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Dr. Nina Radford, Cooper Clinic director of cardiovascular medicine is interviewed by Todd Whitthorne, and gives her thoughts on the ENCORE study as discussed at the recent American College of Cardiology conference.

The ENCORE trial looked lifestyle interventions for lowering blood pressure. Itâs been well described that a diet called the DASH Diet has been associated with reductions in blood pressure. The diet heavily emphasizes fruits and vegetables and has been very effective at lower blood pressure by 10- to 15 points, as much blood pressure lowering effect as many medications offer.

What isnât known is what happens when the DASH Diet is combined with exercise and caloric restriction for weight loss. In the ENCORE study, healthy overweight individuals with slightly elevated blood pressure were put into one of three groups:

        Group 1 â DASH Diet only

        Group 2 â DASH Diet plus behavioral weight management (including supervised exercise three times weekly)

        Group 3 â Usual Care

Researchers found that the participants who followed the DASH diet and also received behavioral weight management support had the best results in managing their blood pressure.

The DASH Diet recommends 9- to 11 servings of fruits and vegetables daily. Dr. Radford urges us to not get overwhelmed by this recommendation. Our serving sizes are simply out of whack. One-half cup orange juice (4 ounces), an amount most of us would find piddling in our glass, counts as one fruit. And a couple of slices of tomatoes on your sandwich at lunch is going to be vegetable serving. We really donât have to eat a giant vat of fruits and vegetables. At lunch, make sure the sandwich has lettuce and tomato, and substitute fruit instead of chips. The biggest obstacle in getting the recommended servings for most people is planning: weâre going to have to go to the grocery store of farmers market and make sure we have the fruits and vegetables available to us. And, when we get home we need to clean and package them up for serving so when we go to reach for a snack or make a meal, including the fruits and vegetables is easy.

Dr. Radford also briefly discusses salt intake for the average person who has slightly elevated blood pressure. In general, reducing the amount of salt we use has less impact on our blood pressure then increasing our intake of fruits and vegetables. This said, Dr. Radford suggests we start a salt reduction plan by eliminating the salt shaker from our dinner table.

The Poly Pill was also discussed that the American College of Cardiology Conference. A Poly Pill combines blood pressure medication, one cholesterol lowering medication, and low-dose aspirin combined into one product. In a large test in India, researchers found the Poly Pill performed well â it lowered blood pressure, reduced cholesterol, and made the blood less sticky. However, this âone size fits allâ pill also has a downside. Researchers found that approximately one third of the participants stopped taking the medication after three months because of side effects.

Dr. Radford says there are seven or eight different classes of blood pressure drugs. Your physician picks the one they believe will work best given your specific health history and condition. The Poly Pill takes this individualization out of the picture. But, for the folks who can tolerate the Poly Pill, itâs a great possible solution to blood pressure control.

Jill Turner is VP of Operations for Cooper Concepts, the company that markets Cooper Complete nutritional supplements. Jill regularly contributes information to the Cooper blog. Email jsturner@cooperwellness.com or call 972-560-3262 with your questions and comments.

Reference Information

American College of Cardiology

http://www.acc.org/

ENCORE Study

http://www.cardiosource.com/rapidnewssummaries/summary.asp?SumID=414

Total mortality after changes in leisure time physical activity in 50 year old men: 35 year follow-up of population based cohort

http://www.bmj.com/cgi/content/full/338/mar05_2/b688

DASH Eating Plan â Your Guide to Lowering Your Blood Pressure With DASH

http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf

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Todd Whitthorne interviews Colette Cole, a personal trainer at Cooper Fitness Center. Colette has a masters degree in exercise physiology, and co-authored Womenâs Health and Fitness Guide with Michele Kettles, M.D., M.S.P.H., medical director of Cooper Clinic in Dallas.

Research shows lifestyle changes such as increasing physical activity and eating a healthy diet can reduce the risk for developing many chronic diseases, and can help manage existing health conditions.  With this in mind, Colette started Female Focus, a four- week lifestyle program specifically for women, concentrating on a range of health topics including fibromyalgia, osteoporosis and cancer. Each group of 8- to 10 women meets twice each week for a group exercise class which focuses on the individual needs of the participants. The class aims to teach both how- and why- each exercise is done, and also includes nutrition coaching from a registered dietitian.

Although the health benefits of exercise are known, when we need to exercise often the first thing we donât want to do is exercise. The class is designed to help women work through barriers to exercise. Colette says the small group dynamic is fantastic. Exercising with a group is motivating and Female Focus offers the benefits of group motivation in small enough classes where participants are ensured personalized attention. Research supports that if we exercise with a âbuddyâ weâre more likely to stick with it.  Colette has noticed that often after a class has ended, the women will continue their friendships and get together to attend a yoga or pilates class, or to walk on the track.

Statistics show one in two women will get osteoporosis, a largely preventable disease, and 30 to 40 percent of the women enrolled in the class are there to prevent osteoporosis. Exercise can improve osteopenia, especially in the trunk. Increasing strength helps prevent falls and improve balance.

Many women lack the knowledge or may be intimidated by strength training and mistakenly participate in cardio training only. Colette believes this is a mistake. Itâs a misconception that weight training builds âbulkâ in women â in fact itâs the opposite. Strength training helps slim, tone, curve and shape the female figure.  Female Focus classes concentrate on increasing trunk strength and balance to prevent falls as well as incorporating exercise into everyday activities outside of class. 

For people who donât have access to Cooper Fitness Center, Todd and Colette talk about how to find a good personal trainer. There are folks in many health clubs who became personal trainers after a 4- or 5 day class. Coletteâs advice is to look for a Certified Personal Trainer who has a college degree in exercise physiology, kinesiology, or another related field of study. In addition, the trainer needs to be certified from a reputable organization such as the National Academy of Sports Medicine, Cooper Institute, National Strength and Conditioning Association or IDEA.  Continuing education is also key â thereâs always new info coming out, so a good personal trainer will continue to engage in ongoing training. Finally, find someone with experience in the area for the need you have. Personal trainers tend to have specialties, so look for someone who has experience working with people who have similar issues.

To enroll in Female Focus, or for more information, contact Colette Cole at 972-233-4832.
 
Jill Turner is VP of Operations for Cooper Concepts, the company that markets Cooper Complete nutritional supplements. Jill regularly contributes information to the Cooper blog. Email jsturner@cooperwellness.com or call 972-560-3262 with your questions and comments.

Reference Information

Cooper Fitness Center Female Focus program information

Womenâs Health and Fitness Guide book

IDEA Health & Fitness Association

National Strength and Conditioning Association (NSCA)

National Academy of Sports Medicine (NASM) 

The Cooper Institute

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Dr. Radford reviews how changes in physical activity impact longevity
Dr. Nina Radford, Cooper Clinic director of cardiovascular medicine was interviewed by Todd Whitthorne, and gave her thoughts on the recent study published in the British Medical Journal looking at lifestyle changes in terms of physical activity for 50-year old men, in a 35-year follow-up.

Dr. Radford reports that patients often come into Cooper Clinic for the first time around age 50. The good news is, even if you start to adopt healthy lifestyles at age 50, youâll see lots of benefits. The study supports Dr. Radfordâs assertion that positive lifestyle changes positively impact overall health.

In the study reported in the British Medical Journal, 2,200 Swedish men were evaluated at age 50 (between 1970 and 1973), and then re-evaluated at ages 60, 70, 77, and 82 years. Researchers wanted to determine the impact of physical activity in inactive, moderately active and very active men, and see if increased physical activity resulted in improved health benefits.

Increased physical activity was determined by asking a couple of simple questions. Men who answered âYesâ to âDo you spend most of your time reading, watching TV, going to the movies, or engaging in mostly sedentary activities?â were labeled low-activity.

The men labeled âmoderately activeâ answered âYesâ to the question âDo you often go walking or cycling for pleasure?â

Men who reported that they engage in any active recreational sport or heavy gardening at least 3 hours every week, or who stated they regularly engage in hard physical training or competitive sports were labeled high-activity.

Researchers followed these men over 35 years. In their conclusions, researchers stated âIncreased physical activity in middle age is eventually followed by a reduction in mortality to the same level as seen among men with constantly high physical activity. This reduction is comparable with that associated with smoking cessation.â

Dr. Radford says it took about 10 years in the high-activity level for the previously low- or medium-active men to realize the increased health benefits of the men who had constantly high had physical activity. The benefits were significant though â researchers saw a reduction in cardiac risk for these guys â as much as the benefits seen when someone stops smoking.

Todd mentions that research shows over-and-over that 150 minutes of exercise per week seems to be the magic number we need to meet in order to get all the health benefits of exercise. Dr. Radford noted that the 3 hours (180 minutes) of exercise seen in the study was pretty minimal given the incredible health rewards.

Dr. Radford suggests that people following as few as 2 reality shows a week probably spend 5- to 6 hours in front of the TV for those programs. If time is tight, her recommendation is that spending time on the treadmill or exercise bike while watching a TV program is an easy way to âfindâ the time needed to exercise.

Jill Turner is VP of Operations for Cooper Concepts, the company that markets Cooper Complete nutritional supplements. Jill regularly contributes information to the Cooper blog. Email jsturner@cooperwellness.com or call 972-560-3262 with your questions and comments.

Reference Information
Total mortality after changes in leisure time physical activity in 50 year old men: 35 year follow-up of population based cohort
http://www.bmj.com/cgi/content/full/338/mar05_2/b688

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Dr. Mitchell talks about studies in the news

Dr. Tedd Mitchell, Cooper Clinic president and CEO is interviewed by Todd Whitthorne, and gives his thoughts on two recent news articles.

Prostate Test Found to Save Few Lives

Two big studies have recently been published regarding prostate cancer were published recently in the New England Journal of Medicine. One study was conducted here in the United States; the other encompassed several European countries. The headlines read âProstate Test Found To Save Few Lives.â Dr. Mitchell says these headlines donât change Cooper Clinic recommendations that men between 40- and 50 years of age get an initial PSA test.

Dr. Mitchell explains that the PSA (prostate-specific antigen) test is a bio marker in the blood. As the prostate gland ages, it grows in size and more of the PSA antigen is released. There are conditions (not just cancer) that can make the prostate release large amount of the antigen. The PSA test is a tool that physicians use to look at PSA levels over time.

Many men will die with prostate cancer but not from prostate cancer. Currently, for every 50 men who are diagnosed and treated for prostate cancer, the life of one man will be extended. For the other 49 men, their lifetime wonât vary. We donât yet know the impact of this statistic over 15- or 20 years.

Cooper Clinic recommends initial testing between 40 and 50 years of age. Dr. Mitchell believes the PSA test is important tool in helping to extend life. However, not all prostate cancers act the same, and itâs important that men diagnosed with prostate cancer work with their physician about a specific plan of action for their treatment. Younger men diagnosed with cancer tend to have a more aggressive form of prostate cancer. In addition, prostate cancer therapy is not without problems â there are side effects and levels of effectiveness. Itâs important to know the man to help determine the right level of therapy. For this reason, men need to review their PSA results with a physician who knows them, knows their general health, their psychological profile, etc.

Dr. Mitchell believes regular PSA testing is important as a series of PSA tests over a series of years is way more important than a single elevated PSA test. If you have someone whoâs had normal or low-end PSA tests, a big change, even if the result is still normal, is still a major concern.

Prevention: Gains From Exercise After Heart Attack Are Lost if Exercise Stops

A study published in the March 16 issue of the journal Circulation, looked at the impact of exercise after heart attack on flow-mediated dilation. Flow-mediated dilation is the flexibility of our arteries. Dr. Mitchell describes our arteries as being like a garden hose. The more flexible the garden hose, the more water that can flow through. An old or damaged garden hose will not pump as much water through it as a new garden hose. Post heart-attack, arteries have a reduced capacity to pump through blood.

The study contained 228 people divided into one of four groups:

        No exercise

        Strength training only

        Aerobic conditioning only

        Strength training & aerobic conditioning

The study found that heart attack survivors can improve the elasticity of their blood vessels through exercise.

Interestingly, each of the exercise groups saw good improvements in blow-mediated dilation. However, after 4 weeks of inactivity/non-exercise, the benefits of exercise were lost. As Dr. Cooper always says, fitness is a journey not a destination, and we canât store fitness.

Dr. Mitchell urges that itâs also important for us to do both aerobic and strength training. He regularly sees older adults who have good cardiovascular conditioning who donât do strength training and are withering away despite their cardiovascular health. Or, on the other hand the meathead who doesnât go to the track. Itâs the combination of fitness weâre after, and excluding one for the other is dysfunctional and simply not in our best interests.

Jill Turner is VP of Operations for Cooper Concepts, the company that markets Cooper Complete nutritional supplements. Jill regularly contributes information to the Cooper blog. Email jsturner@cooperwellness.com or call 972-560-3262 with your questions and comments.

Reference Information

Prostate Test Found To Save Few Lives

http://www.nytimes.com/2009/03/19/health/19cancer.html

Prevention: Gains From Exercise After Heart Attack Are Lost if Exercise Stops

http://www.nytimes.com/2009/03/24/health/24prev.html?partner=rss&emc=rss

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Doug Bibus, MS PhD is considered one of the top omega-3 experts in the world. Dr. Bibus visited Cooper Aerobics Center recently and took time to talk with Todd Whitthorne about omega-3s. Dr Bibusâs research interests include the role of essential fatty acids in nutrition, the role of omega 3 fatty acids in inflammatory response, the application of fatty acids in the treatment of disease and the impact of oxidative stress on performance.

As a researcher, Dr. Bibus analyzes the levels of omega-3 and omega-6 fatty acids in blood samples from both healthy and unhealthy people, and from various populations around the world, to see what people are eating, and to correlate health and disease with omega-3 levels in the blood.

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Cooper Fitness Center ( Dallas) personal trainer Shannon Edwards talks with Todd Whitthorne about the new Power Plate equipment the club is now utilizing, and the weekly Outdoor Power Workout class Shannon and personal trainer David Williams co-direct. Shannon was Cooper Fitness Center personal trainer of the year in 2008, and has a masters in kinesiology and exercise physiology.

Reference Information
-Power Plate http://us.powerplate.com/EN/Come to Cooper Fitness Center
To schedule a personal training session with Shannon Edwards, or to learn more about becoming a member of Cooper Fitness Center, call 972-233-4832 or  (http://www.cooperaerobics.com/For-Individuals/PersonalFitness.aspx) 

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Dr. Tedd Mitchell, Cooper Clinic president and CEO is interviewed by Todd Whitthorne, and gives his thoughts on the 21-year longitudinal study conducted by Stanford researchers to confirm disability and survival benefits of exercise.

Reduced Disability and Mortality Among Aging Runners

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Cooper Wellness Program director of nutrition and registered dietitian Kathy Duran-Thal claims she knows a little bit about a large array of topics when it comes to nutrition and healthy eating. Kathy talks hints and tips on how to simplify nutrition and make healthy eating exciting.

Included is a great breakfast idea, tips for successful weight loss losers, and dining out strategies.

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Dr. Abram Eisenstein, Cooper Clinic director of gastroenterology is interviewed by Todd Whitthorne. Fifty thousand Americans will die this year colon cancer, a largely preventable disease. Dr. Eisenstein discusses the major risk factors for colon cancer and how a colonoscopy can save your life.

Reference Information 

Association of Colonoscopy and Death From Colorectal Cancer: A Population-Based, Case-Control Study

How Much Does Colonoscopy Reduce Colon Cancer Mortality?

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