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Women’s Health & Fitness: Relationship-Based Solutions For Female Clientele Of Any Age

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Please click on this link to read the original blog submission for the month of May in which I was a featured contributor:

http://us9.campaign-archive2.com/?u=2a517c301526ee432715a7f55&id=a975e73eed&e=fe80cede46

Many women can often be intimidated by health club or gym environments for a multitude of reasons. Women who don’t have a clue how to use unfamiliar exercise machines may find the experience of navigating through a whole collection of them rather terrifying.

As if that isn’t enough, some women question their ability to perform exercises with the necessary degree of coordination, balance and strength. Other women may hold onto the common misconception that lifting weights will make them extremely muscular and masculine, so they will shy away from free weights and weight machines, opting instead for more aerobic style activities. What is remarkable is that once these women are educated on the importance of regular exercise and proper nutrition, they experience profound health benefits which impact every aspect of their lives.

Gym owners who are willing to make an effort to address the unique concerns of women have a wonderful opportunity to build trust in their female clients, while also potentially increasing revenue by offering classes, training packages, classes, supplements and apparel which are designed for women.

If one-on-one training is offered at your facility, make sure to develop a group of trainers which can motivate female clients and address their unique concerns without making them feel inadequate or overwhelmed. Women also tend to have more questions about how to eat healthy, and often practice chronic caloric restriction which their bodies eventually adapt to, making it more difficult to drop those last few pounds, so it also makes sense to offer nutritional advice or refer female clients out to a dietician or nutritionist who is affiliated with your facility. Once the clients begin to experience physical and mental transformations, they become great cheerleaders for the gyms in which they train.

On a personal note, I am a proponent of weight training and supportive nutrition, especially in older individuals. One of the cruel consequences of aging is that a progressive loss of muscle occurs, beginning as early as one’s 20’s. I explain to clients that resistance training and an increase in protein intake are both critical for combating the insidious deflation of muscle and sagging skin which are the dreaded signs of advancing age.

It is important to make clients aware of the fact that resistance training will increase muscle-fiber diameter and overall strength, as well as naturally boost growth hormone and testosterone levels in the body.

Such hormonal and metabolic boosts can be incredible blessings for a menopausal woman who has been riding the unpredictable and often uncomfortable wave of hormonal decline, which is fraught with hot flashes, mood swings and, insomnia.

Basically, it is never too late to begin strength training!

For more information on age-related muscle loss in older women, please read my feature article in the September 2014 issue of Muscle & Body Magazine.

Which Is More Effective For Weight Loss: Diet or Exercise?

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As a physician and fitness professional I regularly evaluate people who want to lose weight and have often been asked whether diet or exercise is more effective in helping them to reach their goals.  If I had to choose which type of weight loss strategy was more important, I would say that about 80 percent depends on diet.  In fact, research has shown that the majority of weight loss programs which focused on dietary changes produced 2-3 times greater weight loss than programs focused on exercise.  However, long term management of weight loss can be optimized by a consistent exercise program. 

The fact is that most people are prone to consuming foods which contain large amounts of fat, hidden sugar and salt, and preservatives.  Quite often the portions consumed at one sitting are so large that the body ends up in storage mode which can lead to weight gain.  By becoming aware of the value of nutrient-dense foods and re-patterning one’s eating habits so that such foods form the foundation of a daily meal plan, long-term weight loss and maintenance of a healthy weight can be accomplished.  However, the media pushes “quick fixes” by promoting severe caloric restriction and plans which are nutritionally unbalanced, thus creating a state of malnutrition.  For this reason I discourage fad diets as they almost invariably cause rebound weight gain to occur.  There are also different types of pills which by various mechanisms can assist in weight loss.  However, a number of such products can have deleterious adverse effects and should be taken with caution, if at all.  I do make an exception with thermogenics, which, if used properly, can serve as an effective aid in weight loss. 

But what about exercise?  It is true that exercise can often stimulate hunger, but it also boosts metabolism, has a positive effect on brain function, and builds muscle.  There is also some evidence that intense exercise may lower levels of ghrelin (an appetite stimulant) while raising levels of peptide YY (which suppresses appetite).  In other words, if you plan to incorporate exercise into a weight loss regimen (and I highly suggest that you do), make sure to engage in workouts which are intense and challenging.  One caveat:  the aforementioned satiating effect on hunger is short-lived, so don’t be surprised when your body begins to crave food in an effort to replenish depleted energy stores.  Before you begin to think that exercise is a bad idea when trying to lose weight, consider this: apparently, frequent exercise restores sensitivity to brain neurons that control satiety, thus placing you more in tune with your hunger signals. 

Over the long term, the combination of smaller, more frequent meals, nutrient-rich foods and regular exercise can act as an insurance policy of sorts which will protect your weight loss or weight maintenance efforts.

New York Pro…In New Jersey?

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This year’s New York Pro was held on a Sunday, which is rather unusual since bodybuilding events characteristically take place on a Friday or Saturday. Another odd feature about the date selected for the New York Pro was that it coincided with Mother’s Day. I can’t imagine trying to tell my mother that I couldn’t come out to see her on Mother’s Day because I had to compete on that day! At any rate, there was a great turnout for this event:

11 Men’s Bodybuilding competitors
11 Men’s 212 competitors
44 Men’s Physique competitors
32 Women’s Physique competitors
34 Figure competitors
22 Bikini competitors

I find it odd that the New York Pro was moved to Teaneck, New Jersey this year. I have nothing whatsoever against Teaneck, because I won my Pro Card there, but it makes no sense to keep calling this event the New York Pro if it no longer takes place in New York.

Regardless of the name and location of this highly respected bodybuilding event, some very worthy competitors won titles and Olympia qualifications for 2015:

Men’s Bodybuilding: Juan Morel
Men’s 212: Guy Cisterino, Jr.
Men’s Physique: George Brown
Women’s Physique: Michelle Cummings
Figure: Latorya Watts
Bikini: India Paulino

http://www.flexonline.com/ifbb/2015-new-york-pro-results-are?t=2

The Wrinkle Banisher…That’s Me!

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Puppy wrinkles
Just like the elastic in an old pair of sweatpants, the elasticity of the skin diminishes over time, resulting in unattractive skin folds and lines and a deflated appearance. Sun exposure, cigarette smoking, and consumption of processed foods, sugar and alcohol also contribute to fine lines, uneven skin tone, and brown discoloration. Fortunately, there have been countless advancements in aesthetic medicine which have resulted in the development of non-surgical interventions which can diminish or even completely eliminate these signs of aging.

Some individuals who are needle-shy will opt for laser treatments as a means of resurfacing and refining the skin. However, these treatments must usually be done in series and can be rather costly. Another non-invasive and cost-effective solution for aging skin is a chemical peel. There are many different types of chemical peels available, ranging from very light glycolic acid peels to an aggressive TCA (trichloroacetic acid) peel. One composite peel (phenol, TCA, salicylic acid and Retin-A) which is my personal favorite is the Vi-Peel which is painless, well tolerated by the majority of skin types, and only requires a few days of social downtime. The Vi-Peel is my peel of choice and the one which I offer to my patients. http://www.drstaceynaito.com/#!chemical-peels/comt

Before and after images from a single Vi-Peel treatment

Before and after images from a single Vi-Peel treatment

Another wonderful option for correcting loss of volume in the face is an injectable filler. There are a number of hyaluronic acid based fillers available now (Restylane, Perlane, Juvederm, Belotero) which last 6 months to a year. Radiesse is another natural filler option, which is comprised of calcium hydroxylapatite, a substance which also acts as a biostimulator, stimulating cells in the skin to produce collagen over time. Radiesse lasts 18 months or more and is a very cost-effective treatment for women in their 40’s and beyond who want to refill sunken areas which often develop as menopause looms. http://www.drstaceynaito.com/#!injectable-fillers/c1tgx

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If you have wrinkles in the forehead and around the eyes, Botox and Dysport are excellent treatments and will last for 3 to 6 months. I tend to prefer Botox over Dysport because the effects are more robust and tend to last longer than what I have seen with Dysport over the years. Xeomin is another form of botulinum toxin which is well-suited for patients who have developed a rare resistance to Botox of Dysport over time. http://www.drstaceynaito.com/#!botox-treatments/cr7z
botox-before-and-after

For those of you in the Los Angeles area, I offer the Vi-Peel, Botox, Juvederm (including Voluma), Radiesse, Restylane, Perlane, and Belotero treatments. I also perform electrocautery treatments on benign moles and skin tags. Please visit the links in this blogpost for more information on how to schedule a consultation. Why not start the summer looking your very best?

Clean Eating or Eating Disorder?

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Muscle-Building-Dietfood-and-exercies

Most people are familiar with anorexia and bulimia, but there is a lesser known eating disorder which has high prevalence in the world of competitive bodybuilding.  Though it is not classified as an official eating disorder, orthorexia meets the criteria of one:  obsession, social isolation, and emotional lability.

Orthorexia is an obsessive-compulsive disorder which involves an obsession with healthy eating.  The orthorexic will go to great lengths to avoid foods which contain substances he determines to be unhealthy, such as fats, preservatives, processed foods, etc.  For an orthorexic individual, the focus is on the quality of food, which is in stark contrast to the anorexic’s focus on quantity.  Frequently this disorder may begin as a normal diet or an effort to eat in a healthier fashion, but after some time is taken to the extreme.  In the quest for pure, clean foods, the sufferer becomes obsessed and self-imposed food restrictions become a primary focus.

The distinction between normal individuals and orthorexics is that the health conscious person will practice moderation and won’t wallow in guilt if they indulge in a food which may be deficient in healthy nutrients.  In contrast, the orthorexic individual will obsess about the quality of food and will feel extremely guilty after straying from a self-imposed rigid diet.

Physical Signs and Symptoms of Orthorexia:

  • Because orthorexics limit themselves to foods they deem healthy, they may appear emaciated or malnourished

Behavioral Signs and Symptoms of Orthorexia:

  • Social isolation
  • A tendency to eat alone
  • Aversion to certain foods which have been deemed dangerous or disgusting
  • Criticism of people who don’t engage in healthy eating
  • Experience extreme pleasure in eating properly
  • Feel guilty when they deviate from a rigid diet
  • Strong desire to eat forbidden foods when under stress
  • Has difficulty eating foods prepared in a restaurant or by another person

Medical Signs and Symptoms of Orthorexia:

  • Malnutrition
  • Hypotension
  • Weakness
  • Calcium deficieny
  • Anemia in those who avoid animal protein
  • Decreased gastric motility
  • Abdominal bloating
  • Constipation

An essential element in contest preparation for competitive bodybuilding, physique, fitness, figure and bikini divisions is rigid meal planning.  As a result of this, competitors often dance along, and sometimes cross, the fine line that separates clean eating from a psychopathological relationship with food.  When taken to the extreme, sufferers may experience medical signs of malnutrition similar to anorexia.  While it is common for a competitor to experience feelings of guilt when a specific contest prep meal plan is not adhered to, warning flags should go up when a competitor becomes so obsessed with such transgressions that compensatory behaviors are adopted, such as excessive cardio sessions, laxative usage or starvation.   If such behaviors are commonplace for an individual, behavioral intervention will become necessary in order to restore one’s emotional and physical well-being.

Since prepping for competitions places excessive pressure on an individual and underscores the pursuit of “perfection” in the sport, orthorexic behavior may be so irresistible that it is rationalized as a necessary component of one’s prep.  This in and of itself makes orthorexia particularly insidious and dangerous.

Eating Disorders – An Overview

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Modern society has continually sent a clear message that a slender physique is the most attractive and desirable.  This has not only driven the success of the diet industry as people have scrambled to attain the ideal body, but has also served as the catalyst for numerous eating disorders such as anorexia and bulimia.  These disorders are often encountered in the world of competitive sports and bodybuilding as competitors develop a warped perspective on their relationship with food.  The nature of competition draws driven, obsessive personality types who by fixating on performance goals often will develop an excessive desire to maintain what they describe as clean eating.  If an athlete fails to obtain the ideal leanness which a sport requires, the reaction is often manifested in chronic undereating in a desperate effort to drop fat.  The greatest irony is that many athletes and competitors who are regarded as having the most desirable physiques are beset with poor body image and low self-esteem.

Another relatively common scenario is for a competitor to measure his or her self-worth by how rigidly he or she adheres to a strict meal regimen.  Some individuals will have a strong desire to engage in emotional eating, indulging in what they deem forbidden foods, only to wallow in excessive guilt and self-doubt as a result.  Eating disorders in general will cause an individual to feel tremendous anxiety when in social environments where food is served, so these situations are usually avoided.

It is important not only to recognize the warning signs of an eating disorder, but to also understand how it can undermine one’s fitness goals.  Furthermore, these disorders are extremely deleterious to one’s health and psychological well-being.

BULIMIA:

Bulimia is characterized by compulsive episodes of excessive food consumption followed by purging behaviors such as laxatives, diuretics, excessive training or self-induced vomiting in an effort to compensate for the irregular behavior.  The most common trigger for such binges is the excessive calorie restriction which is seen with dieting or at times with contest prep.  The body responds to starvation by producing powerful cravings which may be irresistible.  However, once the binge has occurred, the individual usually feels a sense of failure since the diet was not strictly adhered to, often causing more binge eating to occur.  A period of purging follows soon afterwards, but the most common purging methods fail to rid the body of all the calories consumed.  On average, laxatives rid the body of 10% of the calories eaten, while vomiting will eliminate 50% or fewer of the calories.

Physical Signs and Symptoms of Bulimia:

  • Normal weight or slightly over ideal weight.
  • Frequent weight fluctuations.
  • Discolored teeth, tooth decay and mouth sores.
  • Calluses or scars on knuckles.
  • Puffy cheeks.
  • Smell of vomit.

Behavioral Signs and Symptoms of Bulimia:

  • Covert food consumption – Bulimics will engage in binges alone
  • Inability to stop eating until abdominal pain and distension set in
  • A pattern of overeating followed by fasting
  • Makes frequent trips to restroom immediately after eating
  • Using laxatives, diuretics or enemas after a binge
  • Excessive high intensity exercise following a binge

Medical Signs and Symptoms of Bulimia:

  • Chronic constipation
  • Abdominal pain
  • Dehydration
  • Lethargy
  • Swelling of hands and feet
  • Chronic sore throat or hoarseness
  • Broken blood vessels in eyes
  • Weakness or dizziness
  • Acid reflux or ulcer.
  • Loss of menstrual periods in women

 

ANOREXIA:

The hallmark of anorexia is excessive food restriction coupled with a severe, irrational fear of weight gain.  These individuals have distorted body images which cause them to feel that they are overweight despite the fact that the majority of sufferers are underweight.  Anorexia sufferers are usually high achievers who harbor perfectionist tendencies which may lean towards or even reside within obsessive compulsive disorder.  However, these individuals feel socially isolated and are overcome with a sense of failure and a loss of control over their own lives.  Ironically, the anorexic behavior of forced starvation which gives one a sense of control eventually takes over and the individual is unable to interrupt the pattern.

Physical Signs and Symptoms of Anorexia:

  • Loss of a considerable amount of weight in a relatively short period of time
  • Wears baggy clothes to hide weight loss
  • Appears emaciated or gaunt
  • Cold hands and feet
  • General hypothermia
  • Dry skin
  • Loss of muscle mass
  • Constipation
  • Hair loss
  • Lanugo (fine, downy hair) on face or back
  • Brittle nails
  • Yellow or grayish appearance to the skin

Behavioral Signs and Symptoms of Anorexia:

  • Complains of being fat despite being dangerously thin
  • Obsessed with nutritional information of food, especially calories and grams of fat
  • Will only eat certain foods
  • Refuses to eat in public or will only eat a small morsel of food
  • Exercises obsessively and becomes very upset if something interrupts plans to exercise
  • Usually avoids fatty foods, fried foods, animal products, bread
  • Often become vegetarians
  • Constantly counts calories in foods eaten
  • Either weighs oneself constantly or avoids being weighed at all costs
  • Eats in private
  • Inability to concentrate
  • Irritability
  • Appears anxious
  • Depression
  • Socially withdrawn
  • Never stops moving or refuses to sit down
  • Obsessive avoidance of food

Medical Signs and Symptoms of Anorexia:

  • Headaches
  • Fainting
  • Dizziness
  • Lethargy
  • Insomnia
  • Lowered blood pressure
  • Lowered heart rate with weak pulse
  • Heart palpitations
  • Hypoglycemia
  • Shortness of breath
  • Loss of menstrual periods
  • Decreased white blood cell count

What’s Up With L.A. Weather?

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Oct weather

Los Angeles is known for its great weather, but those of us who have lived here for many years are well acquainted with the quirks and inconsistencies in the weather patterns. I was born and raised in L.A. and have lived here for the majority of my life, and know first-hand that there are a few cold nights during the winter in which the temperature drops to the upper 20’s Fahrenheit where I currently live. Generally speaking, though, those of us who live in Los Angeles are usually blessed with pretty nice weather most of the time. We often get sunny days with moderate temperatures, and the oppressive humidity which our East Coast beach fantasy counterpart, i.e. Florida, must deal with around this time of the year doesn’t hit us until August and September. No wonder people think we are spoiled with good weather in Los Angeles, because we are.

However, an odd pattern has emerged with the weather lately, in which one week will be blazing hot, reaching temperatures in the high-80’s to mid-90’s, only to be followed by overcast skies and much cooler weather (low to mid-60’s) and the threat of rain the following week. It has become next to impossible to determine how to dress for the day when such fluctuations assert themselves. As an example, last week was so hot that I wore tank tops the entire week, but this week I am bundled up in a warm sweater and leggings. According to the extended weather forecast, things will warm up again next week, with temperatures rising into the 80’s once more. I wouldn’t mind so much if the weather fluctuated from warm to a bit chilly, which would be appropriate for the spring months, but the summer heat has made its appearance far too often this season. Basically, we toggle back and forth on a weekly basis from spring weather to summer weather, and April showers seem to have largely eluded us. When the mercury drops and rain clouds hover over the southland, many of us hope for rain so that the state of California can find some relief from the severe drought it is in, but we just get the overcast skies and perhaps a light drizzle. It is such a tease!

The Scoop On Artificial Sweeteners

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The use of artificial sweeteners can serve as an aid in coping with one’s sweet tooth, especially when trying to adhere to a healthy diet or contest prep plan.  Since artificial sweeteners are non-nutritive, i.e. they have virtually no calories and are not fully absorbed by the body, they do not undermine a calorie-restricted plan.  They can also serve as a great alternative for diabetics since they generally do not raise blood sugar levels.  Another bonus is that artificial sweeteners do not contribute to tooth decay.

The three most popular artificial artificial sweeteners in use in the United States are the following:

Aspartame – This sweetener was tested in more than 100 scientific studies before the FDA gave it a stamp of approval in 1981 along with a statement by the FDA Commissioner which determined, “Few compounds has withstood such detailed testing and repeated, close scrutiny, and the process through which aspartame has gone should provide the public with additional confidence of its safety.” Since that time it has found its way into carbonated sodas, powdered soft drinks, chewing gum, gelatins, desserts, yogurt, tabletop sweeteners and some vitamins. 

Aspartame is composed of aspartic acid and phenylalanine as a methyl ester.  During digestion, aspartame breaks down into aspartic acid, phenylalanine and a small amount of methanol which are released into the blood and used in normal body processes without accumulating in the tissues of the body. The acceptable daily intake for aspartame was set at 50 mg/kg of body weight per day.  This means that the ADI for a 200 lb. individual would be 4,550 mg. 

Sucralose – This nonnutritive sweetener is derived from sugar and is 600 times sweeter than sucrose (table sugar).  It was approved in 1999 for use as a general purpose sweetener and is now found in thousands of products, including cooked or baked goods.  The ADI for sucralose has been set at 5 mg/kg of body weight per day.  For example, if you weigh 200 lbs., your ADI for sucralose would be 455 mg.

Stevia – Also known as Reb-A, stevia was approved for use in food products by the FDA in 2008.  As with other artificial sweeteners, stevia does not affect blood glucose or insulin levels and is safe for use in diabetics.  The ADI for stevia is set at 12 mg/kg of body weight daily, or 1,092 mg per day for a 200 lb. individual.  Stevia is a 100% natural glycoside found in Stevia Rebaudiana, an herd found in the Chrysanthemum family.  It maintains heat stability at 95 degrees Celsius and is non-fermentable and non-discoloring.

Conclusion

For those who are trying to eliminate sugar from their diets, whether for the caloric density or the insulin spikes which it imparts, artificial sweeteners are an ideal alternative for adding flavor and sweetness to foods.  Their intense sweetness ensures that large quantities of these substances will not be ingested.  They can effectively hold sweet cravings at bay and provide important tools in weight loss and weight maintenance programs. 

You Know You Are A Die-Hard Competitor When…

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• You eat most of your meals out of plastic containers
• You avoid restaurants because it is too tough to find clean choices
• You will only travel somewhere if there is a gym nearby
• You think vascularity and sweat are sexy
• You gaze longingly at forbidden foods
• You know what a protein bomb is!
• The smell of tanning solution is very familiar to you
• If you are a lady, you know what it means to use a cup in the restroom
• You have a love-hate relationship with asparagus, fish, and/or chicken
• You walk around your house in clear heels and practice posing when showtime approaches
• You know what two-a-days are
• You are accustomed to using dark sheets and towels post-tan

Competitors, can you think of any others you would like to share here?