Oranges vs OJ

Good morning and Happy Monday! How was your weekend? Did you manage to fit in some exercise? How was your motivation in the cold temperatures?

Speaking of cold, now that the temperature has dropped a few degrees, it will be important to try to avoid winter colds.  A lot of people reach for orange juice to boost their Vitamin C intake.  However drinking juice is not necessarily the best way of increasing your Vitamin C.
 
Instead, increase your fluid intake, eat more vegetables that are high in Vitamin C (particularly red peppers, kale and broccoli) and sleep more to help prevent colds.
 
Fruit juice is often in debate about whether it is healthy or not, especially for those trying to lose weight.  If you want to lose weight or are struggling to keep consistent weight loss, the best advice I can give you is to avoid fruit juice.  Fruit juices are high-carbohydrate and high-sugar. Even though they’re “good for you” there are better sources of nutrients with much less sugar (or none at all).  Eat fruit and vegetables, don’t drink them.  

But why is orange juice not ideal to be having regularly?
 
The key issue is a lack of fibre. When we eat fruit, the fibre forms a protective layer that acts as a barrier to the intestine, slowing down the absorption of sugar. The high sugar content obtained from the digestion of fruit juice can elevate your blood sugar levels, which in turn stimulate your pancreas to produce insulin. The more carbohydrates you eat at once, the higher your insulin levels are likely to increase. For example, your insulin levels will increase more after having a large banana and orange juice compared to after eating an egg and glass of milk, which is much lower in carbohydrate. Having other carbohydrates at the same time, such as a  a slice of bread or cereal, can also further increase your insulin levels.  If this blood sugar is not used for activity/body function, it may get stored as fat to use 'later'.  If you are very active or not trying to lose weight, this is not generally a problem as you are using the energy that you are consuming.

Oranges themselves are an excellent source of vitamin C, just one large orange contains a full day’s dose. Vitamin C is critical for producing white blood cells and antibodies that fight off infections; it’s also a powerful antioxidant that helps protect cells from free-radical damage and plays a key role in producing skin-firming collagen.

Oranges are also high in fiber and folate.  They contain on average:

60 calories for one, 12.5g of sugar, 3.1g fibre
116% of your recommended intake of Vitamin C.

Compare this to orange juice:
 
250ml: 125 calories, 25g of sugar, 0.6g of fibre
200% of your daily recommendation of Vitamin C.
 
Compare this to 1 slice of wholemeal bread (which people often cut out to try to reduce carbs):
 
80 calories, 15g of carbohydrates, 1.5g sugar, 2g of fibre

Please do ask me any questions at all if you want to know more.

Have a 

Just how important is diet and exercise to improve your heart?

Good morning and Happy Wednesday! I hope you've had a great week so far. We've had a busy week here at Clinical Exercise - lots of new enquiries, lots of fab chat over on our Healthy Hearties Facebook group, a HUGE batch cooking session on Monday (fish pie, fish chowder and fish cakes - yes a lot of fish this week!) and an old client has returned from overseas and is getting restarted on his exercise programme.

This week I'm talking all about Heart Health - obviously I'm always talking about heart health but I wanted to really focus on what you can do to ensure you are reducing your risk of having future heart problems.  This is particularly relevant if you have a history of heart problems in the family or if you are recovering from a heart event or currently have a heart condition.

There are so many do's and don'ts to look after your heart - below are the top 5 things you should be doing to ensure your heart is in tip top condition.

Also, this week I have a simple exercise that you can do any time of day to tone up the back of your arms - easy!

Looking after your heart

Cardiovascular disease (heart disease) is the world’s biggest killer, causing over 17 million deaths a year and many of these deaths are preventable through lifestyle changes.

Most people know someone or have themselves been directly affected by heart disease and a lot of times it is avoidable by changing lifestyle habits. If you've had heart problems in the past it's never to late to make improvements to improve your health for the future.

Simple changes in diet by reducing your salt intake and eliminating processed foods from your diet and trying to get a couple of hours of exercise a day can make a huge difference.
 
A healthy diet reduces the risk of coronary heart disease and prevents weight gain which puts pressure on your heart, the introduction of a healthy diet also helps to prevent further worsening of existing heart disease and it’s not too late to start eating healthily.
 
To help prevent heart disease here are five ways to change your lifestyle and take better care of your heart.

1. Follow the Mediterranean diet

A 2013 study showed the Mediterranean diet reduces the risk of coronary heart disease by 30% and prevents weight gain which puts pressure on your heart, the diet also helps to prevent further worsening of existing heart disease and it’s NEVER too late to start eating healthily. Recent attention has been drawn to the benefits of the Mediterranean diet by cardiologist Aseem Malhotra who has recently filmed the ‘Cereal Killers Movie’ about his quest to find out the secret to a long life in the Mediterranean. Check it out here.

2.  Reduce salt
 
Too much salt can cause high blood pressure, which increases the risk of developing coronary heart disease. Reduce your consumption of crisps, take aways, packaged snack foods and processed sauces. As a cardiac nurse this is one of the biggest misconceptions people have – they think if they don’t add salt to their food then their diet is low in salt.  However salt is hidden in so many things you wouldn’t even think – cans of tuna, ham, tomato paste and roasted peanuts.  Always check the label – if a serving size contains more than 10% of your daily recommended intake, avoid or reduce the amount you have.

3.  Say no to processed foods
 
There are lots of hidden saturated fats, sugars and salts in processed food, fast food and ready meals.  Even foods that may appear ‘healthy’ traditional meals such as lasagne are usually made with cheap ingredients and are laden with salt. I would strongly advise people to check the content of the ingredients of any food they buy and start cooking from scratch together – it’s more fun too!

4.  Quit smoking
 
Smokers are twice as likely as non-smokers to have heart disease with all the health issues it causes it is the most important thing you can do for your heart. Try a nicotine replacement to reduce your cravings – electronic cigarettes, patches, gum or lozenges are a great help when you’re quitting.

5.  Exercise more

The heart is the most important muscle and just a small amount of exercise will keep it functioning properly. Exercising for as little as ten minutes a day can make a huge difference. If you haven’t exercised for some time start out with gentle walking and build up – we should be aiming for a minimum of 30 minutes of exercise 5 days per week.

Aim to improve in one of the above areas each week and you’ll soon be on your way to a healthy heart.

Let me know if you have any specific questions at all!

Exercise of the week - Tricep Dips

1.  Sit up straight on the long edge of a stable, heavy chair or a bench. Your legs should be slightly extended, with your feet flat on the floor.
2. Place your hands on both sides of the bench just outside your thighs. Your palms should be down, fingertips pointing towards the floor.
3. Without moving your legs, bring your bottom forward off the bench.
4. Steadily lower yourself. Beginners: Bend your elbows 1-2 inches and push yourself back up. Advanced: When your elbows form 90˚ angles, push yourself back up to starting position.
5. Repeat up to 10 reps, rest and then repeat up to 2-3 times.

Some people find that this exercise is too much on their wrist joints. If so, you may need to change the exercise to triceps kickbacks, which we will cover in the next couple of weeks.

Do let me know if you have any questions at all!

Eggsellent breakfast ideas!

Good morning and Happy Wednesday! I hope you are having a great week so far.

I'm keeping this week's email short and sweet - I've just read some statistics that Wednesdays are the most productive of the week and you are all busy with heads down on a Wednesday! Apparently the least productive day is a Monday morning (obvious!) followed by Thursday and Friday afternoons. Let me know if that's true for you too!

If I can get organised enough then next week's email should be hitting you on a Monday morning :)

Food of the week

This week’s ‘Food of the Week’ is the humble egg.  Now, eggs have received a bad rep over the last few years – often overlooked for their fat content and deemed as bad for the cholesterol, people often shy away from eating eggs.

It was previously thought that eggs raised blood cholesterol levels - one of the main causes of heart disease. The yolk in a single large egg contains five grams of fat, so it was only natural for nutritionists to assume that eggs clogged up people's arteries, especially since they also contain dietary cholesterol. 
 
However, evidence is now showing that eating a lot of dietary cholesterol doesn't increase blood cholesterol.  A 25-year study revealed that people who consume two eggs each day with low-fat diets do not show signs of increased blood cholesterol levels. https://www.hsph.harvard.edu/nutritionsource/eggs/
 
So what does raise blood cholesterol? One of the main theories is that saturated fat does.  Of the three types of fat (saturated, monounsaturated and polyunsaturated), saturated fat raises blood cholesterol and LDL (bad cholesterol) levels.  It so happens that eggs contain mostly polyunsaturated fat, which can actually lower blood cholesterol if one replaces food containing saturated fat with eggs.
 
Other benefits of eating eggs are below:

• Eggs are great for the eyes.  According to recent studies, an egg a day may prevent macular degeneration and cataracts due to the carotenoid content, specifically and zeaxanthin.  Both nutrients are more readily available to our bodies from eggs than from other sources.
• One egg contains 6 grams of high-quality protein and all 9 essential amino acids
• According to a study by the Harvard School of Public Health, regular consumption of eggs may help prevent blood clots, stroke and heart attack.
• Eggs are a good source of choline, which is an important nutrient that helps regulate the brain, nervous system, and cardiovascular system.
• Eggs contain the right kind of fat.  One egg contains just 5 grams of fat and only 1.5 grams of that is saturated fat.  One egg (including yolk) contains 90 calories – a hardboiled egg is the perfect snack!
• Eggs are one of the only foods that contain naturally occurring vitamin D, something most of us are deficient in if we don't get enough sunlight
• Eggs promote healthy hair and nails because of their high sulphur content and wide array of vitamins and minerals.  Many people find their hair growing faster after adding eggs to their diet, especially if they were previously deficient in foods containing sulphur or B12. 

Having eggs for breakfast once or twice a week, a hard boiled egg for a mid morning snack regularly and having an omelette for dinner once a week is a way of bringing more eggs into your diet.  Having them as part of a full English breakfast is not what I'm promoting!

Try the following tasty breakfasts:

• 2 eggs scrambled with one large slice smoked salmon and 1/4 avocado
• 2 poached eggs on 1 piece rye bread
• 2 eggs whisked with a splash of milk - pour into a medium heat pan with some melted coconut oil, sprinkle over some chopped veg - spinach,peppers, mushroom etc. Cook until bottom is set and top is still runny, then place under grill for 2-3 minutes until top is also cooked. Easy omlette!

Let me know any other ideas you have.

Have a wonderful week and see you soon!

Mike's journey - week 1

Meet Mike - he's your typical British gentleman, opening doors for ladies, offering cups of tea on arrival and generally an all round nice guy. Only thing is - his confidence has been shaken. Badly. He retired two years ago from running a successful dental practice and was enjoying the new freedom that not having to work brings - games of golf every Wednesday, laps of the pool each morning and visiting old friends in new countries.

Until April this year Mike felt great - everything was going to plan and he had a deposit down for a month long cruise Russia and Japan booked. He didn't look in bad shape for his age (70) and his wife was busy planning their social calendar for the summer.

In late April, however, after a two day dental conference in London (just keeping in touch with old colleagues and on top of new trends), Mike returned home to his house in Surrey and was gripped with a strange sensation when he walked through the front door. At first he thought he was having a heart attack, as something was not right with his heart. Being in the medical profession he has all manor of gadgets in the house and so took his blood pressure and pulse. His blood pressure was pretty good - 130/80, nothing to get worried about. However his pulse was unreadable on the machine. His wife took it manually and found it was very difficult to count. In fact, it was going so fast and wasn't regular at all so she couldn't count it quick enough. 

Mike could feel the thumping of his heart rate in his chest and knew that it was most likely he was in an irregular heart rhythm. A trip to the GP (lucky they could squeeze him in that afternoon) and an ECG showed that Mike was in Atrial Fibrillation. Often called AF, it is the most common heart arrhythmia in the UK, with up to 1 million people in the UK who are affected.

You can read more about what AF is, what the symptoms are and how it can be treated here.

Atrial fibrillation isn't usually life-threatening, but it can be uncomfortable and often requires treatment.  Treatment may involve: 

• medication to prevent a stroke (people with atrial fibrillation are more at risk of having a stroke)
• medication to control the heart rate or rhythm
• cardioversion – where the heart is given a controlled electric shock to restore normal rhythm
• catheter ablation – where the area inside the heart that's causing the abnormal heart rhythm is destroyed using radiofrequency energy

Mike was given blood thinners to prevents stroke, a beta blocker to reduce his heart rate and amioderone to control the rhythm. After a few days Mike felt a lot better and started to return to his normal activities. However he never felt confident enough to return to exercise.

After a few months of the AF coming back every few days, Mike decided to have the AF treated with ablation, a procedure that requires a one night hospital stay and two weeks recovery. The procedure was a success and Mike was told he was safe to return to his normal life, including exercise.

That is where I came in. After the ablation, Mike wasn't sure where to start. He had the motivation to exercise, but was missing the confidence and knowledge of how, when and for how long to exercise.

This week was a fact finding session - we did a lot of talking, goal setting and really getting to the nitty gritty of what Mike would like to achieve. He had a lot of questions about the ablation, medications and what exercise would be realistic to return to. 

We now have a plan in place - I'm very much looking forward to helping Mike get up and going. He already has his homework for this week (wear a step counter every day to see how much incidental activity he is doing) and our first session will involve a little bit of cardio and a little bit of weights. Within 6 weeks Mike will feel so much more confident about exercising himself and within 12 weeks he will feel a new man. 

I look forward to keeping you posted on how Mike gets on!

Read all about Week 2 HERE!

p.s this isn't a picture of Mike. Although he does have great teeth!

What are my top 5 HEART HEALTH TIPS?

Good morning and Happy Thursday! I hope you've had a great week so far. We've had a busy week here at Clinical Exercise - lots of new enquiries, a HUGE batch cooking session on Monday (fish pie, fish chowder and fish cakes - yes a lot of fish this week!) and an old client has returned from overseas and is getting restarted on his exercise programme.

This week I'm talking all about Heart Health - obviously I'm always talking about heart health but I wanted to really focus on what you can do to ensure you are reducing your risk of having future heart problems.

There are so many do's and don'ts to look after your heart - below are the top 5 things you should be doing to ensure your heart is in tip top condition.

Also, a simple exercise that you can do any time of day to tone up the back of your arms - easy!

Looking after your heart
(It's the only one you've got!)

Cardiovascular disease (heart disease) is the world’s biggest killer, causing over 17 million deaths a year and many of these deaths are preventable through lifestyle changes.

Most people know someone or have themselves been directly affected by heart disease and a lot of times it is avoidable by changing lifestyle habits. If you've had heart problems in the past it's never to late to make improvements to improve your health for the future.

Simple changes in diet by reducing your salt intake and eliminating processed foods from your diet and trying to get a couple of hours of exercise a day can make a huge difference.
 
A healthy diet reduces the risk of coronary heart disease and prevents weight gain which puts pressure on your heart, the introduction of a healthy diet also helps to prevent further worsening of existing heart disease and it’s not too late to start eating healthily.
 
To help prevent heart disease here are five ways to change your lifestyle and take better care of your heart.

 
1. Follow the Mediterranean diet
 
A 2013 study showed the Mediterranean diet reduces the risk of coronary heart disease by 30% and prevents weight gain which puts pressure on your heart, the diet also helps to prevent further worsening of existing heart disease and it’s NEVER too late to start eating healthily. Recent attention has been drawn to the benefits of the Mediterranean diet by cardiologist Aseem Malhotra who has recently filmed the ‘Cereal Killers Movie’ about his quest to find out the secret to a long life in the Mediterranean. Check it out here.

2. Reduce salt
 
Too much salt can cause high blood pressure, which increases the risk of developing coronary heart disease. Reduce your consumption of crisps, take aways, packaged snack foods and processed sauces. As a cardiac nurse this is one of the biggest misconceptions people have – they think if they don’t add salt to their food then their diet is low in salt.  However salt is hidden in so many things you wouldn’t even think – cans of tuna, ham, tomato paste and roasted peanuts.  Always check the label – if a serving size contains more than 10% of your daily recommended intake, avoid or reduce the amount you have.

3. Say no to processed foods
 
There are lots of hidden saturated fats, sugars and salts in processed food, fast food and ready meals.  Even foods that may appear ‘healthy’ traditional meals such as lasagne are usually made with cheap ingredients and are laden with salt. I would strongly advise people to check the content of the ingredients of any food they buy and start cooking from scratch together – it’s more fun too!

4. Quit smoking

 
Smokers are twice as likely as non-smokers to have heart disease with all the health issues it causes it is the most important thing you can do for your heart. Try a nicotine replacement to reduce your cravings – electronic cigarettes, patches, gum or lozenges are a great help when you’re quitting.

5. Exercise more
The heart is the most important muscle and just a small amount of exercise will keep it functioning properly. Exercising for as little as ten minutes a day can make a huge difference. If you haven’t exercised for some time start out with gentle walking and build up – we should be aiming for a minimum of 30 minutes of exercise 5 days per week.

Aim to improve in one of the above areas each week and you’ll soon be on your way to a healthy heart.

Let me know if you have any specific questions at all!
 

Exercise of the week - Tricep Dips

1.  Sit up straight on the long edge of a stable, heavy chair or a bench. Your legs should be slightly extended, with your feet flat on the floor.
2. Place your hands on both sides of the bench just outside your thighs. Your palms should be down, fingertips pointing towards the floor.
3. Without moving your legs, bring your bottom forward off the bench.
4. Steadily lower yourself. Beginners: Bend your elbows 1-2 inches and push yourself back up. Advanced: When your elbows form 90˚ angles, push yourself back up to starting position.
5. Repeat up to 10 reps, rest and then repeat up to 2-3 times.

Some people find that this exercise is too much on their wrist joints. If so, you may need to change the exercise to overhead triceps extensions, which we will cover in the next couple of weeks.

Do let me know if you have any questions at all!

Healthy food myths....busted!

Good morning and Happy Tuesday!  I hope you had a wonderful weekend. Please do keep sending me new ideas and questions for my weekly email as it is very useful to base these on your queries. Thank you so much for your fabulous reviews - I feel honoured to have helped so many people and am glad that you've found me so helpful :)

There are many different views, stories, myths and scare tactics amongst the media when it comes to food. One week coffee is good, the next week it is bad.  I thought I would put down a list of some of the myths and questions that come up and what the latest research shows.

Does olive oil prevent heart disease?

Short answer: Yes. The health benefits of olive oil come from the presence of polyphenols, antioxidants that reduce the risk of heart disease and some cancers. But to get these healthy compounds, consumers should buy good-quality, fresh "extra-virgin" olive oil, which has the highest polyphenol content.  Try having a sprinkle on your salads to increase your intake of good fats.

Do drinks high in sugar lead to diabetes?

Short answer: Yes. The majority of health research has shown soft drinks and high sugar juices to be bad to our health. A 2004 study in the Journal of the American Medical Association found that those who drank one or more sugary drinks per day increased their risk of developing type 2 diabetes by 83% compared to those who consumed less than one of these beverages per month.

Do nuts make you fat?

Short answer: No. As much as 75% of a nut is made up of fat.  But eating fat doesn't necessarily make you fat.  The bigger factor leading to weight gain is portion-size.  Luckily, nuts are loaded with healthy fats that keep you full and (hopefully) prevent you from overeating.  They're also a good source of protein and fiber. Stick to 10-15 nuts in one serving, which is around 150-300 calories, depending on the type of nut (cashews are one of the lowest, macadamias are the highest).

Is walking as effective as running?

Short answer: Yes. Studies have shown that how long you exercise is more important than how hard you exercise.  Running is a more efficient form of exercise, but not necessarily better for you. A six-year study published in the journal Arteriosclerosis, Thrombosis and Vascular Biology found that walking at a moderate pace and running produced similar health benefits, so long as the same amount of energy was expended. Walking the same distance is as good as running, it just takes longer!

Is drinking fruit juice as good for you as eating fruit?

Short answer: No. Calorie for calorie, whole fruit provides more nutritional benefits than drinking the pure juice of that fruit.  That's because when you liquefy fruit and throw away the pulp, many ingredients like fiber, calcium, vitamin C and other antioxidants are lost. For comparison, a 200ml glass of orange juice contains 120 calories and 30 grams of sugar but only 0.3 grams of dietary fiber and 16 milligrams of calcium, whereas one orange contains 60 calories, 12 grams of sugar but has 3.1 grams of fiber and 60 milligrams of calcium.

Are all wheat breads better for you than white bread?

Short answer: No. Not all wheat breads are created equal. Wheat breads that contain all parts of the grain kernel, including the nutrient-rich germ and fiber-dense bran, must be labeled "whole grain" or "whole wheat." Some wheat breads are just white bread with a little bit of coloring to make the bread appear healthier, so keep an eye out for the words ‘whole grain/whole-wheat’ to ensure you receive all the benefits. In fact, give most breads a miss altogether - have you looked at the ingredient list lately? 

Does coffee cause cancer?

Short answer: No. Coffee got a bad reputation in the 1980s when a study linked drinking coffee to pancreatic cancer, however research since then has disproved this.  More recently, health studies have swung in favor of the caffeinated beverage. Coffee has been linked to a lower risk of type 2 diabetes, Parkinson's disease and liver cancer.  One to two coffees per day is fine, any more and you start to rely on caffeine for your energy levels, can cause your blood pressure to rise and adversely affect your sleep.

Do eggs raise cholesterol levels?

Short answer: No. Although egg yolks are a major source of cholesterol, researchers have learned that saturated fat has more of an impact on cholesterol in your blood than eating foods that contain cholesterol. Healthy individuals with normal blood cholesterol levels should now feel free to enjoy foods like eggs in their diet every day, the lead researcher from a 25-year on cholesterol concluded. One to two eggs on several days per week is a healthy addition to your diet. Try having scrambled or poached eggs for breakfast when you have more time, have an egg sandwich for lunch one or two days or make an omelette for dinner one night per week.

Can yogurt ease digestive problems?

Short answer: Yes. Our digestive tract is filled with microorganisms — some good and some bad. Yoghurt, especially natural yoghurt, contains beneficial bacteria, which helps to maintain a healthy balance in the gut. Probiotics can also relieve several gastrointestinal problems, including constipation and diarrhoea.

Is red wine better for you than white wine?

Short answer: Yes. Red wine contains much more reservatrol than white wine, which is an antioxidant found in the skin of grapes that has been shown to fight off diseases associated with ageing.
Here is a link to some more myths and old wives tales - http://www.realbuzz.com/articles/10-health-myths-busted/

Have a fantastic week and do keep your suggestions coming! 

Angela