SUZANNE

Suzanne a 48 year old lady is our most recent client today, and she tells us she is experiencing menopause. After carefully examining her diet with her, we find out that her daily intake of calcium is only about 600 mg/day from the foods that she eats.  Suzanne does not take vitamins either.  The best recourse to take with Suzanne is to provide education in order to help her understand why she is going through her menopause so soon, and based on the given information.  Calcium is needed for our heart, muscles and nerves to function properly and for blood to clot. Inadequate calcium significantly contributes to the development of osteoporosis. Many published studies show that low calcium intake throughout life is associated with low bone mass and high fracture rates. National nutrition surveys have shown that many women and young girls consume less than half the amount of calcium recommended to grow and maintain healthy bones.  However, calcium alone cannot prevent osteoporosis and is not a substitute for medication that may be needed to curb excessive bone loss. Menopause is characterized by the loss of estrogen production by the ovaries. This may occur by natural means or by the surgical removal of both ovaries. This loss of estrogens accelerates bone loss for a period ranging from 5 to 8 years. The reason I use menopause in this explanation, is to make the client aware of the consequences this disease can have on her later in life. There in terms of bone remodeling the lack of estrogen enhances the ability of osteoclasts to absorb bone. Since the osteoblasts (the cells which produce bone) are not encouraged to lay down more bone, the osteoclasts win and more bone is lost than is produced.  Taking only 600 mg/ a day is not nearly enough, Suzanne should be getting 1000mg a day for her age.  Suzanne should also be exercising regularly.  She must be sure to eat a well-balanced diet a day also.  If she is a smoker then Suzanne should quit and consider all the other fact that come with smoking, it can make osteoporosis worse.  Susanne may want to talk to her doctor about HRT (Hormone Replacement Therapy) or other medicines to prevent or treat osteoporosis.  It’s usually best to try to get calcium from food. Nonfat and low-fat dairy products are good sources of calcium. Other sources of calcium include dried beans, sardines and broccoli.  If she is not getting enough calcium from the food she is eating, Suzanne’s doctor may suggest taking a calcium pill. Take it at meal time or with a sip of milk. Vitamin D and lactose (the natural sugar in milk) will help her body absorb the calcium.  The main four essential multivitamin supplements that women require are Calcium, Vitamin D, Magnesium and Vitamin K in order to ensure good bone health.  The best way to get all the nutrients you need is to eat a sensible balanced diet with lots of fruit, vegetables, beans, yogurt, bread and potatoes, together with smaller amounts of  very lean meat, lower-fat cheese and oily fish (esp. sardines). In addition, have at least half a pint of low-fat milk per day. Lastly, cut down on red meat, chocolate, caffeine, nicotine and alcohol, as all these things tend to weaken our bones and increase the risk of getting Osteoporosis. The goal of educating others about their health is a very important factor in prevention.  It does not matter how much medicine some patients receive, there is always a need for the patient education.  As a health educator; it is my responsibility to see that Suzanne is properly instructed as to what she must do to prevent osteoporosis and why.    

References:

 

Cashman, K. (2007, Nov.). Diet, nutrition, and bone health. The Journal of Nutrition, 137(11S), 2507S.  Retrieved from Proquest at

Doyle, L., & Cashman, K.D. (2004, May). The DASH Diet May Have Beneficial Effects on Bone Health. Nutrition Reviews, 62(5), 215-221.

Harkness, L. (2004, Jan/Feb). Soy and Bone: Where Do We Stand? Orthopaedic Nursing, 23(1), 12-18.

Lanham-New, S. (2008, Jan.).  The Balance of Bone Health: Tipping the scales in favor of potassium-rich, bicarbonate-rich foods, The Journal of Nutrition, 138(1), 172S. 

Rafferty, K., & Heaney, R. (2008, Jan.).  Nutrient effects on the calcium economy: emphasizing the potassium controversy. The Journal of Nutrition, 138(1), 166S.

Tylavsky, F., Spence, L., & Harkness, L. (2008, Jan.). The importance of calcium, potassium, and acid-base homeostasis in bone health and osteoporosis prevention. The Journal

The Kids Just Aint Eatin’ Right

Obesity remains a public health epidemic the United States is facing.1-3 Children and adolescents in the United States have not escaped from the obesity epidemic. The prevalence of overweight has doubled for US children aged 6-11 years-and tripled for American teenagers over the past 2 decades. Approximately 17% of children and adolescents between the ages of 2 and 19 years are considered overweight and 34% are at risk for becoming overweight.  Childhood obesity is associated with many health risks. It is the leading cause of pediatric hypertension and associated with type 2 diabetes mellitus, orthopedic complications, increased risk of coronary heart disease, and increased stress on weight-bearing joints.6-10 Hospital cost for diseases/conditions related to childhood obesity has increased dramatically in the past 20 years. Wang and Dietz analyzed the economic burden of obesity in youths 6-17 years of age and found that obesity-related annual hospital costs (based on 2002 constant dollar value) increased more than 3-fold over the 2 decades between 1979-1981 and 1997-1999 from $35 million to $127 million.  This portion of the article above was taken from; School-Based Obesity Interventions: A Literature Review  by Fadia T Shaya, David Flores, Confidence M Gbarayor,and Jingshu Wang  from The Journal of School Health. Kent: April 2008 Vol. 78, Iss. 4; pg. 189, 8 pgs.  

In today’s society we note the need for better nutrition programs, to assist in the challenge that has given birth to adolescent obesity.  With progress seemingly far out of sight, there are a few programs out there that can help.  The school systems around the country are working to solve some of the problems that are help the obesity situation along.  By improving the nutritional value of the foods that are being served within the school cafeterias across the country, we can improve the quality of health for our children.  One program that stood out in my mind had no particular name, but it was a school in Alaska (Robert Service High School) that actually served small Subway sandwiches in it nutrition curriculum.  The program is a simple but smart approach to the growing childhood obesity epidemic in the country today.  In order to improve a more health conscious group, the school had decided if fast foods were intervening in the nutritional care of the students, then why not make it Subway.  This presents a healthier choice then most other fast foods.  Setting up a program as such can prove to be very good for the student and this can also teach them how to make the right choice when making food decisions.  It would be wise to offer the sandwich choice over the Sloppy Joe, hamburger with fries, or hotdog with the works choices often given in most schools.  Even the snack machines have a bad habit of selling less than nutritional valuable items, i.e.; Hoo Hoo Cakes, Bear Claws, and other items saturated with an abundance of fats and sugars .  By educating the student at a young age on how nutrition effects each and everyone us we reduce the risks associated with childhood obesity.  By adding health conscious snacks to the snack machines, we are helping the students make smart decisions and by serving the Subway sandwiches we open up a new door to the nutrition of the student, helping them to learn to make the right choices when eating.

References:

by Fadia T Shaya, David Flores, Confidence M Gbarayor,and Jingshu Wang 

Yaussi, S.C.

American Association of Pediatrics

Hey Steve Over Here

Here again we find ourselves in the common dilemma that embraces most Americans each day.  What is good for me and what is bad for me, do I eat this or that, how do I figure all this out.  In this age of growing nutrition fads, it is hard to tell what is good and what is bad for you.  Remember Jim the 47yr old former weight lifter?  We attempted to set him up with a great program and even planned to monitor his success. So now meet Steve.  As we watch the fitness field grow, we find ourselves surrounded by many “Fitness Professionals”  who make extravagant claims on a day to day basis to the uneducated masses.  By soliciting what is believed to be the good knowledge necessary for a long and healthy life, they open us up for serious health risks.  This is largely due to the fact that most “professionals” give out the wrong information.   It would seem that once again we are having the argument of Good Cholesterol ( HDL) versus bad Cholesterol LDL), again, and as usual the client has gotten the wrong information.  It is imperative that we as nutrition specialist and fitness trainers understand this, if you are giving out this information and unaware of the correct response then consult a professional.  Steve is a 50 y/o, who recently consulted with a personal fitness trainer about what he should be eating.  During the visit he was informed that fat and high density lipoprotein (HDL) cholesterol in the diet are generally harmful to cardiovascular health.  This advice is very sound to the uneducated ear, those of us who rely on our “professionals” to give us clear and sound information concerning ourselves and healthy living.  This advice is terribly wrong.  We will actually discuss a few types of fats.  Let’s start with the fats Steve was told not to eat by his fitness instructor - good fats.  These are the unsaturated kind that helps fight the very diseases that consuming excess fat was said to cause. These unsaturated fats are divided into Monounsaturated fats and polyunsaturated fats, and both types are thought to have beneficial effects on cholesterol levels.     Monounsaturated fats help lower LDL (bad) cholesterol while also boosting HDL (good) cholesterol.  Polyunsaturated fats are also thought to help lower total and bad cholesterol. But monounsaturated fats are favored over polyunsaturated fats because some research suggests that polyunsaturated fats are less stable, and can reduce levels of good cholesterol as well as bad.  But let's not ignore polyunsaturated fats. These are often a good source of omega-3 fatty acids, found mostly in cold-water fish, nuts, oils and seeds, and also in dark leafy greens, flaxseed oils and some vegetable oils. One kind of omega-3 fatty acid is an "essential fatty acid," which cannot be manufactured by our bodies, so eating these foods is the only way to get them. Omega-3 fatty acids are thought to lower blood pressure, combat LDL (bad) cholesterol, fight inflammation and protect the brain and nervous system.  Most cooking oils are made up primarily of unsaturated fats. When it comes to choosing cooking oils, each type of cooking oil varies in its ratio of monounsaturated to polyunsaturated fats. Two oils stand out for their high levels of monounsaturated fats: canola oil and olive oil. Other than nonstick cooking spray, these two oils should be in your pantry.  At the end of the day, a good fat is still a fat in terms of calories. Any labels on cooking oil that describe the oil as "light," are referring to the taste or color, not the fat or calorie content. All oils are 100 percent fat and are worth around 120 calories per tablespoon.  Then there are the bad fats—those artery-clogging saturated fats from meat and dairy products. These fats are solid at room temperature. Saturated fats not only clog our arteries, they also directly raise total and LDL (bad) cholesterol levels. Avoid them as much as possible. But, we are told, some saturated fats may not bad at all: some argue that coconut oil and palm oil may actually be beneficial because their particular fatty-acid make-up means they are metabolized differently in the body. So it could be that plant-based saturated fats may be more beneficial, or at least more neutral, than we think, but there is no broad consensus on this yet. And while coconut oil and palm fruit oil have been rehabilitated in the eyes of some, there are fewer proponents of palm kernel oil.

 

Reference:

Fiona Haynes (Fitness and Nutrition Going Hand in Hand)

Lopez-Miranda, J., Badimon, L., Bonanome, A., Lairon, D., Kris-Etherton, P.M., Mata, P. et al. (Monounsaturated Fat and Cardiovascular Risk. Nutrition Reviews, 64(10), S2-S13.)

Pignone, M. (Low-Total-Fat Diet Did Not Reduce the Risk of Cardiovascular Events. Clinical Diabetes, 24(3), 143-145)

Byrd-Bredbenner, C., & Finckenor, M. (Journal of Nutrition Education, 32(1) American Dietetic Association: Fiber Facts.  Plant this idea: Fill up on fiber

American Heart Association. (2007) Cholesterol: AHA Scientific Position

 

Jonathan’s Bones

What is Osteoporosis?  Well here is the accurate definition.  Osteoporosis is a disease of bone that leads to an increased risk of fracture. In osteoporosis the bone mineral density (BMD) is reduced, bone microarchitecture is disrupted, and the amount and variety of non-collagenous proteins in bone is altered. Osteoporosis is defined by the World Health Organization (WHO) in women as a bone mineral density 2.5 standard deviations below peak bone mass (20-year-old healthy female average) as measured by DXA; the term "established osteoporosis" includes the presence of a fragility fracture.[1] Osteoporosis is most common in women after menopause, when it is called postmenopausal osteoporosis, but may also develop in men, and may occur in anyone in the presence of particular hormonal disorders and other chronic diseases or as a result of medications, specifically glucocorticoids, when the disease is called steroid- or glucocorticoid-induced osteoporosis (SIOP or GIOP). Given its influence is the risk of fragility fracture; osteoporosis may significantly affect life expectancy and quality of life.  (Taber Cyclopedia of Medicine) . 

Jonathan, a 54 year-old male client walks into our office for his initial meeting.  After a brief round of questions and answers and we begin our conversation concerning any possible bone instability and or damage as we go over this with every client.  Confident of himself; Jonathan tells us that he does not have to worry about getting osteoporosis because healthy bones are things that a person is born with and have absolutely nothing to do with nutrition, and osteoporosis is an extremely rare disease that only affects elderly women and not men.   Therefore it is not a very serious or significant disease.  Now this statement will send up some red flags, because here is a gentleman who is not concerned that he could be at risk for osteoporosis.  I would most definitely disagree with the two statements made.  The reasoning of this client is otherwise influenced possibly by television or some form of literature claiming incorrect information.  The fact is that osteoporosis affects quite a large number of people, and in most cases it is due to inadequate dietary intake.    Osteoporosis can be a cause of significant morbidity and mortality in postmenopausal women as well as men. In both men and women, increasing age and low bone mineral density (BMD) are the 2 most important independent risk factors for an initial vertebral or nonvertebral fracture (Bonnick SL. Department of Biology, University of North Texas).  Osteoporosis is in fact a major public health problem, affecting millions of individuals. Dietary intake is an important factor for bone health. Inadequate intake of nutrients important to bone increases the risk for bone loss and subsequent osteopomsis. The process of bone formation requires an adequate and constant supply of nutrients, such as calcium, protein, magnesium, phosphorus, vitamin D, potassium, and fluoride. However, there are several other vitamins and minerals needed for metabolic processes related to bone, including manganese, copper, boron, iron, zinc, vitamin A, vitamin K, vitamin C, and the B vitamins. Although the recommended levels of nutrients traditionally related to bone were aimed to promote bone mass and strength, the recommended levels of the other nutrients that also influence bone were set on different parameters, and may not be optimal for bone health, in view of recent epidemiological studies and clinical trials.

(The Role of Nutrients in Bone Health, from A to Z Cristina Palacios Critical Reviews in Food Science and Nutrition. Boca Raton: 2006. Vol. 46, Iss. 8; pg. 621, 8 pgs).

 

Here are some things that Jonathan may need to take into consideration also;

 

Causes of Secondary Osteoporosis in Men:

 

    * Glucocorticoid medications

    * Other immunosuppressive drugs

    * Hypogonadism (low testosterone levels)

    * Excessive alcohol consumption

    * Smoking

    * Chronic obstructive pulmonary disease and asthma

    * Cystic fibrosis

    * Gastrointestinal disease

    * Hypercalciuria

    * Anticonvulsant medications

    * Thyrotoxicosis

    * Hyperparathyroidism

    * Immobilization

    * Osteogenesis imperfecta

    * Homocystinuria

    * Neoplastic disease

    *Ankylosing spondylitis and rheumatoid arthritis

    * Systemic mastocytosis

 

This should be more than enough to help Jonathan re think that last statement.

References:

National Institute for  Arthritis and Musculoskeletal Diseases and Skin Disease

The Role of Nutrients in Bone Health, from A to Z Cristina Palacios Critical Reviews in Food Science and Nutrition. Boca Raton: 2006. Vol. 46, Iss. 8; pg. 621, 8 pgs

Bonnick SL. Department of Biology, University of North Texas

CYRUS YOU ALRIGHT?

Called the silent killer; hypertension has struck down large number of people over the years. The worse thing is that we let it go unchecked and undetected for year and the next thing we know…its Hydrochlorothiazide and Lisinopril for us. Sound like I know what I’m talking about? Let me help you understand then. Before I took this course, I was on a crash course to doom, and didn’t even know. The worst part is I felt like I was doing fine. I stuffed supplements down my gullet and eat everything in sight, then in August of 2006; I was getting in my last airborne mission before deployment and broke my right leg on a jump. I broke the tibia and the fibula, as well as doing a syndmosis tear of the ligament around the ankle. Talk about bad!! As I sat on my rump for 6 months and still deploying, did some half cocked workouts, my blood pressure unbeknownst to me had gotten worse. It was in August of 2008 that I had my blood pressure recorded at 160/100!!! I was horrified, and began an unbelievable workout regiment, but I still ended up on medication. I hope someone takes this to heart. I know this introduction was long, but this subject is very near and dear to me as it should be to all of us. By the way I went from 248lbs to 210 and I am still going, thank God!!




Cyrus is a 52 year old male, who has come to us for advice. Our concerns are about his blood pressure which reads 180 mm Hg systolic over 120 mm Hg diastolic. Cyrus definitely has hypertension and the first thing we need to do is get Cyrus to consult with a physician immediately. There are certain points when a potential client’s overall health and well being must be taken into the consideration of a health care provider. Hypertension is a very serious medical condition that will require our potential client to consult with an Internal Medicine Health Care Provider, where he can get the right classes. Although we may be able to offer some education, he will need the five day blood pressure check. The five days check up may result in Cyrus have to take medication. These are decisions that cannot and should not be made by us. Cyrus faces the possibility of a stroke, heart attack, aneurysm, and renal failure. Hypertension with type 2 Diabetes will result in further treatment. If not controlled this individual’s life expectancy will be shortened. There is no one identifiable cause for Hypertension, but age, genetics, obesity, insulin resistance, sodium sensitivity and a few more to name does contribute to Hypertension (Anon, 2006. ("Complications of Hypertension" Retrieved from the worldwide web on 5/28/08). This is very bad news for Cyrus, but there is good news. We know that with proper exercise and good dieting, we can help to lower his blood pressure to a safe level. Here is one program that has been doing wonders for prevention of hypertension; the DASH diet. The DASH diet (Dietary Approaches to Stop Hypertension) is a step by step program designed for people with hypertension to get it under control, rich in fruits and vegetables; the DASH diet is enjoying a good success rate as of date. The DASH eating plan has been proven to lower blood pressure in just 14 days. Best response came in people whose blood pressure was only moderately high, including those with pre hypertension. For people with more severe hypertension, who may not be able to eliminate medication, the DASH diet can help improve response to medication, and help lower blood pressure (Champagne, C.M. (Dietary Interventions on Blood Pressure: The Dietary Approaches to Stop Hypertension (DASH) Trial Nutrition Reviews, 64(2:2), S53-57s). Aerobic exercise, such as walking is great way to get you back on the path to healthy living. Remember; don't try to conquer the world the first time out. Be patient, start slowly and gradually increase frequency and duration. During the planning phase carefully consider what barriers might stand in the way of consistency; then develop strategies and accountabilities to assist in eliminating these barriers. You’ll want to start off with exercises such endurance activities such as walking, swimming; cycling and low-impact aerobics should be the core of the exercise program. Exercises that include an intense isometric component that can cause extreme and adverse fluctuations in blood pressure should be avoided. Overall we want to wish Cyrus all the blessings and when his physician gives him the go ahead, and let him know we are here and ready to help out in anyway possible.
References:
Azadbakht, L., Mirmiran, P., Esmaillzadeh, A., Azisi, T., & Azisi, F. (Beneficial Effects of a Dietary Approach to Stop Hypertension Eating Plan on Features of the Metabolic Syndrome. Diabetes Care, 28(12), 2823-32.)
Elmer, P.J., Obarzanek, E., Vollmer, W.M., and Simons-Morton, D (Effects of Comprehensive Lifestyle Modification on Diet, Weight, Physical Fitness, and Blood Pressure Control: 18-Month Results of a Randomized Trial. Annals of Internal Medicine, 144(7), 485-496.)
Schulze, M.B., Hoffman, K., Kroke, A., & Boeing, H. (Risk of Hypertension among Women in the EPIC-Potsdam Study: Comparison of Relative Risk Estimates for Exploratory and Hypothesis Oriented Dietary Patterns. American Journal of Epidemiology, 158(4), 365-373)
Meenu Mirilles PA-C (Controlling Hypertension)
Major Wendy Gray FNP US ARMY (The Healthy Soldier)
Curtis Aberle FNP (Diet, Hypertension, and Weight Management)
John Cadrain PA-C (Cardiovascular Health and Aging)
Rebecca K. McArthur FNP (Lowering Your High Blood Pressure)
The American Heart Association
The 2005 Dietary Guidelines for Americans
(Note: some of the references and citations are taken from courses given at Fort Sam Houston for work reference)

But it tastes Soooooo Good!!

According to this WebMD article; “Vitamin D for Cancer Prevention?”, getting enough vitamin D might cut colon cancer and breast cancer in North America, according to a new research review. The reviewers also suggest that adults should daily take 2,000 international units (IU) of vitamin D -- in a form called vitamin D3 (cholecalciferol) -- to help prevent some cancers, including colon cancer and breast cancer. But that's not a prescription or a guarantee. The review is based on observational studies, which didn't directly test vitamin D for cancer prevention. (By Miranda Hitti, WebMD Health News and Reviewed by Louise Chang, MD). Substantial information exists about the links between certain types of cancers and nutrition. It is important to note that other lifestyle factors, such as smoking, alcohol use, exercise level and obesity also play a role in the risk of developing cancer. With all of this information on how lifestyle contributes to the factors which result in getting cancer, and ways to the risk of getting cancer; can vitamin D help prevent cancer? There are studies that suggest vitamin D has a role, but in the end the evidence is all but conclusive; and we do know many Americans Lack Enough Vitamin D. The next case presents the age old question of Quantity vs. Quality when eating a “well balanced meal”, in which we always seem to have a dilemma. (American Cancer Society: see citations below) It is most certain that in the case of disease prevent and what good nutrition hold for us, we always push toward the latter of the two; for example: it may be smart to that life styles that involve diets high in fruits and vegetables have been associated with reduced risk of cancer, can be beneficial to many of us attempting to achieve this type of lifestyle. On the flip side those of us who are taking the opposite route will not. The quality of the food we eat is very important in one aspect as is the quantity of the food we are eating. It does not help to eat vegetables one day of the week and fast foods the rest of the week , thinking we have our fill of nutrients. We only benefit when we combine both quality and quantity. So when we think about disease prevention and the diet we have, there are many critical factors to pay attention to. How much are we getting from our whole foods and are we getting any whole food at all? When rushing around do we automatically rush to fast foods or can we plan and prepare better to eat healthier foods? How much exercise are we getting, how much rest are we getting, and are we taking into account of use of time to get foods that are properly prepared? These are just some of the factors we need to consider and be sure that quality and quantity don’t clash as a result of our own nutritional mismanagement.

References:
American Cancer Society (2007). Food and Fitness.
Citations: "The Role of Vitamin D in Cancer Prevention." Published online Dec. 27, 2005 and in the February, 2006, American Journal of Public Health (Vol. 96, No. 2:9-18). First author: Cedric F. Garland, DrPH, Department of Family and Preventive Medicine, University of California, San Diego.
"Vitamin D and prevention of colorectal cancer." Published in the October, 2005, Journal of Steroid Biochemistry and Molecular Biology (Vol. 97, No.1-2:179-194). First author: Edward D. Gorham, PhD, MPH, Department of Family and Preventive Medicine, University of California, San Diego.

BIG Jim

It is always better to explain to your client the nature of their condition, or ailment if you are a doctor. However as a Nutrition counselor, we must be able to educate our clients on their responsibilities and help them to achieve the goals they are moving toward. In the case below we will assist our client on how to live a healthy lifestyle. Obesity and overweight need to be recognized as chronic and multifaceted conditions. Treatments that are not lifelong or for the long term and that do not address many or all etiologic factors are unlikely to succeed. The approach to obesity should be akin to that of many other chronic health conditions, such as hypertension and CAD. Successful treatment starts with overcoming the perception of futility that has pervaded physicians' attitudes toward obesity in the last few decades. Fewer than 50% of obese adults report being advised by their healthcare provider to lose weight.11 (Reference) This statistic contrasts with the fact that, as with smoking, targeted counseling of even short duration can result in substantial increases in physical activity or attempts to lose weight. Our client is Jim, 47 year old former weight lifter who was injured during his training. This scenario is very common for many folk, we tend to over work ourselves and eventually injure ourselves. Upon meeting Jim we must give a proper assessment. With that we can move on to begin to put the pieces of a good program together for him. Once we gather information from the client we will give him the proper tools and education needed to improve his lifestyle. Because Jim has a BMI of 31, we must inform him of the dangers that come with being overweight. A good example of what some of the risk factors are diabetes, hypertension, and CAD. The stress alone that one puts on their body form being obese can be a severe disadvantage to healthy living and managing a comfortable lifestyle. As we age, our bodies tend to change. It is very important that Jim understands he may find it a little difficult to change certain things about himself. It may have been a while since he last did any form of training and that could appear as a demotivator in most cases. That is were we come in, we are going to help Jim achieve some realistic goals and have a healthier lifestyle. At 47, Jim’s BMI and weight make him a prime candidate for those factors right out of the box. It is important that Jim understand the nature of these diseases and make plans to change his lifestyle. We should note if Jim is taking any multivitamins, or if he is on any physician prescribed medication, by looking into his medical history. It would be also wise to recalculate and record Jim’s BMI for the purpose of progression. The biggest key to all this is the fact that Jim mentioned to us that he “tends to snack on chips lately, and hasn’t been eating fruits and vegetables” is a noteworthy suggestion that Jim may have a poor diet and nutrition program. Having said this we have to steer this person in the right direction and explain the food pyramid to him, as well as how proper exercise along with good nutrition will be in his best interest. The food pyramid is a great guide which can help Jim find what are the right foods to eat and which ones to avoid, fortunately for him the pyramid is readily accessible via internet. We must also ensure that Jim understands the simplest change in his lifestyle for the better, can result in a beneficial long term effect coupled with proper exercise regime!! Knowing that Jim was once a weight lifter gives us some idea of his ability to perform a good exercise regime, now we need to understand the nature of his injury or injuries, and how they affect him working toward a good program. By coupling both programs together, we can help Jim “get it together”. Once we have sat down and explained to Jim all of the factors working against him and ways to change them through healthy living, we could begin putting together a journal which would chronicle Jim’s progress. We need to ensure that we involve Jim in the decision making process throughout each phase of his transformation. Even though we are their every step of the way, ultimately it would fall on Jim to have the motivation to continue forward progression.
References:
Christopher B. Ruser, MD, Daniel G. Federman, MD, and Susan S. Kashaf, MD Dr Ruser and Dr Kashaf
Shiriku Kumanyika
American Dietetic Association
Harvard Health Journal

I'm on a diet!!!

Often as a personal trainer, I get clients that come to me with a plan already in the works. They have the plan based on how they are going to loose weight and get trim and it usually goes like this: "I got this 21 one day diet and it will help me loose 21 pounds in that time.", or "My friend said she lost 30 pounds in one month by eating just cabbage.", or "I have the perfect diet, I got it from this magazine and it is proven to work by every one who has tried it"., so forth and so on. This drastically changes when they try the diet and gain more than they had before. Even worse, certain infomercials cram the airwaves with use folks who are still fairly overweight telling that one pill and they can still eat what they want; "It really works, I just took the pill". Soon one person goes to the doctor and gets a reality check which consists of Hypertension and Type II Diabetes, then its off the the gym or they just settle for the medication and think to themselves; "As long as I get my medicine, I'm good. Well listen here, we want to be off the meds and out of the deep water don't we? Wouldn't it be nice to just hear out those fitness gurus and health experts telling you to rethink and reinvent yourselves? What do you think? Well they do, the pill is not going to help you; but that guy or girl jumping around on your TV set telling if you are willing to put the time into 30 days worth  in pill......then why not tryout this EXERCISE and NUTRITION plan.  Now understand if you tried something like one of those exercise plans, then you could possibly see some great result.  The cool part is they tell you up front you are not going to get the same results as those in the infomercial.  Here is an even better part, you can go all over the web and read realistic testimonies as well as join online groups that will encourage you to keep going and never give up.  Now there are people who tell you these programs don't work; why you ask?  Because when they don't get the results they were looking for.......they simply quit!!  Don't listen to the naysayers, because here is a news flash:  "If you put total dedication and heart into a fitness program you WILL see results not matter how big or small.  This isn't your typical blog, this one is a heart felt message to all of folks out there who "aren't that concerned with their health, because they really don't get the check ups they are supposed to get, nor do they engage in any form of exercise and nutrition programs. There are many websites out there telling you how to do it the right way, from mypyramid.com to eatright.com. Stop saying "I'm on a diet and start combining healthy eating with healthy living by exercising and eating right"!! Remember; there is only one of you and that is all you get.