Having been fortunate enough to work with kids the ages of 12 and under for multiple jobs I have held growing up, I have seen some of the best and worst ways to coach kids. Some of the worst training sessions happen with the absolute best planning ahead of time. Trying to stay within a box can greatly limit kids fun, which in turn causes activity time to fail. Instead, planning for fun and giving more leeway actually can lead to some of the best sessions for kids from my experience.

As much as anything, I remember only being taught about competition growing up. Cooperation was something that was not taught to me in a more formal manner until I was in college. While cooperation happens in certain team games, it is not something that we truly consciously know or think of early on, and that can hamper some development. Personally, I was and am one of the most competitive people around because of this. I might say I am going to do something for fun, but inevitably within 5-10 minutes that activity turns competitive.

PowerUp P.E.  is an initiative in Rhode Island that looks to make P.E. fun for kids in school and also helps bring the cooperation aspect consciously into the kids’ minds. With activities like “Animal Walks,” “Oscar the Grouch,” and “‘One, Two, Three, We’re Free’ Tag” kids learn fundamental athletic movements in a fun manner.

Going even deeper, kids are able to provide feedback on the activities, and are given feedback in order to improve on their basic movement skills. They also are able to pair these activities with other subjects like social studies in order to less formally learn school subjects like history in a fun manner.

Having something like PowerUp P.E. added to most schools around the USA would be a great way to keep P.E. in most curriculums. Even if P.E. is taken out, this can be a beneficial way to help teach subjects like social studies as it keeps kids both entertained and focused.

I believe this can be used both as a program during the school year, and the summer. It can help maintain knowledge learned during the year if properly used as a summer camp. Also, it can be used both during and after school during the school year. If P.E. is removed from school’s then schools or other places can use this after school to help teach both basic activities and general school classes.

Practitioners should look for ways to implement this as quickly as possible, as it can solve the growing P.E. problem in the USA. 22% of schools already are without P.E. and this program is an ideal way to help bring it back to schools.

1. http://riphi.org/portfolio/powerup-p-e/
2. http://activelivingresearch.org/powerup-pe

Chocolate has constantly been the center of popular health media articles for helping you lose weight, live longer, and even preventing diabetes. I cannot say for certain about those articles, but now there is a new article regarding the common guilty pleasure of many people across the world.

Articles published by both the Washington Post and (republished) by The Independent (UK) claim that chocolate has now been linked to increasing brain function. Is this just another scam? Should we now let kids eat all the chocolate they want? Should we go clean out the grocery shelves of all things chocolate?

The article goes on to explain this theory a little further. They first look back to a study completed in the mid1970’s by a psychologist named Merrill Elias. The purpose of the original study was to “observe a relationship between people’s blood pressure and brain performance.”¹ Who knew, a study from so long ago, with a completely different goal, would now steer us in the direction of eating more chocolate!

Recently, Georgina Crichton, a Nutrition researcher from Australia, analyzed the data from the previous study to determine the effects that habitual chocolate consumption has on the brain. To explain it simply, the researchers have found a positive correlation between those who eat chocolate regularly (at least once a week) and increased ability to complete everyday tasks, and even multitasking. They proposed that this is most likely because chocolate has both cocoa flavanols and methlxanthines both of which can have positive impacts on the old noggin, including increasing blood flow to the brain and enhancing concentration levels respectively.

So back to my original question, do we go clean out the grocery shelves of chocolate in hopes of becoming as smart as we can? Not quite yet. Even Crichton notes, there is more research to be done on this topic, especially on the multiple different kinds/forms of chocolate out there. So, for those of you who eat chocolate along with a well balanced diet and exercise, you can continue living your life as you are. For those of you, like myself, who are not huge fans of the new possible brain food, maybe we should give it a try every now and then.

1. https://www.washingtonpost.com/news/wonk/wp/2016/03/04/the-magical-thing-eating-chocolate-does-to-your-brain/

2. http://www.independent.co.uk/life-style/food-and-drink/features/chocolate-makes-you-cleverer-a-40-year-psychological-study-proves-that-the-sweet-treat-can-boost-our-a6917736.html

3. http://www.sciencedirect.com/science/article/pii/S0195666316300459

Most people of legal drinking age (and even those who are not) are familiar with the distilled Mexican beverage that tends to be a central theme of many college students’ weekends. That being said, many may not consider tequila as their drink of choice after about age 23. But, that may soon change!

According to an article¹, from the Internet source, Nature Health and Beauty, a shot of tequila a day can actually be good for you. Let’s take a step back here, what did I just say? …. Yes you read correctly, many college students’ dreams just came true! Tequila is made from the blue agave plant and therefore contains multiple nutritional benefits. (that is, if served without the sugary substances/juices it is commonly served with.) The article boasts four main health benefits, including tequila being a pro-biotic, stimulating insulin production, aiding in  protecting necessary drugs to the colon, and helping to cure your stress induced insomnia.

The research² on this topic was reported at the 247^th National Meeting of the American Chemical Society (ACS). Lopez mentions that they have found that “agavins reduce glucose levels and increase Glucagon-like peptide-1. (GLP-1).” She goes on to explain that the GLP-1 hormone slows the stomach from emptying thereby stimulating production of insulin.” She also mentioned, “agavins also support growth of healthful microbes in the mouth and intestines.” So, have we found a possible answer for diabetics and for those who do not consider yogurt their #1 probiotic of choice?! Lopez clearly explains that her study is the first of its kind to begin to look at agavins in a whole new light.

Although the article provides an interesting new way of looking at tequila, more research is definitely needed on this topic as well as a large amount of education before physicians start prescribing tequila shots! The research (although completed on mice) in its early stages holds promising results for the future! We need to remind the public that when you reach for your next healthy pure 100% agave “possible” super food, we are not looking to follow the saying “1 tequila, 2 tequila, 3 tequila, floor.”

1. http://www.naturehealthandbeauty.com/drink-shot-tequila-day-heres-incredible-effect-will-body/
2. http://phys.org/news/2014-03-tequila-sweetener-diabeticshelps-blood-sugar.html

Have you ever come across a digital Valentine Day’s card made by Taco Bell reading “Nacho average Valentine’ or have you ever voted on a new potato-chip flavor? Probably yes, especially for children and adolescents. It seems food and beverages companies have found clever ways to reach children and teenagers, encouraging them to interact with a brand and promote it to their friends. A famous example is the Mountain Dew’s DEWmocracy campaign, in which people played an online game to create a new soda flavor. In the next phase, participants were encouraged to recruit others to vote for their favorite flavor finalist. Not long after that mountain dew was ranked first on the tween’s list of “Newest Beverages” they had tried.

According to the article published on The Washington Post, marketing junk food to kids is proven to be effective at increasing child’s preference and consumption of advertised foods. Some of the ways used by these companies include games, animation and virtual realities that convince consumers that what they are watching or playing is not marketing. Food companies have created adver-games, where products were predominantly featured, codes to get to the next level were hidden in food products, and players could enter a new area only by inviting their friends to play. Additionally, using social networks brands track customers on social media to understand their purchasing behavior and pinpoint peer influences. For example, Mountain Dew created an exclusive, invitation-only social network for influential users, where the most loyal fans could endorse products.

The article in based off a paper submitted to The American Journal of Public Health, which posits that many companies realize that children and adolescents do not have the capacity to rationally consider advertising appeals and reject those not in their long-term interest or the self-regulatory abilities to resist the immediate temptation of the highly palatable foods typically promoted. Through social learning theory, continued exposure to advertising that promotes foods and beverages as fun, socially desirable and commonplace, with no negative consequences from consuming them, can influence children’s attitudes and consumption of the unhealthy foods commonly promoted. The findings of the study supports the published article and is in agreement with the reported results.

Food companies claim that the commercial speech doctrine allows them to openly and legally target these products to young people using sophisticated psychological techniques that take advantage of what advertising is how it affects consumer behavior. Health practitioners should fill in the gap by advising parents and guardians to monitor their children and adolescents online activity. Health practitioners can also give recommendation on resources that educate both parents and children on tactics brands use to reach younger audiences. So next time your child shows an interest in a certain unhealthy food, take the time to discover where they first came across the product.

References:

1. http://www.washingtonpost.com/lifestyle/wellness/food-and-beverage-companies-are-finding-creative-ways-to-reach-kids-online-heres-what-to-know/2016/09/29/48cadd42-7b8c-11e6-beac-57a4a412e93a_story.html

2. Harris, J. L., & Graff, S. K. (2012). Protecting Young People From Junk Food Advertising: Implications of Psychological Research for First Amendment Law. American Journal of Public Health, 102(2), 214–222. http://doi.org/10.2105/AJPH.2011.300328

Intense interval training could be the one of most painful workout . While it’s efficiency in improving  fitness is proven to be superior to moderate-intensity continuous training (MICT)by many studies (Gillen et al., 2016; Weston, Wisloff, & Coombes, 2014), the anticipated pain still is intimidating for many exercisers, especially beginners .

According to NY Times, music makes young people more willing to try HIIT.

Matthew Stork, a doctoral candidate in University of British Columbia, has been studying the impact of music on HIIT. His previous finding on this topic is that self-selected music has a positive impact on the peak and mean power output(Stork, Kwan, Gibala, & Martin Ginis, 2015). The new study added more psychological and emotional factors to the findings(Stork & Martin Ginis, 2016). The study showed that the exercise attitudes was significantly better in the music group but the intention score did not change, which left the meaningfulness of the study questionable. The question needs to be answered is whether those questionnaire scores utilized in the study were valid. The scale for attitudes had a Cronbach’s alpha of 0.72, which is low for an instrument, for an instrument usually needs a Cronbach’s alpha of over 0.9 to be justified as a reliable instrument. Even if we assume the questionnaires were valid , what a better attitude towards HIIT means is still not clear. Is it enough to convince people that the results of HIIT is worth the pain? Or this study only tells us those who love HIIT will love HIIT with or without their music, and those who don’t will never do even adding some music can make you feel slight better if you try.

Another problem with this study was its sample size. Only 20 people aging 18 to 30 who usually had moderate-level exercise and had not been exposed to intense interval training were included in the study, which make its generalizability very limited . Some fitness enthusiasts may think of music as a distraction and do not like music when they exercise. Thus this study only revealed the possibility that music may be used as a sort of comfort or stimulant, but whether it helps motivating people to choose a higher intensity remains unclear.

Gillen, J. B., Martin, B. J., MacInnis, M. J., Skelly, L. E., Tarnopolsky, M. A., & Gibala, M. J. (2016). Twelve Weeks of Sprint Interval Training Improves Indices of Cardiometabolic Health Similar to Traditional Endurance Training despite a Five-Fold Lower Exercise Volume and Time Commitment. PLoS One, 11(4), e0154075. doi:10.1371/journal.pone.0154075

REYNOLDS, G. (2016). How Music Might Improve Your Workouts.   Retrieved from http://www.nytimes.com/2016/10/26/well/move/how-music-might-improve-your-workouts.html?rref=collection%2Fsectioncollection%2Fhealth&action=click&contentCollection=health&region=stream&module=stream_unit&version=latest&contentPlacement=4&pgtype=sectionfront

Stork, M. J., Kwan, M. Y., Gibala, M. J., & Martin Ginis, K. A. (2015). Music enhances performance and perceived enjoyment of sprint interval exercise. Med Sci Sports Exerc, 47(5), 1052-1060. doi:10.1249/MSS.0000000000000494

Stork, M. J., & Martin Ginis, K. A. (2016). Listening to music during sprint interval exercise: The impact on exercise attitudes and intentions. J Sports Sci, 1-7. doi:10.1080/02640414.2016.1242764

Weston, K. S., Wisloff, U., & Coombes, J. S. (2014). High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: a systematic review and meta-analysis. Br J Sports Med, 48(16), 1227-1234. doi:10.1136/bjsports-2013-092576

Everyone is familiar with the frequent promotions of new fad diets, cleanses, and detox teas that supposedly claim to help one lose weight instantaneously. Even if some of these claims are true, is the rapid weight loss safe? What is actually being lost (i.e. fat, water, lean muscle mass)? Does the weight stay off long-term? Those are the questions these promotions typically neglect to address. Dietician Lauren Harris-Pincus promotes a healthier and safer way to lose weight. With supporting research from the Center for Disease Control, Harris-Pincus recommends a “slow and steady slim-down approach that vaporizes one to two pounds per week.”^1,2 Additionally, unlike all of the quick-slim crash diets, she recognizes the other lifestyle factors that play a role in maintaining a healthy goal weight, such as behavioral changes in eating, sleeping and physical activity habits.²

Harris-Pincus and New York Post article author Molly Triffin very accurately reiterate what the Center for Disease Control and Prevention research found, that long-term changes in daily eating and exercise habits strongly affect the maintenance of any type of weight loss.^1,2 Not only does a slow and steady weight loss necessitate reducing caloric intake by about 500-1000 calories per day, but also in order to maintain this loss, an individual must participate in about 60-90 minutes of physical activity 3-4 days per week.¹ Triffin also discusses some unwanted side effects of crash diets and attempts to rapidly lose weight, such as increased levels of stress, slower metabolism, loss of muscle tone, and dehydration.²

Clinicians can utilize this easy to read informational article as well as the Center for Disease Control recommendations, to give healthy weight loss advice to clients, patients, athletes, and others. Particularly, explaining the unwanted side effects of crash diets versus the longer-lasting health benefits of a slow and steady weight loss approach support the latter route to attaining one’s goal size. I particularly like Triffin’s quote near the end of the article, as I feel it sums up the major components of a healthy lifestyle: “I encourage my clients to forget about the scale and focus on eating right, exercising, reducing stress, and getting adequate rest.”² Slow and steady wins the race!

¹Healthy Weight. (15 May 2015). Center for Disease Control and Prevention. Retrieved November 4, 2016 from http://www.cdc.gov/healthyweight/losing_weight/.

²Triffin, M. (13 September 2016). What you need to know about losing weight quickly. New York Post. Retrieved November 4, 2016 from http://nypost.com/2016/09/13/what-you-need-to-know-about-losing-weight-quickly/.

A lot of people believe that fat is harmful and we should avoid when we possibly can, especially when we are on a diet plan. Before we deny fat as a whole, we need to know that there is more than one kind of fat. And different kinds of fat may play different roles in human body.

There is already agreement on artificial trans fat contributes to heart problems and diabetes[2]. The previous popularity of trans fit has been contained in the nation, especially in big cities like New York and Los Angeles[3, 4]. But debates continue on whether saturated fat is harmful and should be replaced with polyunsaturated and monounsaturated fatty acids. There is more evidence we can find in the literature associating saturated fat and cardiovascular disease. A meta-analysis published in 2010 synthesizing 21 prospective cohort studies showed that there is no link between higher saturated fat consumption and increased risk of CVD[5]. The studies chosen were relatively small in size and short in duration and thus studies of larger sizes and more years are still needed to assess the effect of saturated fat. However, on the website of American Heart Association, saturated fat has already been categorized as bad fat along with trans fat[6]. It might be too early to make this judgement based on the available evidence. On the other hand, are there better substitutes than saturated fat? The AHA recommended polyunsaturated fat and monounsaturated fat. A newly published meta-analysis suggests that polyunsaturated fat might be a better option than both saturated fat and monounsaturated fat[7]. Certainly when trans fat goes out, something has to go in to replace it. What will that be? For manufacturers, this is usually saturated fat. The total fat amount in food before and after the trans fat ban did not change.

Low fat is one of the biggest pitfalls about diet. While everybody knows that the excessive body fat contributes to development of chronic diseases, fats (except trans-fat), when consumed in a moderate amount, are actually protective of bones, reproductive health, etc. It is not dietary fat, but the excessive body fat caused energy imbalance through a long period of time that is negatively affecting for public health.

1. Sifferlin, A., Here’s New Proof That Not All Fats Are Bad For You. 2016.
2. Willett, W.C., Trans fatty acids and cardiovascular disease – epidemiological data. Atherosclerosis Supplements, 2006. 7(2): p. 5-8.
3. Angell, S.Y., et al., Cholesterol control beyond the clinic: New York City’s trans fat restriction. Ann Intern Med, 2009. 151(2): p. 129-34.
4. McCarthy, M., US gives food manufacturers three years to ban trans fats. BMJ, 2015. 350: p. h3315.
5. Siri-Tarino, P.W., et al., Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr, 2010. 91(3): p. 535-46.
6. Monounsaturated Fats. 2016; Available from: http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/Monounsaturated-Fats_UCM_301460_Article.jsp#.WBT_MfkrJEY.
7. Imamura, F., et al., Effects of Saturated Fat, Polyunsaturated Fat, Monounsaturated Fat, and Carbohydrate on Glucose-Insulin Homeostasis: A Systematic Review and Meta-analysis of Randomised Controlled Feeding Trials. PLoS Med, 2016. 13(7): p. e1002087.

What is the food of the future? In a recent seminar at the 2016 Food and Nutrition Conference and Expo in Boston, this food was identified as pulses. No. Not like the cardiovascular pulses that assure us that our hearts are still pumping. Instead these pulses enhance how well our hearts work and include dried beans, dried peas, chickpeas, and lentils. Dr. John Sievenpiper presented a Canadian study that showed pulses having a significant effect not only on cardiovascular events, but also on diabetes outcomes.

In his research, Sievenpiper has found that incorporating 120 g of pulses a day into the diet has a positive effect on glycemia, lipid levels, blood pressure and body weight. How does this happen? His collaborative studies over the past decade have shown that pulses reduce starch absorption and reduce postprandial glycemia,. By including five servings of pulses a week and following a low glycemic diet (and watching blood sugar levels), hemoglobin A1c can be significantly (p<0.05) improved. Pulse servings eaten consistently through the week were also shown to significantly reduce more weight than isocaloric diets and reduce coronary heart disease risks.

In a case study example, Dr. Sievenpiper brought up a 74-year-old overweight patient with dyslipidemia and metabolic syndrome. He prescribed a Portfolio Diet to replace the high red meat and refined carbohydrate, low fiber, fruit and vegetable diet he had been consuming. The Portfolio Diet includes a variety of cholesterol-reducing food such as, 20 g of fiber from vegetables, whole grains, and pulses and 45 grams of plant proteins including soy products and pulses. After following this patient for less than two years, his triglyceride levels had decreased by 47% and his LDL levels had improved by 78%! While this may not be the standard for every patient, it is quite a show of success.

This information could be life-saving for some patients in desperate need to improve their health. Type 2 diabetes, hypertension, and obesity go hand in hand, and with a few changes to the diet all three could be improved. Clinical practice guidelines are beginning to shift from nutrient-based recommendations, such as low carb or high protein, to more food and dietary pattern-based recommendations. Increasing pulse servings in the diet fits right in with this strategy and can be much more easily understood to the standard layperson. Additionally, the inclusion of pulses can be incorporated into widely recognized and evidence-based diets like the Mediterranean Diet or the DASH diet very simply. More randomized control trials are needed in this area, but the data looks incredibly promising.

Kim SJ, de Souza RJ, Choo VL, Ha V, Cozma AI, Chiavaroli L, Mirrahimi A, Blanco Mejia S, Di Buono M, Bernstein AM, et al. Effects of dietary pulse consumption on body weight: a systematic review and meta-analysis of randomized controlled trials. The American Journal of Clinical Nutrition 2016;103(5):1213-23. doi: 10.3945/ajcn.115.124677.

Ha V, Sievenpiper JL, de Souza RJ, Jayalath VH, Mirrahimi A, Agarwal A, Chiavaroli L, Blanco Mejia S, Sacks FM, Di Buono M, et al. Effect of dietary pulse intake on established therapeutic lipid targets for cardiovascular risk reduction: a systematic review and meta-analysis of randomized controlled trials. Canadian Medical Association Journal 2014. doi: 10.1503/cmaj.131727.

Irritable Bowel Syndrome (IBS) is fairly common medical diagnosis that a registered dietitian will encounter. Twenty percent of the North American population suffers from IBS and as many as two-thirds of patients report specific food triggers which subsequently leads to food restriction. Though diet does not cause IBS, it can be optimized to improve symptoms and patient quality of life.

One of the strategies to combat IBS symptoms is a diet low in particular classes of carbohydrates: fermentable oligosaccharides, disaccharides, monosaccharides and polyols (sugar alcohols) (FODMAPs). In patients with IBS, these carbohydrates are poorly absorbed and are rapidly fermented by GI bacteria. The fermentation process leads to increased water and gas in the small intestine—which results in the uncomfortable symptoms of IBS. A low FODMAP diet is characterized by a reduction in wheat, elimination of lactose and low in disproportionate fructose. The diet appears to effectively control symptoms in ~50-70% of patients with IBS.

FODMAP containing foods are everywhere in an American diet. Wheat, artichokes, chicory root (the fiber added to many foods with “added fiber”) and garlic contain FODMAPs. Even healthy foods can be less-than-ideal for IBS patients; honey, apples, pears, watermelon, mushrooms, onions and cauliflower can be extremely irritating to the stomachs of IBS patients. Though the mechanisms of altered absorption are different per subtype of carbohydrate, the effects from each type are cumulative in the gut. For example, a high fiber cereal for breakfast, a salad with onions for lunch and pasta for dinner all contribute FODMAPs; the cumulative effect over a patient-specific threshold can result in symptoms.

What is even more interesting with FODMAPs is their symptoms are subclass-specific. A patient experiences gas or diarrhea, it is likely from fructan consumption, which affects the sigmoid colon. Conversely, fructose is an irritant to the small intestine which can lead to constipation or pain. An RD can piece together a patients diet with their GI symptoms and tailor a diet very specific to their needs. Thus, the RD plays an  essential role in the management of IBS symptoms. With each patient, practitioners need to conduct detailed dietary recalls and identify the foods that contain FODMAPs and work with the patient to optimize their nutrition plan.

Nee J, Scarlata K. Using Science to Further Define FODMAPs and Simplify Patient Education. Food and Nutrition Conference and Expo 2016. Date: October 17, 2016

Sure, running is healthy, but don’t go too fast because you could die. Well at least that is what this article by The Telegraph suggests. The eye-catching article title is “Fast running is as deadly as sitting on couch, scientists find” because if you end an article title with scientists find then it is 100% accurate.

This article begins by letting the reader know that running faster than 7 miles per hour is damaging and is actually doing more harm than good when it comes to heart and overall health benefits. They then cite the research article and mention that runners that ran the fastest were nine times more likely to die prematurely within 12 years, while those who were the tortoise in this tortoise and hare analogy, were not.

So what is the truth? Well, The Telegraph had it half right. The Copenhagen City Heart Study was a prospective study that was composed of random sample of 19,329 white men and women between 20 to 93 years old, which was narrowed down to 1,098 joggers and 413 healthy non-joggers. With analysis of all-cause mortality and adjusting for age and sex, the researchers found that jogging quantity and frequency were all associated with low mortality. In addition to that, all joggers had lower blood pressure and BMI, lower prevalence of smoking, and lower incidence of type 2 diabetes, which is great news for runners.

However, that’s not the end of the story. When looking at low, moderate, and strenuous joggers, there was a U-shaped association between jogging and mortality and interestingly enough, the fast-paced joggers’ mortality was not statistically different from that of the sedentary non-joggers. What the popular media article failed to mention was that the researchers believe that there could be an upper limit for exercise where the health benefits are no longer effective. The researchers go on to explain that further research needs to be done to test this hypothesis before making any recommendations. Hmm… seems like The Telegraph did not get that memo.

Anyone working in the health field needs to be mindful of these types of articles because while they can contain some interesting information, they can also be greatly exaggerated, thus losing its overall message. This particular study has some great information that health practitioners can utilize. Exercise might have an upper limit, and that is worth investigating. However, for right now, I believe most of the people we will be interacting with will not be included in the strenuous exercising group. It is something we should be aware of, but I am not sure how much clinical application it will have. Overall, we can conclude that (1) 7 miles per hour is not a magical cutoff point, (2) jogging has some great benefits and (3) we should not try to scare people away getting exercise.

1.  Knapton, Sarah. “Fast running is as deadly as sitting on couch, scientists find.” The Telegraph. Published 2 Feb 2015.
2. Schnohr, Peter, et al. “Dose of jogging and long-term mortality: the Copenhagen City Heart Study.” Journal of the American College of Cardiology 65.5 (2015): 411-419.