So what's the deal with CHOCOLATE toddler formula!?

I heard the oddest news report this morning. Apparently, unbeknownst to yours truly, Mead-Johnson, the makers of Enfamil have come out with chocolate flavored toddler formula! Their argument for doing so is rather compelling. Your toddler, between the ages of 12 months and 36 months, is at the pickiest eating stage of her life. There will never be an age at which you will be as concerned about how much your child eats than this age. Mead-Johnson, in their advertising, contends that your child still needs all the same vitamins, minerals and essential fatty acids in their diet for growth, yet here they are not eating.

Well this certainly caught my eye as two of my strong interests are kids and nutrition. The issue is critically important for the physical health of this nation. So I looked a little deeper into the subject. I must say, Mead-Johnson has done their homework on this one. I compared Enfamil Lipil, the standard infant formula with Enfagrow, their new chocolate flavored toddler formula. At first glance, the nutritional information appears great! The calorie count is actually down compared to regular formula. Fat content is down in the range of 2% milk. Sugar content is up a little, but not too much. The balance of vitamins and minerals is impressive and far better than 2% milk which is the current recommendation of professional medical societies. So what's the problem? Mead-Johnson is selling a food product that on the surface seems to meet the needs of both parents and toddlers.

Let me give you an example I think most of my readers will understand very clearly. Yesterday, I had a generous lunch. I like to eat... a lot! I exercise a lot and have good genetics, so I can get away with more than the average person. A couple of hours after this generous lunch, I heard the "Buster Bar" in the freezer calling my name. Now a "Buster Bar" is a wonderful Dairy Queen ice cream treat that boasts a whopping 460 calories! Even for my metabolism and exercise level, that's enough to fuel 1/6 of my day. And this was AFTER I had already eaten well through the morning and lunch hour. The LAST thing my body needed was a "Buster Bar!" So what did I do? I ate it!!! There's no justifying it. My body didn't need it. I didn't reduce the rest of my daily calories to adjust. That's 460 calories that will forever sit there until my body uses it... assuming it ever does!

By the same token, Mead-Johnson is correct in saying that the toddler years are the pickiest years of a persons life. Many days, it appears that the toddler isn't eating anything at all. Most parents and, especially grandparents, can't accept this, can't get their heads around it, and really think that it's bad for their charges to not eat. Nothing could be further from the truth! Toddlers don't eat because they aren't hungry! I hear you now. "But if I offer something different, they eat it. Doesn't that prove they're hungry?" Absolutely not! Did I eat that "Buster Bar" because I was hungry? No, I ate it because it tasted good. Likewise, I contend that if your toddler won't eat regular, healthy food, it is because they are not hungry. If they take chocolate flavored formula when they won't eat anything else, it's not because they are hungry. It's not because their bodies are crying out for the nutrition that is in the formula. It's because it tastes good! Plain and simple.

Whenever I have a question that doesn't make sense to me, I always say, "Follow the money." Mead-Johnson is gambling on the fact that concerned parents don't think their children eat enough, so they are producing a tasty alternative to get your children to eat more. In the process, it just so happens that the more Mead-Johnson can get your child to eat, the more money they will make. And, by the way, the more they can get your child to eat, the higher the risk that your child will be overweight.

If you are truly concerned about the nutrition of your child, discuss vitamins and minerals with your childs physician. There are alternatives that can be given that don't come loaded with 425 calories per 24 ounces with 65 grams of sugar added!

So what's up with concussions?

The weather has begun to warm again and the kids are really itching to get outside. With increased outdoor time comes increased participation in athletic events. Frequently, our young athletes will suffer some kind of head injury and the question always arises as to what to do with these kids.

There are two significant consequences of head injury, concussion and intracranial bleeding. Intracranial bleeding is relatively infrequent. These patients usually (but not always) have a significant head injury. They develop headache, nausea, vomiting and/or irritability that gradually worsens, usually prompting medical attention. We saw this recently with a famous model/actress who'd been skiing, hit her head and over the next 24-48 hours had headaches that came and went, gradually worsening. Unfortunately, she perished due to lack of nearby facilities, lack of recognition of a problem, and patient resistance to admitting her symptoms were getting worse. Anytime that there is a head injury, be very aware of symptoms that are getting worse and have worsening symptoms evaluated quickly.

The second significant consequence is far more common and usually considerably more subtle. A concussion is defined as ANY head injury, no matter how minor, that leads to neurologic symptoms. These symptoms can be as mild as several moments of dysorientation or as severe as "blacking out" for many minutes. Clearly, the more severe the injury or the symptoms, the more seriously physicians take the injury, but studies have shown that even minor injuries can lead to long term changes. These chronic changes include persistant headaches (especially with exercise), persistant trouble concentrating (including one patient I had who developed ADD like symptoms for years after the injury), irritability and other personality changes. These symptoms generally resolve spontaneously, but can persist for weeks, months and potentially even years. The symptoms are treated accordingly, but there is no treatment for the underlying cause, that is, the concussion.

While these symptoms are a serious problem for those who suffer from them, the bigger issue is the risk of secondary concussions and, more importantly, second impact syndrome. The research is very clear that individuals who have had a first concussion are at several fold higher risk of having more concussions in the future. All activities with risk for a head injury most be approached with this risk in mind. Any protection that can be afforded to these individuals to prevent a head injury is appropriate. Second impact syndrome is a rare, but potentially fatal complication of having a second head injury while the symptoms of the first concussion are still present.

With these risks in mind, there are certain guidelines for returning to a risky activity after a concussion. Most experts believe that a very mild concussion (head injury with a little dizziness lasting a minute or so) can return to play once COMPLETELY symptom free for more than five minutes. Any persistent symptoms are a reason to remain out of play. Any loss of consciousness should probably result in an athlete being pulled for the duration of the game. Return to play is determined by persistence of symptoms. There is a very gradual return to full activity. Athletes start with usual activities of daily living (walking, going to school). If there are headaches, difficulty concentrating, trouble with short term memory, or irritability, the athlete doesn't move to the next step. The next step includes basic, gentle exercise. Jogging, biking and swimming would fall in this category. Once these activities can be done completely without symptoms, then the athlete may return to sport specific activities including drills. At this point, weight lifting may be resumed. Only when extensive sport specific skills can be done without any return of symptoms may the athlete be returned to competitive play.

Head injury is a serious injury in any child. Athletes are at much higher risk of complication if they return to play too quickly. The key issue is if there are ANY symptoms that you as a parent can see, don't take any chances. Consult with your pediatrician, trainer or sports medicine specialist on how to proceed.

What IS that white stuff?

Another absolutely beautiful day in St. Louis. We don't get that many, so I hope you're out there enjoying it.

At least once a week, I get a visit or a phone call about white stuff in a baby's mouth. In spite of many warnings from grandparents about "thrash," not all that's white in the mouth is thrush. Thrush is a yeast infection in the mouth. Usually, we find it in babies whose immune system hasn't developed to the point of being able to fight it off. Breaset and bottle fed kids both get it. I seem to see it more often in breast fed kids, but I don't think that's generally true in all communities. The yeast comes off of the breast or bottle nipples. Sometimes, Mom will get the infection on her breasts and develop soreness and cracking.

Other kids will get thrush after a round of antibiotics. Thrush is also one of the primary side effects of inhaled steroids.

The best way to tell if a baby has thrush is to look for white patches on the insides of the cheeks. If these patches can not be scraped off, then it is likely thrush. Often, these same patches will appear on the gums. They usually do not appear on the tongue. There are several different treatments for thrush, all of which are reasonably effective. Preventing thrush involves boiling bottle nipples after use (or sending them through the dishwasher). Sometimes, we recommend mother be treated if it appears she is carrying the yeast and giving it to the baby.

Other white rashes in the mouth are also common. The most common misperception is that a white tongue is thrush. Again, if there are no white patches on the cheeks, there probably isn't thrush. The white tongue is usually caused by the environment in the mouth. Mild dehydration will dry the tongue a little and make it white. A recent meal can become somewhat adherent and look like a white coating on the tongue. Geographic tongue describes a tongue that develops serpentine patterns under certain conditions and these patterns are sometimes whitish, but sometimes reddish.

A big cause of white in the mouth is often confused for teeth coming through. The gums of newborns can develop little white cysts. These cysts are entirely developmental in nature. They seem to come and go over the course of the first several months of life. Unfortunately, they do not usually indicate teeth coming in and they are never an indication of thrush.

So next time it looks like there's white stuff in an infants mouth, think of the wide variety of things that turn the mouth white. Consider what part of the mouth has the white spots. Then, when all the information is in place, give your pediatrician a call.

It's summertime again

Ok, ok, so it's been a while. The in-laws were in town. Cold season is in full swing. The muse just wasn't quite hitting me. Excuses, excuses. Time to get back to work. Hopefully, I'll be back in full swing here now.
So my wife had me working out in the yard yesterday. While I love working out, running, lifting, biking, swimming, I don't actually like working very much and yesterday was work. However, I was enjoying the sun, listening to frogs do their chirping and listening to the birds. Here and there, there were splotches of green showing in the undergrowth in our landscape. So, I guess it was all good.
It reminded me, however, that more of my patients will be spending more time outside here soon. School is out in about 6 weeks. Daylight savings time has started, so evenings are spent outside. It's time for me to start considering problems that occur outdoors compared to indoors.
The most obvious is injuries. While many injuries are unavoidable (hence the word, "accident"), many can be minimized or avoided all together. Bike helmets are critical, especially in neighborhoods where drivers may not be constantly alert. Trampolines should be limited to one user at a time. Children should be supervised anytime they are outside running around. I still remember a camping trip we took with a group. During evening fireside time, several parents were enjoying themselves instead of watching their children dance around the fire. By the time I went to bed, I was a nervous wreck keeping everyone elses children out of the fire pit. Water time should always be supervised and the dangers of river swimming constantly appreciated, even while on a "lazy" float trip. Hiking trips often take hikers close to significant falls and children are very curious what is on the other side of that drop.
Insects and arachnids become a nuisance or worse over the next few weeks. Mosquitos carry West Nile virus. Ticks carry Rocky Mountain Spotted fever, Erlichia and Lyme disease. The occasional brown recluse spider is seen and carries a wicked bite. Chiggers are a constant problem in many grassy or woodland areas. DEET containing products are fairly effective at hiding our presence from many of these critters. Higher concentrations last longer and are probably more effective. Deep Woods Off may be the best. "Natural" insect repellants have not been shown to be effective in discouraging ticks, mosquitos or chiggers.
Sunburns are a constant threat during this time of year, as I found out yesterday, again... High levels of SPF are required as well as frequent reapplication of product. Mixed sunscreen/insect repellant products have not been shown to repell bugs. Sweat and swimming both dramatically decrease the useful life of the applied product. Reapplication as often as every 1/2 to 1 hour may be necessary.
Natural sources of water, while very entertaining, are not really good to be drinking, whether accidental or not. While e. coli tends to be the primary concern of most county health departments in neighborhood lakes such as Lake St. Loius, giardia tends to be a much larger problem. Giardia is a smal protozoa found in many lakes and streams in many parts of the country. It tends to cause loose stools several times a day, often for weeks before anyone discovers that it is the problem.
So, while being outdoors is important for the health of our children, it does pose many risks as well that are very different than their risks indoors over the winter. Until next time, enjoy the beautiful weather we've been having.

My "pee pee" hurts!

What do you do when this complaint comes out? I here it from all ages and both from boys and girls.

Pain in the genitalia comes from a large number of sources. The most common is the basic urinary tract infection. Both boys and girls can get these, though they are far more common in girls due to the proximity of urethra and rectum. Some experts maintain that wiping from front to back prevents contamination of the urethra, but I have my doubts. The ordinary urinary tract infection is caused by bacteria entering into the urethra and bladder and setting up camp there. Increasing fluids, altering the pH of the urine (drinking cranberry juice) and a simple antibiotic usually suffice.

Pyelonephritis is a basic urinary tract infection that has gone up past the bladder and entered the kidneys. Fever, back pain, vomiting, abdominal pain and pain when one urinates are the common symptoms. Depending on how ill the patient is, treatment can be as simple as an oral antibiotic as above, but if one becomes quite ill, IV fluids and IV antibiotics may be necessary.

Neither of these infections is considered "normal" the way ear infections and colds are. Especially in boys, there is sometimes an underlying reason the infection occured in the first place. The most common is urinary reflux. Instead of flowing out of the bladder when one urinates, some of the urine "refluxes" back up toward the kidney. This irritates the ureters, the tubes that go from kidney to bladder, and allows bacteria to persist. Also, abnormalities in the shape and structure of the kidneys can allow bacteria to cause trouble. Doctors often recommend studies to rule out these abnormalities when children develop urinary tract infections.

Other causes of dysuria, pain with urination, include yeast infections, skin infections and irritation of the urethra. Irritation often is caused by some chemical, hence the ubiquitous claim that bubble baths cause bladder infections. This is technically not true, but they CAN cause urethral irritation. Treatment for this is as simple as pushing fluids and avoiding the irritation. Physical manipulation (masturbation) can also cause urethritis in sensitive individuals. Obviously, trauma can also cause pain, and is sometimes the only indication that an individual is being abused.

So the causes of urethral pain are many and can be difficult to sort through. In anybody, if the pain seems to be persistant, give your doctor a call.

What to do with the sniffles and snuffles.

We're, hopefully, coming to the end of cold season. Part of the reason for my delayed posting is because cold season is very busy in the office and I'm just not always the most motivated writer. My apologies if you faithfully read my posts... Cold season is VERY frustrating to parents and causes pediatricians to often rethink how they approach their practices.

The fancy name for a cold is "upper respiratory infection." This unfortanate naming causes all sorts of trouble for pediatricians. This term encompasses ear infections, sinus infections, sore throats and infections of the airway below the nose, but outside the lungs, such as croup. Colds are triggers for all these problems, but don't necessarily include all these problems.

By definition, a cold is caused by a virus. There is a list of several dozen viruses that cause colds, each of which comes in a variety of sub-types. It is this large number of sub-types that causes people to catch cold after cold after cold instead of becoming immune to the common cold. This same variation in sub-types makes it impossible, for now, to create a working vaccine.

The symptoms of the common cold are well known to most people. Cough, congestion, sore throat and fever are the most common symptoms. Headaches, muscle aches, ear aches and chest pain are not uncommon other symptoms. Usually the fevers are low grade, 101 or less, and last no more than 72 hours. The congestion and nasal drainage usually starts out clear, but often will turn yellow or green within 72 hours and stay that way for several days. Our mothers always taught us that green means we need an antibiotic, but it's pretty clear now that this is not true. Your average cold will last 10-14 days, regardless of age. Some fortunate individuals seem to fight off their colds in a much shorter time frame.

Treatment of the common cold is symptomatic. Nasal saline or nasal saline washes (Netti pots) can help relieve congestion. A spoonful of honey as needed, for individuals older than 12 months, can be used to help supress cough. Cough drops may also be helpful. Running a humidifier keeps nasal congestion loose and easier to breath through. Elevating the head of the bed may help the drainage and cough to be more tolerable. Tylenol or Motrin (for those over 6 months old) helps with the muscle aches and fevers.

Cold medications available by prescription or over-the-counter have not been shown to make a difference in symptoms. Available studies suggest that they are merely sedating, which may help with sleep, but not with symptoms.

Colds that have fevers higher than 103, fever lasting longer than 72 hours, cough and congestion longer than 14 days or colds with unusual or severe symptoms need to be evaluated. A common question is "what is more severe?" The most concerning is a headache with neck stiffness as a symptom of meningitis. Shortness of breath and "windedness" may suggest pneumonia. Significant facial or tooth pain may indicate a sinus infection. As always, if you have concerns, discuss your symptoms with your regular physician.

What's the latest with ear infections?

It's time to return to a staple of my trade... ear infections. Ear infections remain one of the most common reasons that parents turn to their child's pediatrician. Often it's due to the middle of the night crying with ear pain. Sometimes it's due to the week long complaining that their child can't hear. Ear infections clearly come in several colors.
Usually, ear infections start off as a "cold" with cough and congestion, often for several days, before the classic sign of ear pain begins. Sometimes, but not always, there is fever. Often, the fever doesn't start until the children have had cold symptoms for a few days. Other times, the children will come in for a regular check up with no symptoms at all and, during their exam, we'll find an ear infection. Parents are always curious how that could possibly be true, but it is.
Probably most frustrating are the kids who complain of ear pain, have cold symptoms, come in to the office and I see no evidence of an ear infection on exam. This is probably due to eustacian tube dysfunction. Basically, the "relief valve" of the middle ear is so swollen and clogged with mucous that the children develop pain, much like the discomfort one has when ascending and descending in an airplane.
For decades, the treatment of choice for ear infections has been a round of antibiotics. That dogma is beginning to change. There have been a number of good studies demonstrating that 90-95% of ear infections resolve without antibiotic therapy. Fifty percent of them are viral infections and won't respond to an antibiotic anyways. There are also more recent studies that suggest that even if the infection is bacterial, antibiotics might not speed recovery or hasten the resolution of pain. The most recent American Academy of Pediatrics guidelines suggest that in children older than two, the pediatrician consider providing pain relief and not antibiotics for the infection. For pain relief, parents can use Motrin or Tylenol. A warm moist washcloth placed over the ear that hurts can also provide relief of pain. Some physicians recommend narcotics (codeine) though I find that these medications provide no more relief than Motrin. Finally, there are prescription ear drops that have a topical anesthetic in them that can temporarily provide relief.
However you choose to treat the ear infection, it is important that someone trained to evaluate ears look at the childs ears to confirm the presence of an ear infection as there are a large number of ears that hurt that are not infected.
As always, consult your child's pediatrician if you have specific questions.

It's RSV season again

I know I've touched this topic before, but since the season has started again and we're in a different format, I'll touch it again. There may even be new information in here. RSV stands for Respiratory Syncytial Virus. The key word here is "virus." It predominantly infects infants and toddlers, but can cause illness at any age. In older children and adolescents, the illness shows up primarily as a cold with cough and congestion lasting one to two weeks. In infants and toddlers, however, there is frequently a severe cough and likely some wheeze. In very small infants, an infection with RSV can actually cause the children to stop breathing all together (called apnea) for short periods.
It's this wheezing and apnea that causes so much trouble with RSV. The wheeze comes because the airways have become inflamed and swollen. These swollen airways have a much smaller air passage than normal and causes the infants to have difficulty breathing (imagine breathing through a straw). This combination causes the respiratory rate to go up and causes the children to have to work much harder than normal to catch their breath. Eventually, some infants tire to the point that they quit working so hard. This is when the trouble begins and their little bodies need help with extra oxygen and maybe even breathing support.
The apnea appears to be unassociated with the swollen airways and can occur without warning in very small infants and is potentially life-threatening.
The biggest trouble is that there are no proven therapies for this infection. Much like the common cold, nothing specifically treats RSV. There is an immunization, Synagis, that can provide some protection for those that are most likely to suffer a severe infection (premies and infants with chronic lung conditions). It is very expensive and does not offer long term protection. Therapies for asthma like breathing treatments and steroids only prove to be helpful in a limited number of patients. There is some suggestion that those who do respond may actually have underlying asthma. Antibiotics don't help at all since it is a viral infection. That leaves physicians with very little to do except watch very carefully for the infants at risk of tiring out and needing extra help. We do that with supplemental oxygen and in severe cases, actually breathing for the infant with a ventilator.
Much like the cold, the best management is to try to prevent this infection. Good handwashing is the cornerstone of prevention. If you know your child has RSV, they are contagious with the start of the runny nose and for several days after that. If your child is wheezing, and especially if he or she seems to be short of breath, then he or she needs to be seen. Give your doctor a call!

The "skin"ny on "Staph"

I'm sure you've all heard about the Staph bug by now. It seems to have made all the news networks at one point or another. Having said that, what do you really need to know? What do you really need to do about it?

At any given point, all of us have millions of bacteria living on our skin. There is absolutely no way to completely eliminate them all, nor is there evidence that eliminating them all is a good idea. One of those "free loaders" is inevitably Staphylococcus Aureus (Staph). Most of the time, humans and staph bacteria coexist happily, but on occasion, this coexistance becomes strained and the staph gets a little out of hand.

Staph infections have a wide variety of common names indicating the wide variety of skin illnesses they cause. Impetigo is a yellow, crusty, weepy sore that is generally found around the nose, but can be found anywhere on the body. It is relatively contagious, but usually can be treated with topical creams. Pustular impetigo is a staph infection that causes small blisters that are filled with pus that can be found anywhere on the body. Cellulitis is an infection in which the staph has actually gotten into the layers of the skin rather than on top of the skin. It shows up as gradually enlarging, painful, swollen red areas on the skin. Usually, it is only located as an isolated lesion unlike impetigo which is usually many lesions. Folliculitis is a skin infection in which the hair follicles or pores have become clogged and the staph multiply in the follicle leading to a small red irritation of each involved follicle. Usually many follicles at a time are involved. Both cellulitis and folliculitis can lead to abcess formation, a large accumulation of pus under the sking that generally increases in size, redness and pain before either spontaneously emptying or being actively drained. Each of these infections are potentially serious and worthy of being discussed and/or treated by your physician.

MRSA has become a hot topic in medicine these days. This stands for methicillin resistant staphylococcal aureus. These staph have adapted to the antibiotics that are usually used for skin infections. In so doing, they've made themselves resistant so these antibiotics no longer work against them. Unfortunately, they have become so common that many physicians, myself included, no longer even use the usual antibiotics. The problem, of course, is as resistance patterns continue to change, we are quickly arriving at a point where we do not have the antibiotics to treat some of these infections.

For most, a skin infection here and there is not a cause for concern. Physicians are seeing an increasing number of individuals and families that tend to have recurring problems with serious skin infections from staph, however. Physicians are unclear on why this is occuring, but it doesn't seem to be particularly dependant on hygeine, but rather genetic and other environmental factors. There is a great deal of discussion, but no clear guidelines or good studies on what to do to help these families avoid future infections. Some have advised bleach baths twice a week, others have recommended the use of antibacterial soaps with bathing, while others suggest that none of these methods work and that these families should just get treated anytime they get the infection.

Needless to say, these infections can be quite serious. Any evidence of a skin infection is a cause for concern and should be brought to the attention of your physician. Sometimes, a simple cream is all you need. Other times, IV antibiotics and or surgical treatment are required. As usual, don't hesitate to call your physician if you're concerned.

It's "stomach flu" season...

Yes, it's that time of year again. I'm hearing about it every day in the office. Not so fun to talk about and certainly no fun when it's your child's turn. Vomiting and diarrhea... two of the least fun things that kids do. What triggers it? Why does my kid have it? Can it be prevented? What do I do now that my children have it?

Gastroenteritis (fancy word for "stomach flu") has multiple causes, both bacterial and viral. Every rare once in a while, it's caused by something other than an infection and we can talk about that in a future post. Children always "catch it" from another individual whether it's viral or bacterial. Typical symptoms are vomiting for about 8 to 12 hours and diarrhea off and on for a week or two. The largest concern with gastroenteritis is dehydration. Most often, children become dehydrated only if the vomiting doesn't resolve within about 12 hours and they are unable to keep down any fluids. Symptoms of dehydration include lethargy, unwillingness to drink despite a known need, glassy eyes, dry mouth and decreased number of trips to the bathroom to urinate. These kinds of symptoms should prompt a parent to take their child to the emergency room.

Once your child begins to vomit, as a parent, you walk a bit of a tight rope between resting the stomach and providing enough fluids to prevent dehydration. Any fluids that you can get your child to drink is ok to use, but often the fluids that go down easiest are Pedialyte, Gatorade, juices and chicken broth. The extra salts in these fluids can be more helpful than straight water. Milk and formula are also perfectly acceptable, but for some children, they will cause more vomiting. Always think small volumes frequently. A half spoonful every 5-10 minutes that is not thrown up is more useful than 2 ounces every half hour that does get thrown up. Often, you need to wait a half hour or a full hour after a child throws up in order to give them more fluids. Ice chips can be helpful in older children if they want to "wet their whistle."

With diarrhea, yogurt is really the only thing that has been shown to consistantly help some with slowing down the frequency and volume. Any yogurt that has active culture can be helpful. There have been studies that suggest that zinc can likewise help, but the studies were done mostly in developing countries. Also, there are no products available in US pharmacies that provide zinc in the dosages suggested.

Blood or slimy mucous in diarrheal stools is a cause for a higher level of concern as they may indicate bacterial infections such as salmonella, shigella or e. coli. Often these infections don't need antibiotics, but they do warrant closer attention.

The best defense against gastroenteritis is the usual stand-by... good hygeine. Always washing hands well before eating, before cooking and after using the restroom or changing a diaper are very important. Likewise, cooking food completely can help prevent salmonella, shigella and e. coli. As with many illnesses, prevention is the best medicine.

New Year's Resolutions

Good Morning,
I thought it would be a good idea to clarify a comment I made in my previous blog concerning the impact of exercise. I actually commented that exercise is both over-rated and under-rated.
Now, those of you who know me, know that I enjoy exercise. I am somewhat limited by torn cartilage in my left shoulder and deteriorating cartilage in my left knee, but that hasn't stopped me from enjoying good exercise. It just limits my choices somewhat. Having said all that, why would I say exercise is over-rated?
I think a good way to see what I'm saying is for me to say that exercise can not reveal what diet has covered up, but diet CAN reveal what exercise has done. Exercise is absolutely critical for cardiovascular health. It improves blood flow. It improves muscle elasticity. It improves strength. It improves basal metabolic rates. It enhances concentration. It enhances insulin sensitivity. All these things are not only good for you, but, in general, if not over-done, make you feel good.
However, the truth of the matter is that it is nearly impossible to out exercise your diet! I work out about 6 hours a week, sometimes a little more, sometimes less. However, that adds up to only about 3000-3500 calories a WEEK (or about 1 lb of exercise/week). I am more than capable of eating 3000+ calories each DAY!!! Needless to say, it would take a huge volume of exercise to lose weight if I didn't control my diet.
On the other hand, cutting 500 calories a day from my usual diet (the equivlent of 3 sodas daily) amounts to 3500 calories each week. That is the pound a week that most experts say is appropriate. Not only that, but cutting 500 calories is not NEARLY so exhausting as 6-7 hours of exercise!!
So, as you make your new year plans, plan appropriately. If your goal is to lose some weight, cutting calories by making smart food choices is critical. Exercise will make you look good, but only if your diet doesn't cover up all your good looks!