Calculate your risk of hip fracture

I just found a very cool new online tool to calculate your risk of hip fracture after age 50 at http://hipcalculator.fhcrc.org/

Researchers used data from 94,000 Women's Health Initiative participants to develop an algorithm to calculate risk of hip fracture in the next 5 years. Activity level, smoking status, weight, use of some specific medications, and family history of fracture after age 54 are factored into the equation.

Since over 300,000 people in the US suffer a hip fracture each year, and fracturing a hip is also associated with increased risk of death and future health decline, identifying people at risk for hip fracture is crucial.

Steps you can take right now to reduce your risk of hip fracture and subsequent health problems:
- increase your daily activity so that you walk for an hour at least 4 times per week
- stop smoking
- get 1200-1500 mg of calcium each day primarily from food, but making up the difference in supplements (each cup of skim milk has approximately 300 mg of calcium)
- take the fracture probability quiz, and talk with your physician about the results

Thanks to healthy parents, a lifetime of drinking milk, and consistent physical activity starting as a child and continuing to today, my risk is <.5%. Be sure and calculate yours.

Red cabbage

It's been years since I've eaten red cabbage.

Yesterday I cooked a German dinner with Caro, an exchange student from Frankfurt, and her American host family. Caro and our German exchange student for two weeks in October, Lena, became good friends, and we cooked a meal together at my house when Lena was here. We decided to try another culinary adventure, but this time at Caro's.

Rotkohl, or red cabbage, was on the menu. I remember eating a lot of cabbage during my time in Germany, but I've never cooked it before. Once we found a sharp knife, the rest was easy! We braised the sliced cabbage with diced onion and apple, and added cider vinegar, a bay leaf, allspice, salt, pepper, and a bit of sugar for seasoning. I loved it, and it brought back great memories of Germany.

If you're tired of eating Italian, Thai, or Chinese food; or just want to try out some German cooking, check out http://www.allrecipes.com/ which has hundreds of authentic German recipes. Or invite a German exchange student over for a cooking lesson.

Turkey thoughts: the day after

T is for time; I'm so lucky to be able to have time to spend with my kids, husband, friends, and family.

H is for health - we're all basically healthy!

A is for attitude; a positive attitude, that is. I firmly believe that if we face life with a positive, can-do attitude, that most of what we want will come to pass.

N is for neighbors. We have wonderful neighbors who are fun to be with, pitch in to help without a moment's thought, and make living in our neighborhood a pleasure.

K is for kitchen. Why is it that when you're together in the kitchen, conversation and fun just seems to happen? Yesterday my husband and kids all helped prepare the Thanksgiving meal, and we had a lot of fun!

S is for sisters. I have two wonderful sisters who I miss terribly, but do we ever have fun when we get together!

G is for grandparents. I was blessed to have four grandparents and one greatgrandfather who were very important parts of my life for years. I wouldn't be who I am without them. Even better, my boys know their grandparents, and also were able to spend time with two of their greatgrandparents before they passed away.

I is for the Internet. Much of my work relies on using the Internet, plus it helps me stay connected with friends and family.

V is for Vermont, the gorgeous state where I live. Even though I've lived in Vermont for 20 years, the sight of the mountains never fails to lift up my spirits.

I is for ideas. I love to hear my boys' ideas about what they want to do with their lives; my husband's ideas for the next chapter in our lives when our kids go to college; my friends' ideas about life in general.

N is for everything new. It's easy to get caught up in doing the same things, in the same way, over and over again. Spice up life with something new!

G is for gifts. Every day, look for the gifts in life. It might be an unexpected hug from a 16 year old who is almost 6' tall. Or a smile from a stranger as you pass on the street. Or an email from a college friend you haven't seen in years. Gifts are everywhere, if we're open to seeing them.

Earn money to lose weight

Money!

That's what it takes for people to stick to a meal and exercise plan and lose weight, according to a recent study by RTI International economist Eric Finkelstein.

The more money people "earn" by losing weight, the more weight they lost. Finkelstein found that over a three month period, people who were paid $14 per percentage point of weight lost were five times more likely to lose at least 5% of their body weight. That means for losing 5% of their weight (10 pounds if you weighed 200 pounds at the start of the contest), you earned $70.00.

Stay tuned for a new website, stickK.com, where you can "put a contract out on yourself". In this case, you pick a price, and if you don't lose a certain a mount of weight the money goes to a charity, friends, or family - your choice. Reach your weight goal, and you get to keep your money.

I have to say I'm skeptical, despite the research to the contrary. I've worked with a few teens whose parents offered to pay them to lose weight. The teens either didn't lose weight, or they lost weight to earn a specific amount of money, then gained the weight back.

Ultimately, having an internal, intrinsic reason for losing weight is more important and significant than a monetary reward in my way of thinking. It will be interesting to see the results from www.stickK.com once they launch. Stay tuned!

Holiday food tips

The first gifts of food are starting to roll in, which brings up the question: what the heck do I do with all these tempting treats? Here are my favorite tips and tricks:

1. Donate to the food shelf. Anything non-perishable is welcome at most community food shelves.

2. Donate to an after school program or community center.

3. Regift to someone else - just make sure they didn't also receive the same gift!

4. Share by saving up all your food gifts for an open house at work or church.

5. Enjoy one treat at a time. I like to look at everything I receive, decide which looks like it tastes the absolute best, then sit down and savor just one bite. Sometimes one bite is all I need. Of course, sometimes two bites are even better! We certainly can enjoy some treats over the holidays, just in portions that we decide are appropriate.

Happy holidays!

Emotional Eating

I asked this question at a talk over the weekend: why do we eat?

There was a lot of silence. Finally, someone said: because we need to eat to live.

My response: I bet that's the LAST reason why most of us eat! Then everybody starting nodding their heads in agreement.

Sure, eating to live is the basic physiologic reason to eat. The fact is, though, that because we live in a society with so much abundance of food, we often eat for emotional, rather than physical reasons. It doesn't matter if we eat an apple or a cream puff. If we're not physically hungry, our body doesn't need those calories, and they end up getting stored as fat.

If you find this topic interesting, check out my online article at Today's Diet and Nutrition: http://www.todaysdietandnutrition.com/nov07exclusiveemotional.shtml Let me know what you think!

Food therapy

I met with one of my coaching clients today who is working to change his eating and exercise habits so that he can lose weight and control his blood sugar levels. He's lost 10 pounds in the past 3 weeks due to hard work, determination, setting specific goals, and carrying through with those goals. He also has a lot of support and encouragement at home. Today he met with his physician, who asked him about working with me. My client calls it "food therapy". I love it!

We don't talk about what to eat and what to not eat. Instead, we talk about how he chooses what to eat, how different foods act in his body, and which foods fit into his goals of weight loss and controlling blood sugar. Our work together is all about defining past eating habits and figuring out what he wants his new eating habits to look like.

For most of us, food is more than simply fuel for our body. Food is tied up with emotions, traditions, celebrations, habits, and family heritage. We can't just give up eating, like people can choose to give up smoking or drinking alcohol. Each person comes to making changes in their eating habits in their own, individual way, which is what makes food therapy so interesting and exciting to me. Each person charts their own course, with their own specific goals in mind.

If you're struggling with changing your eating or exercise habits, perhaps for health reasons or maybe for other personal reasons, think about shifting your focus to food therapy. It's not what you "should" do, but rather what you "want" to do.

November challenge completed!

Mike and I climbed the Burr and Burton, or Blue Summit Trail, to the top of Mt. Equinox yesterday. According to the Day Hiker's Guidebook, it's a 4.5 hour trip but we made it in three hours. The summit is at 3848', the highest mountain in our area.

Even though we've lived where we can see Mt. Equinox for the past 16 years, driven up the toll road, and even hiked at both the summit and the base, we'd never hiked up the entire mountain. That was the challenge!

The trail was steep - the whole way. Unlike most trails that go up and down, there was no down until you reached the top and turned around. The first half was along an old gravel road, covered in leaves. The second half was a rocky trail, more like an old streambed than a real trail. There weren't as many leaves, but numerous downed trees we scrambled over or under.

The hike up Equinox got our hearts pounding, while the hike down was a real workout for our quads.

A beautiful day, great company, and another monthly challenge checked off my list! Challenges so far:

June: Green Mountain Relay Race

July: 5K trail run in Rutland

August: Olympic distance triathlon at Lake Dunmore

September: Century bike ride in Saratoga Springs

October: Cape Cod Marathon

November: summit Mt. Equinox

I don't have a set challenge yet for December. If we have snow, it might be a snowshoe race. If there's not enough snow, perhaps I'll do a run on New Year's Eve. Stay tuned!

How many calories do you drink?

Many of us routinely read food labels and keep track of the number of calories we eat. But how many calories do you drink?

Sweetened beverages such as soda and fruit drinks are the number one source of sugar in our diet. A 12 ounce can of Coke contains 140 calories, all from sugar. Snapple isn't any better: one bottle has about 220 calories.

Alcohol provides more calories than we realize as well. The higher the alcohol content, the more calories. Beer has 12 calories per ounce, white wine 20 calories per ounce, red wine 21 calories per ounce, and 80-proof spirits (gin, vodka, etc) 64 calories per ounce. Since nobody drinks just one ounce, it adds up faster than you think.

Calories in beverages don't make us feel full, either. In fact, we often eat even MORE when we drink alcohol, getting a double-calorie whammy.

Makes you want to drink a cool, tall glass of water, doesn't it?

How much should I eat?

I get asked this question all of the time. There are several ways to respond:

1. We can look at the food label and find out the serving size. For example, 2 Fig Newton cookies is a serving.

2. We can think about the amount of calories we're eating, and fit our snack or meal into a prescribed calorie range.

3. We can think about how hungry we are, and how much to eat to satisfy that hunger.

I really prefer the third method, because we're in charge. Many of us routinely overeat, either out of habit, because we just don't think about it, because we don't want to waste food, or because we like feeling stuffed. When we overeat, our body can only store the extra calories as fat, and most of us don't need the extra body fat!

Try this the next time you're deciding how much to eat:
- Take a couple of minutes to think about how hungry you are.
- Remember that our stomach doesn't hold an unlimited supply of food. Serve yourself the amount you think you want to eat, but realize that you don't have to eat it all.
- Eat half of the food you served yourself, then stop and think. How full are you? How would you feel if you stopped eating right now? How would you feel if you continued to eat? There's no "right" decision here - it's up to you and how you're feeling.
- At the end of the meal, stop and think again about how full you are. Stop eating when you are just barely full. You could eat a couple more bites, but know you're OK if you don't eat any more.

The more often we eat mindfully, typically the less we eat and the more energetic we feel.

Visualize food portion sizes

Are you a visual person? If so, you definitely need to check out Dr. Shapiro's Picture Perfect weight loss plan at http://pictureperfectweightloss.com/

I just love these books, because they're full of absolutely gorgeous pictures of foods, demonstrating how we can eat - and enjoy - far larger portions of foods that are naturally lower in fats and sugars than junk foods, fast foods, and convenience foods.

What would you rather eat:
- one 4.5 ounce black and white cookie; or 2 frozen yogurt cones, 2 cups of fresh fruit, 6 hard candies, and 8 chocolate mint sticks? Both have 640 calories.
- 8 ounces General Tso's chicken (620 calories) or 12 ounces scallops and Chinese vegetables in black bean sauce (320 calories)?
- 1 large soft pretzel, or 11 pretzel rods, or 3 knishes or 3 cups of fresh fruit salad with 2 ounces of peanuts? All options have 470 calories.

Shapiro not only describes these meals, he photographs them in vivid real-life color. He simply recommends eating more lower calorie foods that have higher volume so we feel full. Thinking before we eat makes a whole lot of sense, especially if we can visualize our meals.

Too much folate?

Folate is an essential B vitamin, needed by our body to synthesize DNA. Cells produce DNA every time they divide, and cell division goes on constantly within our bodies. A few years ago, scientists drew a connection between low intake of folate in the first few days of pregancy and the development of spinal bifida and other neural tube disorders in children. Breads and cereals now contain added folate, which has resulted in 1500-2000 fewer cases of neural tube defects each year.

But - new research shows that too much folate, most likely over 800 mcg per day (the current recommendation is 400 mcg per day), can cause increased risk of a variety of different types of cancer, including colon, breast, and prostate. The thinking is that if you have precancerous cells and get too much folate, those cells may divide more quickly, leading to cancer.

Most multivitamins contain 400 mcg of folate, and if you eat a few servings of cereal or granola/cereal bars with added folate it's easy to go over 800 mcg per day. Folate naturally occuring in foods doesn't seem to cause a problem; it's the supplemental folate that appears to be the culprit.

Food labels carry a %DV (percentage of the Daily Value) for vitamins and minerals, not the specific grams, milligrams, or micrograms. The Daily Value for folate is 400 mcg, so if the food label says one serving has 40% of the DV, that's 40% of 400, or 160mcg.

For now, follow these suggestions:
- Keep taking your multi vitamin with 400mcg folate
- If you use protein shakes, smoothies, or other fortified beverages, read the labels for folate content.
- Look at your intake of cereals, granola bars, cereal bars, etc for folate content.
- Keep total folate intake from your multi and fortified foods to under 800 mcg per day.

Running over hurdles

I love to read quotes, and often save my favorites for future use. Here's one I came across today:

"Obstacles are those frightening things that become visible when we take our eyes off our goals." Henry Ford

Wow! How often do we get so caught up in worrying about obstacles, that we forget to keep our eye on the prize? Bumps in the road are going to happen. We will sometimes run into hurdles, instead of leaping over them.

But if we keep our focus squarely on where want to go - and why it's important for us to get there - we'll reach those goals.

What goals are you focusing on today?

Cost of obesity

Did you know that being overweight will end up costing you more?

That's not because you spend money on gym memberships or weight loss programs. It's the monetary increases in health care costs that really add up.

According to Zhou Yang, Ph.D. , lead author of a study published in Health Services Research, found that an elderly person who is overweight at 65 may spend $16,000 more and the obese person may spend $26,000 more than those who are a normal weight at age 65. I don't know about you, but I can think of a lot of ways I'd rather spend money than on health care!

Try these three steps to reduce your weight AND save money:
1. Get moving. Build up gradually so that you're getting some type of exercise for at least 60 minutes total every day. That could be a 15 minute walk in the morning, 20 minutes gardening, 15 minutes walking in the evening, 10 minutes walking up and down the stairs during TV commercials.

2. Avoid beverages with calories - except for skim milk. Instead of fruit juice, drink water and eat a piece of fruit. Make sure you choose skim milk for the fewest amount of calories yet slightly more calcium. Skip drinks sweetened with high fructose corn syrup and opt for water again. Avoid alcohol - you can better protect your heart by losing weight and exercising.

3. Eat one bite less of every food, all day long. If you eat one bite less of every single food you eat all day, you'll consume fewer calories and learn to get by with less. You'll also learn that you don't have to eat everything put in front of you.