Study: 10,000 Steps Per Day Not Enough

by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Diets, Fitness

Wearable fitness monitors (think Fitbit) provide a “motivation alert” as you approach the magic number of 10,000 steps per day, with a “celebration” of lights on their displays when that goal is reached. But a new study shows that objective may not be anything to celebrate — and focuses on a new threshold for maximum health benefits.

The study, published in the March International Journal of Obesity, and reported in The New York Times, is based on mail carriers in Scotland, and researchers at the University of Warwick in England found that the 10,000-step regimen is too conservative. For optimum heart-health benefits, it’s best to go the extra mile — to 15,000 steps.

Mail carriers in Glasgow mostly cover their routes on foot, so researchers knew they would perfect test subjects for the study. They also knew office workers there were seated for most of the day, providing contrast participants. For their study, they followed 111 postal workers of both categories (56 mail carriers, and 55 office workers) and included both sexes between the ages of 40 and 60. Researchers compiled data on blood sugar levels, body-mass index (BMI — a measure of body fat based on height-to-weight ratio), waist sizes, and cholesterol levels. Participants each wore a fitness monitor throughout the day for a week, including time at work, at home and on the weekends.

Researchers compiled data based on activity during waking hours. This included time spent seated and on foot. What they found was enlightening. Between work and home, some of the office workers sat for more than 15 hours in total each day. The office workers who sat for most of the day tended to have larger waistlines, higher BMI numbers, and unfavorable cholesterol profiles. The researchers also figured in late-night shift work (which has been proven affect heart health), family history, and age.

The study also showed that for every hour spent sitting beyond five hours, office workers added about two-tenths of a percent to the likelihood of developing heart disease.

In contrast, any amount of walking or standing reduced the chances of having a large waistline and other risk factors associated with a healthy heart.

But the benefits of the postal carriers who walked the equivalent of at least three hours per day (the magic 15,000) were a step up: They had normal BMIs and waistlines and metabolic profiles — in other words, lessened risk of heart disease.

The study seems to confirm that the 10,000-step goal has not kept pace with modern waistlines and eating habits. Quite a few sources, including RunnersWorld.com, say the 10,000 steps-per-day goal gets its origins from Japan in the 1960s. Dr. Yoshiro Yatano, then a professor at Kyushu University of Health and Welfare, pegged the goal at 10,000 after concern over growing obesity rates. That’s roughly the amount of steps that would burn about 20 percent of a person’s daily calories at the time. He coupled his concerns with a pedometer that was developed in 1965 and the campaign took off.

But it’s a moving target in terms of optimum health benefits. Diets change. Even before the Glascow study, not all health experts agreed to the amount of steps necessary, and some argue the type of exercise makes a difference as well. In fact, the Centers for Disease Control and Prevention offers no step guides at all, preferring instead to focus on 150 minutes of moderate activity per week (which, in steps-per-day language, translates to about 8,000).

Of course, any amount of exercise is better than none at all, and it’s important to remember not to be discouraged if you can’t reach 15,000 steps per day or even 10,000 steps per day. But if you’re among those who set out to get the most heart-health protection possible, and you’ve relied on that magic 10,000, you might want to consider the results of the Glasgow postal workers. Better get moving.

'Low' Fat and Sugar Labels May Confuse Consumers

by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Diets, Fitness

Food labels that say ‘low salt’ or ‘no fat’ may be misleading, suggests a new study.

These ‘low-content’ claims are based on comparisons with other foods and are not standard definitions. Making such a claim doesn’t necessarily mean the food is more nutritious than other brands, the authors say.

Consumers should “turn the package around and look at the entire nutritional profile as well as the ingredients list in order to get a better sense of whether the product overall is healthier or less healthy,” Lindsey Smith Taillie of the University of North Carolina at Chapel Hill told Reuters Health in a phone call.

Smith Taillie and colleagues analyzed data on more than 80 million food and beverage purchases made in the United States by 40,000 families from 2008 to 2012.

“We found that higher-income households tended to be more likely to buy products with these types of claims, which is consistent with previous research that suggests that claims tend to be more utilized by people with higher levels of education,” Smith Taillie said.

As reported in the Journal of the Academy of Nutrition and Dietetics, 13 percent of food and 35 percent of beverage purchases included products with some type of low-content claim. Low-fat purchases were the most common, followed by low-calorie, low-sugar, and low-sodium claims.

On average, packaged foods with low-nutrient claims had 32 percent fewer calories, 11 percent less sugar, and about half the fat and sodium compared to foods that didn’t carry any claims on the packaging.

However, some products with low-nutrient claims actually had more of that substance than foods without those claims.

Also, Smith Taillie said, when a product has a low-sugar claim, for example, it might have less sugar than a reference product or a similar product, “but it doesn’t mean that it has an overall better nutritional quality.”

Or, “it could be a high-sugar food but be low in fat, so it’s going to say low fat on the label. That doesn’t mean that it’s healthy,” she said.

“Essentially, it can be kind of misleading to make a decision about a product based on a front-of-package claim,” she added.

The U.S. Food and Drug Administration regulates what products can claim, Smith Taillie said.

“It’s not that the products are technically wrong in making a low-content claim, it’s just that the rules that allow them to make this kind of claim vary by the claim and by food category,” she said.

Food labels can be confusing, agreed Melissa Rifkin, a dietitian with Montefiore Medical Center in New York City who was not involved in the study.

Understanding what a nutrition fact label means is more important than focusing on marketing claims,” Rifkin told Reuters Health by email.

Key items to focus on are serving size, quantity per container, calories, fat, sodium and sugar, she said.

A new and revamped nutrition fact label is under development, Rifkin said.

“Slowly we will begin to see all labeling take on the new information,” she said.

Exercise: Great Prescription for Older Hearts

by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Diets, Fitness

Regular exercise is potent medicine for older adults with heart disease, a new American Heart Association scientific statement says.

Physical activity should be a key part of care for older adults with heart disease who want to reduce their symptoms and build their stamina, said geriatric cardiologist Dr. Daniel Forman. He’s chair of the panel that wrote the new statement.

“Many health-care providers are focused only on the medical management of diseases — such as heart failure, heart attacks, valvular heart disease and strokes — without directly focusing on helping patients maximize their physical function,” Forman said in a heart association news release.

Yet, after a heart attack or other cardiac event, patients need to gain strength. Their independence may require the ability “to lift a grocery bag and to carry it to their car,” said Forman, a professor of medicine at the University of Pittsburgh Medical Center and VA Pittsburgh Healthcare System.

“Emphasizing physical function as a fundamental part of therapy can improve older patients’ quality of life and their ability to carry out activities of daily living,” he added.

And, no one is too old to get moving. “Patients in their 70s, 80s and older can benefit,” Forman said.

Cardiac rehabilitation is a crucial tool for elderly patients, providing exercise counseling and training to promote heart health, and manage stress and depression. But Forman said it’s not prescribed often enough.

“When treating cardiac patients in their 70s, 80s and 90s, health-care providers often stress medications and procedures without considering the importance of getting patients back on their feet, which is exactly what cardiac rehabilitation programs are designed to do,” he noted.

Daily walking and tackling more chores at home also can be helpful, Forman said. Resistance training and balance training can help prevent falls. Tai chi and yoga employ strength, balance and aerobic features, he explained.

The statement also outlines ways for heart doctors to assess patients’ levels of physical functioning.

The statement was published March 23 in the journal Circulation.

Heart disease in older Americans is a growing concern because the number of people 65 and older in the United States is expected to double between 2010 and 2050.

Daily Fruit Juice OK for Kids

by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Diets, Fitness

Pediatricians have long suggested that fruit juice may prompt weight gain in children, but a new review finds it harmless when consumed in moderation.

“Based on the current evidence, we didn’t find that consuming one serving [of 100 percent fruit juice] a day contributes to weight gain in children,” said study author Dr. Brandon Auerbach. He is acting instructor of medicine at the University of Washington, in Seattle.

To come to that conclusion, the investigators analyzed the results of eight published studies involving over 34,000 children that looked at fruit juice intake and the effect on weight.

Children under the age of 6 who drank a serving a day gained a small amount of weight, but not enough to be clinically significant, the findings showed.

The amount was truly tiny, less than a pound over a year’s time, Auerbach noted. And the review did not prove that fruit juice consumption caused the weight gain.

In addition, children aged 7 to 18 who drank a serving a day saw no clinical effects on weight, the researchers said.

The younger children favored apple juice, while the older ones were more likely to drink orange juice. The study authors explained that orange juice, which has a lower glycemic index, may be linked with less weight gain. Food and drink with a lower glycemic index are linked with lower and slower rises in blood sugar levels.

The researchers stressed that their report specifically focused on 100-percent fruit juice, not fruit-flavored drinks or fruit sodas.

Senior study author, Dr. James Krieger, is executive director of Healthy Food America. He said, “The evidence on weight gain, diabetes [risk] and other health conditions for [drinking] sugar-sweetened beverages — like soda and fruit drinks — is very solid.”

What has been debated, according to Krieger, is whether sugar in 100-percent fruit juice is linked with the same health effects.

For now, Krieger and Auerbach said, they advise parents to follow the American Academy of Pediatrics’ recommendations for 100-percent fruit juice consumption: 4 to 6 ounces a day for children aged 6 and younger, and 8 to 12 ounces a day for kids aged 7 to 18.

Connie Diekman, director of university nutrition for Washington University in St. Louis, said that the new findings put the issue in perspective.

“Concerns around childhood obesity have caused many to try to find ‘the food’ that is the cause,” Diekman explained.

“This study did a nice job in assessing the impact of 100-percent fruit juice on weight, a food often blamed for the growing incidence of childhood obesity,” she said.

“As a registered dietitian, this study reinforces the messages I provide my clients: 100-percent fruit juice — not fruit drinks or beverages — can fit into a healthful eating plan. But it is important, as with all foods, to learn portion sizes,” Diekman stressed.

“In addition, I always remind people that whole fruit — whether fresh, frozen or canned — can provide more satiety since we don’t seem to recognize fullness from liquids, while we do from solids,” she said.

The study was published online March 23 in the journal Pediatrics.