Category: Nutrition

Four Fitness Tracking and Analytics Mobile Apps to Get Your Heart Pumping

These apps offer a tangible way for the body conscious to track calories, monitor steps, and link with friends to stay fit and motivated.  



FitnessPalLogoWhat It Is: MyFitnessPal is one of the fastest and easiest to use calorie counter fitness apps for the iPhone and iPad. With the largest food database (containing over three million food items), the platform is great for keeping track of calories, tracking cardio and strength training and nutrient intake. 

Great Features: You can enter your own recipes and calculate each’s nutritional contents, connect with friends to easily track and motivate each other, and customize weight loss goals based on your specific diet.

Awards: PC Magazine Editor’s Choice Selection and Wired Magazine’s Editor’s Pick for Lifestyle Apps
Cost: Free. Available for iOS, Android, Windows Phone, and BlackBerry.



FitocracyLogoWhat It Is: As the fitness word becomes increasingly social, Fitocracy enables you to join a community of “Fitocrats” who will keep you motivated on your weight loss or get buff journey. This app enables you to track your workouts, earn points, unlock achievements, and if you’re competitive, there’s plenty of that too. 

Great Features:  Fitocracy offers a newsfeed to track friend’s progress and allows you to rearrange workouts, add supersets, circuits, and save routines

Awards: App of the Year by Men’s Journal and Mashable’s Top Innovation in Health and Fitness Winner
Cost: Free. Available for iOS and Android.


Nike Training Club

NikeTrainingClubLogoWhat It Is:  The Nike Fitness app features a collection of visual workouts hosted by celebrity athletes like Serena Williams.  Choose your fitness level and goal, and Nike Training Club picks from more than 100 workouts to get you on the fast track to fit.

Great Features: Nike Training Club features month-long structured programs that’ll help you achieve better results along with 15, 30 and 45-minute workouts featuring audio guidance and video demos from top Nike trainers and athletes.
Cost: Free. Available for iOS and Android.



MovesLogoWhat It Is: Moves is a smart pedometer that records everything from steps taken in a day to miles cycled.  Just carry your phone in your pocket or bag and Moves automatically tracks your everyday exercise.

Great Features: The app’s daily maps and “storylines” give users a new way to easily record and analyze their movement throughout the day, plotting your route on a map and showing calories burned for each activity.
Cost: Free. Available for iOS.

Nutrition, Personal Fitness, Weight loss

Want To Be a Better Version of You?

Accept the Challenge in 2014 

Walk ParkWonder diets and quick weight loss plans get a lot of attention with the start of each New Year. I suggest skipping extreme solutions. Dropping 20 lb. and gaining it right back is not success. The real path to your best health, vitality and weight control requires commitment to a lifestyle that is practical. Here are a few practical suggestions for sustainable health and fitness improvements:

  1. Diet without counting calories. It is too much trouble to weigh and measure every bite of food you put in your mouth. Use portion control and avoid calorie dense foods.
  2. Hit your goal 80% of the time. If you are a perfectionist you will be disabled by your disappointment. Perfect is definitely not practical. So allow yourself some margin.
  3. Keep a journal so you are accountable and honest with yourself.
  4. Drink 11-12 glasses of water a day to combat hunger and fill your stomach.
  5. Keep moving!! You have to move to lose weight and exercise is a good to fight anxiety and depression. 
  6. Weigh weekly to avoid weight drift.
  7. Your weekly exercise routine should include 30 minutes of cardio a least 3 times and resistance training 2-3 times. Find exercise you like doing. Make your exercise social. Exercise with a friend to accomplish two important functions at once.

A sound body requires a sound mind. Learning methods for managing stress and building resilience are important for the sustainability of your challenge. Most women are so accustomed to being caretakers, they neglect their own needs, both physical and psychological. Make time for your mental and physical well being.   

Announcements, Anti-aging, Body Contouring, Doctor-Patient Relationship, Exercise, Nutrition, Personal Fitness, Weight loss

Plastic Surgery after Bariatric Surgery Shown to Improve Long Term Weight Control

Weight lossBeing massively overweight is associated with poor body image, low self-esteem and reduced health related quality of life. In the United States, over 100,000 bariatric surgeries are performed annually to address these health concerns. Gastric bypass, the most frequently performed weight loss procedure, allows rapid weight loss in the first 18 months. However, half of these people gradually regain 10-15 % of the lost weight over the next 10 years. Those regained pounds undo some of the improvements the bariatric surgery brought. A new study reported out of Geneva Switzerland shows that those who have body contouring plastic surgery for the excess skin after massive weight loss are more successful at keeping the weight off for the long haul.

A group of patients who had undergone gastric bypass surgery between the years of 1999 and 2007 were compared for their ability to keep the weight off. Average weight loss was an impressive 99 lb. With a follow up of seven years, the 102 people who had not chosen to have plastic surgery to get rid of the deflated skin had regained an average of 50 lb. However the 98 people who chose body contouring plastic surgery to complete the process after their bariatric surgery only regained an average of 13 lb. over the seven year period.

The authors conclude that bariatric plastic surgery is crucial for successful treatment of morbid obesity. The plastic surgery improves psychosocial functioning and strengthens long term weight loss maintenance., October 2013

Anti-aging, Body Contouring, Doctor-Patient Relationship, Mommy Makeover, Nutrition, Personal Fitness, Uncategorized, Weight loss

Planning on Being a Better You in 2013? Get a Plan you Can Stick With

ApplewtapemeasAll of us want to be a better version of our self, so as the calendar turns over another year, it is the occasion to declare a fresh start. Most of us pick goals that have personal meaning, often connected to how our bodies look and feel. My friends are working out more, de-toxing, exercising, eating organic and losing weight. Health clubs get a surge of new member in January and Weight Watcher’s sessions are full.

So why is it that by spring 90% of  New Year’s resolutions have been abandoned? It is human nature to lose our resolve and return to old habits. So how do we convert to that healthy lifestyle and make it stick? Here are a few suggestions:

  1. Start simple and concrete. Resolutions that are too broad, too big, or too drastic are doomed to fail. Think big, but start small.
  2. Write down the change you plan to make and post it several places. The act of writing it makes the commitment more engrained. Posting a reminder in several places re-enforces the plan. 

You may choose to stop drinking soda or other high calorie drinks. Reminders on the refrigerator or near your bathroom scales can keep it fresh in your mind. Outlook or smart phones can be good to keep you on track. Try emailing yourself daily.

  1. Give a commitment of 21 days, rather than forever. It takes 21 days to form a habit and the short time frame will help you avoid discouragement.
  2. Re-evaluate at three weeks. If you could not reach this goal, try to identify the challenges and come up with solutions. Write down your revised strategy to re-new your commitment. If you did succeed, try adding a new habit to change.
  3. Don’t procrastinate. The next time you start you will wish you had done it sooner. No time like the present. Just do it.

Once you change a small habit you can keep it for a lifetime. Being a better version of ourselves is an accessible goal!

Doctor-Patient Relationship, Nutrition, Personal Fitness, Skin Care, Weight loss

What Causes Dark Circles Beneath the Eyes?

Aging is the Most Common Cause

Your eyes are believed to be a window to the soul. They convey a full range of expression and make a difference in how you are perceived in terms of health and beauty. Dark circles beneath the eyes are detractors. They suggest fatigue or sadness or being past your prime. The physical characteristic can suggest troubles even when your emotions do not match. What causes dark circles and what can be done about them? 

Some people have dark eyelid skin that they inherited from their parents. “Hyper pigmentation” is benign, but just as it is impossible to erase a leopard’s spots, it is difficult to change the natural color of your skin if that is your genetic type. 

Illnesses can cause changes in the tissues around the eyes. Lack of sleep, smoking, and excessive alcohol intake are lifestyle choices that negatively impact the appearance of your eyes. Thyroid, kidney and liver disorders can contribute to dark under-eye circles. Allergies, asthma, and circulatory diseases cause swelling that may lead to eyelid changes. 

For those of us in good general health who were not born with dark lower eyelid skin, the most common cause of circles under the eye is simply aging. Eyelid skin is thin and cheek skin is thick. The zone where thin meets thick is called the “lid-cheek junction.” This line begins to drop as we age. The zone between eyelid and cheek becomes more pronounced and the surface irregularity casts a shadow that creates the dark circle. The lower eyelid shape changes and looks like an upside down triangle with its peak pointing away from the middle of the eye. The line from the inner corner of your eye to the peak of the triangle is referred to by plastic surgeons as the “tear trough deformity.”

The problem can be a combination of dark skin pigment, loose skin, fine wrinkling, excess fat, or loss of fat, gravitational forces and irregular contour.

So what choices are there for dark lower eyelids? Treatment begins with identifying the cause.

1. Hyper pigmentation is caused by excess brown pigment (melanin) in the skin. This may be responsive to fade creams, such as hydroquinone, chemical peels, and sun screens. Other skin care products such as Retin A can be useful. 

2. If the cause of the shadow beneath the eye is a contour abnormality, then injectable fillers such as Restylane and Juvederm can be placed in the tear trough deformity for an improvement that lasts 6-9 months.

3. A blepharoplasty is eyelid surgery that gives long lasting improvement for the eyelid changes of aging. It tightens eyelid skin, repositions fat in the orbit, and smoothes the transition from lower lid to cheek. For more on this topic check out Services>Surgical Facial and visit my Facial Procedures gallery.

Anti-aging, Beauty, Blepharoplasty, Nutrition, Skin Care

Herbal Supplements Can Increase Bleeding Risk at Surgery

Sixty percent of Americans choose homeopathic drugs, food supplements, or herbal products as an alternative to traditional medications to enhance their health. These products are pharmacologically active and naturally occurring plant extracts. Because their source is “natural” and they are sold without a prescription, they have increased in popularity for those seeking a wholesome life style. Despite their natural source, supplements can contribute to prolonged and excessive bleeding at surgery. Here is a list of some of the commonly used complementary/alternative medical products that can be harmful when combined with surgery. The following should be tapered and then discontinued two to three weeks before surgery.

BAICAL SKULLCAP (Chinese Skullcap)- This herb has been used by the Chinese for irritability and dysentery. It interferes with coagulation and can cause bleeding.

BROMELIN. This extract of pineapple is used to treat arthritis. It interferes with platelet function and can cause bleeding.

CHINESE AGRIMONY- This remedy is used for cough and colds, pain relief, and infections. It markedly increases the risk of bleeding.

CHINESE PEONY- Used for gastric upset, this flowering plant interferes with coagulation.

FEVERFEW- Used to reduce fever, treat arthritis and prevent migraines, feverfew can result in withdrawal symptoms as it is discontinued.

FRITILLARIA- This bulb is cooked and eaten to treat hypertension, lung problems and opium toxicity. DAN S HEN- This Chinese product is used for stroke, angina, arthritis, insomnia, and menstrual disorders. It has a powerful antiplatelet effect that leads to bleeding.

DEVIL’S CLAW- Used for centuries in South America for pain, fever, and digestion, Devil’s Claw interferes with normal coagulation.

GARLIC- Garlic has been used as a medicine for centuries. It has been advocated for high blood pressure, fungal infections, heart attack and cancer. There is good evidence of garlic in high doses resulting in bleeding, nausea and vomiting as well as low blood sugar.

GINGER- Ginger is for gastric, distress, migraines and headaches. It is known to interfere with platelet function.

GINSENG- Conditions treated with ginger include colic, infections, aging, and stress. It can increase bleeding, and have side effects of nausea, headaches, and blood pressure changes.

GINKO- Used to treat Alzheimer’s and other memory disorders, ginkgo has been associated with excess perioperative bleeding.

LICORICE- Used for peptic ulcers, cancer, and adrenal insufficiency, licorice can increase bleeding, result in hypertension and lower potassium levels.

CAPSAICIN (red chili pepper)- Capsaicin has been recommended for pain relief, itching and psoriasis. It interferes with platelet function.

SAW PALMETTO- this is a treatment for an enlarged prostate and urinary tract infections. It interferes with normal coagulation.

OIL of WINTERGREEN- Prescribed for inflammation, joint pain, and hypertension, this food flavoring agent has been associated with prolonged surgical bleeding. GEUM JAPONICUM- This diuretic can cause prolongation of clotting time.

JAPANESE HONEYSUCKLE- Homeopathic remedy for fever, ore throat, headache, and infection, Japanese honeysuckle interferes with platelet function.

DAN SHEN- Conditions treated with dan shen include atherosclerosis, insomnia, menstrual disorders, HIV, stroke, angina, and prostatitis. It blocks platelet function and can lead to prolonged bleeding.

VITAMIN E- Popular as an anti-cancer anti-oxidant there is increase in bleeding risk with high does.

FISH OIL- Fish oils are popular for their anti-cardiovascular disease benefits. It is also used to treat dry eyes. Prolonged bleeding times occur and is dependent on the dose.

ARNICA MONTANA- Used in Europe to treat arthritis and muscle aches, it has been popular to reduce postoperative bleeding and swelling. It is associated with bleeding as it interferes with platelets.

CHONDROITAN and GLUCOSAMINE – These two are often taken together to enhance cartilage repair. They increase bleeding potential. Supplements and old-fashioned remedies are not generally thought of as medicines and thus many do not mention them to their doctors. These substances may have been in use for centuries, but they can have harmful effects at the time of surgery. They are classified as a food rather than a drug, so they escape FDA regulation. This can make them variable in quality or dosage.

Make sure your surgeon knows what non-prescription items you are taking so as to avoid any unsafe interactions at the time of your procedure.

Doctor-Patient Relationship, Nutrition, Personal Fitness

What Prompts Successful LIFESTYLE CHANGES for Weight Loss?

In the United States one third of adults are Obese (BMI >30). OBESITY brings a burden of increased medical problems and risk of premature death. Excess body mass significantly decreases energy, activity and sense of well being, not to mention body image. Many resources, public and private are being devoted to combating this epidemic. MICHELLE OBAMA has made anti-obesity her signature issue in the “Let’s Move” campaign.

The Nov 24, 2011 NEW ENGLAND JOURNAL of MEDICINE published a randomized controlled study in 415 obese people to compare two different approaches to supporting WEIGHT LOSS. All patients were followed by their doctors for a two year period. One group of subjects had weight loss coaches that provided in-person support with both group and individual sessions. A second group had its counseling provided remotely by e-mail, phone or web site. The third group was entirely self directed without supplemental advise or support.  

The self directed (non-supported) control group had a mean weight loss of .8 kg, not much change at two years. The two groups that received support both were able to maintain a 5% weight reduction. This modest weight loss is a good start on decreasing cardiovascular and diabetic risk even if it is still a far distance from being at ideal body weight. The group with face-to face coaching did slightly better than those who received their support on line, but support was critical.

The take home lesson is that lifestyle changes are hard to maintain especially when attempted all by yourself.  Education and encouragement make a difference in being able to sustain change in habits. You may lack both time and money for one on one coaching, but taking advantage of on line support systems may be a very good method to reinforce behavioral modifications. Most health clubs offer a supervised program to track diet and exercise. There are multiple web sites for monitoring calorie intake and exercise to track progress in those key behaviors. Here are a few you might find helpful: – Weight Watcher’s Support Network – Weight-Control Information Network – Web site with resources for surgical weight loss – Successful group based on the 12 Steps model

Don’t forget to keep moving!

Nutrition, Personal Fitness, Weight loss

The New England journal of Medicine Explains: Why It Is So Hard to Maintain Weight Loss?

Yo-yo dieters know the disappointment of working hard to achieve a weight loss goal and having the progress fade away as soon as the discipline is relaxed. What makes it so difficult to stay at a stable weight once the pounds have been shed? The October 27,2011 edition of the New England Journal of Medicine (vol.365. No.17 p1597) provided a valuable study that provided some clues to the metabolic explanation.  Researchers from the University of Melbourne in Australia published their study of 50 overweight men and women that were enrolled in a 10 week calorie restriction weight loss program. Hormones were measured before the diet, at 10 weeks, and one year later. The hormones they examined were those known to be responsible for appetite control. These substances are released from the gastrointestinal tract, the pancreas, and fat stores. The hormones circulate to the hypothalamus in the brain where they regulate food intake and energy expenditure. When caloric restriction begins the body increases the output of hormones that create hunger and decrease energy expenditure. In other words these hormones fight to keep the weight on as you struggle to keep it off. If we lived in an area of famine this would be adaptive. In our culture with an overabundance of food, it is difficult to turn off the system that is counter productive in the modern world.

The researchers found that at 10 weeks the dieters had lost an average of 13.5 kg or 14% body weight. One year later they had regained an average of 5.5 kg so that their weight loss from the beginning was only 8.2%. The hormones of starvation were all increased at week 10 and one year contributing to the creep up in weight. These hormones had not returned to normal levels even as weight gain was occurring. A strong physiologic basis appeared to be the cause of regaining weight rather than voluntary resumption of old habits.

These studies will allow researchers to focus on ways to alter the appetite controlling hormones.

Nutrition, Personal Fitness, Weight loss

Summer sports

Summer seems to be an ideal time for setting  personal fitness goals. When the days are long and the sun is out Seattelites seem to have lots of energy and see that much is possible. I have long been a fan of triathlons, especially the Danskin. The terrific thing about the Danskin is that there are women of all ages and sizes who have just decided to get more fit. The idea of the race seems to be for the many participants to have a goal to work towards and have fun accomplishing that goal. It’s a helpful supportive environment that is about enjoying fitness, not competition.  

Having a summer sporting goal such as a triathlon can be a good way to schedule exercise on a regular basis to maintain a healthy lifestyle.  It’s helpful for weight loss, body toning, aerobic fitness and of course, fun.  

Many of my patients are athletic and recognize that regular workouts are a critical part of feeling good about your body.  Plastic surgery works best on those who maintain their fitness. For some, body contouring procedures can be a confidence lifting step that helps to motivate them for healthy choices.

I’ll be doing the Seafair and the Danskin triathlons this summer.  Hope to see you there.

Breast health, Nutrition, Personal Fitness

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