I feel very fortunate to have had the opportunity to meet and work with numerous health, fitness and weight loss professionals in recent years. Being able to pick their brains was a great help in creating a weight control system that worked for me. This page is dedicated to sharing their knowledge in hopes of providing creative insight for the development of your own weight control system.

Mary Toomey has an incredible job. She gets to meet new people all the time and help them realize incredible personal goals as a director of the Train To End Stroke program for the American Stroke Association, a division of the American Heart Association. The ASA focuses on reducing disability and death from stroke through research, education, fundraising and advocacy. Toomey's position encompasses all these things, which is exactly why I asked her to share some basic facts with us about stroke and stroke prevention.

Stroke is the third leading cause of death in our country today, behind heart attack and cancer. What are the risk factors involved and what preventative measures should we be taking?

Risk factors are traits and lifestyle habits that increase the risk of disease. Extensive clinical and statistical studies have identified several factors that increase the risk of stroke. Most of them can be modified, treated or controlled. Some can't.

The more risk factors you have, the higher your chances to have a stroke. The best way to prevent a stroke is to reduce your stroke risk factors. A health care provider can help you change factors that result from lifestyle or environment.

Risk Factors of Stroke

What are the factors you can't change?

What are the symptoms of stroke?

The symptoms of stroke are:

Sudden, severe headache with no known cause Transient ischemic attacks (TIAs) - TIAs are "warning strokes" that produce stroke-like symptoms but no lasting damage. Recognizing and treating TIAs can reduce your risk of a major stroke. It's very important to recognize the warning signs of a TIA or stroke.

What should someone do if they have one or more of these symptoms?

If you or someone with you has one or more of these signs, don't delay! Immediately call 9-1-1 or the emergency medical services (EMS) number so an ambulance (ideally with advanced life support) can be sent for you. Also, check the time so you'll know when the first symptoms appeared. It's very important to take immediate action. If given within three hours of the start of symptoms, a clot-busting drug can reduce long-term disability for the most common type of stroke.

What progress, if any, has been made in stroke recovery?

Cholesterol-lowering drugs - called statins - reduce the risk of heart disease, but this research indicates that they may also protect against damage caused by ischemic stroke. Ischemic strokes result from a blood clot that blocks blood flow to the brain.

In a study of 167 stroke patients (average age 70), those taking statins at the time of an ischemic stroke were better able to care for themselves and be functionally independent three months later than those not taking that class of drugs, said study lead author, Joan Martí-Fabregas, M.D., Ph.D., of Servei de Neurologia at the Hospital de la Santa Creu i Sant Pau in Barcelona, Spain.

Thirty patients had been treated with statins and 137 had not. Symptoms of neurological deficits were essentially the same between both groups at the time of admission. All patients had a computed tomography or magnetic resonance imaging of their brain to determine the presence of an ischemic stroke.

Three months after stroke, recovery was significantly higher among patients who had been taking statins. Using the neurological functioning scale called the Barthel Index, 76.7 percent of survivors who had been taking statins were living without significant disability, compared to 51.8 percent of those not taking statins.

I read an article recently that cinnamon can help control blood glucose. Are there any specific foods that can help ward off stroke?

Researchers found that people who consumed at least 300 micrograms (mcg) of folate per day had a 20 percent lower risk of stroke and a 13 percent lower risk of cardiovascular disease than those consuming less than 136 mcg of folate per day. The findings accounted for other heart disease risk factors such as cholesterol, blood pressure, smoking, and obesity.

Folate is a B-vitamin found in citrus fruits; tomatoes; leafy green vegetables such as spinach and romaine lettuce; pinto, navy, and kidney beans; and grain products. Since January 1998, wheat flour has been fortified with folic acid, the synthetic form of folate, to add an estimated 100 mcg per day to the average diet.

Please tell us about your program, "Train to End Stroke".

The Train to End Stroke program is a team marathon training program benefiting the American Stroke Association, a division of the American Heart Association. It's about being a champion for men, women and children who have experienced a stroke. At the end of the program participants travel to one of several fantastic locations where they run or walk in a full or half marathon -- on us!

Completing a marathon is a life-changing event. So is a stroke.

The program runs in four to five month cycles year round. During the training period, participants enjoy:

The current training season will have participants traveling to either San Diego, California or to Kona, Hawaii in June. The next cycle begins in August, when we will be traveling in January to Phoenix and Bermuda.

For more information about Mary's program in the Chicago area check out their website at www.ttes.kintera.org/chicagoil or email Mary at: Mary.Toomey@heart.org.

For information on the American Stroke Association programs and events available on a nationwide basis visit: local.strokeassociation.org to find out what's happening near you!

Christine Jeffers had been in the graphics field for a good number of years and was looking for a career change. She felt sitting in front of a computer for 8 to 10 hours a day was not a healthy lifestyle, even though she competed in triathlons, ran 5K races and maintained a vegetarian diet outside of work. Her interest in Eastern philosophy led her to explore the art of Shiatsu, which proved to be a perfect fit for her personally and professionally. Once she enrolled in Ohashiatsu Chicago to study Shiatsu massage and philosophy, Christine immediately fell in love with the physical and mental aspects of the ancient Oriental art.

As a Shiatsu therapist,member of the ABMP [Association of Bodywork & Massage Professionals] and an ACE [American Council on Exercise] Certified Personal Trainer. Jeffers now devotes herself to shiatsu massage and education. She conducts private and group therapy sessions, corporate on-site massage and seminar programs, is the health/fitness writer for Chicago Jazz Magazine and founded a website dedicated to promoting the art. ( Go to: www.chicagoshiatsu.com ).

In addition to thanking Chris for doing this interview with me, I am also grateful to her for the many hours of sweat she put in getting Scale It Down on line, back in her 'graphic' hey days.

What exactly is, Shiatsu?

Shiatsu is a healing art that has been practiced in Japan for over 5,000 years. Shi means finger and atsu means pressure. Shiatsu was originally developed in China before acupuncture and was used to prevent disease by promoting the body's natural healing abilities. In China, a doctor was paid until his patient became ill. Can you imagine that kind of policy in effect now!

What is the philosophy of Shiatsu and why is it important?

Shiatsu focuses on the entire body - physical, emotional and energetic. The philosophy behind Shiatsu is that humans are not separate from nature; we are a part of it. Shiatsu takes into consideration the seasons, lunar cycles and other natural occurrences which create energetic, physical or emotional imbalances. It is not just a massage modality, it is an entire philosophy.

Shiatsu is unlike other forms of general massage because it uses the same 5 Element (Fire, Earth, Metal, Water, Wood) Principles as acupuncture and Feng Shui. A shiatsu therapist balances the energy in the meridians - channels of energy. Meridians are related to the 5 Elements which also represent emotions, visceral organs of the body, sense organs of the body, tastes, colors, seasons, directions, time of day, etc. General message targets the balance of the body only, while Shiatsu therapy focuses on the emotional and energetic aspects as well.

Shiatsu acts on the "ki" (chi, prana), or life essence which maintains and nurtures our physical body, mind and spirit. Any type of "dis-ease" is a sign that the energy or ki is out of balance, one part of the body has an excess or too much ki, while another part of the body is ki deficient. A combination of techniques including gradual stretches and pressure, holding, rhythmic rotations and spinal manipulations are used to encourage the flow of ki back to the deficient area. The return of ki to the deficient or "kyo" areas will disperse the ki stagnations or "jitsu" areas.

Many people look upon 'getting a massage' as something you do when stressed out only. Can Shiatsu therapy also work preventatively?

Shiatsu is used to prevent disease by promoting the body's natural healing abilities. Consistent regular shiatsu sessions have many benefits which can prevent illness.

What are the benefits that Shiatsu provides?

The many benefits of shiatsu are:

How is the therapy performed and what type of program would you recommend?

Shiatsu is performed on a futon on the floor with the receiver fully clothed. Shiatsu focuses on the entire body, not just the upper back and shoulders, as other forms of massage do.

A shiatsu program would depend on each individual's lifestyle and goals. If an individual is very imbalanced, with disease and/or healing an injury, they need to receive sessions weekly. Healthy people can receive sessions every two weeks or every month. Proper nutrition, exercise and meditation or other spiritual development should also be included.

Because Shiatsu massage is highly portable, (it can be done most anywhere, taking up little space and safeguarding privacy without the need for disrobement), group and corporate programs are easily achieved. Home party massage has become a trend in recent years, and is highly affordable to the participants. Stress Management Sessions as short as 20 minutes offered in the workplace on a weekly or bi-weekly basis can have a great impact on employee health and welfare.

For more information about Shiatsu and other healing arts, visit www.chicagoshiatsu.com or email Christine at: chicagoshiatsu@yahoo.com. Chicago area residents interested in individual and group massage appointments can call her direct at: 847-322-8687. Corporate info is posted at: http://chicagoshiatsu.com/onsite..htm

Sue Garcia is president of Sue Garcia Fitness, Inc., a group fitness contracting company based in the Chicago suburb of Schaumburg, Illinois. Sue and her employees teach small and large group exercise classes for corporate and community clients throughout the Chicago land area. A former educator, Sue is AEA, AFFA, SCW and Johnny G. certified. Her credentials also include Pilates, group instruction and personal training.

I met Sue when I signed up for her Pilates class. I liked her immediately, because she has a warm personality and does a great job at making a difficult exercise regimen easy to follow - especially for those of us who are fitness challenged, so to speak. (Imagine her surprise, when her least impressive Pilates student approached her to do a website interview!)

What are your recommendations for exercise frequency and recovery when ill with a flu, cold, etc.?

When recovering from an illness, getting well should be the first priority. All unnecessary physical activity should be put on hold until your body is feeling better. Once you are up and about on a regular routine, you can slowly bring exercise back into your routine. Don't expect to workout at 100%. It is unreasonable and may cause additional recovery time. The longer you abstained from working out, the slower you should take to get back to 100%. Listen to your body-if you feel wiped out after a workout, don't push so hard next time. You can always add more to your next workout, but you can't take away the possible negative effects of working out too much. TAKE IT SLOW, THERE'S NO HURRY!

Do you feel there are limitations for Seniors, with regards to performing fitness routines such as: pilates, yoga, strength and resistance training and the like? What suggestions would you make to seniors who want to do more than stroll around the Mall?

Cross training is great for seniors, as well as for all populations. Seniors should follow the accepted guidelines from the American College of Sports Medicine (ACSM). The following are recommended on the development of cardio respiratory fitness, resistance training and flexibility training:

Cardio Respiratory Fitness Frequency: 3 - 5 days/ week Duration: 20 - 60 minutes of continuous or intermittent aerobic activity

Resistance Training Frequency: 2 - 3 days/ week Duration: Minimum of 8 - 10 exercises that condition the major muscle groups is recommended, with a minimum of 1 set of 8 - 12 reps or to near fatigue: FOR OLDER ADULTS, 10 - 15 REPS MAY BE MORE APPROPRIATE.

Flexibility Training Frequency: 2 -3 days per week Duration: 10 - 30 second static stretch, to mild discomfort. At least 4 repetitions per muscle group should be completed. In addition to these guidelines, others would include: Longer warm up and cool down Emphasis on functional exercises such as walking, stair-climbing and squats Balance and coordination exercises Flexibility work to help maintain joint range of motion Adding pilates, yoga, strength and resistance training to any seniors' exercise program is beneficial according to all of the above guidelines. As always, a physician's clearance prior to starting a new exercise program is essential. Many park districts, continuing adult education programs and fitness clubs, offer fitness classes designed for seniors. This is an excellent way to let a professional guide you through exercises that are developed for seniors. These classes are typically much more economical than the expense of personal trainers with many of the same benefits. If you do not feel your exercise routine is not meeting the ACSM guidelines, I would look into educating yourself on how to bring them in.

What's the best way to coordinate the three basic fitness components (cardiovascular, strength & resistance and flexibility training) into an organized and streamlined schedule?

When developing a workout routine keeping the ACSM guidelines in mind you would want to consider a few things. Cross training in one workout can be very beneficial and a time saver. A person can do intervals of cardiovascular training and strength training in one single workout. The whole workout could last 45 minutes, while keeping your heat up the entire time. When a person participates in a Pilates class, he or she is working on both strength and flexibility. Many other group exercise classes offer more than one component of fitness. A personal trainer can help you develop exercise routines that bring in multiple components for both at home and in the gym. If you are bringing in all three components of physical exercise (cardiovascular, strength training and flexibility), don't feel like you should always do the maximum amount of time for each component. Flexibility training at the very least should be done before and after a workout. Each muscle group should be stretched with static stretches at least one minute before and after exercises. Cold muscles should not be stretched. An easy 3-5 minute cardiovascular workout should be done before stretching. Here are 2 examples of a week long workout regimen that meets the ACSM guidelines.

Gym or Health club

Sunday-off

Monday- interval weights and cardiovascular in gym, include 6 minutes of stretching before and after 40 minutes of workout : 52 minutes total

Tuesday-off

Wednesday- 50 minute Pilates class - flexibility and strength: 50 minutes total

Thursday- Kickboxing class - 12 minutes flexibility 48 minutes cardiovascular (often includes strength training): 60 minutes total

Friday-30 minutes elliptical - 12 minutes flexibity, 30 minutes cardiovascular: 42 minutes total

Saturday-off

Total work out hours in a week: less than 4!!!! This could be considered a minimum and any more time to a workout or another day could easily be added.

Home workouts

Sunday-off

Monday-walk or run 30 minutes. 15 minutes strength training, 12 minutes stretching, 30 minutes cardiovascular, 15 minutes strength training: 57 minutes

Tuesday-off

Wednesday- at home Pilates - 20-50 minutes strength and flexibility: total 20-50 minutes

Thursday -walk 40 minutes - 40 minutes cardiovascular, 12 minutes flexibility: total 52 minutes

Friday-30 minute walk - 30 minutes cardiovascular, 12 minutes flexibility: total 42 minutes

Saturday-off

Total hours in a week: just over 3!!! This could be considered a minimum week and more time to a workout or another day can also be added easily.

What alternative exercise activities would you suggest for men and women who normally perform cardio and weight training activities only? Do you believe they should include other activities?

If a person is including just cardio and weight training activities in their workouts they should include some type of flexibility training at the very least. This could be done by adding a Pilates, Yoga or a flexibility class. A trainer could be helpful in suggested flexibility activities, perhaps even an at home video. In addition to adding flexibility, there are many other physical activities a person could benefit from in addition to what they already do. Adding other components to a workout can be very beneficial as well. If you normally work on just muscle endurance (the muscle's ability to perform repeated contractions or hold static contractions), then bring in more muscle strength (the amount of force a muscle can exert in a single all-out effort) for a change and visa versa, both are important. Trying things like Interval training, Fartlek training, Super Circuit training and Pyramid training can add variety to a work out. They can also decrease the risk of injury and reduce the risk of burn-out due to boredom. A personal trainer is a great resource to find out more about these concepts. You could also get information at your local library or take a class or seminar. One should also consider taking a fitness class. A sports conditioning class, boot camp type class, Yoga or Pilates class, could add a lot of variety to a workout. It can bring in exercises that will improve coordination, balance, posture, endurance, speed, flexibility and proper muscle balance. It is a fun and inexpensive way to add new and important physical components to your overall health. Most park districts, continuing education programs and heath clubs offer a variety of classes to meet most needs. One of the most important things to keep in mind when designing a workout is your enjoyment level. If you dislike running, find a different cardiovascular exercise. If you love to be outdoors-include it in your workout. Again, adding variety to a workout can decrease the risk of injury and reduce the risk of losing interest.

Can people with medical considerations which prohibit them from using all or part of their upper or lower body areas still create beneficial routines by utilizing their healthy limbs?

People with medical conditions or limitations could still benefit greatly from exercise. Cardiovascular and strength training activities are important for good health. Maintaining a regular exercise routine will help with muscle balance, self esteem, flexibility, physical endurance and many more physical and mental considerations that may be due to the medical limitations. A personal trainer or physical therapist is a good resource for the types of exercises that best fit. Q? In general, what types of exercise would you suggest for people with back, shoulder and foot problems? A: In general, people with back, shoulder, and foot problems should still be working out. However, it is important to find cardiovascular activity that would not aggravate the problem. Strength training is also very important to keep the surrounding muscle groups strong and of course, adding flexibility is necessary. Higher impact activities might be harmful to the injuries. It really is best to talk to your doctor and physical therapist to find out which exercises to include and which to avoid.

If you'd like to ask Sue any questions, feel free to email her at: suegarciafitness@prodigy.net.

Kirsten Straughan is a registered dietitian experienced in clinical work and private practice nutritional counseling. She has worked with cardiac rehab patients, as well as other illness recoveries, in prenatal nutrition, and weight control for children and their families. She has taught nutrition education courses to the medical residents at University of Illinois and Mercy Hospital in Chicago, and gives seminars on nutrition for: prenatal care, children, women, heart healthy care and the prevention of insulin resistance. In 2002, Kirsten teamed up with former Chicago Bears player, Otis Wilson, for a fitness & nutrition after-school program targeted towards low-income children to prevent and treat childhood obesity. Her passion has always been to focus upon preventative nutrition and offering people alternative and integrative approaches to various illnesses, through education and coaching.

I cannot praise Kirsten enough for taking the time to thoroughly address the questions I asked her. In addition to her private practice and seminars, she is the mother of a four year old, is expecting her second child in December and is working on her Master's in Exercise Physiology at U of I in Chicago. (I had a 'shvitz' just reading that!) Thank you, Kirsten!

What nutritional fact do you find that people are the most misinformed about?

One of the most common questions I receive from clients is how to fit carbohydrates into their diet. There is so much conflicting information about the correct amount of carbohydrates to eat, and many people aren't even aware of what types of foods carbohydrates are, or what a reasonable portion size is. The reality is that people are very individualized when it comes to what types of foods their bodies respond to best. There are people who are insulin resistant (40% of the population by some accounts), who do well to decrease the amount of carbohydrates in their diet. However, there are many who need 50% or more of their calories to come from carbohydrates. Without confusing you even more, here are some facts about carbohydrates and meal time tips that can apply to everyone: Carbohydrates include fruits, dairy products and starches (including starchy vegetables such as potatoes, peas and corn). The reason being that they all ultimately break down to glucose in our body. Sugar is also a carbohydrate, therefore any "sugary foods" would be included in this category as well. It practically goes without saying that these "sugary" foods, such as candy, sweets, sweetened cereals, etc; should be limited in anyone's diet. A diet high in added sugar and refined starches has been linked to an increase in obesity, diabetes and several types of cancer. In regards to serving sizes, starches tend to be the most overeaten. Here are some sample portion sizes: 1/2 cup of pasta (cooked) 1/3 cup of rice (cooked) or other grains (couscous, quinoa, etc) 1 potato the size of a computer mouse 1/2 cup of peas or corn 3/4 cup of cereal Generally, you would need to eat between 2-3 servings per meal. The most important factor regarding carbohydrates is to focus on eating complex carbohydrates. These are foods that are rich in whole grains. For example, whole grain breads, brown rice, whole wheat pasta and whole grain cereals. Whole grains are high in fiber, vitamins and other phytonutrients *.A diet high in whole grains has been connected to a decrease in heart disease, cancer and diabetes. In addition, they help to balance our blood sugar, leading to a longer feeling of satiety or fullness, which helps to prevent cravings and overeating.

* The word "Phytonutrient" means nutrients from plants (phyto). These are nutrients that have been shown to have some health benefit such as decreasing cholesterol, aiding digestion, reducing cell damage (thereby reducing cancer risk), or decreasing menopausal symptoms. Some examples of phytonutrients include lycopene from tomatoes or carotenoids from carrots.

One of the biggest problems for those of us attempting to create healthier eating habits is figuring out what we should and shouldn't be focusing on when it comes to policing our food. Which factors do you feel warrant the greatest and the least attention (barring any medical conditions) with regards to: Calories, Fat, Protein, Carbohydrates, Sodium and Fiber?

Great question Joanne. Often times I feel that calories aren't given the attention they deserve. Our society turned away from calorie counting when we hit the big "no fat" craze of the 1990's. We thought that we could eat a box of fat-free cookies with no dire consequences! Unfortunately, these foods had the fat taken away, but sugar was added to make up the taste. The calories from the original were usually not much different from the fat-free version. This is not to say that I advocate stringent calorie counting, however, if weight loss is an issue for you, it is a good idea to be aware of how many calories you are currently eating, and how many you should be eating to promote weight loss. To give you some general guidelines, women usually need to eat between 1500-1800 calories a day and men between 2000-2200 calories. As far as keeping track of your daily calories, the USDA's website provides a free basic program for entering your food intake (www.usda.gov/cnpp). Food labels also provide calorie information, just remember that the amount of nutrients on the label are for the serving size listed. For example, if the serving size is ½ cup, and calories are listed as 90, then there are 90 calories in ½ cup of the food. If you ate 1 cup, then you would have eaten 180 calories. A registered dietitian can also help you to get a better idea of the amount of calories you are eating, and can help to better pinpoint your nutrient needs, which would take into account your weight, height and activity levels.

Fats
Fat has gotten a bad rap over the past decade, however, things are starting to turn around for this important nutrient! The first thing to point out is that there are different types of fat: saturated, unsaturated, and hydrogenated. Let's start with the good one: Unsaturated Fats. There are two types of unsaturated fats: Monounsaturated and Polyunsaturated

Monounsaturated fats have been shown to help lower cholesterol and triglyceride levels, lower LDL cholesterol and improve blood sugar levels. Foods that are high in monounsaturated fats include olive oil, canola oil, avocados and nuts such as almonds and walnuts.

Omega-3 fatty acids are high in polyunsaturated fats. These are very beneficial for lowering cholesterol and triglycerides, decreasing blood pressure, decreasing blood sugar levels, and have even been shown to be beneficial for mild depression. Foods high in Omega-3 fatty acids include fatty fish (fresh salmon, fresh tuna, mackerel, sardines), flaxseed oil or flax seeds, pumpkin seeds and walnuts. One thing to remember is that fats are still very high in calories, so I am not recommending that you drink olive oil or eat pounds of almonds! A serving size of oil is 1 teaspoon and only 6 -8 almonds will give you the healthy fats you need!

The Bad: Saturated Fat
Saturated fat is the fat that can contribute to high cholesterol and triglyceride levels. Animal fats are usually high in saturated fats; such as butter, eggs, lard, fat in beef, pork, and poultry, processed meats such as salami, sausage and pepperoni and whole fat dairy products such as whole milk and ice cream. However, tropical oils such as palm and coconut, are also very high in saturated fats. These are usually seen on the ingredient list of foods, and are the traditional oil of movie popcorn.

The Ugly: Hydrogenated Fats
These fats have been shown to be even more hazardous to our health than saturated fats as they increase our LDL (bad) cholesterol and decrease our HDL (good) cholesterol. Most fried foods tend to be fried in hydrogenated oils. They are also found in most processed foods including cookies, crackers, chips, snack foods, muffins, pastries, frozen waffles, frozen dinners, etc. Looking at the ingredient list for hydrogenated or partially hydrogenated fats or oils will tell you if they are in a food. Hydrogenated fats have been in the news recently as the fat that will soon have to be included on food labels. They are also the fat that Kraft Foods has announced they will discontinue using in their cookie and snack products. It has been a popular fat to use as it is inexpensive, prolongs shelf life and has a good consistency.

Carbohydrates and Fiber
As I mentioned above, I feel that the quality of carbohydrates is the most important factor when discussing this nutrient. Focus on complex carbs - those that are rich in whole grains and that contain fiber. Fiber is important for much more than a healthy and regular gastrointestinal track. High fiber diets have been linked to prevention of heart disease, lowering cholesterol, lowering risk of diabetes and blood sugar control, prevention of colon cancer. Our goal should be between 25-35 grams of fiber a day. The typical American only eats 12-15 grams a day. Foods high in fiber include whole grain foods (cereals, breads, brown rice, whole wheat pasta, barley, oatmeal, etc), fruits and vegetables and legumes such as beans, peas, lentils, etc.

Sodium
Sodium or salt is important for some people to be aware of, but not the entire population. A salt restricted diet is recommended for people with congestive heart disease or those with salt-sensitive hypertension. The majority of salt we intake does not come from the salt shaker but from processed foods and fast foods. Given that these types of foods are typically high in hydrogenated fats and low in nutrients, they should be foods that we want to decrease in our diets anyway.

The Food Guide Pyramid can be quite intimidating - how can anyone eat all those servings from all those food categories in one day and not go nuts doing it? With this in mind, can you give us a simple and basic food map to follow?

I find that when people plan their meals and snacks around fruits and vegetables and whole grains, everything else tends to fall into place. The goal is 2-4 servings of fruit a day and 3-5 servings of vegetables. If this is drastically more than what you eat now (and chances are it is!), then start by adding one additional fruit and one additional vegetable a day than you are currently eating. A serving of vegetables is ½ cup of chopped veggies, or 1 cup of leafy vegetables. A serving of fruit is a piece of fruit, ½ banana or approximately 1 cup of chopped fruit.

Once you get the fruit and vegetable intake down, then start changing from refined carbohydrates to whole grain carbohydrates. For example, instead of rice crispies or a sugar cereal; change to a low sugar, high fiber cereal. Try brown rice occasionally in place of white rice or whole wheat pasta as a side dish. Remember to watch the portion sizes as listed above.

What are our best sweet and salty junk food bets?

Everyone needs to splurge occasionally and some of these recommendations can even be done daily in the right amounts!

Go Nuts! - For the healthy fat reasons that I discussed above. Try a trail mix with dried fruit, sunflower seeds, walnuts and almonds. Again, remember to portion size!!! About 1/4 of a cup of trail mix is a portion of fat and fruit.

Popcorn - Popcorn is high in fiber and can be a great snack as long as it's not drenched in butter. Air popped or light microwave are the best choices. The only downfall is the potentially high sodium content.

Fruit juice bars, sorbet, or frozen yogurt - These tend to be low in fat and calories and can be a great treat on a summer day. Also try to make your own fruit smoothies - they can turn into a homemade milkshake.

Hot Chocolate - Use low fat milk and real chocolate powder (like Ghiradelli's). It's a wonderful comfort food and the warm milk and protein are very satisfying.

Low fat puddings - These can also be a great comfort food without all the guilt.

Remember that there are no forbidden foods, especially when eaten in smaller amounts!

What is the number one thing you'd like to impress upon us the most?

I feel that moving away from such a high intake of processed foods would do us a world of good. Americans currently spend 90% of their food dollar on processed foods - a good reflection of the state of our nutritional health! Processed foods (which includes most fast foods) tend to be high in saturated fats and hydrogenated fats, low in fiber, lacking in fruits and vegetables and low in nutrients in general. If we could try to plan two of our meals and snacks around "whole" foods, particularly whole grains and fruits and vegetables, I believe our obesity rates and disease rates would plummet.

If you have a question for Kirsten, she can be emailed at: kstraughan@earthlink.net

 

Susan has played the role of therapist in residence for each of Good Morning America's Lock the Door Lose the Weight series. (She had her work cut out for her, to say the least.) Based out of New York, she works with people individually and in group sessions in the areas of depression, women's issues, addiction, weight control and "grief work". According to Amato, grief therapy is about dealing with "loss"; the most obvious being the death of a loved one. (Over the past years, she began working with young women who were widowed by the 9/11 disaster). But loss comes from many different sources: the loss of a marriage through divorce, of a job, of one's health, and from other life changing circumstances we encounter - and yes, even weight loss.

"We mourn about weight loss, over change - what it will do to us, how it will affect our lifestyle, what demands it may put upon us in the process or upon our family. We tend to lose confidence in our own strength and ability when we have ongoing weight control issues and frequently look towards others, (professionals) for the answers. But, therapy is not done to you; it is a relationship that works only when you allow it to - when you open the door."

In talking with Susan, it quickly became evident that to structure her interview in a Q & A format, would take away from the message she wanted to send. We asked her to share her thoughts, on what the biggest obstacles are for people dealing with weight problems, (whether deeply seated emotionally, psychologically or otherwise) and to provide us with as much insight as she possibly could in this limited forum.

Challenge confronts us, obstacles, are what we put in our way. This is why it is imperative to become solution oriented in your approach. The 3 biggest challenges we face when dealing with weight problems, (and they are the same things we encounter no matter what we are trying to accomplish), are: Fear, Effort & Being on Your Side.

Fear…Are you afraid you will not be able to do it (lose weight)? We are all afraid of something, and that's okay. What we need to see is that we can allow fear to exist (rather than shying away from doing something) and work with it. Don't wait to get over fear - do it afraid.

Effort…No matter what, don't give up! You can predict that you will have some bad days and make some poor choices - but instead of quitting, start again, and again, and AGAIN! Athletes are a prime example of why this works. The focus of sports therapy is continual effort, to never stop trying, regardless of circumstances. When we hear of triumph, we admire the effort and respect the accomplishment. No one who is successful got there by trying or attempting to accomplish something just once. It is always the continuous effort that prevails. When you fall off the horse, you get back on - always.

Being on Your Own Side… I cannot emphasize enough how important it is to be on your own side. Negative self talk is detrimental; positive thought is instrumental. For every, "I can't believe I ate those cookies…I'm pathetic…a loser…I'll never be able to do this…" notion you feed yourself, you must immediately reverse the message with a positive resolution and void the downward spiral. For example, replace those negatives with: Okay - so I ate the cookies. I feel disappointed, but not defeated. What can I do to feel better? I can add an extra 15 minutes to my workout today to offset those cookies, and I will feel that I did something about it. Stop beating yourself up - about those cookies and anything else for that matter. Look for the remedy and take charge of your actions. When you talk to yourself positively, you will positively respond.

We all have issues… issues cause us to feel emotions. Our behavior is in response to those emotions. As adults, we cannot behave solely in response to our emotions. We mask, dismiss, modify and deny - we become actors. Your emotions are neither right, nor wrong, they are what you feel and it is important to pay attention to them. Ask yourself the following questions and listen to the answers - to how you feel.

Do I blame myself for not trying 'hard enough?'

Do I minimize my progress and concentrate on the negative?

Do I carry old 'tapes' in my head, like what was said about me when I was a child?

Am I my own worst enemy?

Am I ever pleased with myself?

Equal Time… A primary factor that interferes with weight loss is that the person tends to put others first and rarely considers their own needs. Often, a person is so immersed in "doing for others" that they have actually become unaware of what they need or want and have no idea about going about getting it. As a clinician, I ask about their lifestyle, schedules, what they want in life, how they see themselves, etc. Frequently I find that they are not offering themselves what they offer to others - love, kindness, strength and caring. Encourage and support yourself, equally, as you do so for others.

This is your project… I encourage my clients that it is okay not to share this part of your life with others, family and/or friends. People who love us are well intentioned, but the "advice" and "comments" can often be undermining. It is important not to become the project of the family, so to speak. If you do, you'll subject yourself to questions like, '…so, how much have you lost so far?...should you be eating that piece of pizza? Inevitably, you will resent the entire situation. Let your friends and family (gently) know that you are willing and able to talk about anything but the latest reading on your scale. Weight loss must be something that you want to do, not because someone else feels you should. We all need to be our own experts. You really know what's best for you.

Options Matter… Try different things and find out what works best for you. Would including the buddy system help you? Sometimes, when we can work with another person, it adds needed support. It helps when you commit to another to meet for exercise - especially on those days when you don't feel like it; you know that someone else is counting on you. Would the help of a professional, or attending a group support meeting help you? Explore the options available to you.

You can't change your weight until you change your mind!

You can email Susan at: sjamato@aol.com
or write to her at the following address:
Ms. Susan Amato, C.S.W.
14 E. 60th St. Suite 700
NY, NY 10022

Working with Susan, was indeed a life changing experience. She is capable of drawing out the truth without pain or embarrassment. You find yourself pouring your heart out to her without hesitation - even when you have absolutely no intention of doing so, as I did going in. The last thing I wanted to do during the GMA project was to "get analyzed", so to speak. Who wouldn't run for the hills at the thought of exposing your silly idiosyncrasies and confronting the bad sides of one's self in one sitting? If for any reasons other than these, it is incredible to me that Susan's smile and demeanor could unleash the demons within moments. I told myself that I wouldn't talk about my family, of course, I did. I told myself I wasn't going to cry, of course, I did. And the whole time I rattled on as we sat informally in this huge bedroom of the fat house, I never once felt that I didn't have her full attention or that she was immersed in the diagnosis of my excess baggage. (And don't we all have quite a collection of suitcases we're toting about?)

What I came away with from my time with Susan was this: somehow, in between all those tears and fears, she installed in me the capability of seeing things differently and thinking about things from different angles without beating myself up - which ultimately made looking for answers and new resolutions a conceivable and productive process. And by no means did she do this by preaching or condoning. I truly believe it is the gift of herself she brings to every session - she provides the key to understanding why, which opens the door to change.

 

Joy Bauer was named Best Nutritionist in New York City by New York Magazine. An honor she justly deserves for her credentials are impeccable and her work, devotedly sincere - helping people get a grip on weight management due to eating disorders, diabetes, cardiac rehab, food allergies, gastrointestinal problems and a host of other nutritional concerns. Joy has been published in numerous magazines, appears regularly on national television shows such as, The View, Entertainment Tonight, and MSNBC, and has authored the following books: The 90/10 Weight Loss Plan, The Complete Idiot's Guide to Eating Smart and The Complete Idiot's Guide to Total Nutrition. (For more info, check out Joy's site at: www.joyofnutrition.com.)

I have to tell you that Joy is absolutely a joy to meet and talk to. She stands, maybe, 5 feet tall and weighs far less than I did in 4th grade. People with weight problems (especially women), tend to be uncomfortable talking to petite silhouettes like Joy, but it doesn't bother you when you meet her because you can tell immediately that she has a big heart and a complete understanding of what it's like to live and deal with a fat mentality. In fact, I have to say, she is one of the few (and that's a big FEW), thin people I've ever met who 'get it' to begin with! It was great fun putting these questions together for her and we are truly honored that she agreed to contribute to our website.

What are some of the factors behind a lack of weight loss when a pound's worth of calories have been successfully reduced over a week's time?

A: There really is no scientific answer for that one. I absolutely know this from working with clients. Crunching numbers SHOULD work out, but they hardly ever do. In fact, a person who has a greater loss in a week (say, 4 pounds) typically does not reduce the calories by 14,000 calories (4 X 3500). Don't get caught up with what a text book will say, or the calories burned on an exercise machine. Your body has a mind of its own and some weeks will be greater losses than others for the same amount of food.

When counting calories to lose weight, how much does it matter from what food groups you eat as long as you stay within your calorie reduction goal?

Not much at all. On the other hand, for optimal nutrition, satiety and for stabilized blood sugars -- you'll want to get a great mix of protein, carbs and fat. However, some people with a medical condition called Syndrome X (or insulin resistance) need to eat lower carbs, moderate fat and higher protein for effective weight loss. This does not affect the rest of the world.

How much nutrient deficiency comes to someone who NEVER eats lettuce of any kind? Are multi-vitamins a valid alternative?

None. Lettuce provides some Vitamin K -- but so does, kale, spinach, and other greens. A multivitamin is a good idea for everyone -- those who eat lettuce and those who loath it!

For Women: how does your period affect your weight levels - is it more on the pre-menstrual side or actually during the cycle? And, is it the female imagination, or are there a couple of days every month around this time that women take on the appetite of a football team?

It's NOT your imagination! YES, we are craving, starving, and want to eat anything we can get our hands on -- typically a few days before the period. It is due to the change in hormone levels (rise in estrogen mainly). Also, estrogen increase retains water, so you'll see about 2-4 pound bloat gain on the scale. It's not real weight gain. Clearly stay away from the scale during that point -- too discouraging!

Given the facts that: 1,200 calories/day is the minimum total calories you can eat without sending your body into starvation mode, and that as we age our daily caloric intake slowly declines, there would seem then at some point, we would end up gaining weight at the 1,200 day limit. If this assessment is true, at what age would this start happening, and what suggestions do you have to combat the issue?

No, you'd never gain weight at the 1,200 cal level -- unless you had a thyroid condition. No matter how old you live to. However, it's really 1,000 calories that this starvation slowdown occurs...we just say 1,200 so you [women, especially] do not go below and get too close to the 1,000 mark. The reason that your metabolism declines with age, is due to the loss of lean muscle mass (normal biology). Thus, exercise like crazy and you can defy biology (at least you can lessen the damage).

 

Michael has over 20 years of experience training, educating and motivating people to improve their overall wellness and reach their fitness goals. Based out of Chicago, Sena hosts weekly fitness reports for NBC locally, is the Health & Fitness Expert for United Airlines and co-owns a personal training facility called the Energy Training Center, (ETC.) What makes him stand out in his industry as one of the best, is his common sense approach to health and fitness, charismatic personality and special focus he impresses upon the concept of family fitness Plans. Go to: www.michaelsena.com for more info.

We took a small poll and put together a list of questions for Michael to get the nitty gritty low down on some of those exercise questions you've always wanted to ask…

What is the bare amount of exercise time one can put in on a weekly basis and still get benefits?

The bare minimum amount of weekly exercise anyone should do and still receive benefits is in 30 minute increments, 3 times per week.

What type of exercise would you suggest at the bare minimum amount?

My recommendation is 50% cardiovascular exercise and 50% strength training. The minimum amount of cardio exercise needed to strengthen the heart is 20 minutes/3 times per week. Beyond my recommendation, an individual's goals and needs will also play a role.

Why is strength training so important?

Strength training increases bone density and reduces the risk of heart disease, obesity and diabetes. It is a key factor for improved functionality, quality of life and the best anti-aging remedy ever!

Is there a difference in benefit between the following exercise scenarios? 3 / 30-40 minute strength training routines & 3 / 30-40 minute cardio workouts (of various types), for a total of 6 workouts over the course of a week VS. 3 / 60-80 minute workouts, split equally between strength training and cardio exercise, over 3 days per week.

Yes, the difference is that one routine is a 6 day, (burning calories 6 days/week) and the other only 3 times per week. In this situation it would be better to burn calories more frequently, than seldom!

If you work out in the morning before work, should you eat anything before hand? If so, what would you recommend?

Eating before working out must be done at least 1 hour before. The body needs time to digest before exercising. Something light and low sugar types of food would be best, like fresh fruit.

For people who are accustomed to doing 45-60 minute strength training and cardiovascular workouts 5 times per week, how much can you cut your normal workout down to and still be effective on time deficient days?

Because you're in a groove 5 times a week, when you're short on time on any given day, it won't hurt you [to cut your routine down]. Just keep the intensity high and you won't miss a beat.

With respect to performing strength & resistance training 3 times per week: Are you better off doing upper & lower, with a day of rest in between OR alternating between upper & lower (and doing more reps), with a day of rest in between?

This is a very subjective question and depends on someone's goals. But, why not try alternating one week from the other? As far as "more reps" are concerned, the higher the amount, the more defined the muscle will become. For individuals who are concerned with weight loss, high reps are the perfect recommendation.

Insight from additional professionals will
be added to this page throughout the year.

 

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