7 EASY STRESS REDUCERS

Stress will affect all aspects of your life, career, leisure time, and relationships.  Features include anxiety, intense fear or helplessness, dissociative symptoms, anger, insomnia, and avoidance behaviors.  Also stress will increase the release of corticosteriods, which will add weight, increase blood pressure, and damage the heart and other organs.  So its important to develop easy management tips you can do everyday.

1.  RELAX ON COMMUTE:  Take time going to and from work to clear your mind with relaxing music or book.  When you get to work, you will feel more relaxed and in better shape to seize the day.  When you get home, you will be able to enjoy the rest of your day without nagging worries.

 

2.  TAKE ME TIME:  This can be done while you are relaxing during your commute or at other times during the day, even 5 minutes of alone time will benefit.  This will help re-center the brain, focus on important tasks, and relieve stress.

3.  EXERCISE THE DEMONS:  I have mention some of the benefits of exercise in:

 http://dochealthmd.blogspot.com/2015/01/certain-weight-training-surpasses.html

            Exercising helps the brain by releasing endorphins, which will make you calmer, happier, and more confident.  Also, physical activity will help ease the tightness and tension accumulated within the muscles.

4.  WASH YOUR TROUBLES AWAY:  Taking a long hot shower or bath is generally relaxing in and of itself.  But to add in stress reduction, do it soon after work to symbolize ending and cleaning yourself of the workload and stress.

5.  FUN DINNER TIME:  Although venting may help at times, dinner should be used to talk about other things than work and stress.  Focus on past or upcoming fun events and activities.

6.  HOLD YOU HEAD HIGH:  When walking, keep your head up and back straight, and use good posture when sitting.  This will not only keep you focused on the task, but it will rejuvenate the mind and body by reminding of your importance and value to the workplace, community, and family.

7.  SLEEP IT OFF:  Practice good sleep hygiene.  Proper sleep hygiene will allow you to get the proper amount of sleep, and right kind of sleep.  Getting all stages of sleep, including REM, will allow your body and mind to rest, recharge, and get revved up for the next day.

TURKEY DISHES UNDER 350 CALORIES

Lemon-Rosemary Turkey Meatballs

Makes: 4 servings

Ingredients

1 medium onion, cut into chunks
2 large cloves garlic, smashed and peeled
2 teaspoons freshly grated lemon zest
2 tablespoons chopped fresh rosemary or 1 1/4 teaspoons dried, divided
1 pound 93%-lean ground turkey
3/4 cup fresh breadcrumbs, preferably whole-wheat (see Tip)
1/3 cup freshly grated Parmesan cheese
3/4 teaspoon kosher salt, divided
1/4 teaspoon freshly ground pepper, plus more to taste
1/4 cup all-purpose flour
2 teaspoons extra-virgin olive oil
1/2 cup dry white wine (or substitute more chicken broth)
1 14-ounce can reduced-sodium chicken broth
4 teaspoons lemon juice
1 tablespoon butter

 Preparation

Place onion, garlic and lemon zest in a food processor. Add 1 tablespoon fresh rosemary (or 1 teaspoon dried) and pulse just until the mixture is finely and evenly chopped (but not mushy).
Transfer the mixture to a medium bowl and gently mix in turkey, breadcrumbs, Parmesan, 1/2 teaspoon salt and pepper until combined. Use a generous 2 tablespoons each to shape the mixture into 12 meatballs (about 1 1/2 inches in diameter). Place flour in a shallow dish and roll the meatballs in it to lightly coat. (Reserve the remaining flour.)
Heat oil in a large nonstick skillet over medium-high heat. Reduce heat to medium, add meatballs and cook, turning once, until brown, 3 to 5 minutes total. Transfer to a plate.
Add wine (or 1/2 cup broth) to the pan, increase heat to medium-high and cook, scraping up any browned bits, until almost evaporated, 1 to 3 minutes. Add the can of broth and bring to a boil. Reduce heat to maintain a simmer and return the meatballs to the pan along with the remaining 1 tablespoon fresh rosemary (or 1/4 teaspoon dried). Cover and cook until the meatballs are cooked through, 8 to 10 minutes. Remove the meatballs to a serving bowl.
Bring the sauce to a boil over medium-high heat and cook until reduced to 1 cup, 4 to 8 minutes. Whisk lemon juice and 1 tablespoon of the reserved flour in a small bowl (discard any remaining flour); whisking constantly, add the flour mixture to the sauce along with butter and the remaining 1/4 teaspoon salt. Simmer, whisking, until slightly thickened, 1 to 2 minutes. Strain the sauce through a fine-mesh sieve. Serve the sauce over the meatballs.


Per serving: 346 calories; 15 g fat (5 g sat, 3 g mono); 78 mg cholesterol; 20 g carbohydrates; 0 g added sugars; 29 g protein; 2 g fiber; 641 mg sodium; 446 mg potassium.

Spice Turkey & Lettuce Wraps

Makes: 4 servings

Ingredients

1/2 cup water
1/2 cup instant brown rice
2 teaspoons sesame oil
1 pound 93%-lean ground turkey
1 tablespoon minced fresh ginger
1 large red bell pepper, finely diced
1 8-ounce can water chestnuts, rinsed and chopped
1/2 cup reduced-sodium chicken broth
2 tablespoons hoisin sauce, (see Note)
1 teaspoon five-spice powder, (see Note)
1/2 teaspoon salt
2 heads Boston lettuce, leaves separated
1/2 cup chopped fresh herbs, such as cilantro, basil, mint and/or chives
1 large carrot, shredded

Preparation

Bring water to a boil in a small saucepan. Add rice; reduce heat to low, cover and cook for 5 minutes. Remove from the heat.
Meanwhile, heat oil in a large nonstick pan over medium-high heat. Add turkey and ginger; cook, crumbling with a wooden spoon, until the turkey is cooked through, about 6 minutes. Stir in the cooked rice, bell pepper, water chestnuts, broth, hoisin sauce, five-spice powder and salt; cook until heated through, about 1 minute.
To serve, divide lettuce leaves among plates, spoon some of the turkey mixture into each leaf, top with herbs and carrot and roll into wraps.


Per serving: 276 calories; 11 g fat (3 g sat, 1 g mono); 66 mg cholesterol; 24 g carbohydrates; 0 g added sugars; 26 g protein; 5 g fiber; 543 mg sodium; 390 mg potassium.

Portobello Stuffed with Turkey

Makes: 4 servings

Ingredients

1 tablespoon extra-virgin olive oil
1 sweet onion, thinly sliced lengthwise
2 teaspoons cider vinegar
3/4 teaspoon ground sage
1/2 teaspoon chopped fresh rosemary
1/2 teaspoon salt
1/2 teaspoon freshly ground pepper
1/8 teaspoon ground nutmeg
1 pound 93%-lean ground turkey
4 medium-large portobello mushroom caps, gills removed (see Tip)
1 tablespoon Worcestershire sauce
1/2 cup finely shredded fontina cheese

Preparation

Position rack in the lowest position; preheat oven to 400°F.
Cook oil and onion in a large skillet over medium heat, stirring occasionally and reducing heat as necessary to prevent scorching, until softened and starting to turn golden, about 20 minutes. Stir in vinegar.
Meanwhile, combine sage, rosemary, salt, pepper and nutmeg in a small dish. Place turkey in a medium bowl and sprinkle the spice mixture over it. Gently knead to combine. Form into 4 equal balls. Rub mushroom caps on both sides with Worcestershire. Place one turkey ball in each mushroom cap, patting down to fill the cap. Place on a baking sheet.
Bake the stuffed mushrooms on the bottom rack until the mushrooms begin to soften, about 20 minutes. Remove from the oven, spread the onion mixture over the filling and top with fontina. Continue baking until the cheese is melted and golden and the turkey is cooked through, about 10 minutes more.


Per serving: 283 calories; 15 g fat (5 g sat, 4 g mono); 81 mg cholesterol; 9 g carbohydrates; 28 g protein; 2 g fiber; 530 mg sodium; 573 mg potassium.

UNIQUE PORK CHOPS UNDER 350 CALORIES

MARSALA PORK CHOPS

Makes: Makes 4 servings

Ingredients
1/2 cup Marsala (see Note), divided
2 teaspoons cornstarch
1/4 cup all-purpose flour
4 thin boneless pork loin chops (about 1 pound), trimmed
1/4 teaspoon kosher salt
1/4 teaspoon freshly ground pepper
2 teaspoons extra-virgin olive oil
4 thin slices prosciutto (2 ounces), chopped
1 small onion, halved and thinly sliced
3 teaspoons chopped fresh oregano or 1 teaspoon dried
3 teaspoons chopped fresh chives, divided
1 cup low-fat milk


Preparation
Mix 2 tablespoons Marsala and cornstarch in a small bowl; set aside.
Place flour in a shallow dish. Sprinkle pork chops with salt and pepper, then dredge in the flour.
Heat oil in a large nonstick skillet over medium-high heat. Reduce heat to medium and add the pork chops. Cook until well browned on both sides, about 2 minutes per side. Transfer to a plate. Add prosciutto to the pan and cook, stirring constantly, until browned, about 1 minute. Add onion and cook, stirring often, until it starts to soften and brown, 2 to 3 minutes. Add the remaining 6 tablespoons Marsala, oregano and 1 1/2 teaspoons chives and bring to a boil, scraping up any browned bits. Add milk and the reserved cornstarch mixture to the pan; adjust the heat to maintain a simmer. Cook, stirring occasionally, until the sauce has thickened and reduced slightly, 4 to 6 minutes.
Return the pork chops and any accumulated juice to the pan and simmer, turning to coat, until heated through, 1 to 2 minutes. Serve the chops topped with the sauce and garnished with the remaining 1 1/2 teaspoons chives.

Per serving: 332 calories; 12 g fat (4 g sat, 5 g mono); 78 mg cholesterol; 17 g carbohydrates; 2 g added sugars; 30 g protein; 1 g fiber; 526 mg sodium; 498 mg potassium.

APPLE PORK CHOPS WITH THYME

Makes: 4 servings
Ingredients
3/4 cup reduced-sodium chicken broth, divided
2 teaspoons cornstarch
2 teaspoons canola oil
4 4-ounce boneless pork chops, 1/2 inch thick, trimmed of fat
1 small onion, sliced
1 tart apple, such as Granny Smith, peeled and sliced
1/4 cup apple cider, or apple juice
2 teaspoons Dijon mustard
1/4 teaspoon dried thyme

Preparation
Mix 2 tablespoons broth and cornstarch in a small bowl.
Heat oil in a large nonstick skillet over high heat. Add chops and cook until browned, 2 to 3 minutes per side. Transfer to a plate.
Reduce heat to medium-high and add onion to the pan. Cook, stirring often, until it starts to soften and brown, 2 to 3 minutes. Add apple and cook, stirring often, until tender, 3 to 5 minutes. Stir in the remaining broth, cider (or juice), mustard, thyme and the cornstarch mixture. Bring to a boil, stirring, until thickened and glossy, about 1 minute. Return the chops to the pan and heat through. Serve immediately.

Per serving: 214 calories; 8 g fat (2 g sat, 4 g mono); 60 mg cholesterol; 11 g carbohydrates; 0 g added sugars; 23 g protein; 1 g fiber; 193 mg sodium; 335 mg potassium.

CRANBERRY PORK CHOPS

Makes: 4 servings

Ingredients
1/4 teaspoon dried thyme leaves
1/4 teaspoon salt, divided
1/4 teaspoon freshly ground pepper, divided
4 boneless pork loin chops, (1-1 1/4 pounds), trimmed of fat
2/3 cup cranberry juice cocktail, or orange juice
2 1/2-3 tablespoons clover or other mild honey
2 teaspoons canola oil
1/4 cup chopped onion
1 cup cranberries

Preparation
Mix thyme and 1/8 teaspoon each salt and pepper in a small bowl. Sprinkle both sides of pork chops with the thyme mixture.
Stir cranberry juice and 2 1/2 tablespoons honey in a 1-cup glass measure until well blended.
Heat oil in a large nonstick skillet over medium-high heat until hot but not smoking. Add the chops and cook until browned on both sides, 2 to 3 minutes per side. Push the chops to one side of the pan, add onion to the empty half and cook, stirring, until the onion is soft and beginning to brown, 1 to 2 minutes. Pour half the juice mixture into the pan. Add cranberries. Reduce heat to medium and cook, turning the chops occasionally, until cooked through, 2 to 4 minutes. Transfer the chops to a serving plate and tent with foil to keep warm. Add the remaining juice mixture to the pan. Increase heat to high and cook until the mixtures reduces to form a syrupy sauce, about 2 minutes. Season with the remaining 1/8 teaspoon salt and pepper and up to an additional 1/2 tablespoon honey to taste. Spoon the sauce over the chops.

Per serving: 301 calories; 10 g fat (3 g sat, 5 g mono); 81 mg cholesterol; 21 g carbohydrates; 30 g protein; 1 g fiber; 207 mg sodium; 421 mg potassium.

3 DELICIOUS CHICKEN DISHES UNDER 500 CAL

Chipotle-Glazed Roast Chicken with Sweet Potatoes

Makes: 6 servings



Ingredients


4 sweet potatoes (10 ounces each), peeled and cut into 1-inch pieces

2 1/2 tablespoons olive oil

4 chipotle chilies in adobo sauce, minced

2 garlic cloves, minced

2 tablespoons honey

2 teaspoons cider vinegar

1 1/4 teaspoons salt, plus additional to taste

1 teaspoon cumin

1/2 teaspoon cinnamon

6 boneless, skinless chicken breasts (2 pounds), rinsed and patted dry

Chopped cilantro, for garnish (optional)

Directions


1. Preheat the oven to 400 degrees. In a medium bowl, toss the sweet potatoes in the olive oil and scatter on the bottom of a roasting pan. Roast for 15 minutes.


2. In a small bowl, mix together the chilies, garlic, honey, vinegar, salt, cumin, and cinnamon to make a paste. Rub the paste evenly over each breast. 

3. Place the chicken breasts on top of the sweet potatoes and roast until the chicken is just cooked through, about 25 to 30 minutes. Serve garnished with cilantro if desired.

Nutrition facts per serving: 407 calories, 38g protein, 45g carbohydrate, 8g fat (1.3g saturated), 6g fiber

Coconut-Curry Chicken Fingers with Cashews

Makes: 6 servings


Ingredients


2 pounds boneless, skinless chicken breasts, rinsed and patted dry

1/4 teaspoon salt 

1/4 teaspoon freshly ground black pepper

1 1/4 cups light coconut milk

1 cup skim milk

3 1/2 tablespoons red curry paste

3/4 cup roasted, salted cashews

3/4 cup unsweetened coconut flakes

3/4 cup cornflakes

1 10-ounce bag baby spinach

Directions


1. Preheat the oven to 400 degrees. Lightly grease a large baking sheet. 


2. Cut the chicken into 3-by-1/2-inch strips; season with salt and pepper. 


3. In a wide, shallow bowl, whisk together one cup of the coconut milk, the skim milk, and 1 1/2 tablespoons curry paste. 


4. Mix together the cashews and coconut until finely chopped. Add the cornflakes and pulse until coarse. Transfer the mixture to a wide, shallow bowl.


5. One by one, dip the chicken strips in the coconut milk mixture, letting the excess drip back into the bowl. Place the chicken in the cashew mixture and turn to coat evenly. Transfer each chicken finger to the prepared baking sheet.


6. Bake the chicken fingers in the oven, turning once halfway through, until they are golden all over, about 10 minutes. 


7. While the chicken cooks, whisk together the remaining 1/4 cup coconut milk and remaining 2 tablespoons curry paste. Divide the spinach on plates and top with the chicken fingers. Drizzle the chicken fingers and spinach with the sauce and serve.

Nutrition facts per serving: 364 calories, 40g protein, 15g carbohydrate, 15g fat (6.4g saturated), 3g fiber

Chicken and Chili Stir-Fry

Makes: 4 to 6 servings



Ingredients


1 pound boneless, skinless chicken breasts, rinsed and patted dry

1/2 teaspoon salt

1/2 teaspoon black pepper

3/4 cup reduced-sodium chicken broth

1 1/2 tablespoons low-sodium soy sauce

1 1/2 teaspoons cornstarch

1 teaspoon honey

1 1/2 tablespoons canola oil

1 1/2 teaspoons sesame oil

1 small bunch scallions, chopped, whites and greens separated

3 garlic cloves, finely chopped

1 tablespoon peeled, grated fresh ginger

1/8 teaspoon red pepper flakes

2 cups bean sprouts

1/2 cup unsalted roasted peanuts
Steamed brown rice (optional)

Directions


1. Cut the chicken into 3/4-inch chunks; season with the salt and pepper. In a small bowl, whisk together the chicken broth, soy sauce, cornstarch, and honey. 


2. In a large skillet over medium-high heat, add the canola and sesame oils. When the oil is hot, stir-fry the chicken until just cooked through, 4 to 5 minutes. Transfer to a plate. 


3. Add the scallion whites, garlic, ginger, and red pepper to the pan; cook 30 seconds. Add the bean sprouts; stir-fry 1 minute more. 


4. Stir the broth mixture into the skillet and reduce the heat to simmer. Scrape the browned bits from the bottom of the pan and cook until the sauce is slightly thickened, 1 to 2 minutes. Stir in the peanuts, chicken, and scallion greens; cook 1 to 2 minutes more. Serve over brown rice if desired.

Nutrition facts per serving: 333 calories, 34g protein, 11g carbohydrate, 18g fat (2.3g saturated), 2g fiber

COMPARING ATKINS, ORNISH, WEIGHT WATCHERS, AND ZONE DIETS.

Many popular diets exists, many departing substantially from mainstream medical advice.  I will review the popular ATKINS, ORNISH, WEIGHT WATCHERS, AND ZONE DIETS.

The Atkins diet aims to began with less than 20g of carbohydrates daily, with a gradual increase toward 50g daily.  The Zone diet keeps their diet at a 40-30-30 balance for percentage calories from carbohydrates, fat, and protein, respectively.  People on Weight Watchers keep total daily “points” in a range determined by current weight.  Each “point” is about 50 calories, and most aim for 24-32 points daily.  The Ornish diet is a vegetarian diet containing 10% calories from fat. 

A study was done taking 160 participants randomly divide in either Atkins, Zone, Weight Watchers, or Ornish diet groups and followed for 12 months.  The changes from baseline calories to the end of 12 month calories in each is as follows:
   
                                  Baseline    12 mo
Atkins                         1898        1886
Zone                           2059        1757
Weight Watchers        2056        1832
Ornish                        1947        1819

The highest discontinuation rates were seen in the Atkins and Ornish diet groups, reporting that these diets were too extreme.  After 1 year, all 4 groups show weight loss, without significant differences between each.  In each group, about 25% of participants lost >5%, and 10% lost >10%.  Each group showed reduced total cholesterol, with the Zone (-10.1) and Ornish (-10.8), showing the highest, and Atkins (-4.3) having the least change.  HDL (the good cholesterol) had the same increase in Weight Watchers, Zone, and Atkins (3.4), with the Ornish having a decrease (-0.5).  Blood pressure decreased about the same in Weight Watchers, Zone, and Atkins, but had an increase in the Ornish group.  Although slight, the Zone diet seems to have the most cardiac protective effects.

Weight loss was similar in all diet groups, not necessarily because of the type, but rather the amount of food was decreased in all.  Another study divided people into 4 groups:

High carbohydrates, low protein, low fat
Low carbohydrates, high protein, low fat
Low carbohydrates, high protein, high fat
About equal in carbohydrates vs protein vs fat.

Each group had about the same weight loss.  Each group also consumed 500 calories per day less than they normally did.  Point-in-case, It not necessarily the food you eat, but how much you consume.  Most will see significant results of diets consisting of 1500 calories or less per day.
Proteins take longer for the body to digest and absorb than either carbohydrates, or fat.  Actually carbohydrates are digested the quickest, leading one to eat more carbohydrates to feel full.  Because proteins take longer to process, the body senses satiety quicker and stays full longer.


 I have previously mentioned this in the post:
http://dochealthmd.blogspot.com/2015/01/lose-1lb-per-week-with-these-protein.html

One study placed participants on a high-protein diet consisting of 20% fat, 50% carbohydrate, and 30% protein.  With greater satiety by the high protein diet, the subjects ate about 450 fewer calories per day and lost about 1 lb. per week (11 lbs in 12 weeks).

This diet is closest to the Zone diet, and a sample day's breakfast could be a cup of cooked oatmeal with a tablespoon of walnuts, a small handful of blueberries and 1/2 a scoop of protein powder. Your lunch could be a small tuna and light mayo sandwich accompanied by an apple and dinner a piece of baked cod with 1/2 cup of black beans and a mixed salad with olive oil. Between meals have snacks like a boiled egg and a piece of fruit, a small pot of cottage cheese with pineapple and cashews, or 1 ounce of pre-cooked meat with vegetable sticks and hummus.  I have listed recipe sources below.

STOP TAKING PRESCRIPTION MEDICATIONS FOR ANXIETY

Generalized Anxiety Disorder (GAD) is the most common anxiety disorder with a ratio of women to men at about 2:1.  The general causes are not well understood and the primary symptoms are anxiety, motor tension, autonomic hyperactivity, and cognitive vigilance.  GAD is affected by neurotransmitter systems, including gamma-aminobutyric (GABA), noradrenergic, serotonergic, and dopaminergic systems.

GABA is an important inhibitory transmitter in the nervous system.  Certain drugs may modify its effects by interacting with the GABA receptor, including barbiturates and benzodiazepines.  Benzodiazepines are the drugs most frequently prescribed for anxiety disorders, but have many drawbacks.  Benzodiazepines are associated with adverse effects such as daytime sedation, attention problems, ataxia, memory impairment, slowed psychomotor performance, and addiction/abuse.  The cessation of benzodiazepines can induce increased anxiety, apprehension, and irritability.  Examples include Ativan, Xanax, and Valium.  Since GAD is generally a lifetime disorder, the chronic use of benzodiazepines can be detrimental.



Passionflower (Passiflora incarnata) is an climbing vine with sedative/anxiolytic properties, and the British Herbal Compendium indicates its use for sleep disorders, restlessness, nervous stress, and anxiety.  Passionflower is found to have one of highest GABA content amongst plants, and has been found to induce direct GABA currents within the brain, supporting calming and relaxing properties.



A study was done on subjects meeting the DSM IV criteria for GAD.  The group was divided into two groups, one receiving passionflower (45 drops/day), and the other was given the benzodiazepine oxazepam (30mg/day) for 4 weeks.  Both groups were equal at reducing anxiety, but the benzodiazepine group had more side-effects and impaired job performance.  This study help support that passionflower may be a healthier alternative to benzodiazepines, especially with less side-effects.

The National Institutes of Health recommends one tablet containing 90mg everyday, or 45 drops of liquid extract per day.  As always, consult your primary care provided before use.  Examples of passionflower are listed below.

LEUCINE IS BETTER THAN ALL OTHER AMNIO ACIDS COMBINED FOR MUSCLE GROWTH

To maximize muscle hypertrophy during weight training, one must consume about 1.0-1.5 g/kg of protein.  Researchers have tested the effects of timing of protein supplement ingestion on various physical changes in weightlifters. In general, protein supplementation pre- and post-workout increases physical performance, training session recovery, lean body mass, muscle hypertrophy, and strength. Specific gains, differ however based on protein type and amounts. Studies on timing of consumption of milk have indicated that fat-free milk post-workout was effective in promoting increases in lean body mass, strength, muscle hypertrophy and decreases in body fat. The leucine content of a protein source has an impact on protein synthesis, and affects muscle hypertrophy.  A combination of a fast-acting carbohydrate source such as maltodextrin or glucose should be consumed with the protein source, as leucine cannot modulate protein synthesis as effectively without the presence of insulin. Such a supplement post-workout would be most effective in increasing muscle protein synthesis, resulting in greater muscle hypertrophy and strength.

Anyone involved in weight training would benefit by knowing ideal nutritional intake needed to maximize muscle growth and strength.  Multiple studies have indicated the amino acid leucine to be the sole stimulator of protein synthesis.  A study by Dreyer et al. confirmed this by comparing post-workout consumption of either no beverage or a leucine enhanced beverage.  Leucine alone appears to as effective in stimulating protein synthesis as when, if not better, then when all other branched chain amino acids (BCAAs) are consumed.

Numerous protein sources are available and generally come come in diary- or soy-based sources.  Two important qualities of these two sources are biological value (BV) and protein digestibility corrected amino acid score (PDCAAS).  Biological value is how efficiently protein leads to protein synthesis once absorbed with a maximum value of 100.  PDCAAS score is a maximum of 1.0, and is based on the protein’s completeness of their essential amino acid content. 

Cow’s milk generally contains 80% casein and 20% whey, with a BV score of 91 and a PDCAAS of 1.0; indicating its readily absorbed and promotes protein synthesis while providing all essential amino acids.  Casein by itself has a BV of 77, and whey has a better absorption and utilization with a BV of 104.  Both have a PDCAAS of 1.0.  Casein is what milk gets its milky white color from.  Soy protein has a PDCAAS of 1.0, containing all the essential amino acids, but its BV is 74, making it less bioavailable than milk.  Multiple studies have supported consumption of either protein source increases strength and lean body mass, with decreased body fat in both woman and men.  Studies have also shown that protein divided pre/post-workout (15g each) had superior results compared to all protein taken post-workout.  The best time to take protein is 45-90 minutes pre- and post-workout. 



Because leucine is the greatest amino acid in promoting muscle growth, it should be consumed during post-workout consumption.  3-4g of leucine content per serving needs to be consumed for maximal muscle growth.  Leucine potently activates the mammalian target of rapamycin kinase that regulates cell growth.  Infusion of leucine into the rat brain has been shown to decrease food intake and body weight via activation of the mTOR pathway.  Leucine is an essential amino acid, and so the human body cannot make it on its own.  The highest concentration of leucine is seen in soybeans (2.97 / 100g) compared to cow’s milk (0.27 / 100g).  It is very difficult to find a protein product that offers 3-4g of leucine per serving.  Examples of great leucine supplementation are listed below.

LOSE 1LB PER WEEK WITH THESE PROTEIN SMOOTHIES

There are 2 mechanisms by which increased dietary protein intakes can promote a negative energy balance and loss of body fat. The first is the ability of dietary protein to increase energy expenditure.  A more important mechanism by which dietary protein promotes weight loss appears to be its ability to produce greater satiety than do other macronutrients.



One study placed participants on a high-protein diet consisting of 20% fat, 50% carbohydrate, and 30% protein.  With greater satiety by the high protein diet, the subjects ate about 450 fewer calories per day and lost about 1 lb per week (11 lbs in 12 weeks).  Experts advise consuming about 0.5 grams of protein per pound of your body weight. That's 70 grams for a 140-pound woman.  Try to keep the maximum amount of protein to 30 g per meal and 20 g per snack.  The body can only absorb and utilize about 30-40 g at one time...any excess will be wasted.

Here are some protein smoothie options to start your day, that will keep the hunger down and under 400 calories.



RISE AND SHINE SMOOTHIE

1 cup organic frozen mixed berries
1 frozen banana
1 orange, peeled and segmented
4 – 6oz Vanilla Greek Yogurt

Calories 350
Fat:  1g
Protein: 15g
Fiber:  14g



CRIMSON TIDE SMOOTHIE

1-1/2 cups fresh strawberries, quartered
1/2 tablespoon raw sugar
1/3 cup reduced fat cottage cheese
1/2 cup fat free milk
1 cup crushed ice
1 tsp chia seeds
6 to 8 drops liquid stevia (optional)

Calories 213
Fat:  3g
Carb:  33g
Protein:  16g
Fiber:  7.5g

BANANA KICK SMOOTHIE

1 cup chilled Seattle's Best brewed coffee
1½ bananas, cut into chunks
1 cup nonfat plain Greek yogurt
1 tbsp ground flax seed
2 tsp honey or agave nectar
½ tsp ground cinnamon
¼ tsp grated nutmeg
6 ice cubes

Calories 126
Fat:  1g
Carb: 21g
Protein:  13g
Fiber:  2.5g



GREEN HULK SMOOTHIE

1 small frozen ripe banana, peeled
2 cups baby spinach
1 tbsp Better n Peanut Butter
3/4 cup unsweetened vanilla almond milk
1/2 cup plain fat-free Greek yogurt

Calories 250
Fat:  4g
Carb:  39g
Protein:  17.5g
Fiber:  5.5g

CERTAIN WEIGHT TRAINING SURPASSES MEDICATION TREATMENT FOR DEPRESSION

Depression results in substantial personal and social burdens, including impairment, reduced quality of life, and needing frequent health care interventions.  Those with chronic major depression are often misdiagnosed, with only 22% receiving adequate treatment, and 60% having adverse events from antidepressant medications.  A study in The Journals of Gerontology, was done comparing the effects of resistance training on depression.

The 8-week study compared the effects of assignment to one of three interventions for clinical depression: two exercise interventions (high intensity and low intensity) and a usual care group getting standard general practitioner care.  Participants fulfilled DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) diagnostic criteria for major depression, minor depression, or dysthymia.  Participants assigned to high intensity underwent a regimen of supervised high intensity of the large muscle groups, 3 days per week for 8 weeks.  Exercise machines included chest press, upright row, shoulder press, leg press, knee extension, and knee flexion.  For the high weight training group, the resistance was set at 80% of the one repetition maximum (1RM).  On each machine, participants performed 3 sets of 8 repetitions.  The low weight training group underwent low intensity resistance using the exact same regimen, except they were trained at 20% 1RM.  The group receiving counseling and pharmacological treatment through general practitioners had a average of 5 visits over the 8-week period.

Using the standard pharmaceutical trial definition of a 50% reduction in HRSD (Hamilton Rating Scale of Depression), the high resistance group saw an improvement over twice as effective (61%) compared to either low resistance (29%) or general practitioner group (21%).  Mean strength gains (averaged across all muscle groups) were about 37% in high resistance, 6% in low resistance, and −1% in the general practitioner care group.  The high resistance group saw a greater increase in quality of life:  physical function, role physical, vitality, social function, role emotional, and mental health. The high resistance group also saw the highest positive changes in overall sleep quality.




This study supported the efficacy and dose-response characteristic of weight training exercise for depression, surpassing the general practitioner and pharmaceutical treatment.  High intensity resistance training is superior to low intensity.  High intensity weight training involves 3 sets of about 6-9 repetitions using 70-80% of maximal load, 3 days a week.  Research supports reductions in depression for those doing aerobic exercise 3 days per week.  Weight training can be added to these aerobic regimens for greater gains in depression, or used as an alternative for those prevented from doing aerobic exercises due to comorbidities.  More importantly, high resistance training can serve as an alternative to pharmacological treatments, which are often not very effect with negative side-effects.

AEROBIC EXERCISE PREVENTS BRAIN LOSS FOR ALL

Beginning in the third decade of life, the brain shows structural decline, especially in cognitive processes.  The declining effects are prominent later on in life, which is especially important as the “baby boom” generation ages.  Studies support that aerobic exercise improves cognitive function, including:  working memory, switching between tasks, and inhibiting irrelevant information, all of which are thought to be sub-served, in part, by the frontal lobes of the brain.

Research shows that chronic aerobic exercise induce new capillary growth and interconnections of neurons (via dendritic cells).  This leads to a more flexible and adaptive brain.  One study found that older adults with a history of chronic aerobic exercise had better preserved brains then the same sedentary counterparts.  The greatest difference was in the frontal and parietal regions, responsible for memory, tasking, and personality.   

VO2 max is the maximum rate of oxygen consumption during exercise.  The more oxygen you body can utilize, the greater shape you in.  The average untrained male has a VO2 max of about 35-40 ml/(kg x min), and female 27-31 ml/(kg x min).  Elite runners can consume around 80 ml/(kg x min).

A study in The Journals of Gerontology examined 59 sedentary participants in a 6 months trial of aerobic vs toning exercise.  Each group attended three 1-hour exercise training session per week.  The aerobic group began at 40-50% of heart rate reserve with increases to 60-70%.  Heart rate reserve is the difference between one’s maximum heart rate and resting rate.  Maximum heart rate is calculated by 220 - age, and the typical resting heart rate in adults is 60-80 beats per minute (bpm).  So for a 60 y/o, the maximum heart rate is 160 bpm with a heart rate reserve of 90 bpm above resting heart rate, assuming resting heart rate is about 70 bpm.  Their heart rate reserve at 45% is about 40 bpm above baseline resting heart rate (70+40 = 110 bpm goal during exercise).  The change in maximum oxygen uptake (VO2 max) after 6 months was 16.1% increase in the aerobic group compared to 5.3% non-aerobic group.  The previous sedentary aerobic group had increases in brain volume, in both grey and white matter.


Aerobic exercise is very important in preventing age-related losses in brain structure, stimulating neuron proliferation and capillary bed growth in a simple and inexpensive way, not requiring medications, special tests, and multiple doctor visits.  Also, there is supporting evidence, as above, that only 6 months of regular aerobic exercise not only spares brain volume but also increases brain volume, even in previous sedentary individuals.  So now matter what your age is, there are benefits of aerobic exercise for all. 

To began your aerobic routine, calculate heart rate reserve (HRmax - HRresting), and aim to reach 40% of heart rate reserve to start, increasing slowly until you can maintain 60-70% of heart rate reserve during activity, which can generally be done in 12 weeks.  Many people can reach 40% of heart rate reserve by simply walking.  To see the benefits of aerobic exercise, perform the activity 3 times a week for 1 hour each time, or 6 times a week for 30 minutes.  You do not need be training like an Olympic sprinter to benefit from aerobic exercise.

REMOVE WRINKLES WITH RETINOL!!!

The skin becomes thinner, laxer, and more finely wrinkled through sun exposure, chronological aging, and stress.  BUT....the topical use of retinoids can offer significant clinical improvement!!!

Skin atrophies as it ages, evident by a thinner epidermis and dermis, reduced keratinocytes and fibroblasts.  Much of the skin’s texture is determine by collagen and its synthesis within the dermal area.  Sun-exposed areas, compared to sun-protected skin (i.e buttocks), has less collagen formation.  Collagen  synthesis can be stimulated by CO2 laser resurfacing and topical retinoic acid.  Retinol is a precursor of retinoic acid, and is much easier on the skin that retinoic acid.

Applied topically, retinol is oxidized to retinoic acid and starts to reverse skin atrophy.
The multiple effects of topical retinol are increased matrix molecules, collagen and hyaluronic acid within the skin’s dermis.  Hyaluronic acid is glycosaminoglycan that serves as an important component of many body tissues and the extracellular matrix.  After retinol stimulates and replaces key skin materials, results can seen by the naked eye as early as 2 weeks, but most see significant results by week 4.  Whether your wrinkles are caused by natural aging or sun-exposure, both can effectively be treated by retinol due to its pro-collagen synthesis.


Ideal treatment regimens consists of using 0.4% topical retinol cream applied 3 times per week.  Stop treatment if irritation or other negative side-effects develop.  Do not mix cream with other ointments, and allow the cream to be absorbed by the skin. 

RUNNING SHOES ARE HURTING YOU!!!

I have no affiliation to any shoe company, and do not receive any rewards.  I write as a doctor, trying to help others live a better life, based on experience and scientific research. 

Running shoes have significantly evolved in recent years, yet running injuries like tibial stress syndrome, compartment syndrome, plantar fasciitis, and stress fractures continue to be on the rise.  65-80% of runners suffer an injury annually, and between 1994 and 2007, running-related injuries increased by 34%.  These injuries cost the medical field over 18 billion dollars a year, and many psychosocial issues for individuals.  So why does it seem that running shoe technology and running injuries have such an inverse relationship?

The average runner applies about 3-5x of body weight force at each step.  Chances are a runner’s common path involves a hard surface like concrete, asphalt, or even treadmill...and very little natural surface (grass, dirt, and sand).  These surfaces have very little absorption properties, and the stresses are transmitted throughout the lower limb joints and back.  Image the difference between playing football on grass vs concrete!  Despite the changes in shoes, their advancement has not led to preventing injuries, rather possibly increasing problems. 



The running gait cycle begins and ends when the foot makes contact with the ground, and is divided into four phases: stance phase, early float, mid swing, and late float.  Today’s running shoes are generally loaded with cushioning, elevating the heel 8-16mm.  It is hypothesized that additional arch support and cushioning could be detrimental to overall foot and joint health. Extra support may result in decreased tissue tolerance to mechanical stress and secondarily predispose individuals to developing more injuries.   Naturally, humans are designed to strike the ground in a toe-heel fashion (toes hit the ground first), but traditional shoes have turned us into heel-toe strikers, significantly changing the foot/ankle physiology, predisposing to injury.  Also, the body is naturally leaning forward when running, which is supported by toe-heel running, and opposed during heel-toe running.



The foot is widest near the toes and slimmest at the heal.  The increased total surface area at the toes reduces focal pressures on surrounding joints and ligaments.  Think of the difference when walking on ice with snow shoes vs high-heels. 



Shoe runners tend to display excessive eversion of the heel at foot strike and this may lead to an increased rate of patella-femoral pain syndrome compared with barefoot runners.  The plantar fascia passes over and underneath the heal, making heel-toe running more likely to develop plantar fasciitis.  The heel-toe seen in running shoes leads to more vertical forces on distal joints, leading to knee, hip, and back problems.  Running toe-heel allows greater force displacement and less stress on the joints.  Furthermore, the calve muscles are contracting when running, but a heel first gait forces the calve muscles to stretch, making the ankle less stable and more prone to injury.  So in many ways traditional shoes can be counterproductive.  The extra cushioning, raised heel, and arch supports lead to significant changes in ankle kinetics, leading to injuries in multiple joints.  Orthotic devices are often rigid, which provide maximum strength and less flexibility, but can increase pressure on the bony prominences and contribute to the development of lower-extremity injuries, including stress fractures.


As discussed, barefoot running changes the ankle back to natural movement and function, reduces loading stress, and decreases risk of injury.  But to actually run barefoot today is very dangerous from puncture injuries (glasses, metal, nails, rocks, etc), and may be inappropriate is some circumstances.  Even though some find the toe shoes funny looking, they are essential in supporting barefoot running techniques while providing great protection.  If you are switching to barefoot running, do so slowly, as the lower limb has become accustomed to the maladaptive pattern set by traditional running shoes.  Without a stepwise approach, rushing into fully using barefoot running shoes can lead to injuries.  To transition, use the 10% rule and increase every week.  So the first week, run in your barefoot shoes 10% the time/distance you would normally do, and increase by 10% the next week.  Once transition has been completed, many report decreased joint and back pain, along with better posture and faster/easier running.  

KNOW WHAT'S IN YOUR DIET SUPPLEMENTS AND SAVE YOUR MONEY!!!

Over 50 individual dietary supplements and more than 125 commercial combinations for weight loss are available.  About 1/3 of U.S. adults are obese, with weight loss supplement sales earning well over $1 billion annually.  There is a clear disconnection, with many of the supplements being ineffective, and even more having serious negative side-effects.  Know what is in you supplement, their effectiveness, and probably save your money.


INCREASE ENERGY

Ma Huang- A shrub native to China and Mongolia that contains sympathomimetic compounds, called ephedra alkaloids, and was used to make Ephedrine.  One study showed a weight loss of about 2 lb. more per month compared to control group.  However, there is limited research, and no long-term data (>6 months) is available.  50 trials showed a 2.2-3.6 fold increase in developing psychiatric, autonomic, cardiovascular, and gastrointestinal symptoms.  More specifically, these reports included episodes of hypertension, arrhythmias, myocardial infarction, stroke, and seizures, with 10 deaths and 13 with permanent disability.
    Related supplements with similar actions and side-effects:    Bitter orange and country mallow




INCREASE CARBOHYDRATE METABOLISM

Chromium- The deficiency of this elements is associated with hyperglycemia, hyperinsulinemia, hypertriglyceridemia, and low levels of high-density lipoprotein cholesterol.  It is believed that chromium helps control carbohydrate metabolism, influencing weight.  But...cases on healthy people without diabetes does not support this theory and data on those with diabetes are indeterminate.  Rhabdomyolysis and renal failure, possibly related to ingestion of more than 1,000 mcg daily of chromium picolinate, have been reported, do to free-radicals from chromium.

Ginseng- No control trials currently exist that show it supports weight loss.




DECREASE HUNGER

Guar Gum- This supplement is derived from the Indian cluster bean, Cyamopsis tetragonolobus, but no study supports weight loss.

Glucomannan- Is a dietary fiber from plants.  Is well tolerated with some evidence of minor weight loss with dosages of 3-4g/d, but only very few small trials have been performed.

Psyllium- Derived from the seed husk of Plantago psyllium.  This shows evidence of improving glucose and lipid levels in diabetes (type II), but did not support weight loss.




INCREASE FAT OXIDATION/REDUCE FAT SYNTHESIS

Hydroxycitric Acid (HCA)- This comes from the Malabar tamarind tropical fruit (Garcinia Cambodia) native to India, with effects on the mitochondria.  One 12-week study found a 2 lb. weight loss in woman using 750mg/d, but another study using 1,500mg/d in both sexes showed no benefit.

Conjugated Linoleic Acid (CLA)- Is a group of trans-fatty acids known to reduce fat uptake in obese mice.  Current research does not support weight loss, with reports of gastrointestinal side-effects (e.a. diarrhea and nausea).

Green Tea- Contains catechins which support weight loss and fat absorption.  But effects are seen after 650mg/d of catechins (5-6 cups of green tea).  Supplements are available to achieve this amount.

Licorice- Some reports of reducing body fat mass, but has serious side-effects:  Psuedoaldosteronism, hypertension, and hypokalemia.

Pyruvate- This is an organic acid involved in many metabolic pathways.  A small 6 week study showed a 2 lb. weight loss, but there remains no large conclusive studies.  May cause diarrhea and bloating. 




INCREASE WATER ELIMINATION

Dandelion- Appears to have diuretic activity, but weight loss studies are lacking and could cause serious negative side-effects similar to conventional diuretics (dehydration, electrolyte abnormalities, heart arrhythmias).




OTHERS

St. John’s Wort- Is a flowering plant of the genus Hypericum.  No support for weight loss exists

Spirulina- This blue-green algae contains phenyalanine, but the FDA has declared no effectiveness for weight loss.

Apple Cider Vinegar- Does contain some vitamins and minerals, but has not been studied for weight loss. 

GREEN TEA WILL HELP WITH WEIGHT LOSS

The benefits of green tea are growing each year.  Of the benefits of green tea, weight loss may be the most important.  Research strongly supports that waist circumference is a better predictor of health problems than body mass index (BMI).  BMI is usually determined by the skin pinching test.  Your body consists of different kinds of muscle, nerve, endocrine, and connective tissue/cells.  So it seems logical that different fat cells would exist, and they do!!!  This is important because different cells to do not respond to hormones, drugs, stress, etc., homogeneously.  So, certain compounds may be used to specifically target fat cells linked to obesity.

Without going into great deal, basically two different types of fat exists, subcutaneous and visceral.  Subcutaneous fat exists underneath the skin throughout the body.  Visceral fat is deeper within the body and surrounds mainly the abdominal organs.  Research supports that basal free fatty acid (FFA) flux, lipolysis rates and secretory protein expression are markedly higher in visceral compared with subcutaneous fat cells.  These findings suggests visceral fat cells are more influenced by stress, hormones, and calories compared to subcutaneous fat.  Visceral fat is also linked to obesity related health concerns like diabetes, heart disease, hypertension, and cancers.  Subcutaneous fat plays more of a body insallation role to stay warm, so it stays more consistent then visceral.  When fat is gained, both types can expand, but visceral fat gain greatly exceeds that of subcutaneous.


Catechines are a plant secondary metabolite that is a natural phenol and antioxidant.  They not only help reduce existing fat cells, but also prevent dietary fat-induced weight gain.  Stored fats can be released and oxidized to create energy, called lipolysis.  Visceral fat has the highest rate of oxidation compared to subcutaneous fat.  Tea catechins have be shown to increase fat oxidation, particularly during the postprandial (after eating) period.  This supports that catechins burn stored fat and reduce new fat from being absorbed.    A study in the Journal of Nutrition, found  that subjects consuming green tea catechins (625mg/d) after 12 weeks had a 8.7% intra-abdominal fat area loss compared to 0.3% fat loss by the control group.  They also found that people consuming catechins had an increased baseline metabolism (3-4% increase in 24h energy expenditure).




So, catechins can be consumed to aid in weight loss and prevention.  By specifically targeting abdominal fat (visceral), the waist will decrease along with store fat, decreasing chances of diabetes, hypertension, heart disease, cancers, etc.  When combined with exercise, the oxidation of fat effect is increased.  But the type of exercise is very important.  Fat oxidation takes multiple steps and requires oxygen, so aerobic exercise (jogging, dancing, biking, etc) will support more fat oxidation compared to anaerobic (weight training, sprints, etc).  The effects of green tea catechins are found after consuming about 625mg/d of catechins.  Brewed green tea contains the most catechins but to reach 625mg, you have to drink about 5-6 cups per day, which can be hard to do on a consistent basis.  However, this can achieved by taking catechin supplements, which can be found at most vitamin and health store.  The best deals I have found are on Amazon.