5 Smart Carb Swaps

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Eating fewer carbs does not mean giving up everything you love. A few easy changes can make a big difference in how much you consume. Instead of choosing carb sources loaded with sugar, fat, and calories, opt for more nutrient-dense alternatives filled with fiber, heart-healthy fats, and whole grains. You’ll be surprised at much you love the alternatives below and how delicious eating low-carb can be.

1. BBQ Baked Beans

GOOD: Beans are full of fiber.

BAD: Lots of sugar in the sauce—13g for a total of 32g carbs.

BETTER: Black beans with sautéed red bell pepper, jalapeño, lime, and fresh cilantro. 10g fewer carbs and an additional 1.5g fiber.

2. Salad Dressings

GOOD: You’re eating salad!

BAD: Dressing choices, such as honey mustard (one of my favorites!!) and raspberry vinaigrette contain roughly 7g refined carbs per 2 tablespoons, all from sugar. And most light or fat-free dressings add sugar to make up for fat.

BETTER: Opt for oil and vinegar-based dressings instead; you’ll get zero carbs and lots of heart-healthy fats.

3. Apples with Low-Fat Caramel Dip

GOOD: You’re eating apples—25g balanced carbs and 4g fiber.

BAD: That caramel sauce has 26g carbs in just 2 tablespoons, all from sugar.

BETTER: Swap caramel for 1 tablespoon peanut butter. You’ll add 4g filling protein.

4. Cracker Jacks

GOOD: Whole grains and nuts.

BAD: The caramel adds 30g refined-sugar carbs per cup.

BETTER: Lightly salted oil-popped popcorn and nuts.

5. Mashed Taters

GOOD: More veggies.

BAD: No skin = 2g less fiber.

BETTER: Mashed butternut squash has just 47 calories, 12g carbs, and 4g fiber per ½ cup. Add a teaspoon of butter for 34 calories and 2.4g sat fat.

Not bad alternatives! And if you want to take your health goals to the next step, check out the challenge.

Nutrition challenge: If half of your daily grain intake is not 100% whole grain, I challenge you to “up-your-ante!” If this is old news to you, then what challenge will you take on?

Adapted from: Sidney Fry, MS, RD

Nutrition Daily Nugget 🍏

Get your kids in the kitchen! They’ll be more excited about eating healthy foods when they’ve been involved. Give them age-appropriate tasks and keep a step-stool handy.

Daily Inspiration Nugget

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World will have more obese children and adolescents than underweight by 2022

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The number of obese children and adolescents (aged 5 to 19 years) worldwide has risen tenfold in the past four decades, according to a new study led by Imperial College London and the World Health Organization (WHO). If current trends continue, more children and adolescents will be obese than moderately or severely underweight by 2022. The study is published in The Lancet. It analyzed weight and height measurements from nearly 130 million people aged over five (31.5 million people aged 5 to 19, and 97.4 million aged 20 and older), the largest number of participants ever involved in an epidemiological study. More than 1000 researchers contributed to the study, which looked at body mass index (BMI) and how obesity has changed worldwide from 1975 to 2016.

During this period, obesity rates in the world’s children and adolescents increased from less than 1% (equivalent to five million girls and six million boys) in 1975 to nearly 6% in girls (50 million) and nearly 8% in boys (74 million) in 2016. Combined, the number of obese 5 to 19-year-olds rose more than tenfold globally, from 11 million in 1975 to 124 million in 2016. An additional 213 million were overweight in 2016 but fell below the threshold for obesity. Lead author Professor Majid Ezzati, of Imperial’s School of Public Health, said: “Over the past four decades, obesity rates in children and adolescents have soared globally, and continue to do so in low-and-middle-income countries. More recently, they have plateaued in higher income countries, although obesity levels remain unacceptably high.”

Professor Ezzati adds: “These worrying trends reflect the impact of food marketing and policies across the globe, with healthy nutritious foods too expensive for poor families and communities. The trend predicts a generation of children and adolescents growing up obese and also malnourished. We need ways to make healthy, nutritious food more available at home and school, especially in poor families and communities, and regulations and taxes to protect children from unhealthy foods.”

More obese than underweight 5 to 19-year-olds by 2022

The authors say that if post-2000 trends continue, global levels of child and adolescent obesity will surpass those for moderately and severely underweight for the same age group by 2022. Nevertheless, the large number of moderately or severely underweight children and adolescents in 2016 (75 million girls and 117 boys) still represents a major public health challenge, especially in the poorest parts of the world. This reflects the threat posed by malnutrition in all its forms, with there being underweight and overweight young people living in the same communities. Children and adolescents have rapidly transitioned from mostly underweight to mostly overweight in many middle-income countries, including in East Asia, Latin America, and the Caribbean. The authors say this could reflect an increase in the consumption of energy-dense foods, especially highly processed carbohydrates, which lead to weight gain and poor lifelong health outcomes.

Dr. Fiona Bull, the programme coordinator for surveillance and population-based prevention of noncommunicable diseases (NCDs) at WHO, said: “These data highlights, remind and reinforce that overweight and obesity is a global health crisis today, and threatens to worsen in coming years unless we start taking drastic action.”

Global data for obesity and underweight

In 2016, there were 50 million obese girls and 74 million obese boys in the world, while the global number of moderately or severely underweight girls and boys was 75 million and 117 million respectively. The number of obese adults increased from 100 million in 1975 (69 million women, 31 million men) to 671 million in 2016 (390 million women, 281 million men). Another 1.3 billion adults were overweight but fell below the threshold for obesity.

Regional/Country data for obesity, BMI and underweight

Obesity:

The rise in childhood and adolescent obesity in low- and middle-income countries, especially in Asia, has accelerated since 1975. Conversely, the rise in high-income countries has slowed and plateaued. The largest increase in the number of obese children and adolescents was seen in East Asia, the high-income English-speaking region (USA, Canada, Australia, New Zealand, Ireland and the UK), and the Middle East and North Africa. In 2016, obesity rates were highest overall in Polynesia and Micronesia, at 25.4% in girls and 22.4% in boys, followed by the high-income English-speaking region. Nauru had the highest prevalence of obesity for girls (33.4%), and the Cook Islands had the highest for boys (33.3%).

In Europe, girls in Malta and boys in Greece had the highest obesity rates, at 11.3% and 16.7% of the population respectively. Girls and boys in Moldova had the lowest obesity rates, at 3.2% and 5% of the population respectively. Girls in the UK had the 73rd highest obesity rate in the world (6th in Europe), and boys in the UK had the 84th highest obesity in the world (18th in Europe). Girls in the USA had the 15th highest obesity rate in the world, and boys had the 12th highest obesity in the world. Among high-income countries, the USA had the highest obesity rates for girls and boys.

BMI:

The largest rise in BMI of children and adolescents since 1975 was in Polynesia and Micronesia for both sexes, and in central Latin America for girls. The smallest rise in the BMI of children and adolescents during the four decades covered by the study was seen in Eastern Europe. The country with the biggest rise in BMI for girls was Samoa, which rose by 5.6 kg/m2, and for boys was the Cook Islands, which rose by 4.4 kg/m2.

Underweight:

India had the highest prevalence of moderately and severely underweight (BMI <19) throughout these four decades (24.4% of girls and 39.3% of boys were moderately or severely underweight in 1975, and 22.7% and 30.7% in 2016). 97 million of the world’s moderately or severely underweight children and adolescents lived in India in 2016.

Solutions exist to reduce child and adolescent obesity

In conjunction with the release of the new obesity estimates, WHO is publishing a summary of the Ending Childhood Obesity (ECHO) Implementation Plan. The plan gives countries clear guidance on effective actions to curb childhood and adolescent obesity. WHO has also released guidelines calling on frontline healthcare workers to actively identify and manage children who are overweight or obese. Dr. Bull added: “WHO encourages countries to implement efforts to address the environments that today are increasing our children’s chance of obesity. Countries should aim particularly to reduce consumption of cheap, ultra-processed, calorie dense, nutrient poor foods. They should also reduce the time children spend on screen-based and sedentary leisure activities by promoting greater participation in physical activity through active recreation and sports.”

Dr. Sophie Hawkesworth, from the Population Health team at Wellcome Trust, which co-funded the study, said: “Global population studies on this scale are hugely important in understanding and addressing modern health challenges. This study harnessed the power of big data to highlight worrying trends of both continuing high numbers of underweight children and teenagers and a concurrent stark rise in childhood obesity. Together with global health partners and the international research community, Wellcome is working to help identify new research opportunities that could help better understand all aspects of malnutrition and the long-term health consequences.”

My thoughts: The unfortunate and sad reality is that I was not surprised when I read the research. 😔 However, this is just more proof that we have to work together as a world, not a country, to fight this epidemic…..and not only obesity but eating disorders as a whole. We can win!

Adapted from: NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128*9 million children, adolescents, and adults. The Lancet, 2017 DOI: 10.1016/ S0140-6736(17)32129-3

Nutrition Tip of the Day

Schedule time each week to plan healthy meals! Keep your recipes, grocery list, and coupons in the same place to make planning and budgeting easier.

 

Daily Inspiration 

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Why Nutrition Is Critical to Cognition

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As life expectancy lengthens around the world, the incidence of dementia and cognitive decline is also increasing. The number of people affected by dementia is growing exponentially, with an estimated 46.8 million people diagnosed worldwide.1 By 2030, that number is predicted to grow to 74.7 million. Nutrition-based interventions are making a big difference for patients with cognitive decline, including Alzheimer’s disease (AD).2,3

Multi-pronged lifestyle interventions offer the greatest hope for prevention and delay of cognitive decline.4 Researchers are evaluating the neuroprotective effects of plants and their impacts on disease-related neural dysfunctions.2 Plants contain flavonoids, which modulate signaling pathways. These flavonoids have antioxidant and anti-inflammatory properties that affect both phosphatidylinositol 3-kinase (P13K)/AKT and mitogen-activated protein kinase (MAPK). Flavonoids may be important for both neural rehabilitation and recovery of cognitive performance.2 For patients at risk of or diagnosed with Alzheimer’s disease, a high-flavonoid diet may be especially beneficial.

Before considering specific lab tests, it may be more useful to evaluate patients’ everyday diet. Overall nutrition may be more important than single nutrient measurements. For instance, one population-based sample with longitudinal follow-up offers evidence that a nutrient-dense diet is an important factor in retaining cognitive health after AD diagnosis.5 The study found that patients with dementia often have declining nutrition scores over time. It may be no surprise that cognitive decline patients struggle to maintain a nutritious diet. Lower nutrition scores predicted a faster rate of cognitive decline. Higher nutrition scores had the opposite effect. This suggests that nutrition status could be a key predictor for dementia progression, as well as key for prevention.5

In addition to affecting cognitive scores, nutrition affects underlying brain structures. For example, polyphenols in foods have anti-inflammatory effects on microglia.6 Poor nutrition, such as consuming a Western diet, is correlated with reduced hippocampal volume.7 As research continues to develop, the underlying mechanisms and protective effects of nutrition will continue to influence clinical care.Clinical understanding of how lifestyle factors impact cognition and brain structure continues to evolve.

References:

  1. Prince M, Wimo A, Guerchet M, et al. World Alzheimer Report 2015—The Global Impact of Dementia. London: Alzheimer’s Disease International; 2015. https://www.alz.co.uk/research/world-report-2015.
  2. Bakhtiari M, Panahi Y, Ameli J, Darvishi B. Protective effects of flavonoids against Alzheimer’s disease-related neural dysfunctions. Biomed Pharmacother. 2017;93:218-29. doi: 10.1016/j.biopha.2017.06.010.
  3. Morris MC. Nutrition and risk of dementia: overview and methodological issues. Ann N Y Acad Sci. 2016;1367(1):31-37. doi: 10.1111/nyas.13047.
  4. Livingston G, Sommerlad A, Orgeta V, et al. Dementia prevention, intervention, and care. Lancet. 2017 July 19. doi: 10.1016/S0140-6736(17)31363-6.
  5. Sanders C, Behrens S, Schwartz S, et al. Nutritional status is associated with faster cognitive decline and worse functional impairment in the progression of dementia: the Cache County Dementia Progression Study. J Alzheimers Dis. 2016;52(1):33-42. doi: 10.3233/JAD-150528.
  6. Peña-Altamira E, Petralla S, Massenzio F, Virgili M, Bolognesi ML, Monti B. Nutritional and pharmacological strategies to regulate microglial polarization in cognitive aging and Alzheimer’s disease. Front Aging Neurosci. 2017;9:175. doi: 10.3389/fnagi.2017.00175.
  7. Jacka FN, Cherbuin N, Anstey KJ, Sachdev P, Butterworth P. Western diet is associated with a smaller hippocampus: a longitudinal investigation. BMC Med. 2015;13:215. doi: 10.1186/s12916-015-0461-x.
  8. Dauncey MJ. Nutrition, the brain and cognitive decline: insights from epigenetics. Eur J Clin Nutr. 2014;68(11):1179-85. doi: 10.1038/ejcn.2014.173.

Nutrition Tip of the Day

Think About Portion Sizes! Reduce your portion sizes by using a salad plate instead of a dinner plate. Your brain will still register that you are eating a full plate of food and you can leave the table satisfied, even though you’ve consumed fewer calories. Once you’ve mastered small plates, shrink the size of your bowls, glasses and spoons too.

Daily Inspiration 

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3 Signs You Are Not Eating Enough

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With so much discussion about health problems related to being overweight or obese, the topic of undereating may not appear to a huge concern, but believe me, it is. Often, when individuals are working on weight loss, fitness gain or performance optimization, the issue of undereating comes up just as frequently as overeating does. We all know why it’s so easy to eat too much: portion sizes have expanded dramatically, bulk buying habits encourage us to keep more food around at all times, we’ve been encouraged to snack in between meals with little regard for hunger cues, and so many of our modern foods are less satiating than fresh, wholesome food we ate just a generation or two ago (low in fiber and protein, high in refined carbohydrates).

It’s not so easy to understand why so many people are chronically undereating for their health, but a major contributor is the emphasis on calorie math that leads so many people into risky dieting patterns. Don’t get me wrong, managing calories appropriately is critical for weight loss and body composition management. However, if we’re not careful, a calorie math-focused mindset can be a risk factor for a number of negative adaptations.

Logically, chopping a couple hundred calories out of your daily intake can seem like a no-brainer way to encourage your body to burn extra energy from fat stores. And it will probably work for most people – at least temporarily. As many internet calorie calculators would have you believe, if you want faster results you can choose a larger energy deficit and get a faster linear path to weight loss. So if eliminating 300 Calories from your normal day is good, dropping 500 or 1000 Calories is even better, right?

It’s just not that easy! Our physiology is smart. It likes balance and homeostasis. We’re wired for survival, not for six-pack abs. If you’ve found yourself in a place where you’ve followed “diets” below your true caloric needs for any length of time, you’ve probably begun to experience at least some of the negative consequences of not eating enough.

It takes a trained eye to spot the main indications of not eating enough. But once you learn these main signals, you’ll be more likely to enjoy continued progress towards your goals through more ideal eating patterns. Note: the downfalls of “not eating enough” discussed below are in the context of persistent or prolonged undereating (longer than a few weeks), not necessarily indicative of missing a single meal or eating too little for a couple of days.

Your diet changes who you are.

Irritable, anxious, mentally exhausted, foggy-brained, unable to focus, or mildly obsessed with or fixated on food? Sounds like what happens when you go on a diet, right? Most of us have experienced episodes of “hanger” or mustered through periods of difficult concentration on our mission to lose a few pounds of pudge.

It is not wise to take these mood or cognitive changes lightly though. They are serious signs that your metabolism is beginning to make negative adaptations to the caloric deficit you’re experiencing. Our brains consume about 20% of our total energy expenditure, which is why when you go on a lower-calorie diet by restricting total intake by 20 to 50%, you become a fundamentally different person. Whether it’s the frank energy shortage or insufficient intake of nutrients your brain depends on to maintain healthy neurotransmitter levels, undereating leads to significant brain changes.

If your brain is chronically deprived of energy to operate at full capacity, you’re eventually going to experience cognitive deficits including memory changes, impaired alertness, judgement or concentration. If the energy deficit is extreme enough – like the restriction experienced by subjects of the Minnesota Starvation Experiment of the 1940’s – the mental and cognitive changes can border on psychosis and perhaps even be permanent. Those subjects were fed an average of 1600 calories per day during the six month “starvation” phase of the experiment.

This was a 50% calorie reduction from their baseline, which sounds extreme, but compared to many persons, this is not an unrealistic difference between “normal” eating and their “dieting” intakes. The effects of “starvation” on these subjects were profound, and included changes in sense of humor, increased self-criticism, and altogether negative changes to social affect. Even without cutting calorie intake in half, conscious calorie monitoring or restriction increases cortisol output and perceived stress. In other words, consciously not eating “enough” automatically makes you less resilient against the stresses of daily life.

This shows us how important it is to complement any “dieting” efforts with a healthy amount of monitoring of our mental and social well-being through strong social support systems and consistent self-reflection or gratitude. Calories are not more important than character. If you sense your mood, cognition or personality changing, it may be one of the first indicators that your “diet” is leading to negative adaptations.

Your physical health suffers.

Often times, we ignore the first negative signs of not eating enough (brain changes) because we’re motivated by aesthetically-focused outcomes. So, we press on and suffer through the next set of negative adaptations that can arise from chronic under-feeding; physical breakdown. Sometimes it can be difficult to tell if these changes are completely negative or just part of the process of improving fitness. Because experiencing soreness, lowering resting pulse and blood pressure, and some fatigue are to be expected as we go through a training or weight loss program. However, one must continually evaluate their physical resilience to make sure their calorie intake is sufficient to maintain their health as their physique changes.

To lose weight the right way, you can’t just monitor your scale weight. You must measure other indicators of physical change such as body fat changes, lean mass levels, physical performance and physical health. Are your skin, hair, and nails looking healthier and are you feeling younger as you trim down or are you noticing visual and sensory signs of premature aging?

For example, if you’re losing more muscle than fat, you’re not eating enough. If you’re not gaining or maintaining your physical strength or abilities week to week, you’re probably not eating enough. If you’re noticing extended soreness after workouts, prolonged healing time, or your hair is falling out more easily, you’re definitely not feeding your body enough to positively adapt to your program.

Evidence suggests that eating enough calories to support progressively harder physical training (as opposed to cutting calories to induce weight loss) is the better way to promote physical health and physique changes (loss of body fat and gain of lean tissue). At least one study showed significantly poorer exercise performance capacity when subjects restricted their calories by an average of 12% from their baseline. The subjects experienced dramatic decreases in VO2, muscle size and muscle strength over the course of twelve months.

It’s commonly assumed that maximizing fat loss is often accompanied by performance plateaus and/or mild decreases, but this study suggested energy deficits created through smart training rather than dietary restriction ultimately results in both fat loss and performance improvement. That’s the holy grail of health improvement, and it happens when we’re fed well enough to physically repair from the exercise stress we encounter. Unfortunately, many people try to chronically diet and exercise to double up on the calorie math advantage. What happens after more than a couple weeks of this?

Your hormonal ‘soup’ sours.

The longer your body experiences under-nourishment, the more severely it will adapt. The adaptations are aimed at survival, so any system that’s not absolutely necessary to survival gets down-regulated. As mentioned above, our stress hormones elevate mainly to support the energy needs of our vital organs (at the expense of all other tissues like muscle).

Chronic elevations in cortisol can cause the hormones that control our metabolic rate to decrease significantly, sometimes in as little as a few weeks of being on an energy restricted diet. This decrease results in a decrease in our body temperature, brain activity, heart rate, digestive processes and just about every other system in our body. Reproductive hormones often plummet (mainly testosterone in men and progesterone in women) so much that libido, affect and reproductive cycles become severely or even permanently deranged.

It’s quite unfortunate, but the repeated cycles of dieting and weight re-gain often lead to significant alterations in hormonal balance, which are often combatted by even more extreme dieting patterns. It’s a vicious cycle.

What to do

You may not like this advice, but in order to optimize your fat loss and fitness, you probably need to abandon hopes of quick success and focus on the (slower) road to prolonged health. Ditch the use of internet-based calorie calculators that only account for your age, gender, height and weight. These calculators do not account for your dieting or exercise history, so they can only apply an overly-simplified calorie math equation that cannot predictably help you optimize your physiology. Consult with a Registered Dietitian Nutritionist who can provide an individual assessment of you metabolism and physiology needs. Happy Healthy!!

Adapted from: Paul Kriegler, RD

Nutrition Tip of the Day

Find Time To Sleep! No amount of multivitamins, super foods or juices can help you if you are neglecting your REM cycle. Sleeping seven plus hours per night is required in order for the body to detoxify, repair and rebuild for the next day. When you are tired you will oftentimes opt for food that is high in sugar and caffeine to give you that temporary energy boost. Failing to ignore your body’s silent cries for sleep can result in potential health issues, as well as weight gain.

Daily Inspiration 

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10 Benefits of Walking

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  1. Walkers Live Longer

  2. Walking helps prevent weight gain

  3. You can walk off weight

  4. Walking reduces Cancer risk

  5. Walking reduces the risk of Heart Disease and Stroke

  6. Walking reduces Diabetes risk

  7. Walking boosts your brain power

  8. Walking improves mood and reduces stress

  9. Walking can be a fun time to catch up with friends

  10. Walking helps you stay present and gets your eyes off computer/phone screens

Tip of the Day

Create a work of art! Add color to salads with baby carrots, shredded red cabbage, or green beans. Include seasonal veggies for variety throughout the year.

Daily Inspiration 

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Strategies to Prevent Obesity

Obesity, it’s a complex problem, and there is no single or simple solution to the obesity epidemic. Policy makers, state and local organizations, business and community leaders, school, childcare and healthcare professionals, and individuals must work together to create an environment that supports a healthy lifestyle. There are several ways state and local organizations can create a supportive environment to promote healthy living behaviors that prevent obesity.

State and Local Programs

Resources are available to help disseminate consistent public health recommendations and evidence-based practices for state, local, territorial and tribal public health organizations, grantees, and practitioners. Knowing your body mass index (BMI), achieving and maintaining a healthy weight, and getting regular physical activity are all actions you can take for yourself to combat obesity.

Community Efforts

To reverse the obesity epidemic, community efforts should focus on supporting healthy eating and active living in a variety of settings. Learn about different efforts that can be used in early childhood care , hospitals , schools , and food service venues .

Healthy Living

The key to achieving and maintaining a healthy weight isn’t short-term dietary changes; it’s about a lifestyle that includes healthy eating and regular physical activity.

  • Assessing Your Weight
    BMI and waist circumference are two screening tools to estimate weight status and potential disease risk.
  • Healthy Weight
    A high BMI can be an indicator of high body fatness. Visit the Healthy Weight Website; learn about balancing calories, losing weight, and maintaining a healthy weight.
  • ChooseMyPlate
    Healthy eating habits are a key factor for a healthy weight. Visit the ChooseMyPlate Website; look up nutritional information of foods, track your calorie intake, plan meals, and find healthy recipes.
  • Physical Activity Basics
    Physical activity is important for health and a healthy weight. Learn about different kinds of physical activity and the guidelines for the amount needed each day.
  • Tips for Parents
    Learn about the seriousness of childhood obesity and how to help your child establish healthy behaviors.

Reprinted from CDC

Tip of the Day

Eat smart at and away from home. When you’re the chef, you control what you’re eating. If you eat out, check and compare nutrition information to choose healthier options.

Daily Inspiration 

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Standing Provides Real Advantages Over Sitting

Time spent standing, rather than sitting, was associated with lower fasting plasma glucose, triglycerides, and cholesterol in a new study. Researchers attached a monitor to nearly 700 participants over 7 days and found that each additional 2 hours per day spent sitting was significantly associated with higher body mass index (risk ratio 1.03, 95% CI 1.01-1.05; P<0.001), waist circumference (Beta=2.12, 95% CI 0.83-3.41, or around 2 centimeters; P<0.001), fasting plasma glucose (about 1%), total/high-density lipoprotein (HDL) cholesterol ratio (5%), triglycerides (12%), 2-hour plasma glucose (4%), and with lower HDL cholesterol (0.07 mmol/L). The study was led by Genevieve Healy, PhD, at the University of Queensland, in Australia, and appeared on Thursday in the European Heart Journal. The associations of sitting with fasting glucose and lipids were independent of moderate to vigorous physical activity, according to the researchers. Associations with the adiposity markers and 2-hour plasma glucose were no longer statistically significant after they were adjusted for exercise.

“These findings provide important preliminary evidence on the potential benefits of standing for cardio-metabolic risk biomarkers, especially improved lipid metabolism,” wrote Healy and colleagues. “This has important public health implications given that standing is a common behavior, the most common alternative to sitting, and predominantly replaces sitting in some types of effective and acceptable environmental sitting-reduction interventions.” A lot of research has been done on sitting: a recent meta-analysis found that those who spent a lot of time in chairs faced a higher all-cause mortality risk, independent of whether or not they exercised after sitting, but exercise has been shown to lead to clear benefits for kids and adults who lead otherwise highly sedentary lifestyles. Many have replaced sitting with standing, but the benefits or harms of standing aren’t known and little research has been done on it, according to Healy and colleagues.

In the study, they also found that replacing two hours a day of sitting time with stepping was associated with a lower BMI (11%) and with lower triglycerides (14%) and higher HDL-cholesterol (0.10 mmol/L). In an accompanying editorial, Francisco Lopez-Jimenez, MD, of Mayo Clinic wrote that the study offered an important contribution to the wealth of evidence pointing to the need to avoid sedentary behavior. “The fight against sedentary behavior cannot be won based only on the promotion of regular exercise,” he wrote. “A person walking while at work for 2 hours, standing for another 4 hours, and performing some daily chores at home for another hour will burn more calories than jogging or running for 60 minutes.” He added that those in the healthcare world, including policy makers, should look at ways to get people to move more often. “Healthcare providers, policy makers, and people in general need to stand up for this. Literally,” he wrote.

Data were taken from the Australian Diabetes, Obesity, and Lifestyle Study, which began in 2000 but underwent its third data collection in 2011 and 2012. The authors wrote that 782 participants agreed to wear the activity monitor provided and, of those, 741 (73%) gave at least one day of complete data. The patients were an average age of 57, and 57% of them were women. On the day that the participants were recruited, they underwent biochemical, anthropometric, and behavioral tests, and following an overnight fast, a standard oral glucose tolerance test was administered. The activity monitor was from PAL Technologies and secured to the right anterior thigh with a hypoallergenic patch and waterproofed. All of the participants were told to wear the monitor continuously for 7 days and to record in a diary the times they went to sleep and woke up. Periods when the participant was asleep were not monitored.

Metabolic-equivalent minutes of stepping and time spent sitting, standing, stepping, and stepping as part of a more vigorous physical activity were totaled for each day; they were then averaged across the days, and intensity of stepping time was calculated. Healy said in a press release that more work is needed to understand cause and effect. “While the study cannot show that less time spent sitting causes the improvements in these markers of health, the associations it reveals are consistent with what is known already about the benefits of a non-sedentary lifestyle,” she said. In the study, blood samples were collected from the participants. Triglycerides, total cholesterol, high-density lipoprotein (HDL) cholesterol, and fasting and 2-hour post-load plasma glucose were measured. Blood pressure was taken using a monitor, and BMI was recorded.

The authors also collected information about patients’ socio-demographic and behavioral attributes and medical history. Most of the patients provided at least 4 days of monitor data (97%), and 82% of them provided data for all 7 days of the study. Limitations of the study included selection bias, there were minor but statistically significant differences between the included participants and those in the larger study who opted not to do the tests. “There was a tendency to exclude those with lower dietary fat intakes and those who were older, shorter, of lower socioeconomic position, post-menopausal, not taking the oral contraceptive pill, and with some poorer health characteristics,” the authors wrote. “As previously observed there were some biases in loss to follow-up with a number of small but statistically significant differences in baseline characteristics between those who attended the wave three follow-up versus those who did not.” In addition, the authors noted that larger, and longer, studies are needed to establish definitive evidence.

Tip of the Day

Kids on the move. Encourage your kids to be active every day. Look for ways to make physical activity a part of your day. Do activities that build your muscles, get your heart pumping, and make you feel good.

Daily Inspiration

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