Orthorexia Nervosa: The New Eating Disorder

The October 2010 edition of The Idea Fitness Journal for A.C.E. Certified Professionals had a very interesting article on this newly recognized eating disorder. In summary, this eating disorder involves an extreme amount of self-discipline with a feeling of superiority over others less disciplined.  Suffering  individuals are attracted to a restricted or complicated diet that leads to an imbalanced diet.  The imbalance is due to extreme restriction or elimination of major food components.

An interesting tidbit about my job is that not only do I have to understand who I can work with as a client, but I must also have solid grasp on who I cannot work with.  The scope of my practice is clear, but the history of the person I consult with may not be.  Eating disorders fall outside the scope of my practice, so proper screening is required.  This new eating disorder is intriguing to me as two things clearly differentiate this from other disorders like anorexia or bulimia.  Orthoexia Nervosa sufferers have no fear of weight gain.  Second, it is as equally pervasive among males as it is females.  There are, however, common similarities between this and the other more historically recognized disorders.  Please click on the link to read the complete article:  http://www.ideafit.com/fitness-library/orthorexia-nervosa-a-primer?sourcecode=ACEIFJ
One thing clear is that where moderation isn't involved in a lifestyle, the potential for trouble lurks.  This could mean excessive exercise, extreme dieting or relationships being adversely affected as a result of such extreme behavior(s).  Extreme behaviors do not lead to balance or optimal health.  If any of these behaviors sound like yours, please be open to discussing with your physician.  Efforts to embrace a healthier lifestyle can turn extreme and the desired objective of positive effects can be lost. 

S.M.A.R.T. Goals

Right now, many people are contemplating their 2011 New Year's resolutions. Many fitness resolutions die within the first four weeks of a new year for many different reasons.  One obvious reason behind such failures is that the goals behind these resolutions are not S.M.A.R.T. in nature.  A powerful tool to use when attempting goals involving health & fitness is to make sure that the goal(s) created are S.M.A.R.T. 
This can be defined as follows:
Specific
Measurable
Attainable
Relevant
Time-bound

Goals set without these five parameters tend to be poorly defined and therefore, proper direction and focus towards attainment is lost.  Breaking down each component more specifically means:

Specific goals recognize why it is being created, the benefits of it, who is involved, what needs to be accomplished and where it will be accomplished.

Measurable means that with progression towards the goal, there should be a means to monitor progress.  If there is no measurement procedure, then it is difficult to tell if one is on track to meet the goal, or if efforts have to be redirected.

Attainable means that the goal being set forth must be achievable. Many failed attempts to reach a goal surround the fact that it was not realistic in nature.  When an attainable goal is set, it is much easier to visualize attainment, stay motivated and persevere in the efforts required.  Think about the person you know that swears they are going to hit the gym every day for two hour workouts.  That is not achievable for most and will lead to certain burnout.  Less really is more as consistent, realistic progress leads to success.  Remember that smaller goals always add up to bigger ones.

Relevant means that the goal should surround the needs and abilities of the person attempting it.  If you find yourself to be rather uncoordinated, then perhaps stay away from heavily choreographed group fitness or dance classes.  If you love cycling, then include group cycling classes, stationary bike or other cycling activities to keep things relevant. 

Time-bound means that there should be a time fence established on the goal.  If one wishes to lose 5 lbs, but does not define a time frame for doing so, then incremental steps to achieving it cannot be clearly established.  Making efforts time-bound helps build in accountability.

If you are gearing up to an improved you next year, then try the S.M.A.R.T. strategy and improve your chances of success. 

     

Physical Fitness Components

Physical fitness has four major components and industry experts are looking ahead into the possibility of a fifth that might include mind/body vitality.  I believe a quality fitness program will include focus on all of the components, not just one.  It may be relatively easy for an individual to achieve muscular strength or solid cardiovascular endurance, but those that work towards development of all four major components will become wickedly strong and healthy.  What are the four basic components?

Muscular strength
This is one component of muscular fitness. it is the maximal force that a muscle or muscle group can exert during a contraction. This strength is necessary for everyday functioning as we lift and carry items nearly every day.  The second component is muscular endurance, which is the ability of a muscle or muscle group to exert force against resistance over a sustained period. It represents the duration or number of repetitions that can be performed without fatigue.

Cardiovascular endurance
This is the maximal capacity of the heart, blood vessels and lungs to deliver oxygen and nutrients to working muscles so energy can be produced.  The higher one's cardio endurance, the more physical work can be performed before fatigue.

Flexibility
The ability to move joints though their normal full range of motion.  Good flexibility helps prevent musculoskeletal injuries, assists with good posture and provides functional movement.

Body composition
This refers to the body makeup and what portion of the body is lean body mass vs. body fat.  Lean body mass includes muscles, bones, nervous tissue, skin, blood and organs. These items positively contribute to a good metabolic rate and contribute to physical performance.  Body fat can be broken down further into essential fat and storage fat.  Essential body fat is thought to be necessary for maintenance of life and reproduction and is thought to be about 2 - 5% for men, 10 - 13% for women.  Storage fat has no real value and excess is associated with health issues including hypertension, type 2 diabetes and coronary artery disease.

If you want to embrace the "total health package", then solid emphasis should be put on all of the physical fitness components.  Consultations and workouts I bring to my clients will include all.  I do not desire for my clients to get into good shape, I want them to get into great shape. The group fitness classes I teach also include these elements as I want every class participant to experience a complete workout and feel exhilarated throughout. 

Try not to settle into the rut of concentrating on one or two activities that develop only one or two components of fitness.  Instead, challenge yourself to develop further by taking your fitness to the next level. Widen your scope of efforts and experience better health.    

Crummy Health Equals Crummy Life

It is better to be proactive with your health than reactive. I work with many high risk individuals who can only wish they intervened earlier on behalf of their own health. They have given me a meaningful glimpse into the future. Poor eating and lousy exercise habits cost us our health and eventually, quality of life. One of the hardest things for me to see is someone taking their health for granted. Word to the wise: Once your health is gone, it can be gone for good. A price cannot be put on quality of life, and honestly, an unhealthy lifestyle is rather pricey. I shall elaborate.

If you are a smoker, are overweight, or take even one medication, you can expect to pay 50% more on your health insurance premium (in the individual market). This cost otherwise gets passed along to the employer of such individuals in group plans. Most health plans require a doctor visit co-pay, which may be expensive depending on the insurance plan and chosen deductible. Do not forget to include the co-pay on prescription medications, which, may or may not be covered by insurance altogether. Please also don’t forget about astronomical laboratory fees for blood work, etc. Start increasing the number of doctor visits and medications, and the costs add up quickly. Start getting into more serious health issues such as Diabetes, heart disease, or cancer and more medical specialists, office visits, medications and tests will be required. Even worse, secondary medications may have to be prescribed in order to control one or more side effects created by the primary prescribed. Ugh!

What people must realize is that their choices today will affect the quality of their life later on. Unnecessary weight gain now could mean a knee replacement or another degenerative, orthopedic issue in the future. Poor diet now will likely lead to high cholesterol and high blood pressure later. A sedentary lifestyle today will mean an even more sedentary lifestyle later in life.

The best defense with your health is a good offense, so get going NOW. Really, what are you waiting for? If you want to keep the total cost of your health ownership down, and the quality up, positive changes have to be made now. You will later reap the benefits of any positive investments you make today. My father passed away in his fifties due to poor lifestyle choices. I, however, am doing things differently to ensure that family history ends with him. Will you responsibly intervene in the legacy of your family’s medical history and on behalf of your health?

Look far into your future and decide if you want to be an active, healthy retiree playing with your grandchildren and traveling about, or if you would rather scuttle around coping with chronic pain in between doctor appointments and trips to the local pharmacy. You have a choice today, make the right one.

Overcoming Unhealthy Thinking

As a fitness professional, I regularly encounter individuals that have carried unhealthy thinking, patterns and problems from childhood straight into adulthood. Such problems might include distorted body image, emotional eating, or hyperfocus on scale weight. Often, such individuals have been told by family members that they would look great if they could just lose 5 more lbs., or how good they would look if they hadn’t inherited the family thighs, rear end, etc. Others have weighed themselves multiple times a day for years and with every fluctuation of the scale, beaten themselves up over it. These behaviors are self-punishing and unproductive, yet very common. I strongly believe that there is much more surrounding weight loss and wellness that requires redirection of thought and elimination of negative self-talk.

I work hard to help my clients reframe how they look at their efforts in weight loss and exercise adherence. This is a challenge for me every day as old habits die hard and especially those that are deeply rooted. Sometimes I witness break-throughs, where I see new thought processes emerging, only to see old ones re-emerge a week later. The bottom line is that it takes six months to establish new behaviors. It takes real commitment to graduate into healthier, more balanced thinking. Old habits are not created overnight, and they shall not be undone overnight either.

In an effort to help my clients reframe how they view themselves and their efforts, I encourage them to do the following:

• Reward yourself to doing something right. Most people excel at beating themselves up when they experience failure, but no one rewards himself or herself for a job well done (especially women). If you eat better for a month, or exercise regularly for two weeks, then reward yourself for doing so…just don’t make it a food related reward.
• Look back (often) at where you started from to measure your success. Are you less fatigued walking up stairs or across a parking lot? Fitting better in your clothes? Sleeping better at night? Eliminated any small, nagging pains? Review your progress and celebrate victories along the way.
• Confront the people in your life that sabotage your fitness efforts and ask them for their help. Make them an ally instead of an enemy. Tell them that you are a "work in progress" and that you are doing the best you can and how they can help you do better.
• Embrace a healthy lifestyle and a new thought process that focuses on the long term. Do not decide to drop a few pounds or start exercising in order to fit into a bathing suit, look good for a high school reunion, etc. Events come and go, and then what? Do it because it is the right thing to do for your health today, tomorrow and beyond.
• Honor your emotions and try to process them versus "stuff" them down with food. Food is supposed to nourish and provide fullness, not to fill emotional voids. Try to sit with your feelings and process them to seek better understanding before running to food as an answer or consolation.
• Surround yourself with other people on a similar journey and share with each other what works and what doesn’t. Find someone as motivated as you, or more motivated and rally around each other. This helps build accountability and support.

In summary, there is a definite mental process that occurs with the physical and should be embraced every bit as much. A healthy lifestyle will include feeling good about one’s self, honoring one’s body, and being the best possible at any given age. These aspects far outweigh "scale weight" and add much more to the overall package of happiness and self-satisfaction. Also, remember that the act of "trying" is an important one, and that often we learn from failures when we experience them. So, embrace any failures along the way in your fitness journey as learning experiences and move on.
　
　
　
　
　
　
　

Eating Out & Eating Healthy

The truth is that eating out does not automatically translate to unhealthy eating. Consistently eating out, however, may require a little more thought and strategy. Some solid suggestions below are provided from mypyramid.gov

• As a beverage choice, ask for water or order fat-free or low-fat milk, unsweetened tea, or other drinks without added sugars.
• Ask for whole-wheat bread for sandwiches.
• Start meal with a salad packed with veggies, to help control hunger and feel satisfied sooner.
• Ask for salad dressing to be served on the side. Then use only as much as you want.
• Choose main dishes that include vegetables, such as stir-fries, kebobs, or pasta with marina sauce.
• Order steamed, grilled, or broiled dishes instead of those fried, or sautéed.
• Choose a "small" or "medium" portion. This includes main dishes, side dishes and beverages.
• Order an item from the menu instead of heading for the "all you can eat" buffet.
• If main portions at a restaurant are larger than you want, try one of these strategies to keep from overeating:
• Order an appetizer or side dish instead of entrée.
• Share a main dish with a friend.
• If you can chill the extra food right away, take leftovers home in a doggy bag.
• When your food is delivered, set aside or pack half of it to go immediately.
• Resign from the "clean your plate club" when you’ve eaten enough, leave the rest.

• To keep your meal moderate in calories, fat, and sugars:
• Ask for salad dressing to be served on the side so you can add only as much as you want.
• Order foods that do not have creamy sauces or gravies.
• Add little or no butter to your food.
• Choose fruits for dessert most often.
• On long commutes or shopping trips, pack some fresh fruit, cut-up vegetables, low-fat string cheese sticks, or a handful of unsalted nuts to help you avoid stopping for sweet or fatty snacks.

　
Source: www.mypyramid.gov

Understanding Osteoporosis

Osteoporosis can be defined as low bone mass and poor bone structure that can lead to an increased risk of fractures. Although osteoporosis can occur at any age, it is most common amongst people over 50 years of age. After the age of 30, our bones begin to gradually lose minerals at a small rate every year (under 1%). This small amount does add up over time and explains why people experience low bone density in their fifties.

Risk factors surrounding the disease fall into two basic categories, those that can be controlled and those that cannot. The following information comes from Winters-Stone,Kerri. Action Plan for Osteoporosis. USA: Human Kinetics, 2005.

Risk factors you cannot control:
-Being female
-Being thin or having a small frame
-Advanced age
-A family history of osteoporosis
-Being postmenopausal, either early or surgically induced
-Low testosterone levels in men
-Being Caucasian or Asian, although African Americans and Hispanic Americans may be at risk as well

Risk factors you can control:
-A diet low in calcium
-An inactive lifestyle
-Cigarette smoking
-Excessive use of alcohol

Risk factors you may be able to control:
-Abnormal absence of menstrual periods (amenorrhea)
-Anorexia nervosa
-Use of certain medications, such as corticosteroids and anticonvulsants

The best mode of diagnosing osteoporosis is done via DXA, or dual energy x-ray absorptiometry.  In short, this shows how much mineralization exists in certain bones. This mineral density testing is an accurate gauge of actual bone strength. Stronger bones are less likely to fracture. The best way to avoid fractures is to avoid falls. Exercise that includes resistance training works both to assist in retaining bone density and improving balance. This reduces the risk of falls and subsequent fractures.

Scores associated with bone density testing are age group comparisons (Z-scores) and also (T-scores) which is a comparison made against a healthy 25 – 30 year old person of similar ethnicity, gender and race. There is more you can research to better understand actual scoring criteria and accuracy of other testing.

The National Osteoporosis Foundation recommends a bone density test for the following:
-All postmenopausal women under age 65 who have one or more additional risk factors for osteoporosis (in addition to being postmenopausal and female)
-All women age 65 and older regardless of additional risk factors
-Postmenopausal women with one or more fractures (to confirm diagnosis and determine disease severity)
-Women who are considering therapy for osteoporosis if bone density testing would facilitate the decision
-Men or women with one or more of the following: prolonged exposure to certain medications, such as steroids used to treat asthma or arthritis, anticonvulsants, and certain cancer treatments; chronic disease that affects the kidneys, lungs, stomach, and intestines and alters hormone levels; or low levels of the sex hormone testosterone

In summary, understanding your family history, risk factors and early evaluation will offer the best approach to preventing or postponing the onset of osteoporosis. As always, discuss your family medical history and any concerns you have with your physician.