Diet and Exercise

Diet and Exercise

There is certainly a LOT of information available on the Internet about which types of diet might work for a variety of conditions. Some of the information can be helpful, others misleading.

For your reference, here is what we recommend to our patients about certain types of diets and exercise programs:

Calcium and Vitamin D Supplementation

For whom
Most women and men should make sure they have an adequate intake of calcium and vitamin D
Benefits
Reduces bone loss, reduces likelihood of fracture
Risks
High doses of calcium may increase risk of kidney stones
Recommendations
  • For pre-menopausal women: (and men): 1000 mg of daily calcium and 800 IU of Vitamin D
  • For post-menopausal women: 1500 mg of daily calcium and 800 IU of Vitamin D
  • Avoid taking more than 2000 mg of calcium per day
  • Take calcium in divided doses (500 mg 2-3 times per day) as doses above 500 mg are not readily absorbed
  • Avoid smoking or excessive alcohol consumption
  • Do some weight-bearing exercise (e.g. walking), ideally 30 minutes at a time, 3 days per week
Calcium Supplements
Calcium carbonate (e.g. Caltrate, Oscal, Tums): effective, inexpensive, best absorbed with a low-iron meal (such as breakfast), not readily absorbed in elderly or those with low stomach acidity. Chewable forms (e.g. Tums, Viactiv) are preferred and better absorbed.
Calcium citrate (e.g. Citracal): good for elderly individuals or those with low stomach acidity
Dietary Sources

300 mg of calcium can also be found in each of the following:

  • milk or yogurt (1 cup)
  • natural cheese (1.5 oz)
  • orange juice, calcium-fortified (9 oz)
  • broccoli (2 cups)
  • cooked spinach (1 1/2 cups)
  • cooked kale (1 1/2 cups)
  • salmon (3 oz)
  • firm tofu (3/4 cup)
  • sardines (6-7)

Homocysteine Lowering Diet

For whom
Those with high levels of homocysteine and a personal history of blood clots. May also benefit those who have high levels of homocysteine and who want to reduce their risk of stroke or heart attack (though research has not shown any benefit to date)
Benefits
May reduce the likelihood of blood clots and cardiovascular disease
Risks
Individuals may very rarely develop nerve dysfunction
Supplement Recommendations
  • Folic acid 1 mg/day
  • Vitamin B12 0.4 mg/day
  • B complex vitamin
Dietary Recommendations

Dietary sources of folic acid include:

  • leafy green vegetables
  • beans and peas
  • citrus fruits

Dietary sources of B-complex vitamins include:

  • potatoes
  • bananas
  • lentils
  • beer (yeasty brews)

Cholesterol Lowering Diet

For whom
Individuals with high cholesterol levels generally benefit from diet and lifestyle changes, independent of taking cholesterol-lowering medications
Benefits
May reduce the likelihood of heart attacks and strokes
Risks
Minimal
General Recommendations

Start by exercising daily. Exercise is well-proven to lower your triglycerides, raise your good cholesterol (HDL), lead to a healthier weight and decrease your overall cardiovascular disease.

Be more conscious of what you eat. Start by choosing the right fats. Avoid saturated fat (meats, creams, and fried foods), partially hydrogenated oils (processed foods), and fat substitutes (Olestra, shortening, and margarine).

Consume more omega 3 fatty acids contained in fish (salmon, tuna, and sardines), freshly ground flax seeds, nuts and nut butters (walnuts and pumpkin seeds have the highest amounts), and omega 3 fortified eggs.

If you have any doubt that you’re getting enough, it may be a good idea to add an omega 3 fatty acid supplement containing 300mg of both DHA and EPA. Also consume more monounsaturated fats contained in avocados and olive oil (extra virgin and first cold pressed is preferred).

Increase your consumption of fiber found in fruits, vegetables, beans, nuts and whole grains. These should be the foundation of any healthy diet. Though you can see the results in as little as six weeks, we wouldn’t recommend rechecking your level until at least a year to give you time to really embrace the changes.

Other helpful links

Lifestyle Recommendations for High Blood Pressure

For whom
Individuals with high blood pressure may benefit from a regular exercise program with associated weight loss
Benefits
May lower blood pressure by 5-15 mm and reduce risk of heart attacks and strokes. Secondary benefits of exercise include weight loss, decreased stress, improved mental capacity and other improvements in mood
Risks
Extreme forms of exercise should be avoided, particularly in those with active heart disease
General Recommendations

Start slowly. The changes you make need to be sustained over many years to have any meaningful impact. Avoid injury and discouragement by building a workable regimen into your lifestyle.

Try to do 20-30 minutes of low-impact aerobic exercise at a time. This could involve walking, light jogging, stair climbing, riding a bicycle, or swimming.

Target a heart rate of approximately 110-130 beats per minute (you should be able to have a comfortable conversation while exercising). To check your heart rate, place a finger on the thumb side of your wrist, about an inch from the base of your thumb and feel for a pulse. Count the beats you feel in 10 seconds and multiply by 6.

Work your way up to 2-3 days per week of regular exercise. The best form of exercise is built into your weekly schedule so it becomes part of your routine.

Combine your exercise program with a balanced meal low in fats and simple sugars to help improve your chances for weight loss.

Keep up the program. Once you stop, it’s much harder to start again.

If you experience an injury, stop exercising for a few days. Then slowly work your way back up to a regular program over the next few weeks.