visits after meals, tooth decay caused by the acids of the stomach from vomiting so much, fatigue, weakness, sore throat, irregular heartbeats.

The emotional side effects include: low self-esteem, self-criticism, self-worth determined by how much they have lost or gained, fear of not being able to stop eating, guilt from eating, avoiding functions that involve eating including social outings, substance abuse (laxatives, recreational drugs, diuretics).

The side effects of bulimia can lead to many other health problems including stress on the heart and kidneys, and decreases in potassium and magnesium, which are needed to keep the heart nourished with proper electrolytes. The body becomes weakened and unable to function properly.

Bulimics realize they have a problem, so the treatment is much easier than would be for an anorexic. A relapse after treatment may happen; but with proper counseling and nutritional assessment, it can be cured or controlled. Counseling with families cannot be stressed enough as families tend to blame themselves for this disorder. Once an understanding of the disorder is achieved, a lot of stress is lifted and proper treatment is able to begin.

Compulsive Overeating

A person who eats excessively for comfort characterizes compulsive overeating. They find comfort in food, bringing a short-lived satisfaction. Often during stressful times, they binge and feel that they cannot stop eating. Their self-worth is all based on weight and what they feel society sees as normal.

Symptoms of compulsive eating include: binge eating, starting and stopping most any new fad diet that hits the market, being overweight but never eating a thing in public and eating in the privacy of their own home away from people. Sneaking food becomes a habit, but also very comforting.

Emotional symptoms include: anxiety of not being able to stop eating voluntarily, depression with crying spells, embarrassment about weight, distorted views about themselves, weight and foods are the focus of life. Regardless of the person's size, they are malnourished and need to be treated. They are commonly those that try all the fad diets; and when results are not seen quickly, they slide back into the eating disorder. Constant emotional support is needed for these patients. Once the desired weight is achieved, they will still have a poor body image and think that they are large, when in fact they are not. This could lead the patient back into the vicious cycle of compulsive overeating.

Like bulimics, compulsive overeaters know they have a problem, so they are more easily treated than an anorexic. With proper counseling and nutritional guidance, they can resume a normal lifestyle. Families also need to have counseling on how to deal with such a problem. Understanding the disorder is the first step to recovery for the family.

Overview:

With all eating disorders, there is the constant threat of relapse. In an unhealthy setting, this will be a roller-coaster ride for some families. There is no quick fix and treatment may take anywhere from several weeks to several years. Treating the entire family is as important as treating the patient. Once the family recognizes the signs, they can more quickly get assistance in helping their child or loved one to receive treatment.

Often families do not want to admit that they are suffering from an increased amount of anger over these disorders. The anger is a normal progression when the patient chooses not to help him or herself, thus leaving the family to feel as though they have failed. Anger management counseling for the entire family, and not just a single member, is recommended if you feel overwhelmed. Family members, such as siblings, may even feel embarrassed or ashamed; this too is completely normal. A well-established child and adolescent counseling service in your area will help the siblings understand and cope with their feelings.

High stress or demanding situations are unhealthy for patients suffering with eating disorders. The tendency is to run back to what they feel is the only thing in their lives that they can control, their eating habits.

Motivation and Support: The Zen of Sports Success

Zen by definition refers to a movement of Buddhism that emphasizes enlightenment by means of meditation and direct, intuitive insights.

Since I'm not a Buddhist, I use the word zen to refer to deep, but also profoundly simple, insights we can all appreciate.

When it comes to being successful in any sport, there are many zen-like principles you can use to improve your performance and develop yourself to achieve more of your true potential.

Start with the basics and grow from there

In all things, and in all sports, one must begin with the basics. We may live in a hurry-up world, but if you want to achieve great success in anything, particularly a sport -- which requires the development of both your mental and physical strengths and abilities -- you must start slow. Even a triathlon champion must first learn to crawl and walk before he can run. Learning to ride a bike and to swim usually follow later. All the most basic skills must be developed before he can concern himself with advanced concepts like speed and long-term endurance.

Learn from the wisdom of those who have gone before you

True champions seldom get there all by themselves. The flames of their success are often sparked by one who has gone before and then are fanned by a coach, guide or mentor. Look at the Olympic gymnasts and figure skaters as an example. Young students who show potential are often recognized and placed with the Olympians of former years who guide and train them. It is a great honor and a significant advantage to benefit from the lessons others have already learned. In doing so, you accelerate your learning curve and significantly increase your ultimate chances for success. Even if you don't have your sights set on the Olympics, you can learn from experts in the sport, a personal trainer or a coach in your sport.

Practice, practice, practice

Repetition is the key to mastery. Many athletes may hit a home run at some point in their lives, but only the very best will consistently hit the ball over the fence time after time and game after game. Only those athletes who regularly practice their chosen sport will achieve a measure of performance that is regularly good enough to be deemed exceptional. The saying "if you don't use it, you lose it" is very true in this case. Great athletes who try to take the easy way out will never aspire to the same level of success an average athlete with perseverance can attain. If you want a high batting average, you've got to get up to bat a lot more times than the next guy. Stick with it -- especially when the going gets tough.

Focus your concentration

In order to achieve something, you must have a goal. In order to have a goal, you must know something about your sport. Study your sport, study those who have gone before you and achieved a measure of success, and concentrate on learning all you can from them -- and from your own experiences. Stay focused on the task at hand and the action to follow. Block distractions from your thoughts and concentrate on the present moment.

Visualize your success

Never consider the negative "what ifs" or spend time worrying about what could go wrong. Always give your undivided attention to exactly the way you want it to go. See your success in your mind. Picture or visualize what you want to achieve. Play it like a movie in your mind. Concentrate on the image and think positive thoughts. Constantly reaffirm to yourself that the vision can become reality. You are what you think you are. You can become what you believe you can become.

Practice patience

Anything worth having is worth working for -- and waiting for. Success in sports is often like that. Along with all the practicing, concentrating and visualizing, a successful athlete learns to develop patience. Olympic athletes don't train to compete in a few short weeks or even months. They learn the basics and develop and refine their skills over the course of many years with the best instruction and guidance money can buy. Along the way, they experience disappointments and setbacks -- sometimes injuries and recovery, training and retraining. Serious success in a sport is not for the faint of heart -- or the impatient person. Sports all-stars aren't born. They are developed. With time, practice and patience.

Grow and mature

With age often comes wisdom and insight. Some physical skills are like that, too. You need to develop and grow before you can hope to attain your ultimate success. You must develop your skills over time. An athlete needs to develop physical muscles, flexibility, stamina and strength to become successful. Dancers build leg muscles and control over their movements with time and maturity. They develop flexibility and agility, grace and endurance. There's a reason you've never seen a six-year-old prima ballerina. It is like this with all sports.

Invest in yourself wisely

Your body is like a bank account. If you make regular, healthy investments over a period of time, you can expect to receive dividends. If you eat healthy, drink plenty of water, exercise, get enough rest and don't pollute your body with chemicals and toxins, your body will perform at its peak. If you don't … well, garbage in, garbage out, as the saying goes. Given the possible return on investment, why not invest in the best for you?

Stretch yourself

Your skills and abilities will change over time. With practice and repetition, things that once challenged you will become easy and routine. A successful athlete keeps raising the bar, stretching herself to do more with each new accomplishment. Goals grow and change. Yours should, too. Keep pushing yourself to achieve just a little bit more. Run a little longer, a little further or a little faster. In doing so, you will come ever closer to your ultimate potential.

Be at peace with yourself

Not everyone will make the Olympics. And even of those that do, only one athlete will walk away with the gold. Only one team will win at the Final Four. Only one team will win the Super Bowl. While it sometimes seems our world is totally focused on winning, you need to recognize that your personal best may not be the world's best. And that's OK. There isn't much room at the top, and it's pretty hard to balance up there at the top of the heap anyway. It's a precarious position at best, and most people don't last up there very long. Be content with your accomplishments and your own personal growth and development. You've worked hard to get where you are. Be proud of it.

Never get too cocky

We've all seen them -- so I won't name names: those athletes who strut their stuff and think they are God's gift to mankind -- or at least to a particular sport. Like the games wouldn't go on without them. They may reign supreme for a while, but even kings get overthrown. And so it is with athletes. World records are broken. New superstars displace old. New players outperform veterans. Winners become losers. Remember? It's pretty precarious at the top. So even if you get there, remember where you came from. Don't forget about that long hard climb. And while you're up there, reach down and give someone else a helping hand and lift them a little higher. It's lonely up there all by yourself.

Appreciate the gift you've been given

Everyone has special gifts. You have a gift. I have a gift. Yours may be super athleticism in a particular sport -- in fact, it very likely is or you wouldn't have much interest in this article. Whether you are an all-star quarterback, an Olympic skier or an aspiring tennis player -- whether your thing is hitting a puck into a goal, spiking a volleyball over a net or diving into the deep end, recognize that your talent is a gift. Be thankful for your gift, use it wisely and share it with others. Help them to develop their gifts -- whether they are in sports and athleticism or in another area, and always give something back. Those who have been given much should likewise share their abundance. It keeps a healthy balance in the world.

Is that zen-like enough for you? All the profound, philosophical insights that lie behind the secrets of success for athletes around the world can be summed up so simply. That's the secret of zen … simple, profound insights that really work. I'll bet even Buddha would agree.

Exercise and Wellness

The principles of sports physiology outline the underlying mechanisms that help to bring about a healthy transition from a not-so-healthy state. The life practice of regular exercise, healthy diet and relaxation creates benefits that can be seen and felt quickly!

By putting in an effort for regular exercise, the person without illness is rapidly rewarded by an increase in overall well-being and stamina. The same principles apply to men and women; although differences in body size, composition and hormones influence athletic performance.

Men benefit from the anabolic effect of testosterone produced by male testicles. It gives substantially greater muscle size and therefore strength to male, compared with female, muscles.

Sometimes women have been shown to have greater athletic endurance due to increased body fat. The female sex hormone, estrogen, is known to increase fatty deposits in the breast, hips and subcutaneous tissues of the female. On average, the non-athletic female has a substantially larger percentage of body fat compared to the non-athletic male who, through the influence of testosterone, will have considerably more muscle than the non-athletic female and considerably more strength as a consequence. It is clear that males may perform better than females in contests requiring straightforward muscle strength and speed, whereas increased fatty deposits may supply energy in long tests of endurance for females.

Another influence on performance differences comes from the differing effects of the sex hormones. Testosterone is associated with aggression and competitive drive, in contrast to the calming influence of estrogen. When a person is exercising, the strength, power and endurance of muscles determine the performance. In general, a person with more testosterone and therefore, more muscle, will have greater strength. However, exercise training programs facilitate increased muscle strength. The holding strength of a muscle has implications for performance as well as injury, as stretching an already contracted muscle can lead to internal tearing. The power of a muscle determines how much it can do in a given period of time, whereas endurance depends to a large extent on nutrition that supports a person's effort. A high-carbohydrate intake allows for the availability of glycogen to the muscles, and therefore, a greatly improved performance compared to that allowed by a mixed or high fat diet.

Different muscle metabolic systems are utilized depending upon the type of exercise performed. A system called the Phosphagen System is used for short bursts of muscle power, such as jumping and football dashes. This complex system involves the metabolism of adenosine triphosphate, the basic source of energy for muscle contraction. The Glycogen-Lactic Acid Systemprovides energy over a longer time span.

The first stage of the processing of glycogen takes place without oxygen, when each glucose molecule is split into two pyruvic acid molecules. Adequate oxygen intake is needed for the second stage of the processing of glucose from glycogen; otherwise the pyruvic acid is converted into lactic acid, resulting in severe muscle spasm and fatigue. TheGlycogen-Lactic Acid Systemsupplements the performance of thePhosphagen Systemto sustain performance over intermediate muscle activity such as that required in playing basketball. TheAerobic Systemrequires the oxidation of nutrients to supply energy and helps to sustain performance over time as long as the nutrients are available. This system provides the resources required over long distances and time spans such as marathon running and jogging and is supplemented by theGlycogen-Lactic Acid Systemwhen more power is required such as in rowing or long swims. The type and duration of the exercise will determine which system or combination of systems will be activated the most frequently.

While the body utilizes both carbohydrate and fat in exercise, a high carbohydrate diet and adequate muscle glycogen are required for optimal athletic performance. A high carbohydrate intake and avoiding tiring exercise beforehand facilitates better recovery after heavy exercise. Similarly, to avoid excess fatigue in training, it is useful to be aware that when training for muscle building, muscle strength increases about 30 percent during the first six to eight weeks of training but not much more after that.

Different people are suited to different types of athletic performance because of their genetic inheritance of their muscle type -- having relatively more fast or slow twitch muscle fibers. Fast twitch muscles are larger in diameter and deliver more power over a shorter time span. Slow twitch fibers are primarily for endurance. Training does not alter percentage of fast or slow twitch type fibers so people are inherently geared to different types of performance. Slow twitch types are better suited to endurance than fast twitch types who are better suited for fast sprints and jumps.

The heart's ability to pump blood to the muscles is the most limiting factor in exercise, while oxygen consumption is a vital factor in endurance performance. The rate of oxygen usage under maximal aerobic metabolism is expressed as VO2Max, which for people who are marathon runners, is nearly twice as much as that in the untrained person. This is partly determined genetically by chest size in proportion to body size, as well as strength of respiratory muscles. The rate at which oxygen can diffuse from the alveoli into the blood differs in different types of sports people. Those who have greater oxygen requirement per minute have greater diffusing capacity; oarsmen have nearly four times the capacity of non-athletes at rest. It is thought that this might be improved by training. Also, people select themselves into those activities for which they are most suited.

There is a direct relationship between work output, oxygen consumption and cardiac output during exercise. The untrained person can increase cardiac output about two thirds of the output of a trained athlete, although resting output is the same in each. The heart enlarges in athletes who perform endurance sports such as marathon runners who achieve a higher maximal cardiac output, perhaps 40% greater than the untrained male. This gives a distinct performance advantage, as it is the ability of the heart to deliver blood, and therefore oxygen, to the muscles that will ultimately determine endurance performance ability.

Many people take up a sport for health and recreation reasons rather than for competition. Adequate and optimal diet, incorporating carbohydrates of the right type, especially pasta and rice, with plenty of good quality drinking water helps to facilitate good recovery from exercise and to prevent dehydration, a cause of sudden death if not recognized early.

Rest and adequate sleep are vital. Without these, the sports person can become vulnerable to muscle strain and other injuries.

The correct clothing for the sport selected is essential as is the preservation of body heat in cold conditions. However, the recognition of the possibility of heat stroke in warm conditions is especially important in order to prevent exhaustion and possible death. The body loses its ability to reduce its temperature if the temperature has over-elevated. This latter situation brings about significantly over-activated intracellular chemical reactions producing yet more heat. This can occur in either very hot or humid conditions or when wearing the wrong clothing which allows excess body heat to build up to the point where tissue and brain cells become destroyed, leading to weakness, dizziness, collapse and unconsciousness. Thus, it is obvious that when undergoing training for any type of sport, however gentle, certain elements need to be built in to ensure safety.

The benefits of regular exercise are indicated by improved well-being, better overall health, improved sleep and immune system function, reduced frequency of illness and better day-to-day function, performance and quality of life. With care and planning, exercise adds a new and vital dimension to healthier living.

Reference
Guyton, A.C. (1992).Human Physiology and Mechanisms of Disease, 5th ed. Philadelphia: W.B.Saunders.