Tom Brokaw was the keynote speaker last week as The Cooper Institute celebrated its 40th anniversary. The celebration paid tribute to Dr. Kenneth Cooper, whose name is synonymous worldwide with wellness and physical fitness programs. “Long before wellness became part of the health care debate, Ken Cooper was promoting fitness and personal responsibility, a message that has an enduring urgency for all ages," said Brokaw, now a special correspondent for NBC News. The former NBC Nightly News anchor spoke about his personal passion for healthy living at the luncheon.

Today Mr. Brokaw remains very active and has found an interest in cycling as can be seen in the exclusive interview with Dallas News NBC 5 below¹:

Cycling is a great non-impact activity for the body. It has a MET equivalency of 8 to 10 METs depending on speed and terrain². In understanding METs, this really means that cycling burns 8 to 10 times as much energy as just sitting at rest. This would equal about 320 to 400 calories for a 170 pound individual cycling for 30 minutes.

As you can see from the caloric energy expended, cycling is an effective means of exercise. This was also confirmed by an article³ in the Archives of Internal Medicine discussed in the previous blog "Health Benefits of Active Commuting" that adults who reported walking or riding a bike as part of their commute to work were more physically fit. Also if you choose, it can allow you to see the world like Brokaw has done through his cycling. Cycling does have some risks, although you can work to reduce those as is discussed in "Being Bikeable."

One of the big ways to reduce risk is by wearing a helmet, which is almost as simple as wearing a seatbelt. Research shows that helmets have a significant effect on lifesaving capabilities like a seatbelt. Thompson’s study⁴ in the Journal of the American Medical Association indicates that bicycle helmets, regardless of type, provide protection to cyclists of all ages involved in crashes, including those involving motor vehicles. In the study it was found that helmet use was associated with a reduction in the risk of any head injury by 69%, brain injury by 65%, and severe brain injuries by 74% compared to those who did not use a helmet.

Physical activity has been said to help save lives, and based on the research above, a bicycle helmet should be considered in the same regards. A helmet should be part of the gear that goes along with bicycling. 

So grab your helmet and go see the trail, the streets around your house or even the world – all on a bike.

¹ McGarry, J. (Producer). (2010). Brokaw talks passion, surfing and serving america . [Web]. Retrieved from http://www.nbcdfw.com/station/as-seen-on/Brokaw-Talks-Passion-Surfing-and-Serving-America-92452599.html

² Ainsworth BE. (2002, January) The Compendium of Physical Activities Tracking Guide. Prevention Research Center, Norman J. Arnold School of Public Health, University of South Carolina. Retrieved [02/25/10] from the World Wide Web. http://prevention.sph.sc.edu/tools/docs/documents_compendium.pdf

³ Gordon-Larsen P, Boone-Heinonen J, Sidney S, Sternfeld B, Jacobs DR, and Lewis CE.  Active Commuting and Cardiovascular Disease Risk:  The Cardia Study.  Archives of Internal Medicine.  2009;169(13):1216-1223.

⁴ Diane C. Thompson, Frederick P. Rivara, and Robert S. Thompson. Effectiveness of Bicycle Safety Helmets in Preventing Head Injuries: A Case-Control Study. JAMA, Dec 1996; 276: 1968 - 1973.

"Save America's cooking skills!" "Improving food literacy!" Everyone from nutritionists and obesity researchers to chefs are starting to shouting these slogans. Why? Because many Americans can't cook, resulting in a dinner choice of either eating out (often fast food) or packaged, convenience food (often high in fat, salt, and calories).

Researchers in Australia (Queensland University of Technology) are leading a research project to study food literacy in young adults (16-26 years old) and how to improve them. Specifically, they're defining food literacy as a "combination of food choices, shopping, and cooking" and looking at what food skills people need to be healthy and how measure and influence them.

While the results of this project are pending, other studies have shown that Americans' cooking skills have declined over the past few decades. Here are a few questions from a cooking test put out by the National Pork Producers Council¹:

1. How many ounces are in a cup - 4 ounces, 6 ounces, 8 ounces, or 16 ounces?
2. True or False? To retain the vitamins when cooking vegetables, use little water.
3. Marbling in meat indicates: tenderness, fat content, freshness, or aging?

Answers: 8 ounces; true; fat content.

How did you score? When 735 adults were asked these and other cooking knowledge questions nearly three-quarters flunked. The survey found that 50 percent didn't know how to thicken gravy correctly, 75 percent didn't know that broccoli should be cooked uncovered to maintain its color, and only 55 percent knew there are three teaspoons in a tablespoon.

Some argue that Americans are cooking less today because food companies have persuaded people it's faster and easier (no shopping, prep, or clean-up) to buy prepared food; Americans see cooking as a weekend recreation rather than an everyday occurrence; and lack of parental cooking over the years has led to more people who don't have the know-how or confidence to cook. Others, however, argue that more Americans are cooking today to save money and enrollment in cooking classes (including online cooking classes) and purchases of cookbooks has increased.

Either way, it's probably worthwhile for all of us to reflect on whether we know how to dredge, braise, and butterfly or when to add a little thyme or cumin to a meal. By cooking at home we can ensure healthful foods are served to our families, can save money, and can put on a tea or dinner party, if needed.

The most recent champion of keeping Americans' cooking skills alive is Jamie Oliver, British chef and star of Jamie Oliver's Food Revolution recently broadcast on ABC. He asks Americans to "start a food revolution in your own home, all you need to do is cook something. From scratch. With fresh and raw ingredients - no packets, no cheating!" and pledge to do it once or more each week with family and friends. To get started, his website provides a variety of recipes, how-to videos, and listings of equipment and cupboard basics.

What do you think? Is it time to stop watching others cook (in restaurants, on The Food Network) and do it ourselves?

¹National Pork Producers Council in Des Moines, IA; the test was contained in a mailed questionnaire sent out for the council by National Family Opinion Research, Inc. in Toledo, OH.

The more time you spend laying in bed asleep the fewer calories you burn and thus, the greater your risk for overweight and obesity.  Right?

That may seem logical but that is not what the research is showing.  In fact, a growing body of scientific literature suggests that sleep duration is inversely related to obesity.  That is, with increasing hours of sleep, obesity risk goes down.  To a point. 

What studies have found so far is that sleeping on average less than seven hours per night increases obesity risk.¹ But sleep duration of longer than eight or nine hours per night may also slightly increase obesity risk.   So for now, it appears that the sleep sweet spot for reducing obesity risk is 7-8 hours per night.  Now, these data are from large studies that average information across many different people.  So scientists and health professionals know that within a large group, everyone’s personal sleep need will be slightly different. 

Nonetheless, given the obesity epidemic, the link between sleep duration and obesity is intriguing.  And because there is little harm (and potentially a great benefit in terms of health and safety) in recommending adequate sleep, public health campaigns are gearing up to remind Americans that  getting enough (but not too much) sleep is a healthy obesity prevention habit that goes hand in hand with healthy eating and active living.

Getting Your 7 to 8 Hours

Do you sleep for seven to eight hours a night?  Be honest.  If so, good for you.  Keep it up. 

If not, take a hard look at what prevents you getting enough sleep.  Here are tips from the National Sleep Foundation:

• Establish consistent sleep and wake schedules, even on weekends
• Create a regular, relaxing bedtime routine such as soaking in a hot bath or listening to soothing music – begin an hour or more before the time you expect to fall asleep
  Exercise regularly during the day or at least a few hours before bedtime
• Finish eating at least 2-3 hours before your regular bedtime
• Avoid caffeine and alcohol products close to bedtime and give up smoking
  Create a sleep-conducive environment that is dark, quiet, comfortable and cool
• Sleep on a comfortable mattress and pillows
• Use your bedroom only for sleep and sex (keep "sleep stealers" out of the bedroom – avoid watching TV, using a computer or reading in bed)

For more information and helpful tips on healthy sleeping habits for people of all ages,

• National Sleep Foundation
• National Heart, Lung and Blood Institute

¹ Patel JR.  Short sleep and obesity.  Obesity Reviews.  2009. 10(Suppl 2):61-68.

New research out of the University of Chicago suggests that eating foods labeled as "healthy" makes some people hungrier (and eat more!) than eating foods labeled as "tasty" or not eating at all. Thus, researchers suggest that if you're trying to encourage a family member to lose weight it's best not to focus on the healthfulness of the foods you serve.

A series of studies were performed to examine how imposed healthy eating influenced individuals' experienced hunger. In one study, research subjects were all given the same protein bar and told their job was to taste a food that was described as either healthy or tasty (imposed conditions) or to choose between the bars (free-choice conditions). Then, they rated their hunger. Subjects that were given the bar described as healthy said they were hungrier after eating it than those who were given the same bar described as tasty or those who freely chose their bar. In another study, subjects were given the same piece of bread that was described as healthy or tasty. In addition, they were asked how much they valued watching their weight. As in the previous study, subjects given the bread described as healthy rated they were hungrier and consumed more of an available snack than those given the bread described as tasty. But, this wasn't true among the subjects who valued watching their weight. Instead, they felt that they chose to eat the healthy bread.

Study authors explain that while people eat to fulfill their appetite, another major goal people have when selecting food is to maintain good health. But, these are conflicting motives - eat to get full or choose less (or lower calorie) food to be healthy. In people trying to be healthy or lose weight, the "maintaining good health" goal is strengthened when they eat a food described as healthy when freely chosen and often even when imposed. However, imposed healthy eating in those not committed to health/weight loss believe that the health goal is sufficiently met after they eat a food described as healthy, increasing the strength of the conflicting motive to fulfill their appetite.

Take away message: Encouraging healthy eating is a lot more complex than telling someone what to eat or even serving someone healthy foods. People who are not committed to eating healthfully need to feel that they have made the choice to eat the healthy food. Therefore, let them make the choice by offering a variety of foods including tasty healthy foods and don't emphasize the healthfulness of the foods you serve.

Finkelstein, S. (2010). When Healthy foods make you hungry. Journal of Consumer Research, Retrieved from http://www.journals.uchicago.edu/doi/abs/10.1086/652248 doi: 10.1086/652248.

Gilbert R. Kaats, Ph.D. is passionate about health enhancing products and has researched them over the past 32 years.  This blog is a summary of his research and findings regarding the usefulness of pedometers.¹  The concept is simple as related by Kessinger in the December 2007 issue of The Original Internist “…Find what works, make sure it works, and then add to it; re-tool one good idea with another. Never take away from what works. Always add to it.” ² Pedometers work; they serve to increase physical activity and “…the device is a great little motivator.” Says Dr. Dena Bravata. ³

We all know that the most common reason people give for not exercising is lack of time. The bottom line is few sedentary adults will actually adopt exercise as a regular regime for a lifetime. This lead researchers to a strategy of reframing “exercise” as “physical activity” in order to increase the chances of a sustained behavior change in adults.  When we simply ask people to move more and incorporate it into their day instead of finding specific time to exercise they do it. You most likely have heard of or have participated in a pedometer program that encourages accumulating 10,000 steps a day. While increased movement or “physical activity” is not as beneficial as aerobic training or resistance training it should not be underestimated in its benefits for producing real health benefits. Cindi Caciolo, former editor of Prevention Magazine, took the challenge to wear a pedometer and track steps or “clicks” and was shocked as she got a major reality check. On days she thought she was busy and active she had only accumulated 4,500 clicks.  She began to realize that the constant feedback from the pedometer set the stage for behavior modification. “What gets measured gets managed” Caciolo stated. 

An important feature of wearing the “clicker” or pedometer is how users learn to increases their clicks without expending much additional time.  For example when the phone rings most of us answer and stay seated (sedentary behavior) while we complete the conversation.  But pedometer users have figured out that they can pace in their office or home while talking on the phone.  One user commented that “Every time my mother calls, it’s good for 2,000 clicks”. In a study that examined pedometer use and its potential increase in patient lifestyle ambulatory activity, Stovits et. Al. [2005] reported that mean daily step counts in the group wearing pedometers rose 41% over a 9-week study period.

So in keeping with the “Never take away from what works. Always add to it” wisdom, we need to promote the use of a pedometer that is accurate.  Independent researchers and universities have found the Yamax’s units to be the most accurate and are now considered “the Gold Standard”. The recommendation is made on reliability, validity, and durability.  It is marketed by HealthTech Products (210.274.6193). A quality pedometer should be recommended by exercise leaders and medical practitioners because an unreliable pedometer will likely undermine the patient’s or client’s confidence in the measurements and will provide rationalization to discontinue tracking steps/clicks.  The concept that is working with pedometer use is found in the following 3 steps: 1) Wear the pedometer throughout the day.  The goal is to get more clicks, not to exercise more or start a workout program. 2) Track it. At the end of the day record the number of clicks.  You may log on to the “Clicker Trainer Program” from HealthTech.  It automatically translates other activities into clicks so all activity is figured in your day and week.  3) Graph it.  A visual picture of your progress is very motivating, and supports your new behaviors.

¹Kessinger JA IV. The legacy continues. Original Internist. 2007;14(4):187.
²Kaats GR.Restructuring Body Composition: How the Kind, Not the Amount, of Weight Loss Defines a Pathway to Optimal Health. Taylor Publishing, Dallas, Texas,2008.
³Bravata DM, Smith-Spangler C, Sundaram V. et al. Using Pedometers to Increase Physical Activity and Improve Health: A Systematic Review JAMA. 2007;298(19):2296-2304

If you're an owner of an iPhone, iPad, Palm, Blackberry, Android, or other smartphone or mobile device you're likely a fan of apps (short for software applications). While games remain the number one downloaded and used application, apps for mobile shopping, social networking, and utility/productivity tools are gaining in popularity.  

We've created a brief list of apps that may help you achieve calorie balance. Please comment on any of these apps and suggest other apps that you've found to help you decrease calories in and/or increase calories out. With over 100,000 apps available at Apple's App Store (not to mention the thousands from sites like Handango or the Palm, Blackberry, Andriod, or Microsoft stores) I'm sure we've missed many good ones!

• Locavore - Use GPS or enter a zip code to discover food that’s in season and grown nearby; search for local farmer’s markets or tap 'I Ate Local' to find out what people in your area are eating.
• Allrecipes.com Dinner Spinner - Perfect for those of us who often don't think about dinner until our drive home from work; find a quickly and healthy recipe with ingredients you have at home or let the app spin a dinner idea up for you while you're at the grocery store.
• Grocery iQ - Buy what you need (and only what you need!) with this tool that helps you build your grocery list; use your favorites list and shopping history to quickly build new lists.
• GoodFoodNearYou - Recommends healthy food options based on your location, which is tracked by GPS; targets popular casual dining restaurants, fast-food restaurants, grocery stores, and convenience stores nearby.
• Nutrition Menu - Calorie, Exercise, Weight, and Water Tracking - Nutritional information for over 93,000 foods (including those from popular restaurants); set eating and activity goals and track your progress.
• iMapMyWalk(Run, Ride, or Hike) - Uses the built-in GPS in the iPhone 3G to track and record every mile you walk, run, ride, or hike.

If you're not an owner of a mobile device that supports apps or don't download apps for your mobile device, market research companies predict that it won't be long before you jump aboard. It's predicted that downloads of mobile apps will double from 2.5 billion last year to 4.5 billion this year and jump to 21.6 billion in 2013! So if this list doesn't apply to your now, come back when you join the app world. Of course, there will probably be thousands of new, improved apps to choose from by then!

Note: Mention of specific weight loss programs/tools does not imply endorsement by The Cooper Institute.

Ninety percent of Americans will have high blood pressure by the time they kick the bucket.  One-half of Americans over the age of 60 currently have high blood pressure. 

The fact that high blood pressure increases risk for stroke and heart disease makes it something everyone should pay attention to.  The urgency is compounded by the more recent findings that high blood pressure is associated with increased risk for dementia and Alzheimer’s disease. 

Changes in diet, increased physical activity, weight loss, and of course, medications have been shown to reduce blood pressure.  But the prevalence of high blood pressure and its dire impact on multiple organs from the heart to the brain make it imperative that we find new treatments to reduce its impact. 

A new study has shown that a combined approach of diet, physical activity, and weight loss can significantly reduce blood pressure and improve cognitive function – in just four months¹.   In this study, 126 overweight men and women were randomized to one of three groups:

1. Control group – no changes in diet, physical or body weight
2. DASH Diet – low-sodium, low-fat diet that stresses high intake of fruits, vegetables, whole grains and nonfat dairy foods
3. DASH Diet + weight loss – same as group #2 plus additional education on calorie restriction and 30 minutes of physical activity 3 times per week

The results?  Both the DASH Diet and DASH + weight loss groups significantly lowered blood pressure.  In addition, the DASH group and the DASH + weight loss group significantly improved some measures of  cognitive function.  The positive findings were especially remarkable for people with the most advanced states of cardiovascular disease.

Get Ahead of the High Blood Pressure Curve

While the current data suggest that just about everyone will have high blood pressure at some point in their life, there are things you can do that may protect your heart and your brain from the ill effects of high blood pressure.

Maintain a healthy weight or lose weight if you are overweight.

Be physically active – Doing something is better than doing nothing.  Work up to doing at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity per week. 

Eat a DASH-style diet – Include lots of fruits and veggies and whole grains.  Include nonfat milk products and limit sodium and fat.  For more information about the DASH diet, click here. 

¹ Smith PJ, et al.  Effects of the dietary approaches to stop hypertension diet, exercise, and caloric restriction on neurocognition in overweight adults with high blood pressure.
Hypertension. 2010 Mar 19. [Epub ahead of print] 

With the arrival of spring you may have seen some people out running without any shoes on or wearing something that looks like a glove on their feet. Well the latest buzz around the fitness industry is—yes, you guessed it—barefoot running. While barefoot running is in the spotlight now, it actually has been around for quite some time. The running shoe wasn’t invented until the 1970’s so this is a relatively new piece of equipment when you look at how long humans have been running. And even since the running shoe emerged, the trend of barefoot running has come around the pike several times.

So why the sudden increase in interest again?

 A new study published in the January 28th issue of the journal Nature shows that barefoot runners have a different running technique which may help to decrease the collision forces that act on the body. The authors analyzed the running styles of five groups of people—U.S. adult athletes who have always worn shoes, Kenyan adult runners who grew up barefoot but now wear cushioned running shoes, U.S. adult runners who grew up wearing shoes but now run barefoot or with minimal footwear, Kenyan adolescents who have never worn shoes, and Kenyan adolescents who have worn shoes for most of their lives. They found that most shoe runners strike their heels when they run, whereas barefoot runners tend to strike toward the middle or front of the foot.

So what is the big deal?

Well the authors found that heel striking causes a large and sudden collision force to act on the body which is often equal to two or three times the runner’s body weight. Because barefoot runners land more on the balls of their feet, less collision force develops. It is believed that the spring in the arch of the foot and the Achilles tendon help to mitigate the collision forces. 

So less collision force has to mean less injury—right?

Well, not necessarily. Experts can’t seem to agree and there isn’t enough research to support the thinking one way or the other. The authors of this study hypothesize that forefoot or midfoot striking can help avoid or lessen repetitive stress injuries, especially stress fractures, plantar fasciitis, and runner’s knee. However, they are quick to point out that their hypothesis has yet to be tested and that there have been no direct studies on the efficacy of forefoot strike running or barefoot running on injury.  Other experts believe that forefoot striking for long distances can actually lead to Achilles tendon issues, shin splints, and more knee pain. As you can see, the verdict is still out.

So what if you have been thinking about starting to run barefoot?

Barefoot running is definitely something that should be started gradually. Most people in this country spend most of their time in shoes whether it be walking in them or running in them. As a result, their mechanics and muscles within their feet and lower leg have developed differently. It is common to experience “tired” feet and very stiff and sore calf muscles when first beginning. Doing too much too quickly can lead to injury. The authors of the study suggest starting by walking around barefoot more frequently. Then they suggest no more than a quarter mile to one mile every other day the first week. From there they suggest increasing your distance by no more than 10% per week. If soreness remains they suggest NOT increasing the distance. Additionally, if there is pain, they always suggest stopping, letting the body heal, and seeing a physician if necessary. This information is not to take the place of information provided by a coach or physician and, as a reminder, there is no evidence that barefoot running is better for you so many experts believe there is no need to make this transition.

What about running surface?

Even on hard surfaces such as pavement, collision forces are low with barefoot running so barefoot advocates claim that it can be done on any surface. Because so many surfaces have debris such as glass, pebbles, and sticks, wearing a “minimal” shoe (those that do not have a heel cushion or arch support, that have a flexible sole) may be a good idea.

Of final note, anyone who has sensory loss to their feet (i.e. a diabetic) should not run barefoot or in minimal shoes. In fact, these individuals should probably wear shoes of some type at all times in order to protect their feet. If you have any foot-related problems, you should seek the advice of a medical professional before you start barefoot running. Hopefully with this latest interest, more research will be conducted that will provide more insight into the benefits and/or disadvantages of barefoot running.

Lieberman, D. E. et. al. Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature 463: 531-565, 2010.

As a dietitian and parent of a picky eater I am often distraught over the vegetables that go untouched on my child's plate. I've read many good books that describe how to feed your child so he/she will eat (and like!) healthy foods, but vegetables is one food group that I just can't seem to conquer. Despite the variety and great number of times I offer vegetables, my child just won't touch them - not even peas, corn, or potatoes! Recently, however, we've had one success - raw carrots. Recent research from Wageningen University (the Netherlands) has given me some insights into what I might be doing wrong...

Researchers served two readily available and commonly eaten vegetables - carrots and french beans - that had been mashed, steamed, boiled, stir-fried, grilled, and deep-fried to over 250 children aged 4 to 12 years. The children were then asked which vegetables they preferred. Results showed that the majority of the children like the steamed or boiled vegetables best. Researchers attributed this to the fact that the steamed and boiled vegetables retained their original taste, color, and crunchiness. Furthermore, they found that brown patches on vegetables (from stir-frying or grilling) were a turn-off to the children and that crunchy vegetables were much more appealing than slimy ones - 'mouth-feel' was very important. Children ages 4 to 6 years seemed to view vegetables according to their color and shape whereas older children (11 and 12 years) grouped vegetables by more abstract qualities like tastiness and the time of eating.

So what does all of this boil down to? Think about how the vegetables you serve look and feel to your child. The researchers point out that when teeth and jaw muscles are in the developing stage children may have less control over the food in their mouth. A vegetable that is crunchy and has a uniform surface without brown coloring and without a granular texture is your best bet.

Need some recipes for crunchy, colorful, smooth veggies? Check out these sites:

• Fruits and Veggies: More Matters (Centers for Disease Control and Prevention)
• Fruit and Veggies: More Matters (Produce for Better Health Foundation)
• Dole

Zeinstra, G.G. (2009). Parental child-feeding strategies in relation to dutch children's fruit and vegetable intake. Public Health Nutrition, 22, 1-10.

Most people experience muscle soreness 24 to 48 hours after a new exercise program. Individuals have tried everything from massage, ultrasound and nonsteroidal anti-inflammatory drugs (NSAID) such as ibuprofen and aspirin to help reduce muscle soreness. Oral NSAID drugs are the most commonly used anti-inflammatory but may have gastrointestinal side effects. A topical (medication applied directly to the skin) anti-inflammatory version of ibuprofen was recently tested to determine if it decreases muscle soreness. It is thought that the topical application would eliminate the gastrointestinal side effects associated with oral ibuprofen.

The study "Effects of Ibuprofen Topical Gel on Muscle Soreness" examined the effect of a 10% ibuprofen gel on muscle soreness¹. The study included 106 subjects who had not participated in a strength training program for the past six months and did not have a job that required strenuous activity. Subjects completed six sets of 10 repetitions of machine bicep and leg curls. Thirty-six hours after exercise the subjects applied a placebo (gel without ibuprofen) treatment or ibuprofen gel to the exercised muscle groups. Subjects rated their pain at intervals for 108 hours after exercise.

The results of this study showed that topical ibuprofen gel had no effect on muscle soreness. It also did not reduce peak levels of muscle soreness.

There is no general agreement among research studies as to the benefits of NSAID oral or topical treatments to reduce muscle soreness. Additional studies are required to better determine if ibuprofen affects muscle soreness.

1. Hyldahl, R. D., Keadle, J., Rouzier, P. A., Pearl, D., & Clarkson, P. M. . (2010). Effects of ibuprofen topical gel on muscle soreness. Medicine & Science in Sports & Exercise, 42(3), 614-621.