October 2006 Archives

"Zero grams of trans fats per serving." This jingle may sound familiar, and if it does. then you are probably one of many Americans who may not fully understand the concept of what this entails. Trans fatty acids are a type of fat found in processed foods such as cake mixes, frostings, cookies, doughnuts and other high-fat pastries, crackers, stick margarines and shortenings. They are also found in fast foods and virtually anything you can fry. They are found in pancake mixes, pop tarts and even the breakfast cereals we give our children. Now, a sandwich made of peanuts and shortening may not sound appetizing, but unless you are buying all natural peanut butter, that's basically what you are buying. And that great tasting popcorn you get at the movies, well that's not butter you are putting on top. It is actually butter-flavored popping oil that is used to pop the popcorn. This is loaded with trans fats, just as the cheese in your nachos are. Trans fats are also found naturally in animal products -- but in very small amounts. This includes meats, cheeses and dairy products.

You may be wondering how such a thing is made, so let's first learn how these fats are formed. Trans fats are fats that are liquid to begin with. Take palm, palm kernel or coconut oils for example, which are some of the worst fats we can consume. They undergo a process called hydrogenation, in which hydrogen is added to the liquid. They are then transformed into a semi-solid form such as shortening. This is all done via an artificial/chemical process. Many manufacturers are using this process and are including trans fats in their products today. "Why?" you may ask. It's simply because the trans fats add more flavor, texture and shelf-life to the product. This yields a better tasting product that can last on the shelf a longer time. This translates into less money spent by the manufacturers and a more affordable product for the consumer. Have you noticed how many trans-free products cost a bit more than their counterparts? It is more expensive to manufacture organic and non-processed food products. Just take a look at the grocery store next time and compare prices.

As of 2006, and manufacturers were required by the Food and Drug Administration to list trans fats on their labels of packaged foods. If the product has a nutrition label, it has to list trans fats. The tricky part is that the manufacturer only has to list it if the product contains 0.5mg or more. So if the product contains less than that, it doesn't have to list it on the label. This is very misleading to the general public as they believe their product contains 0 grams of trans fats; when, in actuality, it might contain some. So remember, just because the label says "0 grams" doesn't mean the product is trans free. And, currently there is no recommended daily allowance value for trans fats. However, just recently the American Heart Association set forth some dietary guidelines for trans fat consumption. It is recommended that the total amount of trans fats be limited to less than one percent of the total calories you consume.

So how do you become an expert at finding it on the label? Just look for the words, "partially hydrogenated oil or hydrogenated oil" in the list of ingredients. These are trans fats. If you see anything hydrogenated in the first four ingredients, this means that there are a great deal of trans fatty acids in the product. It would be best to put it back on the shelf. And remember, if it is in the ingredient list, but not listed on the label, there is less than 0.5 mg per serving. Now imagine if you have several servings! You will more than likely be well above the 0.5 mg minimum that is required on the label. Some manufactures have gotten much smarter and may have a breakdown of the product, such as listing what the filling consists of, then the topping. This way, the trans fats seems to be listed near the end. The product could still very well be loaded with it, but by reading the ingredient list, it seems harmless. It is important that consumers be expert label readers and look for these hidden clues prior to making food purchases.

"But my restaurant claims they use 100-percent vegetable oil in their menus," you might say. "That's a good thing, right?" Not necessarily. Your restaurant might claim to use 100-percent vegetable oil, but what they fail to tell you is that it may be 100-percent hydrogenated vegetable oil. This type of oil is cheaper, makes the food tasty and can last for days once it's in the fryer. The restaurant industry can still get away with this claim due to the fact that it is still vegetable oil, just as many manufacturers do.

So why should we care about trans fats? Research has shown a direct correlation between consumption of trans fats, heart disease and obesity. Trans fats are known to raise total cholesterol, "bad" cholesterol (LDL) and lower our "good" cholesterol (HDL). This puts us at risk for heart disease and stroke. Trans fats, the more hydrogenated they are, the more artery-clogging damage they do. This is comparable to throwing some hot bacon grease down your kitchen sink. Eventually it will harden and food particles will start to stick to it causing plumbing problems and soon the water you pour in will not drain properly. It is the same concept with the trans fats. With time, trans fats will clog the pipes to the heart which will ultimately lead to heart attack and stroke.

It was first believed that saturated fats were far more damaging than trans fats, but studies show the opposite is actually true. However, a diet high in saturated fat can still lead to artery damage. Saturated fats are fats that also come from animal products, meats, cheeses and dairy products, much like cholesterol. Excessive consumption of saturated fats and cholesterol can still raise your "bad" cholesterol (LDL) and total cholesterol. This, along with a low level of "good" cholesterol (HDL) could put one at risk for heart disease and stroke.

Excessive consumption of foods high in trans fats is also associated with an increased risk of obesity. Obesity in turn is linked with an increased risk of certain cancers, high blood pressure, heart disease, and Type 2 diabetes. According to the American Diabetes Association, there are an estimated 202,250 Bexar county residents diagnosed with diabetes and another 67,416 that are undiagnosed. Texas is twice the national average with a whopping 14 percent of our population being diabetic. Finding all we can on good eating habits is crucial in the fight toward reducing the incidence of diabetes and its complications.

A simple blood test performed by your doctor can check to see if you are at risk for heart disease and stroke by checking your cholesterol levels. These include total cholesterol, "good" cholesterol (HDL), "bad" cholesterol (LDL), and triglycerides. Per the American Heart Association guidelines, normal blood fat levels are as follows for the average American:

Total cholesterol < 200 mg/dl
HDL > 60 mg/dl
LDL < 130 mg/dl
Triglycerides < 150 mg/dl

The general recommendation is to have your cholesterol levels checked every five years starting at age 35. If you are overweight, have a chronic condition such as high blood pressure or diabetes or have a family history of heart disease or high cholesterol, you should have the test much sooner. Talk to your doctor about it. The best way to lower your risk for heart disease and stroke is to lower your "bad" (LDL) cholesterol and raise your "good" (HDL) cholesterol. This can be done by maintaining a healthy weight, exercising regularly, increasing fiber in the diet and developing good eating habits.

Good eating habits start with learning how to read and understand food labels. The more we know about saturated and trans fats, the more likely we are to make healthful food choices for ourselves and our families. The best cooking is home cooking, the way grandma used to make it. Don't depend so much on those processed foods, the ones that usually call for milk, water, oil and butter. More than likely, they are loaded with trans fats. At least with home cooking, you know what is going into your food, onto your plate and into your loved ones.

Lucy Romero, R.N., B.S.N. is a diabetes educator and Senior Public Health Nurse for "Families Preventing Diabetes," a program of the San Antonio Metropolitan Health District. This program empowers community members to serve as community health advocates helping to reinforce and model healthy behaviors through peer education. The goal of the "Families Preventing Diabetes" program is to prevent or delay the onset of Type 2 diabetes and lessen the risks and complications associated with the disease.

In one of my previous articles I described how a non-running activity, such as putting a pen to paper to log your miles can help you establish a consistent pattern of running. When logging those miles becomes a habit, then runners often create increasingly progressive goals to test themselves. The goals they create range from completing their first 5K all the way up to becoming a champion athlete. Once again, a non-running exercise can help you in these efforts. I call it "flapping your jaw."

Flapping your jaw is basically talking to yourself or to anyone within earshot who might be mildly interested in what your specific plans are for all that running you're doing. Flapping your jaw doesn't have to be boastful or arrogant, it simply means you want to let others in on what you are aiming for.

Machelle Cochran, a truly nice woman who would never be mistaken as a boastful or arrogant person, has told me that she wants to run a qualifying time for the 2008 U.S. Women's Olympic Marathon Trails. Cochran, the head cross country and track coach at Alamo Heights High School, simply is stating her aspiration, as you would expect a goal-oriented person might do. After the statements are made, runners know that they need to put in the leg work.

One of the greatest jaw-flappers of all time was Steve Prefontaine. Perhaps the greatest American distance runner of all time, in the early 70s, Prefontaine held all seven American track records from the 3,000 meters to the 10,000 meters. There were some who thought he was good because of his confidence, while other thought he was a little bit too cocky. He did back up his words more often than not and performed at an extremely high level at a very young age. He was a classic case of someone who "talked the talk" and then was able to run the run.

As a personal example of how flapping your jaw can work for an age-group competitor like me, I let it be known that my goal this summer was to break 20 minutes in the 5K. I felt this goal, although challenging, was within my capabilities. After increasing both the quality and quantity of my workouts, I was ready to attempt this. Beginning in May, I ran four 5Ks, but I didn't break through the barrier. I ran 21:00, 20:18, 20:20 and 20:13. With one more race on my schedule, the Silver Stars 5K on August 12, I was determined to give it another shot.

Turns out that fate and multiple jaw flapping were also present on that day. Fellow runners Jim Faucett, Toni Gonzalez and I would team up for a memorable race. It started when I bumped into Faucett during the pre-race warm-up. We made a pact earlier in the year to race against each other. For the last few years we have been trading off who would win against the other. In 2006 we never raced, and now, quite unexpectedly, we found ourselves facing off. I knew Faucett would raise my adrenaline and push me to a good effort. I asked Faucett what his time goal was in this race. Sure enough he said, "I would like to break 20 minutes." My pulse raced, I said "Me too". Faucett, then said, "Hey, you know Toni Gonzalez? She wants to break 20 minutes really bad."

Turns out all three of us were bearing down on the 20-minute mark. Toni Gonzalez had a similar pattern of oh-so-close calls this summer. She had run a 20:17, 20:03 and a 20:16. So when the gun went off, there was no doubt every second would matter. I didn't see Faucett or Gonzalez until just past the one-mile mark. Sure enough we were all in sight of each other and on pace. The humid weather and the AT&T parking lot hill, however, were making things tough. Faucett was 20 yards ahead at two miles, and I was shoulder to shoulder with Gonzalez. We hit the 2-mile mark in 12:50. We would have to run a solid last mile and hope for the best down in the home stretch if there were to be any hope of making the time goal.

I remember saying to myself "Fight!" at the last water stop. I knew that the race and the time goal were on the line. It was certainly on the line for Gonzalez because she passed me at 2.5 miles and looked strong. I tried to stay with her, and we were soon gaining ground on Faucett. When we made the final turn, Faucett took off. I said it was too early to go, especially with this heat; sure enough, Faucett misjudged the finish line and slowed back down. I looked at my watch, something I rarely do unless I'm at a mile marker, and it read 19:04 with about 300 yards to go. I said to myself, "Hey, it is still possible."

The homestretch in front of the AT&T Center was lined with people on both sides of the finish line, and with the clock in sight I started to sprint. I didn't catch Faucett or Gonzalez, but that wasn't the point. And as the clock ticked away, I was all smiles when I crossed the tape. The final tally was etched for all to see. Toni Gonzalez 19:54, Jim Faucett, 19:56 and Paul Baltutis 19:59. All three of us had all met the time goal. In races it doesn't get any better than talking the talk and running the run. Told you so.

Paul Baltutis is the manager of Soler's Sports in Alamo Heights. He is also a certified Marathon Coach for Team in Training. He can be reached at sage_run03@yahoo.com.

By Nicole Rogers, MPH, CHES

Nearly half of all American adults -- 90 million people - have difficulty understanding and using health information, according to a report from the Institute of Medicine. Examples of health information include your doctor's instructions, your prescription at the local pharmacy, physician referrals, health insurance coverage and/or information on federal programs such as Medicaid, Medicare and CHIP. The same report concludes that people who have a hard time understanding health information have a higher rate of hospitalization and use of emergency services and that this may lead to billions of dollars in avoidable health care costs to families and their healthcare providers.

More than a measurement of reading skills, health literacy also includes writing, listening, speaking, calculating and conceptual knowledge. It is the degree to which individuals have the capacity to obtain, process and understand basic information and services needed to make appropriate decisions regarding their health.

People of any age, income, race or background can find it challenging to understand health information. In fact, according to the American Medical Association, poor health literacy is "a stronger predictor of a person's health than age, income, employment status, education level and race."

At some point, most individuals will encounter health information they cannot understand. Even well-educated people with strong reading and writing skills may have trouble comprehending a medical form or a doctor's instructions regarding a drug or procedure.

Several factors have contributed to the need to improve health literacy. Rapid advances in medical research and technology have made communicating patients' diagnostic and treatment options highly complex. All too frequently, physicians do not explain their information in layperson's terms or in a way that patients can understand. Physicians are under increasing time pressure in today's clinical setting. They may not recognize when patients do not understand medical information or instructions. Many patients, because they are embarrassed or intimidated, do not ask health care providers to explain difficult or complicated information. If patients do not understand medication and self-care instructions, a crucial part of their medical care is missing, which then may have a adverse effect on their clinical outcomes.
Research conducted through several studies suggests that people with low literacy:

• Make more medication or treatment errors
• Are less able to follow treatments
• Lack the skills needed to negotiate the health care system
• Are at a higher risk for hospitalization than people with adequate literacy skills.

Understanding the tasks that patients are required to carry out further after receiving health information emphasizes the importance of health literacy. When giving health information, the provider should be aware if the person receiving it is literate in one or more of the following ways:

• Visually literate: able to understand graphs and other visual information.
• Computer literate: able to operate a computer.
• Information literate: able to obtainand apply relevant information
• Numerically or computationally literate: able to calculate or reason numerically.

If not, the provider will need to alter his or her health information messages in a way that the individual will be able to understand the health information being provided.

Among the populations vulnerable to health literacy issues are the elderly (age 65 and over), minority populations, immigrant populations, low-income populations and people with chronic mental and/or physical health conditions.

Creating strategic partnerships is an important step in improving health literary. On the national level, Pfizer, one of the country's largest pharmaceutical companies, has taken some positive steps. Pfizer has supported more than five years of research, in both academic and clinical settings, to determine the causes of inadequate health literacy and the scope and impact of the problem. Based on this research, the company has begun to develop solutions that center on clear health communications.

The company partnered with the American Medical Association Foundation to raise awareness and understanding of health literacy among physicians and to develop tools that will improve communication with patients. The AMA Foundation awarded Pfizer a grant to develop a tool kit and a Web site, as well as other grants to support physician-focused clear health communication programs and media outreach efforts. The AMA's distribution network will be used to take these programs to their membership.

Pfizer also is supporting the Florida Health Literacy Study, a clinical trial at the University of South Florida designed to determine the most effective interventions for improving health outcomes for patients with diabetes or hypertensions. In addition, the company is developing community-based initiatives with national patient advocacy groups in association with the National Health Council.

Locally, The Health Collaborative again this year is supporting the efforts of the San Antonio Health Literacy Initiative. The organization is hosting its second annual San Antonio health literacy conference, "The Impact of Health Literacy," on October 13 at the Sheraton Gunter Hotel. Last year, the San Antonio Health Literacy Initiative brought together many community health and social service organizations to begin discussing health literacy and its impact on our community. The seminar - the first to be held in the city on health literacy - was a good first step in increasing awareness of health literacy in our community.

Raising awareness of the issue in our community continues to be important and there is much that we all can do in collaboration. Here's what you can do to help.

Health care professionals
If you are a health care professional, work to increase awareness of the health literacy in the workplace and in your professional organizations. This can mean writing an article on health literacy for your organization's newsletter and including information on health literacy events, like the upcoming conference, in your organization's newsletter. Make plans now to become a sponsoring organization of the San Antonio health literacy conference next year. Collaborate with other health care organizations and put together your own meeting program on health literacy. This type of collaboration means more attendees and the opportunity to secure more high-profile speakers.

Business and community leaders
If you are involved with a business, professional or social organization with funds to invest in the community, consider funding a project related to health literacy. A good start is to contact The Health Collaborative. We serve as a clearinghouse to give your organization an overview of the many aspects of the health literacy issue and put your organization in touch with organizations already involved in health literacy that can use your support.

Church involvement
If your church offers services for seniors, consider sponsoring a health literacy seminar for seniors and their adult children/caregivers. Your church may be able to partner with several other churches to reach a larger audience and to work with a local hospital to provide speakers.

Nicole Rogers, MPH, CHES, is the executive director of The Health Collaborative. A cutting-edge, public-private model for solving community health issues, The Health Collaborative began informally in 1997 when several area health care organizations agreed to put aside their competitive business practices to conduct the first community health assessment. The mission of the organization is to improve the health status of the community through collaborative means. Representatives of this group are dedicated to the health and well being of our community in the spirit of collaboration. Partners include the major health systems in San Antonio, Metro Health, the YMCA of Greater San Antonio, Community First Health Plans, Methodist Healthcare Ministries and a community representative. For more information on health literacy and other community health issues, visit their Web site, www.healthcollaborative.net.

By Shannon Sutton, CPT

In last month's article, we began our brief series on simple, yet effective mini-workouts that can be done virtually anywhere (such as at the office) and in very little time (such as during your lunch break). The exercises previously described can be performed over time with many variations. As we proceed to the lower body exercises, keep in mind that constantly "tweaking" your routine will keep your body guessing what is next, thereby making your workout more effective. The longer you do the "same ol', same ol'," the more quickly your body adapts and the sooner you plateau. By simply changing the number of repetitions, the number of sets, the amount of weight, the tempo, the range of motion, and so on, you have altered your routine. This applies to your cardio routine as well.

If you have done the same 30 minutes on the elliptical machine, the bike or treadmill, try changing the incline and/or altering the speed. Intervals are great! Try a new piece of equipment, and begin to incorporate it into your cardio routine for cross training. Change the order and amount of time in which you use the different pieces. Just be sure to keep an eye on your heart rate and stay within the parameters of your targeted zone.

Lunges: Begin with feet parallel at hip's width. Step forward with your right foot (bending front knee to 90 degrees directly over the ankle) and push back to starting position. Repeat. Beginners should form a straight line from torso to standing knee to establish form and balance and gradually progress to a deeper, longer lunge.

Reverse lunges: Reverse lunges are performed with the same concept and form; however, step to the rear (keeping your chest up and joints stacked). Repeat 15 - 25 reps or more and switch legs. As you progress, you may choose to incorporate the use of a step for both lunges and reverse lunges.

Ball squats: Using a properly sized ball, begin by placing the ball between your lower back and the wall. Walk your feet out a step or two (about hip's width) and lower your body down as if you were sitting in a chair. Be sure your knees remain over your ankles (and no further than your toes). Balance your weight on your heels, squeeze your glutes and return to starting position. Repeat.

Hamstring curls: Lie on your back with palms down and heels balanced on the ball. Slowly raise your torso (beginning with your tailbone) and balance weight between your upper back/shoulders and your heels. Slowly roll ball in toward glutes, hold for a count, roll ball out and repeat. Keep glutes contracted and navel pulled in at all times.

Calf Raises: Stand on a step with weight on the balls of your feet. Raise heels up, pushing the weight through your big toes as high as you can, hold and then lower back down. Try to lower your heels slightly beyond the step and repeat. You may choose to turn your heels in slightly, out slightly and then parallel for three varying sets. For more of a challenge, work one calf at a time and/or add additional weight (such as a dumb bell in opposite hand).

Try alternating this routine with last month's upper body "lunch-break workout" for a surprisingly effective fitness regimen. Variety in your workout is very important, especially over time; however, consistency is key right now!

Shannon Sutton is an independent C.P.T. Her certifications include ISSA, NASM, APEX and Reebok. She has invested years in helping individuals reach health, fitness and wellness goals. Contact her at (210) 722-3962.

They are a couple like no other. Long-time San Antonians Ralph Bender, 82, and partner Liz Fritz, 46, exude health and well-being. They've spent decades traveling the world, punctuating every few years with Olympic games attendance. When you meet them, their vibrancy and energy are contagious. Could it be travel, or is it the 36-year age difference that's the anti-aging elixir we've all been searching for?

"It's very important to be around young people because they are the breath of life," says Bender, architect emeritus and former San Antonio City Planner. "So don't hang around a bunch of old people. They're very nice, and we love old people, but don't hang around with them."

Their choice of kindred spirits certainly adds spice to their youthful recipe. But the main ingredients are regular exercise and good nutrition. "We've both been committed to staying in great shape so we could do things around the world," Fritz says. Things like reporting for News 4 WOAI as Olympic correspondents at the Salt Lake City, Utah, and Torino, Italy, winter games. With seven Olympics under their belts, both say being in good physical condition is a must for doing the games right. "We walk all day and all night when we're traveling," says Bender. "It's a blast!"

Travel isn't their only motivation though. Continuing their work as early-childhood advocates with organizations that Ralph helped found, such as Voices for Children, the Alamo Community College District and LULAC Parent/Child Scholarship Trust program, also keeps them moving.

Staying in shape means they've tried all kinds of fitness regimens. "We've done running, walking, skiing, Spinning - even worked with personal trainers. Ralph also fenced for many years. But it wasn't until a little over a year ago that we found a workout that we both like and that works," she says.

Taking it super slow
That regimen is known as SuperSlow, a high- intensity, low-force exercise strengthening method that is comprised of a cycle of weight-lifting repetitions. Monitored by Dr. Charles Christian and his certified instructors, exercisers complete 20-second cycles (10 seconds lifting, 10 seconds lowering) on specialized equipment until they reach momentary muscle failure. The whole-body workout lasts approximately 20 minutes and should be done two times a week. The philosophy behind the program is to safely build muscle and increase the resting metabolism, allowing the body to burn more calories even while at rest.

At age 72, Bender quit fencing and gained a lot of weight. "He went on these crash diets off and on for years," says Fritz. After his last crash diet he lost 16 pounds in only a few months. However, he was devastated when his doctor told him he'd lost mostly muscle. "That's why I'll do SuperSlow the rest of my life - because I've not only gained that muscle back, but I'm maintaining it and have remained injury free. At my age that's something!" touts Bender, one of the founding members of the San Antonio Sports Foundation and past president of the USA Pentathlon, the national governing body for the Olympic sport.

Both of them not only swear by the strength-training program, but also its nutritional component, Dr. Barry Sears' Zone Diet®.

After witnessing overweight friends die young, Bender and Fritz have become even more committed to their healthy lifestyle. "The reality is, many people don't know how to stop creating fat on their body. They think they can lose all the weight they need to by exercise alone. That's just baloney," exclaims Bender. "The key is not to get fat in the first place - stay at a reasonable weight and you can avoid a lot of hell when you get older."

Make no mistake, they're not sacrificing anything in the meal department. "Dr. Sears' diet is simple: 40 percent good carbohydrates, 30 percent protein and 30 percent good fat. That leaves plenty of room for variety. We enjoy everything we eat," claims Bender. "Ralph especially enjoys jelly beans," chides Liz with a smile.

Natural body building
Liz Fritz has recently taken her fitness to a new level. A former commercial real estate maven, she's been ardently raising money for children for the last 10 years, in addition to her travels with Ralph. About five months ago, she went looking for something that would help strengthen her back because she was feeling the effects of sitting at a desk for years. During this same period, she ran into one of her original fitness trainers from the 1980s. "I was amazed to see even after all these years, she hadn't let go of her fitness," remembers Fritz.

That's when she realized her "happy hour" diet just wasn't going to cut it anymore. "I looked around at my peers who were at the top of their game and knew I could take my body to another level," she shares. It was one of her SuperSlow trainers, Amanda Antonini, who introduced her to Karen Martinez, her current fitness mentor.

With Martinez' expert guidance, Fritz spent five months preparing for the 2006 Alamo Classic Showdown, a natural bodybuilding and fitness competition held in October. (Note: This publication went to press before the competition was held.)

She stopped eating candy, desserts, cut out the alcohol and religiously followed a comprehensive training program that basically had her eating every three hours and adding weight-lifting to her cardio exercising three times each day, as well as drinking at least a gallon of water. She went from 132 pounds to 118 in just five months. "She completely transformed her body," says Bender proudly. "She's always had a nice figure, but now she has this athletic physique - she's toned and radiant."

"For me this training has been the greatest education in nutrition. I understood how cardiovascular and strength training worked, but I could never get my body to respond," explains Fritz. Although she won't continue as rigorous a schedule after the competition, "it's more of a seasonal thing," she says. She has taken the nutritional concepts to heart and feels she'll be able to maintain her newly toned physique.

"I don't sleep in anymore because I'm so excited to start the day. I'm so turned on to the fact that I know how to make my body healthy - it's amazing motivation," she says.

Fritz says her newfound nutritional knowledge will also help her with her volunteer work with a new program called "Go Girls Go." "This program recently launched by the San Antonio Sports Foundation addresses health and fitness issues young girls are facing today - diabetes, obesity, lack of interest in physical activity. I wanted to make sure I understood not only the fitness component of health, but nutrition too, so I could be confident in helping girls with these challenges," she says.

Fitness equals freedom
It's their lifetime partnership in taking care of each other that promises to keep this couple trotting the globe. Both are keenly aware of the freedom good health affords. "We have so many places we still want to explore," says Bender with a gleeful look in his eye. "Not to mention the Beijing Olympics in '08 to attend!"