Muscle Medicine: The Revolutionary Approach to Maintaining, Strengthening, and Repairing Your Muscles and Joints (8 page)

WEIGHT AND JOINTS

According to a 2003 study in
Obesity Research
that looked at fifty-seven hundred Americans over the age of sixty, 56 percent of severely obese people had significant knee pain compared to 15 percent of the normal-weight group. In another recent study, severely obese women were twenty-five times more likely to suffer torn cartilage than their normal-weight counterparts; severely obese men were fifteen times as likely.

WHAT TO EAT: THE GOOD, THE BAD, AND THE UGLY

So, what to eat? Fortunately for us, there isn’t one way to eat to control weight, another way to support bones and muscles, and another to fight disease. Healthy eating is healthy across the board. In the past decade, scientists have arrived at a consensus about what an optimal diet should look like. The two diets that have been most intensively studied, and heartily endorsed by researchers, the Mediterranean and the DASH (Dietary Approaches to Stop Hypertension), dovetail on the basics: heavy on whole grains, fruits, and vegetables, and light on sugar, salt, and animal fat. (The DASH emphasizes calcium, which, as we’ll discuss, is good for the musculoskeletal system.)

Let’s break it down. Everything you consume falls into three categories. Protein provides the building blocks for muscle growth and repair, and for the functioning of the immune system. Carbohydrates are fuel—your body breaks them down into simple sugars that are burned for energy. Fats provide essential lipids for the production of cell membranes and hormones, and allow the absorption of fat-soluble vitamins.

MINDFUL EATING

Stop eating when you’re no longer hungry. Considering seconds? Wait ten or twenty minutes until your stomach sensors have had time to register fullness.

Eat a nutritious appetizer such as soup or a salad before the entrée.

Use smaller plates. We’re serious. Portion control works.

Spread out your calorie intake over the day with a high-quality midmorning and/or midafternoon snack such as yogurt, peanut butter, or a banana.

Proteins, carbs, and fat—all are essential parts of our diet, despite what you may have picked up from an endless stream of articles about low-fat versus low-carb strategies for losing weight. Healthy eating is all about appreciating that “good” proteins, carbs, and fats should be the cornerstones of your diet, and their “bad” evil twins should be eaten only in moderation or reserved for the occasional splurge.

Good protein delivers those necessary amino acids (from which the body builds
new cells and repairs old ones) with a minimum of high-fat, high-calorie baggage. Poultry (without the skin) is an excellent low-fat protein mainstay, as are low- or no-fat dairy products. But if you like red meat, there’s no reason why you have to eliminate it altogether. A smallish five-ounce serving of a lean cut such as sirloin translates to fifteen grams of fat, which should fit almost anybody’s daily nutritional budget. On the other hand, ten ounces of spareribs equals eighty grams of fat. You do the math.

Good carbohydrates are for the most part “complex” carbs, such as grains, fruits, and veggies, which are packed with fiber and water, which slow down digestion. Not only do these foods provide a nice, even energy flow over the day, they’re packed with vitamins, minerals, and disease-fighting compounds. Sometimes the term
volumetrics
is used to describe the weight-control strategy of eating high-quality, high-bulk foods that fill you up without adding too many calories.

The “evil twin” carbs are the simpler ones that your body can most quickly break down and use as fuel. Sweets, snacks, and drinks laced with corn-syrup sweetener are one example. Starchy food with the fiber processed out of it—white bread, white rice, white pasta—is another. Simply put, whole foods are good, the refined, processed versions are not. When the simple carbs hit your system, blood sugar levels rise quickly and dramatically, stimulating your body to produce correspondingly high levels of insulin to clear the sugars out of the bloodstream and get them into muscle and liver cells for short-term storage. You may feel a boom-bust effect, a sugar rush followed by a feeling of fatigue or depletion. Over time, you can overstress your insulin system, leading to insulin resistance and, in serious cases, adult-onset diabetes.

As recently as fifteen years ago, all fat seemed to come in one flavor—bad. Weight-loss gurus and academic experts alike agreed that dietary fat—which packs nine calories per gram compared to four for carbohydrates and protein—was the major culprit behind heart disease and the ever-expanding American waistline. That was then. Now we appreciate the role of “good” fats in the diet. Monounsaturated fats, found in olive oil, canola oil, avocados, and nuts, helps lower LDL (low-density lipoprotein), the so-called bad cholesterol, and offers protection against disease. Polyunsaturated fats contain essential fatty acids that the body needs but does not itself produce. The omega-3 fatty acids are the stars of this group—they lower bad cholesterol and can reduce tissue inflammation, which explains why
they seem to protect against diseases as various as heart disease, Alzheimer’s, and arthritis. The most plentiful source of omega-3s is cold-water fish, but because of well-founded concern about mercury toxicity, you’re better off sticking with the small fry down on the food chain such as herring and sardines. Other options are the new fortified foods such as omega-3-fortified eggs and orange juice, or supplemental oil and gelcaps.

The fats that deserve their nasty reputation are saturated and trans fats, both of which raise levels of LDL cholesterol. (Interestingly, it turns out that the dietary cholesterol found in egg yolks doesn’t have a pronounced effect on cholesterol levels in the blood and doesn’t deserve most of its old bad rep.) You don’t need a nutrition degree to know that chicken skin, beef fat, and dairy products such as full-fat milk, yogurt, and cheese are heavy in saturated fats. But your body does need a modest amount of saturated fat, so unless you’re on a strict low-fat diet for a heart condition, you can partake sensibly, from time to time. “Bad” saturated fat does taste good and does promote a feeling of satiety.

About trans fat, we have nothing positive to say. Trans or partially hydrogenated fat is created when vegetable oil is hydrogenated or processed to stay solid at room temperature. It’s in margarine and vegetable shortening, commercially produced baked goods, and junk food. It raises bad LDL cholesterol and lowers good HDL (high-density lipoprotein) cholesterol. Fortunately, trans fats’ deservedly bad press has prompted quite a few manufacturers to reduce or eliminate it from their products, so it’s not as ubiquitous as it once was. Still, it pays to eat defensively—check the labels in the supermarket or the convenience store, and not only for trans fat. If the product in question has a laundry list of hard-to-pronounce preservatives and artificial flavorings, keep moving down the aisle. Better yet, move over to the fresh-produce aisle.

TOXIC FOOD?

Food safety is a legitimate concern. Buying organic is an effective, if somewhat more expensive, way to reduce your exposure to potentially harmful chemicals in the food supply. An influential group of environmental researchers in Washington, D.C., has developed a list of fruits and vegetables, “the dirty dozen,” that have the heaviest pesticide load when conventionally grown. Spend 10–50 percent more
for the organic versions and you’ll be getting the most safety bang for your organic buck (see the box at right). You may also want to consider organic milk, beef, and poultry, also 10–50 percent more expensive than their conventional counterparts, which eliminate the hormones and antibiotics.

THE DIRTY DOZEN

(Compiled by the Environmental Working Group)

You may have noticed that we’ve talked mostly about food quality, not quantity, which is an individual matter. But nutritionists have found that when people make thoughtful food choices, their diets usually land within the government’s dietary guidelines—approximately 45–60 percent carbs, 20–35 percent fats, and 10–35 percent protein—without their having to patrol the supermarket with a set of scales and a pocket calculator. But healthy differences in preferences may be influenced by your genetics. (The Alaskan Inuit evolved to thrive on a diet that heavily featured seal blubber. You, probably, have not.)

THE WHEN OF EATING

We said at the outset that maintaining a healthy weight is all about balancing the calories you consume with the calories you burn (and we’ll get to the “burn” in the exercise chapter, which comes next). One more factor can be important: the when of eating.

Our colleague nutritionist Heidi Skolnik works with the New York Giants players and New York–area women at the Women’s Sports Medicine Center at Manhattan’s Hospital for Special Surgery. As Skolnik tells her clients, the body will likely
signal that it wants food about every three hours. Even if you eat three squares daily, you’ll probably still get hungry between meals. Most people adopt one of two unconscious strategies. They tide themselves over with junk food—sodas, chips, a scone, whatever is handy. Clearly, an extra load of sugar and trans or saturated fat is a bad idea. Or people ignore the hunger pangs (fairly easy if you’re busy at work) and compensate by eating more at lunch or dinner or by having a late-night snack. The large infusion of calories late at night can overwhelm the body’s capacity to break down and use them, causing many of the calories to be converted into body fat for storage. The solution is having a mid-morning or afternoon snack: a banana with some peanut butter; a container of yogurt; or an apple with some cheese (see the box above). If you still crave a late-night snack, you’ll be able to make it a small and reasonable one.

NUTRITIONIST HEIDI SKOLNIK

Whether you’re in the boardroom or the locker room, you want to be strategic about how you fuel your mind and your body. Maybe you’re not being put through grueling workouts every day, but you have to stay alert in afternoon meetings and keep your weight under control. Healthy snacking, and staying away from junk food, is key. That doesn’t just happen. If you stock your refrigerator with five yogurts or five packets of trail mix for the week’s snacks, you’re a lot less likely to wind up eating junk food.