Summer is on it’s way!  How can I tell?  Is it that the days are longer?  Is it that it is getting hot?  Is it that I’m getting fewer and fewer prescriptions for antibiotics?  Nope!  It’s that the bloody Sensa and Hydroxycut commercials seem to be playing back to back.  I completely understand that fitting back into that summer dress or your favorite swim suit is important.  Trust me… I’ve got before and after pictures coming up in the next couple weeks to prove to all of you that I practice what I preach.  The one thing that I have been hammering at for months is that changing your diet is not enough.  Taking a pill will not make you healthy.  Being or becoming thin will not make you healthy.  If you are thin, but do not exercise you are what we call a skinny fat person.  You are at risk for diabetes, high blood pressure, high cholesterol because thin does not always mean healthy.  Cardiovascular exercise and toning exercise, together, can really give you the best results (damn, there’s that “balance” thing again).

Cardiovascular exercise, whether its swimming, running, walking, dancing, etc, increases your heart rate.  What does the heart use for energy again?  Oh yeah, fat.  Cardiovascular exercise can help tone you as well, but it’s major purpose is to burn fat.  HIIT, or high intensity interval training, is most effective at burning fat.  It works off of intense cardiovascular exercise to medium or mild exercise.  For example:  Sprinting for 2 minutes and jogging or walking for 2 minutes.  It keeps the muscles confused and revs up the metabolism for longer than just the work out.  This means extra toning, extra fat burning, and, my personal favorites, it’s a shorter workout (usually) and it keeps me engaged (a boring workout will shoot my motivation faster than chocolate mousse).  Cardiovascular exercise doesn’t need to be high impact either.  You can do it on a bike, some forms of yoga can be primarily cardiovascular, swim, hula-hoop, whatever gets your heart rate up!

Toning exercises build up muscle strength.  Free weights, yoga, kinesthetics, resistance training, and weight machines.  You don’t need big fancy machinery though.  Using your own body weight, soup cans, resistance bands, or some cheap weights from Target… all of these things will do the same thing!  They’ll increase your stamina and make sure that you build lean muscle (If you don’t want to get bulky, use smaller weights and more reps).  Circuit training is one of my favorite ways to tone.  It works multiple muscle structures, you can do as many or as few circuits as you want, and you can do the circuit as fast or as slow as you want.  If you’re really challenged, just remember:  stop, take a breather, and take your time.  Just get through one circuit, you can work up to two or three later.

Still not convinced?  Do you seriously want to keep shaking your Sensa instead of your booty?  Here’s some more reasons to exercise:

1. Increase your HDL (good cholesterol)
2. Decrease your LDL (bad cholesterol)
3. Decrease your blood pressure
4. Decrease your risk for Type 2 Diabetes (or manage your diabetes)
5. Increase your metabolism (Pills don’t do this, action does)
6. Increase your stamina
7. Decrease your risk for heart disease
8. Boost your mood (that’s right, a dopamine AND serotonin boost without going to the pharmacy!)
9. Boost your energy
10. Decrease your risk for osteoporosis
11. Manage arthritis
12. Decrease your risk for falls
13. Decrease your risk for stroke
14. Decrease your risk for certain types of cancer
15. Control your weight
16. Sleep better
17. Have better sex (if that’s not motivation I don’t know what is)
18. Improve your focus as you get older (Squirrel!  Let me tell you, I’ll take any help I can get…)
19. It can be soooo much fun (Jump rope and tag were my favorite childhood memories)
20. And most important:  You are 100% worth the work.

My favorite cardio and strength training exercises are Zumba, Tone It Up, and Self’s Drop 10.  They’re  fun, very positive, and have a great community!

• Zumba is done in YMCA’s, gyms, and community centers all over the US!  It’s based off Latin dancing and I have patients who pay $30 a month at the gym and I have other patients who pay $2 a class at the community center!  They even have Water Zumba for lower impact… oh yeah, and you get to dance.  How much fun is that?!  Dance party!!!  Check out the many different classes available (even for kids) and locations: http://www.zumba.com/
• Tone It Up puts out a monthly calendar and try to keep things positive.  You can get as involved or uninvolved as you want.  I love to brag about my successes and even though I am not a frequent commenter on their Facebook I always get positive feedback.  Now, some of you might have met me (especially if you’ve been coming to Mixtures for a long time), but I’m not a perky, giggly person.  I’m pretty sarcastic (I know, you’re shocked) and blunt, but when it comes to working out I really need for someone to be positive and these girls (as smiley and irritatingly happy as they are) are incredibly supportive to their followers and make a point that no matter what size your are, you are worth the work.  When I started following them I couldn’t run worth beans.  A year + later I’m running and using heavier weights and able to do all the circuits.  It’s all about building up to it.  Follow them on facebook, twitter, and their blog and watch for their free workout videos (with accompanying PDFs) and HIIT workouts: http://toneitup.com/index.php  Trust me kids, man or woman, young or old, their workouts are great for working at your own pace.
• Self magazine released in April and May a Drop 10 eating and workout program!  The eating program even includes on the go items from Subway and Starbucks!  The best part?  It allows for fun calories like french fries and ice cream and chocolate (oh my!).  The workouts include cardiovascular three times a week and toning twice a week.  Even with my insane schedule I can fit it in AND I even followed the plan on vacation!  What you need?  Weights and your cardio of choice.  The girls at Tone It Up helped arrange the program too so it’s all very positive and if you can’t do something?  Just ask them what to substitute.  You may have a hard time with some of it, but you’re worth trying SOME of it.  The down side?  You have to sign up.  The upside?  Ummm losing at least 10 pounds.  Yes please: http://www.self.com/drop10

Remember, you’re worth it!

Do you have a favorite workout, video, or trainer?  Please share with the readers!  I know you people are reading and I’m dying for some real live comments (not just the bizarre spam that I filter out daily).

So we’ve all seen those commercials where someone is panicking about death and dying because their loved one is trying to feed them a popsicle laced with… high fructose corn syrup *dun dun dun.*  Their loved one then begins to tell them how corn sugar is the same as any other sugar blah, blah, blah.

Unfortunately, this isn’t entirely accurate in one way or the other.   As you will recall from the blog on carbohydrates, not all sugars are created equal.  The same is true with high fructose corn syrup and sugar (sucrose).  The main difference is how the body metabolizes fructose and sucrose.  Sucrose that we as our every day kitchen sugar is the most readily available form of energy.  The body will use it the minute it hits blood stream.  In fact, the moment that sucrose hits the tongue it is broken down into glucose for the body to use immediately.  This is why we use sucrose in diabetics to revive them during low blood sugar.  It is not only found in candy, but also in breads and fruits.

Fructose is also found in fruits, but not in such high concentrations as in soda and as a sweetening additive in so many other processed foods.  This additive that we know as “high fructose corn syrup” cannot be broken down into glucose like sucrose can.  Its simply a matter of breaking sucrose into its parts, glucose and fructose.  Since fructose is not concentrated the quantities of each, in moderation don’t cause as much of a problem.  Fructose, especially the concentrated sort, can be very dangerous in the doses that we consume it here in the United States.  Fructose must first be metabolized into fat before it can be transformed into glucose.  This is why people tell you that drinking soda is literally pouring on the pounds.  High fructose corn syrup is usually the first ingredient in soda and is often found in processed breads and sweets so instead of getting a little fructose from adding a cup of sugar to an ENTIRE batch of cookies we are drinking or eating a massive quantity of fructose from our processed foods.

How much sugar equivalents high fructose corn syrup adds! Remember what I said about concentration and quantitiy?

I want something to be noticed in what I just said.  Fructose, sucrose, and glucose are all apart of normal every day foods, but it is the quantity that makes it dangerous.  It is the quantity of everything we eat that has lead us to be a more unhealthy nation.  I’m going to say it again: “Everything in moderation!”  So go and have that popsicle on a hot day!  Have a root beer float for dessert or a ginger ale when your stomach hurts, but don’t chug down one soda after another and don’t make a habit of eating processed food every time you want a treat.  Treat yourself with some strawberries or a home made cookie.  Stay active and you can always enjoy life and your favorite treats, but do it all in moderation.

We live in a wonderful time where hormones are readily available to women for the treatment of menopause symptoms.  Hot flashes, fatigue, weight gain, hair loss, and low libido can all be treated with hormone replacement of estrogens (yes that’s plural), progesterone, and testosterone.  It’s all about balance, but sometimes the hormones cause undesirable side effects, sometimes hormones can’t be used (because of cancer or other health reasons), and sometimes the effects of menopause are mild enough that the blood tests and daily hormone replacement aren’t worth it to the woman.  Today I want to go over the top 5 most complained about menopause symptoms and non-hormonal ways to help make them more manageable.

Hot Flashes:  Hot flashes are caused by the body’s inability to thermoregulate because the hormone ratio’s are off.  This can be one of the most uncomfortable symptoms of menopause because it can effect someone at social events, it can effect sleep, and its just plain annoying.  You’re hot, you’re cold, you’re hot, you’re cold.  Oh my god MAKE IT STOP!  There are a few things that can help:

1. Watch your stress levels.  High stress can set off a hot flash.  That’ll teach you to lose your temper (hee hee).
2. Watch out for certain foods.  Caffeine and high sugar diets can set off hot flashes (that makes a frappuccino a bit of a no-no).  Spicy foods can also set off a hot flash.  To a degree it will take you figuring out what your own triggers are and avoiding them, if possible.
3. Dressing in layers can help because as you warm up you can peel the layers off and as you cool down you can restore those layers.
4. Keeping a cool rag handy, especially at night for those hot flashes that pop up and wake you up.
5. If you’re looking for supplements to help, taking 400IU of vitamin E a day can help and, if not, you can always add Evening Primrose oil supplements to the mix.

Fatigue:  This is being caused by the hormone changes and those wicked hot flashes that are keeping you up at night.  It also is probably being caused because of the type of people menopausal women are.  At this point in your life you are running around taking care of your significant other, children, work, friends, the dog, and pretty much everyone else but you.

1. Remember to take 10 minutes for yourself every day at least.  Sit down and relax and take some deep breaths.
2. Remember to eat healthy because this will help with your hormone balance and energy levels and start exercising to help with hormone regulation and boost your body’s energy levels.  Yoga is GREAT for this.  Deep breathing, stretching, and some really good kinesthetics!  It’s a great workout and also helps with relaxation.  It can be that workout you can squeeze in before bedtime without winding yourself up!
3. Remember, you can’t take care of anybody if you don’t take care of yourself!

Weight Gain:  I think this one really bothers women the most.  Your whole body changes in menopause and that belly fat that you may not have ever dealt with starts to creep in.  It’s hard and its frustrating.  Your body’s hormones change and your body becomes stressed.  Stress means that your body goes into starvation mode (Damn those animal instincts) and so it begins to store fat that we really don’t need.

1. The best way to handle this is to change your lifestyle.  Stay away from refined carbohydrates.
2. Lots of fruits, lots of veggies, lean protein, fiber, and portion control.  It’s not easy.  I hammer on it a lot (Yes I can feel you glaring at me right now).
3. If you mess up for a day don’t worry.
4. If you want a naughty day, that’s okay.
5. If your husband and kids don’t like spinach, tough cookies.  If Mama ain’t happy ain’t nobody happy.
6. Get out and exercise.  Take a bike ride, go for a walk, jump rope (so much fun!), do yoga, do tai chi, but do something.

Hair Loss:  This is an imbalance in the ratio between testosterone and estrogen.  This is so frustrating because women really define their femininity by their hair.

1. Make sure you are taking a multivitamin at this point.  I don’t suggest multivitamins normally, but prenatal vitamins can be really helpful for women suffering from this problem.
2. Add in Omega-3 fatty acids.  Fish oil and chia seeds are my favorite.  If those fish burps are bothering you put your fish oil in the fridge and remember taking over 1200mg can also decrease your risk for heart disease, help your skin and your memory.

Low Libido:  This is the thing that a lot of women don’t want to talk about.  Don’t worry.  You’re still dead sexy!  Menopause can really take a toll on your energy levels (see tips above), your confidence because of your body changing (pretty dang sure that person you’re sleeping next too doesn’t look the same as the day you met them either.  Remember you’re growing old together and that’s just bloody romantic), and you may be suffering from vaginal dryness. Vaginal dryness can really make sex painful and then it’s no wonder you don’t want to get intimate.  Ouch!

1. Get those omega-3 fatty acids in your diet again.
2. Do some kegels to strengthen up (yes it counts as working out) and encourage healthy cells.
3. Lubrication helps, but so would vitamin E suppositories and Cocoa Butter suppositories.  These things can be compounded fairly easily.
4. Just don’t be embarrassed to ask and talk to your doctor and your partner!

Remember, Mixtures Pharmacy is here to answer all your questions.  We can help you find the right supplement, find a great doctor, compound your medication, and try to make menopause as easy a transition as possible.  Just remember you need to take care of YOU.

Ideas For Management:

• Food Journals:  Write down what you ate, when it was, when you took your insulin, how much you took and your blood sugars.  If you do not use insulin a food journal will still be helpful for your doctor and diabetic educator.
• Use measuring devices:  Humans are HORRIBLE at estimating quantity.  Scales are relatively inexpensive and who doesn’t have measuring cups and spoons?
• Watch your carbs:  Shoot for ONE SERVING per meal (read that nutrition label)
• Exercise:  Chart this in your journal too.  This will help you see your progress and help you figure out how it helps your blood sugars and which ones are better for your sugars.  For example: I do much better with toning workouts because they keep my blood sugars steady.  If I do too high intensity of a workout my blood sugars crash (and then I raid the fridge).  No one says you need to run or do high intensity interval training.  Just go for a walk or do some weight lifting with some soup cans.  Something is always better than nothing.
• Stick yourself:  I know it isn’t pleasant to poke yourself with your lancets or your insulin needles.  I have an uncle who doesn’t like needles and he told my Grandmother (a long time diabetic) “Oh I’d die if I had to do that all the time.”  She told him “No, you’d die if you didn’t.”  If you don’t test when your doctor wants you to test then you’re ignoring your body.  Your pancreas and liver can’t keep track of your sugars anymore so it’s time for YOU to do it.
• Read, read, read:  Knowledge is power.  Don’t believe everything you read, but take what you read and ask for help deciphering its significance.
• Communicate with your doctor and pharmacist:  We’re here to help you.  If you don’t know how to read a nutrition label, ask!  If you want to know if those FiberOne Bars really are better for you, ASK!  No one is going to make fun of you.  If something about your treatment is frustrating you, tell us.

Questions to Ask:

• How does my medication work?
• When should I take my blood sugar?
• Why should I take my blood sugar at that time?
• How am I doing?
• What can I do to lose weight?
• What can I do to my diet to help manage my blood sugar better?
• I have an injury and I don’t know how to exercise.  What can I do?
• I feel overwhelmed.  Explain what is going on.
• What are my goals?
• How do I meet my goals?
• What goal should be my biggest priority?

Resources:

• http://www.calorieking.com  This is an internet site that also has books and apps that helps you figure out serving sizes, carbs, and calories.  It contains regular food AND restaurant food!  So handy to go out to dinner!
• http://www.diabetes.org/  This is the American Diabetes Association.  It is fairly easy to navigate and contains everything from diet, to fitness, to diabetes basics.  It is an AMAZING resource.  The only thing I don’t like is that sometimes they utilize the fake sugars too much, which have been clinically shown to cause weight gain.
• http://www.livestrong.com  This has food information, recipes, getting fit tips, help with smoking cessation, apps, food journals, articles.  Lots and lots of info and ideas!
• http://www.heart.org  The American Heart Association also has health tips, recipes, and getting fit tips.

There is so much information out there!  Go out and take diabetes by the horns.  Remember, you’re the boss!!