Walking Counts as Exercise… REALLY!

On NPR this morning, I heard Renee Montagne utter this intriguing line, “About half of all Americans say they exercise regularly.”  I literally laughed out loud as exercise is a big topic of conversation this week in my house, with my parents visiting from Florida. My dad had a second heart surgery last summer and my mom has high cholesterol, and they really would benefit from regular exercise. I know this. They know this.  And yet….they are not among the apparently half of Americans exercising regularly.

Maybe peer pressure (as opposed to kid pressure) would help? So I listened keenly. In fact, after noting that half of Americans say they exercise regularly, Renee continued with proof that it’s true:

“That’s the finding of a recent poll NPR conducted with the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. The most popular exercises are cardio/aerobic using treadmills, elliptical machines, and stationery bikes. But leading the pack: going for a walk!”

I looked up the poll: Sports And Health In America. Published in June 2015, this study interviewed 2,506 adults age 18 and older who were interviewed on the phone, in English and Spanish, between January 29 – March 8, 2015. While this study is 50+ pages of intriguing facts, one thing I did not see is a breakout of exercise among those age 70+, which I could have used as fodder for exercise discussion with my parents.  Sigh.

But no matter – there was a really key nugget for me to use with my folks!  After Renee’s introduction, the Health News story, “Take A Hike To Do Your Heart And Spirit Good” continued with Patti Neighmond discussing a topic near and dear to my heart (literally, sorry for bad pun) – is walking REALLY exercise?

Because I’m of two minds about walking.  For my parents, I have tried and tried to get them to believe that walking is vital – that to lower cholesterol and blood pressure and have a healthier heart, they need to WALK. Daily. That the lower energy my father feels sometimes – one year after heart surgery – is because he’s not exercising enough – and his cardiologist has said the same thing!  I’ve purchased iPods (and set up remote IT sessions to load music) and workout clothes. I’ve asked. I’ve noodged. I’ve cajoled. To mixed effect (that said, big kudos to you, Dad, for you for getting on the treadmill at my house this am – color me very impressed!)

And yet – when I was injured this winter and could not play tennis or spin for several months, I didn’t walk. Instead, I was a slug (a very sad slug) so I did nothing – and gained weight and let my cardio conditioning lapse. All because as much as I harp on my folks about how walking is exercise, I guess I have never believed it counts as ‘real’ exercise.

Turns out, it does.

In  her piece, Patti Neighmond asked: “Is Walking Really Exercise?” (emphasis is mine). She even asked it the same way I would, with some degree of snark:

“But are they kidding themselves to think a moderate walk is really helping them much, exercise-wise? Should we all be power-walking or jogging if we want to count that activity as good for us?”

She went on to answer:

“Dr. Tim Church, who studies the effects of physical activity at Louisiana State University’s Pennington Biomedical Research Center, is reassuring on that score.”

He says, “Too many people think you have to exercise really, really hard to get a benefit, and nothing could be further from the truth. You’re actually getting probably 95 percent or more of the benefits when you’re walking as compared to jogging.”

The NPR story is about five minutes long and I found it pretty interesting: you can listen to it here.


Ms. Neighmond wraps up with this recommendation: “Federal Health Officials suggest 150 minutes a week of moderate physical activity. That’s about 30 minutes, five days a week.  If you’re walking, it would be a moderate pace – so you can still carry on a conversation.”

What’s a moderate pace? Well, it depends, of course, on your overall fitness level. According to the Center for Disease Control’s very interesting Measuring Physical Activity Intensity page, a moderate pace is a ‘brisk walk’ of 3 mph or faster; doing the math, that translates to a pace of 20 minutes per mile. That said, according to an article I found on about.com, How Fast Is Brisk Walking, “fitter people still will not be in a moderately intense exercise zone at that pace. A pace of 15 minutes per mile, or four miles per hour, is more likely to put fitter people into a moderately intense exercise zone.”

Personally, I’m inspired by goals – so knowing the pace I should be targeting is inspiring. Others like to count steps: I know many people using a FitBit to hit a daily step goal (have you read David Sedaris’ hilarious FitBit story, Stepping Out? And, um, I  had no idea my iPhone 5 was counting my steps for the past year! Check out the ‘health’ app: your’s might be too!)  For others, counting steps or tracking to a particular pace is not fun (gasp!) – for these folks, just getting out there and walking with a friend no matter the pace is what matters.

So find what inspires you … and just get out there and walk!

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Have You Tried Parsnip Fries?

Last week, I tried Parsnip Fries for the first time at my friend Chris’s house and it was a side-dish revelation (yes, the same Chris who shamed me into cooking more – read here). I cannot fathom why I haven’t read or heard about this delightful and nutritious dish – especially because it’s dead-simple to make, even for me, who does NOT like chopping!

I’ve mastered preparing asparagus and brussels sprouts for roasting – but have long struggled with all kinds of potato chopping.  Amazingly, I found peeling and chopping into ‘fry’ shape 1 parsnip far, far easier than the same prep for sweet potatoes. (I’m probably the only one who finds chopping oval sweet potatoes into long, rectangular or triangular fries difficult…but converting one shape to the other is just not intuitive to me.)

I was delighted to find that since the parsnip is already long and skinny-ish, it’s easy as pie for even spatially-challenged folks like me to cut into nice, rectangular fry-like shapes!

In fact, it was so easy I might even be able to relax my no-drinking-wine-while-chopping rule!  Though that’s probably a bad idea…

OK, now that you know the up-front chopping part is easy, wait to you see how easy it is to finish the prep.

Here’s the crazy-easy ‘recipe:’ wash and peel parsnip, cut into fry-shaped pieces, splash with olive oil, salt and pepper and a seasoning of your choice (see below) and bake on a cookie sheet at 425 or so for 20-30 minutes, turning once or twice.

As to seasoning, Chris used a balti seasoning which was quite good. I went with some garam masala which I liked equally well (if you’ve never shopped Penzeys Spices, they’re a great resource).  Best bet for this dish is to choose a spice with a little bite to complement the slight sweetness of the parsnip. When I make these again – and I will – I’ll try the same spice set I use for sweet potato fries – chili power and cumin – as that’d work too (though the garam masala was so good, it’ll be hard to shift!) Or you can use no seasoning beyond salt and pepper if you prefer.

ParsnipDinnerI served these fab, healthy ‘fries’ with mustard roasted fish, roasted asparagus and roasted brussels sprouts. Nary a fry was left.

Don’t they look good?

Even better – these crisped up nicely, have few calories and very little fat, have zero cholesterol and are a good source of dietary fiber! All that and they taste great too!

Give them a whirl – and comment back on your favorite seasoning!

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Study Proves Exercise Staves Off Bad Cholesterol

I’ve been in an exercise black hole since January 29th – the day I hurt my elbow shoveling. Since I had tennis elbow surgery 10 years ago, I knew this time to immediately stop playing tennis and quit spin to let my elbow heal. Suddenly it was 4 months later and I’ve gained weight and am out of the regular exercise habit.

YES, I could have done some other exercise. YES, I have both a treadmill and an elliptical in my home. NO, I didn’t use them and instead wallowed in my sadness that I’d reinjured my elbow.

And YES, I regret my sloth as I gained 5 pounds in four short months.

My elbow is still not 100% but now I’m on the slow path to regaining cardio fitness – and hopefully losing the weight that irks me daily as my jeans don’t fit.

And while exercise is harder than ever for me (getting old really bites: various body parts scream in protest when pushed), the good news is that a recent study of 11,000+ men proves that exercise may delay age-related high cholesterol levels.

An article entitled,The Effect of Cardiorespiratory Fitness on Age-Related Lipids and Lipoproteins was published online in the Journal of the American College of Cardiology, on May 11, 2015. While I can’t read the actual article as it costs $35 to purchase (!) I’m writing based on several reputable sources who reported on this study.

Researchers used data from the Aerobics Center Longitudinal Study in Dallas, Texas, collected from more than 11,000 men between 1970 and 2006 to assess total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides.

As Lisa Rapaport of Reuters reported in her article, Men Who Exercise May Delay Age-Related High Cholesterol, in the study, “researchers followed thousands of men over several decades, periodically drawing blood to test their cholesterol and then making them run on treadmills to measure their cardiorespiratory fitness. Men who could run longer and faster – signs that their bodies more easily deliver oxygen to muscles – also had lower cholesterol.”

“The better men did on fitness tests, the more likely they were to have lower total cholesterol, as well as lower levels of what’s known as low-density lipoprotein (LDL), the bad kind of cholesterol that builds up in blood vessels and can lead to atherosclerosis, blood clots and heart attacks.

Fitter men also had higher levels of so-called high-density lipoprotein (HDL), the good cholesterol that helps purge the bloodstream of LDL.

Men with higher cardiorespiratory fitness levels had better cholesterol profiles than less fit men from their early 20s until at least their early 60s, though the difference diminished with older age.

At the same time, men with lower fitness levels reached abnormal cholesterol levels before age 40.”

Said differently, unfit men were at risk of developing high cholesterol in their early 30s, but those with better fitness levels did not see it rise until their mid-40s, around 15 years later.

Dr. Gregg Fonarow, professor of cardiology at the University of California, Los Angeles, was widely quoted about this article online: “Exercise is a vital component of achieving lifelong cardiovascular health. Regular physical activity and maintaining physical fitness has been shown to be associated with a lower risk of [heart attack], stroke, and premature cardiovascular death.”

How much exercise is needed? According to study co-author Dr. Xuemei Sui, an Assistant professor at the Arnold School of Public Health at the University of South Carolina, to achieve the fitness levels necessary to ward off age-related high cholesterol, men should get 150 minutes a week of moderate activity (gardening, dancing, brisk walking) or 75 minutes of vigorous activity (jogging, running, swimming, cycling).

That’s 30 minutes of aerobic activity (a brisk walk!) five days a week, or 3-4 runs a week (or for me: tennis or spin 2-3 times a week).

Of course this study was done just with men. Actually, healthy white men. Of course that is incredibly frustrating. But I am going to go out on a limb and assume the same healthy benefits may confer on men and women in general.

And hope that getting back to the regular/daily exercise that will make my jeans fit again will also keep bad cholesterol at bay.

 

 

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Moist Dry-Poached Chicken Breasts

Two weeks ago, things reached a new level of low when my good friend, cartoonist Chris Juneau, asked, “Do you EVER cook anymore or do you eat out every night?”  While that felt a tad unjust (Chris’ query was in reply to my dinner invitation! At a restaurant where we’d won a gift certificate at Chris’ charity fundraiser!!), in the end, she was right. I’d pretty much stopped cooking (and gained weight, but that’s another story).

And with that single snarky comment, I’d been shamed right back into the kitchen.

That week, I made my usual favorites: Baked Arctic Char with Baked Sweet Potatoes (recipes on Going Lo-Co Recipe page) and Mustard Roasted Fish (see my Mmm Mmm Mustard Roasted Fish post for info and recipe).

Then I switched things up by using salmon instead of arctic char and made them both again. Yes, that was sarcasm.  Yes arctic char and salmon taste nearly identical. Yes, at this point, my husband bought some steak and grilled it while I baked more fish.

Clearly I needed help.

So at 5:30 one evening the following week I went to a different market – one where fish is not their best offering – and peered at some nice looking chicken. The package was labeled “dry-rubbed, beer-seasoned (oxymoronic on two levels: crazy, right?) boneless chicken breast.” They looked and sounded great, so I grabbed them.

It wasn’t until I got home that I found a problem: no cooking directions. Oh, and also that’s when I remembered that I absolutely detest dry chicken breast. And here I was with what was already advertised as dry.

Sigh.

But now it was dinner time and I was hungry and it was too late to go buy some fish. I briefly considered tossing the chicken and dining out, but even I was sick of pizza. That and Chris’s wagging finger taunted me (okay, so that part wasn’t literally true, but it kind of felt that way. It doesn’t help that Chris is a great cook and gardener. If she wasn’t so smart and so very funny I’d hate her.)

So I hopped online to look for a way to make the damn chicken I’d bought – and make sure it would be easy – and tasty.  What I found was a new-to-me technique called “dry-poaching” (yes, oxymorons abound in this post). I decided to give it a whirl because of it’s oh-so appealing title: “How To Bake Chicken Breasts in the Oven: The Simplest, Easiest Method.”

And it was GOOD and EASY.

My husband and I very much enjoyed this dry-rubbed chicken which I dry-poached, served alongside some leftover sweet potato and a kale salad I’d purchased at the same market.

A PDF of the recipe is here:  Dry-Poached Chicken Recipe. Read TheKitchn recipe editor Emma Christensen’s post for excellent photos and directions.

To me, this method is easier than cutting parchment paper into heart shapes and crimping them shut which is recommended in most ‘en papillote’ method directions – which feels a fussy to me. Though that said, one en papillote recipe to try might be Rachael Ray’s Chicken In A Sack which doesn’t sound fancy or fussy at all!

Finally, one last kick in the butt – this one to myself from myself. It wasn’t until I penned this post that I remembered I have another great, easy way to make moist chicken in like 15 minutes: my countertop grill/panini maker. I’d completely forgotten about my panini maker because with my son in college now I’m not making breakfast paninis all the time (see Panini Magic for recipes.) So my panini maker is no longer on my counter and I’d totally forgotten about it.

So now I’m recommending two lo-co, home-cooked-chicken alternatives to dining out: pull out some parchment paper and try this dry-poaching recipe or grab your George Forman indoor grill and griddle up a nice chicken breast. If you toss a few sweet potatoes in the oven (they warm up well – make more for leftovers!) and pair the chicken and potatoes with some pre-made fresh kale salad (and wine) and it’s as good as dinner out.

And certainly healthier and more lo-co than most of my dining out options. Plus there’s the added benefit of no risk of snarky comments from friends!

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Why You Should Ask For Advanced Lipid Testing

Controversies in Cardiovascular Medicine is the intriguing title of a 2009 article in the American Heart Association’s Circulation publication.

Stop laughing – cholesterol research can be intriguing!  I’d label the situation frustrating more than intriguing, but here’s what is going on.

The controversy is essentially that advanced lipid testing (explained in Cholesterol Tests Your Doctor Hasn’t Told You About) has been around for 50 years and is a better predictor of cardiovascular disease risk than standard cholesterol blood tests, and yet these ‘advanced’ tests are still not widely prescribed.

In fact, the ‘standard’ cholesterol blood panels (total cholesterol, LDL and HDL) often inaccurately portray risk for many people: those, for example, with normal cholesterol levels who heart attacks. And yet, standard lipid testing is still the norm.  It’s kind of crazy.

As explained in the Circulation article:

“Standard tests of low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) misidentify coronary heart disease (CHD) risk status in a substantial portion of the population. Tests of apolipoprotein concentrations are superior to standard LDL-C tests, and it can be argued that they should replace standard lipoprotein cholesterol testing.”

The Circulation article goes on to explain that the advanced testing used to be difficult and expensive – but this testing is now more widely available:

“Advanced lipoprotein tests that were previously available only from university research laboratories are now provided by several commercial laboratories.”

Indeed, since Berkeley Heart Lab (which was one of very few offering advanced lipid testing years ago) was bought first by Celera Corp in 2007 and then by Quest Diagnostics in 2011, it is now far easier — and inexpensive — to get advanced lipid testing!

And yet, it’s not widely prescribed.  Sigh.

I just had an advanced lipid panel done in December 2014. It wasn’t easy to get (my internist said not necessary; it wasn’t until I had to see cardiologist for sudden high blood pressure that he agreed it was a good idea). But I’m glad I did because I now have a much better understanding of my personal cardiac disease risk.

Here’s what I learned – and below these key points is some further info about test results that may be pertinent as you consider ASKING FOR advanced lipid testing:

  • My total cholesterol is ‘high’ at 266 and my LDL cholesterol is ‘high’ at 159
  • I have elevated ApoB (score of 123) which contributes to higher cardiac disease risk. But that is offset by other test results.
  • My LDL pattern is type A, which is optimal.  This is the fluffy kind that doesn’t stick to the arteries like the smaller, denser, more dangerous Type B LDL cholesterol.
  • My C-Reactive Protein score of 0.8 is also considered optimal / low risk.

Total and LDL Cholesterol: I find it frustrating that the lab reports still characterize my Total 266 and LDL cholesterol of 159 as ‘abnormal’ or ‘high’ (meaning, high ‘risk’) even though the November 2013 cholesterol guidelines say these scores are not, indeed, high or risky or need treatment. (The new guidelines indicate risk when  LDL>190, along with other factors).

Why do the lab reports not match the new guidelines?  This is inane.

ApoB: I am concerned about my elevated ApoB.  I wrote about apolipoprotein (ApoB) testing and explained why many believe it’s a better predictor of cardiac risk than LDL and total cholesterol testing in ApoB and Cardiovascular Risk.  So this is something I need to keep track of. Interestingly, the lab report says my score is ‘high’ risk and yet, when I dug further, I found a table that showed my personal target is probably <130 (see blog post for details).  Frustration #2 that there are not clear standards.

LDL Pattern Type: The type of LDL cholesesterol you have matters. As explained in the Physican’s Weekly article In The LDL World, Size Matters, roughly half of all people who have heart attacks have ‘normal’ cholesterol levels.  That’s because small sized LDL (Pattern B) can puncture the walls of the arteries and cause plaque buildup – so even ‘normal’ amounts can be dangerous.  If you have high LDL but it’s the Pattern A type which is big and fluffy, that cholesterol bounces off arterial walls so causes less plaque buildup and is thus less dangerous even if you have a ‘lot’ of it.

While I have the preferred / less dangerous Pattern A LDL cholesterol, I found in researching that Pattern B can be modified: if you have Pattern B, you can get it to change to pattern A with diet and exercise!  Which is great.  But that leads me to wonder whether just because I have pattern A now means it sticks (sorry, pun intended) or if it can change to pattern B.  I intend to stay with my lo-co diet and exercise plan, just wondering if I risk changing to Pattern B if I’m not careful. I need to check in with my cardiologist on this.

C Reactive Protein: I was relieved to find my C Reactive Protein score was low. As explained in a Circulation article from 2003 entitled C Reactive Protein: A Simple Test to Help Predict Risk of Heart Attack and Stroke, the C Reactive Protein test is an important measure in assessing cardiac risk. “When measured with new “high sensitivity” CRP assays, levels of CRP less than 1, 1 to 3, and greater than 3 mg/L (milligrams per liter) discriminate between individuals with low, moderate, and high risk of future heart attack and stroke…  Evidence also indicates that individuals with high CRP levels are at increased risk of developing diabetes.”

Now that the Advanced Lipid testing has provided a more in-depth look at my cardiac disease risk, I understand why my cardiologist feels that my 266 Total cholesterol is not terribly concerning. And doesn’t need treatment.

So if you, like me, want a far clearer understanding of your personal risk of cardiac disease, you should ask your doctor to order Advanced Lipid Testing, including scores for:

  • Advanced Lipid Panel Reflex Direct LDL (measures direct LDL and provides the info on particle pattern, number and size)
  • ApoB
  • C-Reactive Protein – the high sensitivity test

Sad to say you’ll probably have to ask your doctor to order Advanced Lipid Testing – he or she is NOT likely to order these tests unless you ask. Which is a shame.

Because as the Circulation article concludes, these tests have been around for 50+ years, are now easily and widely available, and they pick up risk that typical cholesterol panel testing might miss:

“One advantage of ALTs is the greater insight they provide clinicians into individual patient disorders often masked by standard lipid tests considered to be within “normal” ranges.”

It’s important to ask, because advanced lipid testing might reveal that although your cholesterol is not high, you are still at risk. This testing is easy, cheap and could save your life. It will provide you with a more in depth understanding of your cardiac disease risk.

It’s a simple, important question. Ask about advanced lipid panel testing the next time you see your doctor.

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