Stress and Your Mental and Physical Health: The Catecholamine and Prada Connection

Samantha Heller MS RD

Got stress?  Who doesn’t?  The psychological roller coaster we call life can really knock your socks off if you let it.  Although a stress response is necessary a survival instinct, over time too much stress can make you sick.  However there are ways to manage the ups and downs and spin arounds we experience daily.

The Catecholamine and Prada Connection: How Stress Works

Epinephrine and norepinephrine (also known as adrenaline and noradrenaline) are neurotransmitters.  Imagine you are in the mall and suddenly here is an announcement over the PA that the “Genuine Stuff” shop is having a huge sale. All Prada bags are 75% off and the latest Caldwell golf clubs are 50% off.  Imagine the mad dash you and everyone else make for the store. You heart is racing, eyes dilated, breathing heavily, as you race to grab your dream putter before anyone else.  Your body has launched into the fight or flight mode ignited by the release of catecholamines. When your stress level skyrockets and your body responds.  Fight or flight is a survival response in the body and epinephrine and norepinephrine are key players.  All the physiological effects such as heart pounding and big eyes (for a better field of vision), prepare you to either fight for your life or run for it.

Your body does not differentiate between a life threatening situation or a money saving opportunity.  If you mentally perceive a situation as a stressor, your body flips on the stress response.  Occasional bouts of acute stress do not have unhealthy physiological consequences.  Chronic stress does.  Chronic stress that comes from struggles at work, traffic and family can wear out your body and it’s defense systems.  When you get stressed your body does not know whether you have to fight for your life or you just had a fight with your spouse.  If the stress is chronic, then the flight or fight response is in over drive which can create some serious health problems.  Research suggests that chronic stress can precipitate depression, poor memory, diseases such as cardiovascular disease and effect brain function. Some research suggests that chronic stress can increase belly fat.  Managing stress can help keep brain chemicals in balance and your body healthy.

IN OTHER WORDS No matter what the source of stress is, your body will respond as if it is in a life threatening situation.  Chronic stress wreaks havoc in the body and increases the risk for disease, cognitive decline and may cause atrophy in certain regions of the brain.  So unless you want your brain to disintegrate, chill out.

Tips for managing stress

  • Cardiovascular exercise is one of the best all time stress busters. Walk, run, Zumba, dance with the stars; whatever you enjoy doing is good for your body, health, brain and mood.
  • Deep breathing.  Really, this does work.  Taking a few slow, deep breaths can help engage your ‘rest and relax’ response in the parasympathetic nervous system.  Deep breathing tells your central nervous system that everything is ok.  Your body will slow the release of stress hormones like cortisol, it is dumping into your blood stream  and that in turn can help lower blood pressure and heart rate.
  • Keep perspective.  Avoid making a tempest in a teapot over small issues.  Just because your mother-in-law mentioned your weight – again – does not mean you need to go to pieces. Look at the situation realistically and move on.
  • Avoid stress eating.  Eating high sugar and high fat foods can cause mood swings, energy crashes and erode your coping skills.  Eat as healthfully as you can and limit alcohol.
  • Laugh. There is nothing like a good laugh to shatter a tense or stressful situation.  Instead of launching into the familiar default anger mode, find some humor in the moment.  Do not take yourself or others so seriously.

Adapted from Get Smart: Samantha Heller’s Nutrition Prescription for Boosting Brain Power and Optimizing Total Body Health

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Tips for Surviving Thanksgiving from Beginning to End

Samantha Heller MS RD

Thanksgiving kicks off the unofficial start of the holiday eating season.  The American Council on Exercise reports that an average Thanksgiving meal can add up to 3,000 calories and 229 grams of fat.  This does not include picking in the kitchen and snacking after the meal! But Thanksgiving comes once a year and there is no reason why you cannot enjoy your favorite holiday dishes without going overboard. Here are some tips you to help you survive the holiday season, belt buckle intact.


✧    Do not go to Thanksgiving dinner starving.  That is a sure fire recipe for over eating.  Eat normally, if a little less than usual beforehand.

✧    Prepare yourself mentally for any given occasion including weird relatives and annoying in-laws.  This way you can sanely choose healthy foods, control how much of your favorites you are going to eat and not over indulge

✧ To keep from blowing all those hours at the gym on the hors d’oeuvres.  Be sensible. You can save hundreds of calories with a few easy changes. Pick the raw vegetables over the cheese, salsa over the creamy dip, a small handful of nuts over pig in a blanket and shrimp cocktail over mini-quiches.

✧ One cup pf eggnog is 343 calories and an astounding 19g of fat and this does not include the alcohol.  If you have to self medicate with alcohol to deal with family lunacy, then do so with wine, spritzers or light beer.  You will save at least 200 calories per drink and all the fat.

Red wine 3.5 oz = 74 calories

White wine 3.5 oz = 70 calories

Light beer 12 oz = 99 calories

✧  Be realistic.  No one actually alternates wine with seltzer.  When you arrive at your holiday party, start with seltzer, water or diet soda.  Switch to the alcohol later on.  You will drink less and feel a lot better in the morning.


✧ Turkey Trivia:  Contrary to current myth, eating turkey will not make you sleepy. Tryptophan is an amino acid found in many foods including turkey, peanuts, yogurt and bananas.  It is the chemical precursor to the neurotransmitter serotonin, a calming agent in the brain.  Eating foods that contain tryptophan therefore can increase serotonin and in some instances make you sleepy.  But when you eat a meal there are a lot of other amino acids vying for entry into the brain.  Trypotphan usually loses out.  Post-Thanksgiving dinner lethargy is more likely due to too much food, alcohol or Uncle John’s 400th telling of the time he almost fell in a sink hole.

✧ What’s the point of thanksgiving without stuffing?  Unfortunately, even a small serving of turkey stuffing can cost you between 200-450 calories and up to 16 grams of fat.  If you love it, indulge and enjoy in small portions.

✧ There are up as many as 113 calories and 6g of fat in a small 3 ounce serving of turkey gravy. Use a tablespoon instead of a ladle to dole out your gravy portion.  Pour just enough for taste.

✧ Cornbread can be made with cheese, jalapenos, broccoli or even SPAM.  Still it is a better choice then the lard laden biscuits and white rolls (except the SPAM cornbread with 21 grams of fat and over 1,000 mg of sodium).  Cornbread offers a decent ration of calcium and phosphorus too.  For an added bonus, spread some cranberry relish on it.

✧ Cranberry relish or sauce is really good food.  Cranberries are packed with vitamin C, flavonoids and polyphenolic compounds that help fight heart disease and cancer.  This is one Thanksgiving tradition you can celebrate all year.

✧  Load your Thanksgiving plate with vegetables.  The greater the variety of vegetables and fruits you eat, the more powerful the health benefits.  An article in the American Journal of Clinical Nutrition reports that there is a synergistic effect of phytochemicals in fruits and vegetables that accounts for their strong anticancer and antioxidant activities.

✧ Creamed onions are a staple at many Thanksgiving meals.  Beware, these pearls of bad breath are doused with up to 14 grams of fat, most of it saturated.  Pass this dish and go for the Brussels sprouts.  These tiny powerhouses are crammed with, iron, magnesium, phosphorus, copper, fiber, vitamin A, vitamin C, vitamin B6, thiamin, riboflavin, folate and potassium.

✧ It is difficult to malign a vegetable.  But take perfectly healthy green beans, smother them with canned cream of mushroom soup and French fried onions and a small 3/4 cup serving of this casserole will cost you 10g of fat and 850mg of sodium.   Pile your plate with salad greens instead.

✧ Skip the mashed potatoes made with butter and cream and choose the sweet potatoes.  Sweet in taste and for your body, sweet potatoes are so nutritious that NASA selected them as one of the crops for their Advanced Life Support Program.  Sweet potatoes offer a healthy dose of fiber, vitamins C, B6, and E, potassium, and beta-carotene.  Scoop off the marshmallows and brown sugar, sweet potatoes are sweet enough on their own.

✧ For healthy mashed potatoes use fat free milk or soy milk, olive oil and garlic. Add sautéed spinach and use your hand blender to combine for healthy, bright green, spinach mashed potatoes.

✧ Cooking sweet corn on the cob or canned or frozen corn, releases valuable disease fighting compounds such as ferulic acid says a study from Cornell University.  Cooking also raises the antioxidant activity in corn, which helps the in fight against cancer and heart disease (bring floss).

✧ Put down the salt shaker and grab the oregano. Adding fresh herbs like oregano, rosemary, dill and thyme to your holiday fare will up your intake of rosmarinic acid and other highly effective antioxidants.


✧ To avoid the mega calories in one slice of pecan pie, pick off a few pecans and munch on them.   You’ll still get the sweet taste and all the healthy benefits like vitamin E, copper and monounsaturated fat pecans have to offer. A study at Loma Linda University in California found that pecans lowered serum total and LDL cholesterol and increased HDL cholesterol.

✧ Pumpkin’s orange color comes from a boatload of beta-carotene.  Beta-carotene, which is converted into vitamin A in the body, is a powerful player in maintaining the health of your eyes, lungs, skin and immune system.  Nibble on sliver of pumpkin pie and pass on the whipped cream and crust. OK have a little of the crust. It is a holiday after all.

✧  Remember it’s ok to say “no thank you” to well wishing pie pushers.  Even if Aunt Mary says she baked your favorite double colossal cream pie, you can politely decline, saying you would like to save some for later or that you would like a small sliver.

Final Tips

✧ Be sure to squeeze in some exercise.  You can miss the first few plays of the football game while you are out taking a walk, playing Frisbee, or a game of catch with the kids.

✧ Do not stuff yourself.  Eat until you have had enough and are comfortable.  Stuffing is for the turkey.




Posted in Cancer, cardiovascular disease, exercise, Fitness, Food, Health, Nutrition, obesity, Uncategorized, weight management, Wellness | Leave a comment

The Dangers of Ab Flab

Samantha Heller MS RD

Spare tire.  Middle aged spread.  Pot belly.  Love handles.  Muffin top.  Ab flab.  All these playful terms are what the medical profession calls abdominal obesity or central obesity.  Unfortunately abdominal obesity is anything but fun.  In fact it is downright dangerous. Research has shown that in young and older people alike, those with big bellies are at increased risk for chronic diseases such as insulin resistance, diabetes, cardiovascular disease, hypertension, stroke, mortality and cancer1-7. According to the Center for Disease Control and Prevention, more than one third of U.S. adults—more than 72 million people—and 16% of U.S. children are obese8. Over half of U.S. adults have abdominal obesity9.

Why is abdominal fat so bad?

The fat in our bellies behaves differently than fat in other parts of the body. Scientists used to think that fat cells were just a repository for excess fat (adipose tissue).  However, in recent years scientists discovered that fat cells secrete hormones and other substances10. “Fat cells are active little endocrine factories producing a wide array of hormones and other compounds that are poured into the blood”, says Harvey B. Simon, M.D. Associate Professor of Medicine at Harvard Medical School and founding editor of the Harvard Men’s Health Watch newsletter.  Some of the substances have anti-inflammatory actions (adiponectins) and some increase inflammation (cytokines).  Abdominal obesity refers to the accumulation of fat around your middle called subcutaneous fat (SC) and also a depot of fat that is hidden beneath your abdominal muscles called visceral fat (VF).  Subcutaneous fat, the fat around your waist that you can pinch with your fingers, contributes to systemic inflammation, cardiovascular disease and full body disease11.  Excess visceral fat is particularly dangerous because it releases more inflammatory compounds than other fat cells.  Cytokines released into circulation from visceral fat such as interleukin 6 and tumor necrosis factor increase inflammation, oxidative stress and the risk for many diseases12, 13.  Visceral fat is highly active tissue says Steven Heymsfield M.D., Executive Director, at Pennington Biomedical Research Center in Louisana, and the former Deputy Director of the New York Obesity Research Center at St. Luke’s-Roosevelt Hospital. This storehouse of deep fat which lays right over the intestines (also known as mesenteric visceral fat), is filled with immune cells such as white blood cells that mop up microbes and other toxic substances that may escape through the intestinal wall.  “Visceral fat is important in immune function”, Heymsfield says.  Yet a surfeit of visceral fat means not only a lot of inflammatory compounds being released into the blood but also a lot of free fatty acids (FFA). Due to its active nature visceral fat continually releases FFAs into the bloodstream. Scientists suspect that the route the free fatty acids take from visceral fat to the liver causes problems. Free fatty acids released from visceral fat are dumped into the portal vein which takes blood and the FFAs directly to the liver.  In a sequence of complex metabolic steps the chronic overflow of fat to the liver results in high cholesterol, high triglycerides and insulin resistance14.   In addition, Simon says that excess visceral fat has been linked to fat accumulating around organs such as the heart and liver which impairs their ability to function.

Why does fat accumulate around your middle?

Genetics influence where our body decides to store extra fat. Even if you are genetically inclined to store fat around your waist you are not doomed to end up looking like your portly Aunt Ida.  Research and common sense tells us that certain behaviors can pack on ab flab including smoking, drinking alcohol15, over eating and being a couch potato.  If you quit smoking, drink less alcohol, manage your calorie intake and engage in daily exercise, you will still have Aunt Ida’s blue eyes but not her waist size.

In addition to genes, hormones, stages of life e.g. menopause, aging, physical activity and how much we eat are important factors in an expanding girth. Chronic stress may also play a role. “Stress is linked to behaviors such as increased eating, drinking and smoking, less exercise and increases in cortisol levels” says Stephen Siegel M.D. FACC, FACSM, assistant professor in the NYU School of Medicine department of cardiology and president of the Greater New York Regional Chapter of American College of Sports Medicine.   Research suggests that cortisol, a stress hormone, can lead to an increase in abdominal fat in adults and adolescents16, 17.

Are you at risk?

“Abdominal obesity is defined as waist circumference.” Says Heymsfield.  To find out if your belly is putting you at risk Heymsfield says you need to know your waist circumference and your body mass index (BMI).  “Together waist circumference and BMI can be very helpful in assessing your health risks,” he says. There is a high range of waist circumference for any given BMI.  Some people carry their weight in their thighs or buttocks and have a reasonable waist size.  But if their BMI is over 25 they are considered obese and are vulnerable to all the health dangers associated with obesity.  Then again other people may have a BMI under 25 but a large waist circumference which categorizes them as being abdominally obese. Simon agrees that measurement of girth a very good predictor of hazard.  “But don’t kid yourself”, he says.  “The guy who keeps his 35” belt but wears it lower and lower so that eventually his belly is hanging over it is not doing himself any favors”.

Checking your waist circumference is as easy as taking out a tape measure and wrapping it around your waist (but don’t cheat by sucking in your gut when you take the measurement).

If you know your weight and height you can easily find your BMI on a BMI chart (available on line or in your doctor’s office).


Underweight = <18.5

Normal weight = 18.5-24.9

Overweight = 25-29.9

Obesity = BMI of 30 or greater

Men & Women are equally at risk

“Men have roughly double the amount of abdominal fat as women”, says Heymsfield.  So it is not unusual to see men with big bellies.   “In women that compartment is saved for pregnancy,”  he adds.  But once menopause hits things change. Menopause is associated with selective deposition of visceral fat18 as well as other metabolic changes that increase women’s risk for heart disease.

What to do


The good news is that research is showing that you needn’t diet to lose abdominal fat (although if you are overweight losing weight is always a good idea).  Cardiovascular exercise (aka aerobic exercise) can decrease ab flab without a reduction in calories11.  “Modest daily walking, at least 2-3 miles a day where you burn approximately 100-150 extra calories/day is important along with a generally active lifestyle.”  says Simon.   The STRIDDE study19 out in October 2006 found that people who exercised lost visceral and subcutaneous fat without a reduction in caloric intake (or an increase).  Walking the equivalent of 11 miles a week prevented accumulation of VF.  More exercise resulted in a loss of ab flab.  The bad news is that subjects who did not exercise gained a significant about of abdominal fat including VF in only 6 months. There is a high cost of a sedentary lifestyle in the short and long term.

Postmenopausal women are not stuck with belly fat.  A study in the Journal of the American Medical Association found that postmenopausal women who engaged in 45 minutes of exercise daily such as brisk walking, lost between 3.4 percent and 6.9 percent of their abdominal fat in a year’s time20.

Combining a healthy diet with regular exercise is the best overall approach.  Data from the ongoing Framingham study shows that eating healthy foods and exercising regularly reduces both SC and VF21.  Healthy foods include whole grains, beans, low or non-fat dairy, lots of vegetables and fruits. Eating lean protein22 like fish, poultry and tofu is associated with a reduction in abdominal fat. Reducing the amount of saturated fats, the kind found in butter, cheese, meat, and ice cream helps reduce belly fat and the risk of cardiovascular disease.

If you are overweight or obese you need to lose some weight for the sake of your health and well being.  Stay away from fad diets and quick fixes.  And never starve yourself. Here are simple steps you can take to start on the road to good health and a healthy weight.

  • Use smaller plates and bowls
  • Stop drinking sugar sweetened beverages such as sodas and fruit drinks
  • Be sure to include vegetables with lunch and dinner
  • See a registered dietitian to help you create a healthy eating plan
  • Use low or non-fat milk, cheese, yogurt and cottage cheese
  • Go meatless a few nights a week.  Try a whole wheat pasta primavera with lots of vegetables.
  • Stop eating after dinner and in front of the TV or computer

Dangers of ab flab

  • Watching more than 3 hours of TV a day packs pounds around your middle23.
  • Ab flab in mid-life increases the risk for dementia and cognitive decline later in life24.  A study in the journal Neurology found that central obesity in mid-life triples the risk of dementia 30 years later24.
  • Researchers in the U.S. and the Netherlands found that women and men with a large waist circumference had a 50% increased risk of mortality compared with people with smaller waist sizes, irrespective of their overall weight25.
  • Data from the Women’s Health Initiative found that the bigger a woman’s waist the greater the risk for lung cancer in current and former smokers26.
  • Excess abdominal fat is associated with insulin resistance, metabolic syndrome, diabetes and heart disease18.
  • A study presented by the American Academy of Neurology found abdominal obesity was associated with migraine headaches. Women with extra belly fat were 30% more likely to experience migraines than women without excess belly fat27.
  • An article in the journal Nutrition, Metabolism and Cardiovascular Diseases reports a positive association between chronic stress and obesity in adolescents16.
  • Research from Korea says that visceral obesity is associated with colorectal cancer28.
  • Abdominal obesity is a potent risk factor for stroke29.

Ways to Reduce Ab Flab

  • Limit Saturated fats. Scientific evidence suggests that reducing the amount of saturated fats, the kind found in butter, cheese, meat, and ice cream helps reduce belly fat.
  • Consume more healthy fats like olive, canola, peanut, and walnut oils30, 31.  Better for your waist and your arteries.
  • Substituting a modest amount of protein for carbohydrate is likely to lead to lower abdominal obesity22.  For example have a ¾ cup of brown rice (instead of the usual1 ½ cups) with a 4 oz serving of salmon and a hearty helping of vegetables for dinner.
  • Cut back your alcohol intake. Drinking alcohol is associated with increased VF and SC21.
  • Quit smoking.  Smoking increases belly fat22.
  • Manage stress. Chronic stress can increase belly fat in adults and kids16, 17, 32.   Take time to de-stress and relax when you can.  A few deep breaths in a frustrating moment can work wonders.
  • Add whole grains to your diet.  A study in the American Journal of Clinical Nutrition found that consuming whole grains decreased abdominal fat and CRP levels in obese men and women33.  Whole grains include whole wheat bread & pasta, brown rice, corn tortillas and quinoa.
  • Exercise daily.  Walk, dance, bike, skip rope.  You’ll lose ab flab and reduce the risk for many chronic diseases too.


1.            Wang Y, Rimm EB, Stampfer MJ, Willett WC, Hu FB. Comparison of abdominal adiposity and overall obesity in predicting risk of type 2 diabetes among men. Am J Clin Nutr 2005;81:555-63.

2.            von Hafe P, Pina F, Perez A, Tavares M, Barros H. Visceral Fat Accumulation as a Risk Factor for Prostate Cancer. Obes Res %R 2004;12:1930-5.

3.            Lee C-D, Jacobs DR, Jr., Schreiner PJ, Iribarren C, Hankinson A. Abdominal obesity and coronary artery calcification in young adults: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Clin Nutr 2007;86:48-54.

4.            Zhang C, Rexrode KM, van Dam RM, Li TY, Hu FB. Abdominal Obesity and the Risk of All-Cause, Cardiovascular, and Cancer Mortality: Sixteen Years of Follow-Up in US Women. Circulation 2008;117:1658-67.

5.            Bigaard J, Frederiksen K, Tjonneland A, et al. Waist circumference and body composition in relation to all-cause mortality in middle-aged men and women. Int J Obes Relat Metab Disord 2005;29:778-84.

6.            Kanai H, Matsuzawa Y, Kotani K, et al. Close correlation of intra-abdominal fat accumulation to hypertension in obese women. Hypertension 1990;16:484-90.

7.            Winter Y, Rohrmann S, Linseisen J, et al. Contribution of Obesity and Abdominal Fat Mass to Risk of Stroke and Transient Ischemic Attacks. Stroke 2008:STROKEAHA.108.523001.

8.            NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION. Obesity: Halting the Epidemic By Making Health Easier: Centers for Disease Control and Prevention; 2009.

9.            Li C, Ford ES, McGuire LC, Mokdad AH. Increasing Trends in Waist Circumference and Abdominal Obesity among U.S. Adults[ast]. Obesity 2007;15:216-.

10.            Matsuzawa Y. Therapy Insight: adipocytokines in metabolic syndrome and related cardiovascular disease. Nature Clinical Practice Cardiovascular Medicine 2006;3:35-42.

11.            Swienckowski Jessica, Close Kelly. American Heart Association Annual Scientific Sessions 2009.  November 15-18.  Orlando FL.  Day #1 Highlights draft. CloserLook 2009.

12.            Fontana L, Eagon JC, Trujillo ME, Scherer PE, Klein S. Visceral Fat Adipokine Secretion Is Associated With Systemic Inflammation in Obese Humans. Diabetes 2007;56:1010-3.

13.            Pou KM, Massaro JM, Hoffmann U, et al. Visceral and Subcutaneous Adipose Tissue Volumes Are Cross-Sectionally Related to Markers of Inflammation and Oxidative Stress: The Framingham Heart Study. Circulation 2007;116:1234-41.

14.            Schaffler A, Scholmerich J, Buchler C. Mechanisms of disease: adipocytokines and visceral adipose tissue–emerging role in nonalcoholic fatty liver disease.[see comment]. Nature Clinical Practice Gastroenterology & Hepatology 2005;2:273-80.

15.            Dorn JM, Hovey K, Muti P, et al. Alcohol Drinking Patterns Differentially Affect Central Adiposity as Measured by Abdominal Height in Women and Men. J Nutr %R 2003;133:2655-62.

16.            De Vriendt T, Moreno LA, De Henauw S. Chronic stress and obesity in adolescents: Scientific evidence and methodological issues for epidemiological research. Nutrition, Metabolism and Cardiovascular Diseases 2009;19:511-9.

17.            Epel ESP, McEwen BP, Seeman TP, et al. Stress and Body Shape: Stress-Induced Cortisol Secretion Is Consistently Greater Among Women With Central Fat. Psychosomatic Medicine 2000;62:623-32.

18.            Despres J-P, Lemieux I, Bergeron J, et al. Abdominal Obesity and the Metabolic Syndrome: Contribution to Global Cardiometabolic Risk. Arterioscler Thromb Vasc Biol 2008;28:1039-49.

19.            Slentz CA, Aiken LB, Houmard JA, et al. Inactivity, exercise, and visceral fat. STRRIDE: a randomized, controlled study of exercise intensity and amount. Journal of Applied Physiology 2005;99:1613-8.

20.            Irwin ML, Yasui Y, Ulrich CM, et al. Effect of exercise on total and intra-abdominal body fat in postmenopausal women: a randomized controlled trial.[see comment]. JAMA 2003;289:323-30.

21.            Molenaar EA, Massaro JM, Jacques PF, et al. Association of lifestyle factors with abdominal subcutaneous and visceral adiposity: the Framingham Heart Study. Diabetes Care 2009;32:505-10.

22.            Lewin GA SH, Yuen D, Merchant P, Mamaladze V, Tsertsvadze A, et al. Effects of Omega-3 Fatty Acids on Child and Maternal Health. Evidence Report/Technology Assessment.  Omega-3 Fatty Acids on Child and Maternal Health. Evidence Report/Technology Assessment No. 118. (Prepared by the University of Ottawa Evidence-based Practice Center, under Contract No. 290-02-0021.) Agency for Healthcare Research and Quality.; 2005 August. Report No.: AHRQ Publication No. 05-E025-2.

23.            Cleland VJ, Schmidt MD, Dwyer T, Venn AJ. Television viewing and abdominal obesity in young adults: is the association mediated by food and beverage consumption during viewing time or reduced leisure-time physical activity? Am J Clin Nutr 2008;87:1148-55.

24.            Whitmer RA, Gustafson DR, Barrett-Connor E, Haan MN, Gunderson EP, Yaffe K. Central obesity and increased risk of dementia more than three decades later. Neurology 2008:01.wnl.0000306313.89165.ef.

25.            Koster A, Leitzmann MF, Schatzkin A, et al. Waist Circumference and Mortality. Am J Epidemiol 2008;167:1465-75.

26.            Kabat GC, Kim M, Hunt JR, Chlebowski RT, Rohan TE. Body Mass Index and Waist Circumference in Relation to Lung Cancer Risk in the Women’s Health Initiative. Am J Epidemiol 2008;168:158-69.

27.            Peterlin B. Lee, Rosso Andrea L, Rapoport Alan M, Scher  Ann I. Prevalence of Migraine in Abdominal Obesity throughout the Adult Life-Cycle: NHANES 1999-2004 Scientific Sessions: Headache: Basic and Clinical Science American Academy of Neurology 2009;Abstract.

28.            Oh T-H, Byeon J-S, Myung S-J, et al. Visceral obesity as a risk factor for colorectal neoplasm. Journal of gastroenterology and hepatology 2008;23:411-7.

29.            Suk SH, Sacco RL, Boden-Albala B, et al. Abdominal obesity and risk of ischemic stroke: the Northern Manhattan Stroke Study. Stroke 2003;34:1586-92.

30.            Paniagua JA, Gallego de la Sacristana A, Romero I, et al. Monounsaturated fat-rich diet prevents central body fat distribution and decreases postprandial adiponectin expression induced by a carbohydrate-rich diet in insulin-resistant subjects.[see comment]. Diabetes Care 2007;30:1717-23.

31.            Summers LK, Fielding BA, Bradshaw HA, et al. Substituting dietary saturated fat with polyunsaturated fat changes abdominal fat distribution and improves insulin sensitivity. Diabetologia 2002;45:369-77.

32.            Vicennati V, Pasqui F, Cavazza C, Pagotto U, Pasquali R. Stress-related Development of Obesity and Cortisol in Women. Obesity 2009.

33.            Katcher HI, Legro RS, Kunselman AR, et al. The effects of a whole grain enriched hypocaloric diet on cardiovascular disease risk factors in men and women with metabolic syndrome. Am J Clin Nutr 2008;87:79-90.

Posted in Cancer, cardiovascular disease, Dementia, Diabetes, exercise, Fitness, Food, Health, Nutrition, obesity, Uncategorized, weight management, Wellness | 9 Comments

Is Red Meat Really Bad for You?

By Samantha Heller MS RD

Is red meat, processed meat and foods containing saturated fat really as unhealthy as they say?   The answer is no.  The fact is red and processed meats and saturated fat are far worse for your health than the meat and dairy industry want you to know.  Ethical and environmental issues aside, all you have to do is take a look at the scientific literature (studies done on humans not on animals or in test tubes) and it reveals irrefutable evidence that consuming animal foods and processed foods high in saturated fats in the quantities we eat them can be deadly over time. Even the United States Department of Agriculture, a government organization and a rather conservative one at that, recommends that people eat less animal foods and begin a shift towards a more plant based diet.

The Science

Research is finding that diets high in red meat and/or processed meats may increase the risk of type 2 diabetes1, colorectal cancer2, 3, mortality4, coronary heart disease5, breast cancer6, 7, esophageal, liver and lung cancers8 and chronic obstructive lung disease9.  Red meat and other animal foods are high in saturated fat which increases internal inflammation10, serum cholesterol, LDL cholesterol (the bad cholesterol) and arterial inflammation11 and dysfunction12.

• Scientists have found an association between dietary saturated fats, the incidence of Alzheimer’s disease13 and an increased decline in cognitive function14.

• Saturated fat has been associated with an increased risk of atherosclerosis15-17 and diabetes18 and may increase fat storage in your abdomen19, 20 (commonly referred to as ab flab).  Ab flab in and of itself increases the risk for heart disease, diabetes and Alzheimer’s disease.

• Studies have shown that eating red meat may increase the risk of colorectal cancer21-24, lung cancer (irrespective of smoking status)25, and has been linked to prostate cancer26.

• Recent studies show that red meat intake is associated with metabolic syndrome, stroke, cognitive decline and age related macular degeneration27-30.

• A study of over 500,000 people found that people who ate the most red and processed meats had a higher risk of mortality, cancer and cardiovascular disease31 than those who ate lesser amounts of these foods.

What does it mean?

Succinctly put: we eat too much meat: beef, steak, pepperoni, sausage, bacon, pork, lamb, ham, salami, hot dogs etc, butter, cheese, ice cream etc. Case in point:

• The average intake of meat in the U.S. in 2002 was 200 pounds per person, 23 pounds higher than in 197032

• American’s eat on average 33 pounds of cheese per person a year33

• In 2004 Americans consumed over 1.3 million pounds of butter34

Our bodies are not designed to handle such titanic amounts of saturated fat, processed or red meat.  Our bodies do not know we can order pizza 24/7 or go to a store filled with food any time we want.  Our bodies still believe we need to run out each morning and catch breakfast.  Thus drowning our systems with animal foods day after day leads to physiological dysfunction and disease.

Scientists have not pin pointed a single cause because there are probably a myriad of biochemical reasons why the human body cannot tolerate a constant assault of bad fat and meat.  Researchers are looking into how meat is processed, the iron content and other variables that may contribute to the deleterious effects of meat.  Some mechanisms have been identified for example, how saturated fat depresses LDL (bad) cholesterol receptors on hepatic and other cells leading to an increase in serum cholesterol35, but there remains much to be done in the scientific arena.

What you can do to protect your health starting today

Cut back on your intake of meat and other animal foods: how often you eat them and your portion size when you choose to eat them.  Start experimenting with beans, soy, nuts and nut butters such as peanut, almond and cashew butter, and low or non-fat dairy (low or non-fat means much of the saturated fat has been removed).  There are many delicious, easy to make vegetarian dishes including vegetarian chili, pasta primavera, veggie burgers, hummus in pita with chopped cukes & tomatoes, edamame-vegetable succotash and hearty lentil soup.  Do your body a favor by going meatless and cheeseless at least a few days a week.  Chances are you will lose pounds, gain energy and feel revitalized.  Your body will thank you year after healthy year.



1. Fung TT, Schulze M, Manson JE, Willett WC, Hu FB. Dietary patterns, meat intake, and the risk of type 2 diabetes in women. Archives of Internal Medicine 2004;164:2235-40.

2. Fung T, Hu FB, Fuchs C, et al. Major dietary patterns and the risk of colorectal cancer in women. Archives of Internal Medicine 2003;163:309-14.

3. Giovannucci E, Rimm EB, Stampfer MJ, Colditz GA, Ascherio A, Willett WC. Intake of Fat, Meat, and Fiber in Relation to Risk of Colon Cancer in Men. Cancer Res 1994;54:2390-7.

4. Cai H, Shu XO, Gao Y-T, Li H, Yang G, Zheng W. A prospective study of dietary patterns and mortality in Chinese women. Epidemiology 2007;18:393-401.

5. Hu FB, Rimm EB, Stampfer MJ, Ascherio A, Spiegelman D, Willett WC. Prospective study of major dietary patterns and risk of coronary heart disease in men. Am J Clin Nutr 2000;72:912-21.

6. Cho E, Chen WY, Hunter DJ, et al. Red meat intake and risk of breast cancer among premenopausal women. Archives of Internal Medicine 2006;166:2253-9.

7. Cui X, Dai Q, Tseng M, Shu X-O, Gao Y-T, Zheng W. Dietary Patterns and Breast Cancer Risk in the Shanghai Breast Cancer Study. Cancer Epidemiol Biomarkers Prev 2007;16:1443-8.

8. Cross AJ, Leitzmann MF, Gail MH, Hollenbeck AR, Schatzkin A, Sinha R. A Prospective Study of Red and Processed Meat Intake in Relation to Cancer Risk. PLoS Medicine 2007;4:e325.

9. Varraso R, Fung TT, Barr RG, Hu FB, Willett W, Camargo CA, Jr. Prospective study of dietary patterns and chronic obstructive pulmonary disease among US women. Am J Clin Nutr 2007;86:488-95.

10. Esposito K, Giugliano D. Diet and inflammation: a link to metabolic and cardiovascular diseases. Eur Heart J %R 101093/eurheartj/ehi605 2006;27:15-20.

11. Pirro Matteo, Schillaci Giusepps, Savarese Gianluca, et al. Attenutation of inflammation with short-term dietary intervention is associated with a reduction of arterial stiffness in subjects with hypercholesterolaemia. European Journal of Cardiovascular Prevention and Rehabilitation 2004;11:497-502.

12. Keogh JB, Grieger JA, Noakes M, Clifton PM. Flow-mediated dilatation is impaired by a high-saturated fat diet but not by a high-carbohydrate diet. Arteriosclerosis, Thrombosis & Vascular Biology 2005;25:1274-9.

13. Morris MC, Evans DA, Bienias JL, et al. Dietary Fats and the Risk of Incident Alzheimer Disease. Arch Neurol 2003;60:194-200.

14. Morris MC, Evans DA, Bienias JL, Tangney CC, Wilson RS. Dietary fat intake and 6-year cognitive change in an older biracial community population. Neurology 2004;62:1573-9.

15. Mustad VA, Etherton TD, Cooper AD, et al. Reducing saturated fat intake is associated with increased levels of LDL receptors on mononuclear cells in healthy men and women. Journal of Lipid Research 1997;38:459-68.

16. Kurzweil R. Live Forever. Psychology Today 2000;33:66.

17. Merchant AT, Kelemen LE, de Koning L, et al. Interrelation of saturated fat, trans fat, alcohol intake, and subclinical atherosclerosis. Am J Clin Nutr 2008;87:168-74.

18. Wang L, Folsom AR, Zheng Z-J, Pankow JS, Eckfeldt JH. Plasma fatty acid composition and incidence of diabetes in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Clin Nutr 2003;78:91-8.

19. Sung Jidong, DeRegis Jamie R, Bacher Anita C, et al. Lower Dietary Polyunsaturated to Saturated Fat Ratio Is Associated With Increased Visceral Adiposity. In: American College of Cardiology Annual Meeting  Lipids–Clinical and Prevention; 2003 March 30; Chicago.  Absrtact; 2003. p. Abstract.

20. Hays NP, Starling RD, Liu X, et al. Effects of an ad libitum low-fat, high-carbohydrate diet on body weight, body composition, and fat distribution in older men and women: a randomized controlled trial.[see comment]. Archives of Internal Medicine 2004;164:210-7.

21. Chao AP, Thun MJMDMS, Connell CJMPH, et al. Meat Consumption and Risk of Colorectal Cancer. JAMA 2005;293:172-82.

22. Lewin MH, Bailey N, Bandaletova T, et al. Red Meat Enhances the Colonic Formation of the DNA Adduct O6-Carboxymethyl Guanine: Implications for Colorectal Cancer Risk. Cancer Res 2006;66:1859-65.

23. Norat T, Bingham S, Ferrari P, et al. Meat, Fish, and Colorectal Cancer Risk: The European Prospective Investigation into Cancer and Nutrition. J Natl Cancer Inst 2005;97:906-16.

24. Jenab M, Ferrari P, Slimani N, et al. Association of Nut and Seed Intake with Colorectal Cancer Risk in the European Prospective Investigation into Cancer and Nutrition. Cancer Epidemiol Biomarkers Prev 2004;13:1595-603.

25. Alavanja MC, Field RW, Sinha R, et al. Lung cancer risk and red meat consumption among Iowa women. Lung Cancer 2001;34:37-46.

26. Kushi L, Giovannucci E. Dietary fat and cancer. American Journal of Medicine 2002;113 Suppl 9B:63S-70S.

27. Eskelinen Marjo H, Ngandu Tiia, Helkala Eeva-Liisa, et al. Fat intake at midlife and cognitive impairment later in life: a population-based CAIDE study. International Journal of Geriatric Psychiatry 2008;23:741-7.

28. Yamagishi K, Iso H, Yatsuya H, et al. Dietary intake of saturated fatty acids and mortality from cardiovascular disease in Japanese: the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC) Study. Am J Clin Nutr 2010;92:759-65.

29. Azadbakht L, Esmaillzadeh A. Red Meat Intake Is Associated with Metabolic Syndrome and the Plasma C-Reactive Protein Concentration in Women. J Nutr 2009;139:335-9.

30. Chong EWT, Simpson JA, Robman LD, et al. Red Meat and Chicken Consumption and Its Association With Age-related Macular Degeneration. American Journal of Epidemiology 2009;169:867-76.

31. Sinha R, Cross AJ, Graubard BI, Leitzmann MF, Schatzkin A. Meat Intake and Mortality: A Prospective Study of Over Half a Million People. Arch Intern Med 2009;169:562-71.

32. American Heart Association, American Stroke Association. Heart Disease and Stroke Statistics — 2008 Update.  Our Guide to Current Statistics and the Supplement To Our Heart and Stroke Facts. Dallas: American Heart Association, American Stroke Association; 2008 2008.

33. United States Department of Agriculture. Long-term growth in U.S. cheese consumption may slow. In: Davis Christopher G, Blaybey Don P, Dong Diansheng, Stefanova Stela, eds. Washington D.C.: Economic Research Service/USDA; 2010.

34. Understanding Dairy Markets: Sales and Consumption. Agriculltural and Applied Economics, 2010. (Accessed at

35. Schaefer EJ. Lipoproteins, nutrition, and heart disease. Am J Clin Nutr 2002;75:191-212.

Posted in Alzheimer's disease, Cancer, cardiovascular disease, Dementia, Diabetes, exercise, Food, Health, Nutrition, obesity, Uncategorized, weight management, Wellness | 1 Comment

Alcohol and Your Health: A Slippery Slope*


Samantha Heller MS RD

Alcohol makes you drunk, causes wicked hangovers and many regrets.  It is addictive. According to the Centers for Disease Control & Prevention 50% of adults in the U.S. are current, regular drinkers.  Chronic alcohol consumption can cause cirrhosis of the liver , progressive neurodegenerative disease1, obesity, vitamin deficiencies, high blood pressure and an increased risk of certain cancers including upper aerodigestive tract, rectum, liver, and breast2-4. In addition, prolonged or excessive alcohol intake has been associated with an increased risk of dementia.5 Alcohol consumption causes more than 100,000 deaths annually in the United States5.  Alcohol is high in calories. Per gram it has almost twice as many calories as protein or carbohydrates..  An article in the Journal of the American College of Cardiology sums up the effects of drinking alcohol nicely:

“Excessive alcohol intake increases the risks of motor vehicle accidents, stroke, cardiomyopathy, cardiac dysrhythmia, sudden cardiac arrest, suicide, cancer (most notably of the breast and gastrointestinal tract), cirrhosis, fetal alcohol syndrome, sleep apnea, and all-cause mortality.6

Thus it is natural for me to want to tell you not do drink alcohol at all.  But I have to be honest with you, there is an up side to drinking alcohol, especially wine.  It tastes good, goes great with food and has health benefits.

We have all heard that red wine is good for our heart. Scientists suggest drinking red wine decreases the risk of  cardiovascular disease and is healthy for our arteries7.  Alcohol contains antioxidants and other compounds like resveratrol that may be cardio protective as well as neuroprotective.  Research studies that have examined the relationship between alcohol consumption and dementia suggest that there might be an association between small to moderate amounts of alcohol and a reduced risk of dementia8.  For example:

  • The Nurses Health study found that in women, up to one drink per day does not impair cognitive function and may actually decrease the risk of cognitive decline9.
  • In patients with mild cognitive impairment, up to 1 drink/day of alcohol or wine may decrease the rate of progression to dementia10
  • A study with a 34 year follow up (a really long time in science) found that in women wine was protective of dementia but that beer and spirits may increase the risk of dementia11.
  • The Cardiovascular Health Study reported that compared with non-drinkers those who drank  1 to 6 drinks weekly had a lower risk of incident dementia among older adults12

To Drink or Not To Drink

The American Heart Association says that if you drink, do so “in moderation.”   The AHA says one drink is one 12 oz. beer, 4 oz. of wine, 1.5 oz. of 80-proof spirits, or 1 oz. of 100-proof spirits.  These days if a bartender poured you a 4 oz. glass of wine you’d think he was being chintzy.  Just look at the size of today’s wine glasses compared with 30 years ago.  So while some medical experts may recommend consuming alcohol moderately, the reality is very few people know what that means or can stick to it. My advice:  Do not start drinking alcohol if you do not drink now6.  If you do drink alcohol chances are you need to lower your intake.  It is a slippery slope for folks to only have one or two small drinks at a time.  Not many can limit themselves to that. In addition alcohol may interact with certain medications and increase the risk of liver damage.  If you are on any medications consult with your physician about drinking alcohol.

And NEVER drink and drive.  It is just not worth it.


1.            Balk EM, Raman G, Tatsioni A, Chung M, Lau J, Rosenberg IH. Vitamin B6, B12, and Folic Acid Supplementation and Cognitive Function: A Systematic Review of Randomized Trials. Arch Intern Med 2007;167:21-30.

2.            Beasley J, Coronado G, Livaudais J, et al. Alcohol and risk of breast cancer in Mexican women. Cancer Causes and Control 2010;21:863-70.

3.            Tjonneland A, Christensen J, Olsen A, et al. Alcohol intake and breast cancer risk: the European Prospective Investigation into Cancer and Nutrition (EPIC). Cancer Causes & Control 2007;18:361-73.

4.            Allen NE, Beral V, Casabonne D, et al. Moderate alcohol intake and cancer incidence in women. Journal of the National Cancer Institute 2009;101:296-305.

5.            Gunzerath L, Faden V, Zakhari S, Warren K. National Institute on Alcohol Abuse and Alcoholism report on moderate drinking. Alcoholism: Clinical & Experimental Research 2004;28:829-47.

6.            O’Keefe JH, Bybee KA, Lavie CJ. Alcohol and Cardiovascular Health: The Razor-Sharp Double-Edged Sword. J Am Coll Cardiol 2007;50:1009-14.

7.            Lippi G, Franchini M, Favaloro EJ, Targher G. Moderate red wine consumption and cardiovascular disease risk: beyond the “French paradox”. Seminars in Thrombosis & Hemostasis 2010;36:59-70.

8.            Peters R, Peters J, Warner J, Beckett N, Bulpitt C. Alcohol, dementia and cognitive decline in the elderly: a systematic review. Age Ageing 2008;37:505-12.

9.            Stampfer MJ, Kang JH, Chen J, Cherry R, Grodstein F. Effects of moderate alcohol consumption on cognitive function in women.[see comment]. New England Journal of Medicine 2005;352:245-53.

10.            Solfrizzi V, D’Introno A, Colacicco AM, et al. Alcohol consumption, mild cognitive impairment, and progression to dementia. Neurology 2007;68:1790-9.

11.            Mehlig K, Skoog I, Guo X, et al. Alcoholic Beverages and Incidence of Dementia: 34-Year Follow-up of the Prospective Population Study of Women in Goteborg. Am J Epidemiol 2008;167:684-91.

12.            Mukamal KJ, Kuller LH, Fitzpatrick AL, Longstreth WT, Jr., Mittleman MA, Siscovick DS. Prospective Study of Alcohol Consumption and Risk of Dementia in Older Adults. JAMA 2003;289:1405-13.

Posted in Alzheimer's disease, Cancer, cardiovascular disease, Dementia, Fitness, Health, Nutrition, obesity, Uncategorized, Wellness | 1 Comment

Trouser Trauma: A Seasonal Wake Up Call

Samantha Heller MS RD

When the season’s change inevitably I find myself deep in the midst of  trouser trauma.  Will the pants, capris or shorts from last season still fit?  Will they be tight around my waist or thighs?  I do not go through this with shoes.  My shoe size does not seem to change each year. Trousers, whatever their length, are ruthless in their assessment of body weight.   Sometimes I wait and make extra trips to the gym before I attempt a try on.  I asked my nutrition students about this phenomenon.  Surely I am not the only one who goes through this.  “Oh I totally go through that” says Marcy, a personal trainer.  “It freaks me out every time.”

How to avoid Trouser Trauma

Weigh yourself occasionally to catch, what I call, ‘creeping weight’. Once a week is good. Even two extra pounds a year will add up significantly over a few short years.  Ten pounds in five years.  Oy.

You are probably brilliant at rationalizing why you cannot button the pants that fit last year.  They shrunk at the dry cleaners or in the wash.  It  is water weight.  It was a holiday weekend.  I am just getting older and this is normal. It is muscle.  The pants were this tight last year.  Fuggedaboudit.  Face it.  You put on a  few pounds and will continue to do so if you do not get a handle on it right now.

What to do

Try to figure out where the extra calories are coming from.  Are you snacking more? Eating after dinner (this is a big one)?  Exercising less?  Consuming more alcohol than before?

Keep a food diary, which means writing down everything you eat  (everything.  even a stray cookie or handful of pretzels) for a week or so. This will really help you figure out what is going on.  You may be surprised to discover where the extra calories are coming from.

Take your workout up a notch.  If you are walking 30 minutes 3 days a week make it 5 days a week.

Add minutes.  If 30 minutes of cardio is getting pretty easy, add another 15 minutes. You can vary the intensity of your work out too.  For example,  alternating walking briskly for 5 minutes, then slower for 5 minutes.  If you are fit, then you can add a variety of interval training techniques to rev your workout, burn more calories and increase your level of fitness.

Pull out a tape measure.  Wrap it around your waist – not under it.  If your waist if even near 40” for men or 35” for women you are at serious risk for chronic diseases like diabetes and heart disease.

Don’t wash or dry clean all your pants or waist fitting clothes like skirts, at the same time.  It’s too easy to use that as an excuse that they all shrank.

Posted in cardiovascular disease, Diabetes, exercise, Fitness, Health, Nutrition, obesity, Uncategorized, weight management, Wellness | 2 Comments

Top 10 Grilling Tips to Avoid Carcinogens

Samantha Heller MS RD

For many of us summer is the season for outdoor BBQs, grilling and fun.  In fact we love grilling so much that the USDA reports that over half of Americans say they are cooking outdoors and grilling year round.  But there is a down side to grilling our favorite foods that you should know about.  Grilling meat, poultry and fish can create carcinogenic compounds.  Heterocyclic amines (HA) are formed when amino acids and other substances found in meats, poultry and fish are burned at high temperatures and are very well done.

Another carcinogenic substance, Polycyclic Aromatic Hydrocarbons (PAH) is formed when fat or juice from meats drip onto hot coals and burns  The PAHs rise with the smoke and are deposited on the surface of the food; not just the meat but any food near enough to it on the grill to be affected.  PAHs can also form directly on the food when it is charred.  Here are ten easy steps you can take to make your grilling safer and healthier.  Plus a bonus section on fun foods to add to your grilling repertoire.

Tips for Safe Grilling

Clean the grilling surface before placing any foods on it.  Don’t just wipe it off. Really clean it.

If you’re using charcoal, let the excess starter fluid burn off before putting food on the grill.

Never squirt starter fluid on smoldering charcoal. It can cause an explosion.

Defrost meat in the refrigerator before grilling. If you try to grill frozen meat the outside chars while the interior remains cold.

After grilling, always remove blackened or charred material from the food’s surface.  Or at least some of it.

Choose lean cuts of meat and trim all excess fat from meat.

Use tongs or a spatula to turn foods. A fork can pierce meat and allow juices and fat to cause the flames to flare-up

Keep smoke away from cooking foods by covering the grill with aluminum foil punched with holes.

Partially pre-cook foods my microwaving, boiling or broiling before grilling.  Less time on the BBQ means fewer carcinogens are formed

Marinating foods in low or non fat marinades using vinegar or lemon, prior to grilling may help protect them from the formation of carcinogenic substances.

Fun Grilling Ideas

Go radical and grill healthy new foods like zucchini, eggplant, mushrooms, corn, carrots, and tomatoes. Grilled vegetable kabobs are fun for kids and adults.

Skip the meat all together and grill tofu or veggie burgers

For a sweet, melt in your mouth dessert: grill fruits like figs, peaches, pineapple or even berries. Strawberries and other small pieces of fruit can be folded in aluminum foil so they don’t fall through the grill grates.  Add to low or non fat vanilla yogurt (frozen or regular) for a delicious dessert.

For more safe grilling tips go to:

Posted in Cancer, Food, Health, Nutrition, Uncategorized, Wellness | 4 Comments