Ask Well: Exercise and Weight Loss

By GRETCHEN REYNOLDS

Q: Is weight loss truly greater (for the same time expended) when exercising at moderate (say, 60 percent of maximum capacity) versus more intense levels (85 percent of maximum capacity)?
Reader Question • 271 votes

A: Actually, the reverse is true. Minute for minute, you will expend more energy and therefore burn more calories if you exercise intensely rather than moderately. In other words, running for 30 minutes uses more calories than walking for that same half hour.

I suspect, though, that you refer to the widespread belief that you burn more fat when you exercise moderately compared with strenuously, which is true. During intense exercise, the body needs rapidly combustible calories from carbohydrates, but when you’re moving at a relatively unhurried pace, the energy demands are lower, and the body can turn to slower-burning fat for fuel. According to a 2009 study in The Journal of Strength and Conditioning Research, exercising at an intensity of about 65 percent to 80 percent of your maximal heart rate, or a pulse rate of about 105 to 130 beats per minute, maximizes the amount of fat that you burn during a workout but requires less overall caloric expenditure per minute than tougher exercise.

Intense exercise may also quell later appetite, unlike gentler exercise. In an interesting study from earlier this year, men who rode stationary bicycles intensely for 30 minutes consumed far fewer calories afterward than when they rode moderately for 30 minutes and had lower blood levels of the hormone ghrelin, which is known to stimulate appetite.

Still, the keys to losing weight with exercise are common sense and restraint.

“It all comes down to energy balance,” or calories in and calories out, said Edward Melanson, a professor at the University of Colorado School of Medicine in Denver, who has conducted many studies of exercise and weight loss. Most of us will burn only 200 or 300 calories in a moderate 30-minute exercise session, he said, adding, “You replace that with one bottle of Gatorade.”

http://well.blogs.nytimes.com/2014/07/28/ask-well-exercise-and-weight-loss/?_php=true&_type=blogs&ref=health&_r=0

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Most People Think Alzheimer’s Is a Normal Part of Aging

Most People Think Alzheimer’s Is a Normal Part of Aging

It’s important not to think of the disease that way.
 

In a retirement home in Angervilliers, eastern France, a woman with Alzheimer’s disease looks at an old picture of herself. (AFP/Sebastien Bozon/Getty)

A multinational survey released today found that 59 percent of people incorrectly believe that Alzheimer’s disease is a typical part of aging.

“People misunderstand that Alzheimer’s really is a disease,” Angela Geiger of theAlzheimer’s Association, which led the survey, told me. “It’s fatal. And it’s going to be affecting more and more people, whether or not it runs in their family.”

Aging increases a person’s odds of getting Alzheimer’s disease, and researchers are still learning how age disposes neurons to the disease process, but it’s clearly distinct from normal aging. 

Even before a person starts experiencing symptoms of Alzheimer’s dementia, their brain is developing deposits of proteins called amyloid plaques and tau tangles. Neurons begin to work less efficiently, eventually failing to connect and communicate with on another and dying. Damage spreads to the hippocampus—the seat of forming  new memories—which shrinks as its neurons die. In the final stage of Alzheimer’s, a person’s brain is appreciably diminutive.

The United States’ National Alzheimer’s Plan has the goal of being able to “prevent and effectively treat” Alzheimer’s disease by 2025. The G7 adopted the same goal in December. Geiger said realistically meeting that will require billions of dollars in research investment—though that would pale compared to the costs of caring for millions of people with the disease. In 2010, costs of care for people 70 and older with dementia in the U.S. were between $159 billion and $215 billion, according to the department of Health and Human Services. Those costs are set to soar as worldwide prevalence of Alzheimer’s disease increases, affecting roughly 76 million people by 2030. 

“With the right amount of awareness,” Geiger said, “this is a disease where we can have a major breakthrough in our lifetimes.”

http://www.theatlantic.com/health/archive/2014/06/alzheimers-is-a-disease/373023/

Stress Causes Health Problems, Which Then Cause More Stress

Stress Causes Health Problems, Which Then Cause More Stress

July 08, 2014 3:37 AM ET
 
Staci Moritz and her son Aidan, 11, play at a park in their neighborhood in Portland, Ore. Caring for three children and her injured husband exacerbated her health problems.

Staci Moritz and her son Aidan, 11, play at a park in their neighborhood in Portland, Ore. Caring for three children and her injured husband exacerbated her health problems.

Beth Nakamura for NPR

Stress is bad for your health. And bad health causes a lot of stress.

Poor health and disability are common among people who say they suffer from a lot of stress, according to a by NPR, in partnership with the Robert Wood Johnson Foundation and the Harvard School of Public Health.

And it’s not just those whose own health is poor. Serious illness and injury often impose enormous stress on entire families.

Meet Staci Moritz, a 44-year-old mother of three young boys from Portland, Ore.

She describes her life as “pretty idyllic” until about five years ago. Then her marriage foundered and she and her husband separated. Four years ago she got laid off from her job. And the next day, the biggest blow fell.

“About 8 o’clock at night I received a call from one of the hospitals here in Portland,” Moritz recalls.

Her husband was in the emergency room, terribly injured. Cycling home from work, he’d been hit by a car and dragged underneath the vehicle for 30 feet.

He suffered profound brain injury that put him in a coma for three weeks. He didn’t die, but for a long time it wasn’t clear if he would ever recover.

“His functional ability at the time was that of an infant,” Moritz says. “He couldn’t speak. He lay in bed, surrounded by netting so he wouldn’t fall out, in diapers.”

And then, one day, he turned a corner.

Moritz says, "My own well-being has taken a back seat just because everyone around me needs so much."

Moritz says, “My own well-being has taken a back seat just because everyone around me needs so much.”

Beth Nakamura for NPR

“I walked into the room with our children and he cried and he mouthed the words, ‘I love you,’ ” Moritz says. “It was just overwhelming. You know, he recognized them. That was the significance of it. He knew who we were. And so that gave us a little bit of hope.”

Her husband continued to improve. But when he didn’t need hospital care any longer, he couldn’t take care of himself. Doctors said he’d have to go to a nursing home.

“I couldn’t permit that,” Moritz says.

So even though they were separated, she took him home to help him recover.

“It was the right thing to do — for him and for my children,” she explains.

That decision would mean years of unrelenting stress for Moritz. It puts her among the nearly 4 in 10 Americans with “a great deal of stress” who, according to our poll, say health problems in their immediate family were a contributing factor.

In Moritz’s case, she not only ran the household and was the sole functioning parent for three rambunctious boys, but she took care of all her husband’s needs, got him to medical appointments, paid all the bills — even after he moved into his own apartment.

Meanwhile, there were big financial stresses, too.

“We could no longer pay the mortgage and we lost our home of many years to foreclosure,” Moritz says. “It just feels like assault after assault after assault.”

And while she was coping with all this, Moritz says, friends and family backed away.

“The thing that’s hard to accept,” Moritz says, “is the lack of contact — people saying, ‘Hey, how are you? How are the kids doing? Do you want to talk?’ The isolation compounds the relentless stress.”

Over the past four years, that stress has undermined her own health. “I have some chronic health conditions that have been affected by the stress of managing all this,” Moritz says. “My own well-being has taken a back seat just because everyone around me needs so much.”

She’s got a new full-time job as a human services manager, but she’s had to take so much time off because of her own illnesses that she’s maxed out her sick leave.

That’s not unusual. According to by the Eliza Corp. and the Altarum Institute, people caring for sick or disabled family members are nearly twice as likely to suffer from chronic health conditions themselves, and are 63 percent more likely to die, than noncaregivers the same age.

And Moritz’s children have suffered health problems, too.

“During the year after the accident, my oldest child spent a month in residential treatment for behavioral problems that hadn’t existed before,” she says. “And my middle child spent a week in acute care in the hospital for emotional and behavioral problems.”

Moritz plays with her sons (from left) Elliot, 8, Ariel, 6, and Aidan in their apartment. The children also have had health problems since their father's accident.

Moritz plays with her sons (from left) Elliot, 8, Ariel, 6, and Aidan in their apartment. The children also have had health problems since their father’s accident.

Beth Nakamura for NPR

While Staci Moritz’s story is especially tragic, our poll results show that millions of Americans are suffering from toxic stress with many of the same features.

In addition to the 37 percent reporting “a great deal of stress” who are coping with health problems in their immediate family, more than half of stressed-out respondents say they have to juggle too many responsibilities and have problems with finances.

Traci Spencer-Griffin of Oakland, Calif., is one of them. She’s seven months pregnant, has a toddler, is employed full time in health care, and says that “being a black woman” is a category of stress all its own.

“I am stuck between helping with my grandparents and parents and raising my own family,” Spencer-Griffin says. “We are dealing with the death of parents after battles with illness and hospice care, the birth of new babies and so much more every day. I can barely think straight most of the time.”

But despite all the illness-related stress out there, 82 percent of people in our poll say a doctor, nurse or therapist didn’t talk to them about the need to reduce stress for the sake of their health.

Even among those with current high levels of stress, most say health care providers didn’t discuss the dangers.

“The reality in the health-care system is we don’t ask,” says , a Boston health-care consultant who, with her colleagues, has analyzed the responses of millions of health plan members asked about life stresses.

Drane urges health-care providers to ask patients about stress. But she says most respond that they don’t have the time or the resources to help patients address the causes.

“I’ve had doctors full-on laugh at me when I talk about this,” Drane says. “At the same time they will acknowledge, ‘I know these things are true, and I know these things are why real people are not taking good care of themselves and why they’re sicker.’ “

Drane thinks health plans and health-care providers eventually will integrate stress management into routine care. She and her colleagues have found that patients suffering from toxic stress cost the system a lot more.

“People who were experiencing these life challenges in the end were costing five times as much,” Drane says. “They were 2.6 times as likely to have diabetes, 2.9 times as likely to have back pain. They were 5 times as likely to be having mental health issues.”

Meanwhile, Staci Moritz and her husband — who’s now working part time and, remarkably, riding his bicycle again — have gotten a divorce. She continues to help meet some of his needs, but says she needs to turn over much of the task to professionals.

“I have to go on living,” she says. “I’ve done everything I can at this point. And I did it mostly alone.”

It’s for her own health, she says, and for the good of her boys, who are now 6, 8 and 11.

http://www.npr.org/blogs/health/2014/07/08/327256681/stress-causes-health-problems-which-then-cause-more-stress

 

Can World Cup Heartbreak Affect Your Health?

As Brazilian fans start to recover from their devastating loss to Germany in the World Cup semifinals, experts say that heartbroken fans should be sure to take care of themselves as losing can come at a cost greater than national pride or a Sad Brazilians Tumblr, it can even affect the health of diehard fans.

A 2013 study published in Psychological Science journal found that fans were more likely to eat high fat and high calorie meals after their team lost an important game. Researchers looked at the eating habits of 726 people in cities with National Football League teams.

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In cities where a team lost, fans consoled themselves by eating 10 percent more calories on their food than a normal Monday and 16 percent more saturated fat according to The Telegraph.

 

PHOTO: Brazil soccer fans cry as they watch their team get beat during a live telecast of the semi-finals World Cup soccer match between Brazil and Germany, inside the FIFA Fan Fest area on Copacabana beach in Rio de Janeiro, Brazil on July 8, 2014.

Leo Correa/AP Photo
PHOTO: Brazil soccer fans cry as they watch their team get beat during a live telecast of the semi-finals World Cup soccer match between Brazil and Germany, inside the FIFA Fan Fest area on Copacabana beach in Rio de Janeiro, Brazil on July 8, 2014.

 

A similar study by the same authors conducted a study with 78 French sports fans and found when fans–especially soccer fans–wrote about a game their favorite team had lost they ended up reaching for comfort food.

While experts have long known that people can overeat when they’re emotional, it wasn’t clear if simply losing the big game would qualify.

 

PHOTO: A supporter of Brazil in tears is pictured during the FIFA World Cup 2014 semi-final soccer match between Brazil and Germany at Estadio Mineirao in Belo Horizonte, Brazil on July 8, 2014.

Thomas Eisenhuth/Getty Images
PHOTO: A supporter of Brazil in tears is pictured during the FIFA World Cup 2014 semi-final soccer match between Brazil and Germany at Estadio Mineirao in Belo Horizonte, Brazil on July 8, 2014.

 

According to the study’s lead author and Ph.D candidate in marketing at the INSTEAD business school in Paris, Yann Cornil, the researchers were surprised with how clear the findings were.

“The research was usually done in a lab in which people watch sad movies and we look at how much we eat,” said lead author Yann Cornil. “It’s not very realistic. We were not sure in collecting real world data would replicate the results.”

 

PHOTO: A Brazil soccer fan reacts in frustration as he watches his team play a World Cup semifinal match against Germany on a live telecast inside the FIFA Fan Fest area on Copacabana beach in Rio de Janeiro, Brazil on July 8, 2014.

Leo Correa/AP Photo
PHOTO: A Brazil soccer fan reacts in frustration as he watches his team play a World Cup semifinal match against Germany on a live telecast inside the FIFA Fan Fest area on Copacabana beach in Rio de Janeiro, Brazil on July 8, 2014.

 

But binging after a loss isn’t the only way game can affect the health of devoted fans. Yann pointed out a 2011 study that examined traffic patterns after college and basketball games and found that nerve-rattling close games could result in a rise in fatalities by as much as 133 percent.

Dr. Todd Peters, a child and adolescent psychiatrist at Vanderbilt Medical Center, said the biggest fans will often strongly identify with a team and this can be even more pronounced during international competitions where a sense of national pride also unifies fans.

 

PHOTO: Brazil soccer fans cry as they watch their team lose 7-1 to Germany at a World Cup semifinal match on a live telecast inside the FIFA Fan Fest area on Copacabana beach in Rio de Janeiro, Brazil on July 8, 2014.

Leo Correa/AP Photo
PHOTO: Brazil soccer fans cry as they watch their team lose 7-1 to Germany at a World Cup semifinal match on a live telecast inside the FIFA Fan Fest area on Copacabana beach in Rio de Janeiro, Brazil on July 8, 2014.
 

“There’s the associating with the players, but also saying ‘This is us against the world,’ in the competition,” said Peters. “People will identify with certain player attributes or identity of a team…it’s that key piece that does bring up the level of emotions you see in defeat.”

Peters said it might just be game, but that fans can experience the same emotional devastation as going through a break-up, including depression and anger.

“When there is a loss it is almost like a break-up,” said Peters. “The team can no longer go on. You have to wait another four years to experience it again.”

So take it easy Brazil fans, and be sure to take care of yourselves.

http://abcnews.go.com/Health/world-cup-heartbreak-affect-health/story?id=24488267