Strongwomen.com - Your Virtual Trainer with Dr. Miriam Nelson

We recently heard from Regine, a Strong Women reader who was going through a stressful period. On top of everything else, she was gaining weight. Our suggestion for both problems: exercise! You can read Regine's story below. Her messages included a suggestion: "You know, there must be lots of other women out there facing stressful situations. Do you think it might be helpful to focus on this in one of the newsletters?" Yes! Thank you, Regine, for bringing up this important topic.

Exercise is a terrific way to improve mood and decrease anxiety. Researchers have known for years that aerobic exercise counters depression, but only recently have we begun to explore the mood-enhancing benefits of strength training. A colleague of mine, Dr. Maria Fiatarone, did one of the first pilot studies, working with a small group of older men and women who suffered from depression. After 10 weeks of strength training, 14 out of the 16 people in the group no longer met the clinical criteria for depression! This improvement is equal to what we see from powerful medications - but without the side effects. We suspect that a combination of both aerobic exercise and strength training is the most effective for reducing stress and improving mood.

If you are down in the dumps or anxious because of difficult personal issues, I encourage you to rev up your exercise routine. It will help you combat depression, stress and anxiety - and may have other benefits, as it did for Regine.

Excerpt from Strong Women, Strong Bones: Everything you need to know to prevent, treat, and beat osteoporosis.

Unless we take vitamin D supplements, our bones change with the seasons, reflecting our exposure to the vitamin D-forming rays of the sun. Bone density reaches its annual peak after the summer. Seasonal losses begin later in the fall as days get shorter. We reach our annual low in late spring. And then the days grow longer again. The difference between high and low points can amount to 2 to 4 percent. That's why it's very important to consistently schedule bone density tests for the same time of year - otherwise you may just see seasonal changes.

Strong Women, Strong Bones will reach bookstores in early April. Meanwhile, you can get an early look by visiting the Strong Women web site http://www.strongwomen.com, where the first chapter is posted.

If you subscribe to Woman's Day, you'll find an excerpt in the April 18 issue, which should reach you at the end of March. If you're not a subscriber, you can buy the magazine from a newsstand or supermarket after April 1.

ln next month's Newsletter I'll tell you about my upcoming book tour for Strong Women, Strong Bones - I hope to be able to meet some of you as I travel around the country.

"If you're a woman with bones, you'll want to read Strong Women, Strong Bones. Like its best-selling predecessors, Strong Women Stay Young and Strong Women Stay Slim, this book teaches women how to take charge and make dramatic changes in their health and appearance through nutrition and an exercise program that includes strength training. The authors present the results of the latest scientific research as it applies to us directly - and in a clear, friendly, accessible style."

From the review by Joan Price, co-author of The Complete Idiot's Guide to Online Health and Fitness; author of The Complete Idiot's Guide to Online Medical Resources and Joan Price Says, Yes, You CAN Get in Shape! http://www.joanprice.com

"I am a 49 year old woman who has been doing the Strong Women Stay Young regimen for 15 months now. I love the way I feel both during and after the workouts. But I have gained 10 lbs. and inches around the waist and hips in spite of my regular exercising. My clothes are getting tight. What can I do to lose those inches that have crept up on me? Why isn't my exercising making a difference?"

In her message, Regine explained that she was going through a very stressful period: She had been working in Europe. Then her mother, who has Alzheimer's, was hospitalized in a coma. Regine returned to the US to arrange for her mother's care. That would have been plenty. But she was also dealing with upheaval concerning her job, not to mention perimenopause. She'd been taking medication to regulate her period, and wondered if that might be responsible for the gain - after all, she wasn't eating any differently. But she'd started using the medication many months before, and the weight gain was new.

"The usual culprits with weight gain are decreased physical activity and/or increased food intake. When someone has a major lifestyle change - as you did when you came back to the US - it's very easy to make small changes in activity and eating patterns that can add up over time. For example, if your everyday life at work involved more walking, standing, stair climbing, etc, than you're doing now, that could account for part of the change. Similarly, you might be eating differently without realizing it - for example, US portions tend to be much bigger than European portions. Again, the differences could be very small on any one day, but if nearly every day you're eating just 150 extra calories and burning 150 fewer calories, that would account for a 10-pound weight gain in four months."

Regine hadn't mentioned if she was doing aerobic exercise as well as strength training. We suggested that she start - for overall fitness and for stress reduction, as well as for her weight.

Regine wrote back immediately: "You are right - perhaps I am more sedentary now that I am at home. I have not been doing any aerobic activity (except snow shoveling :-) ). I run around a lot less now that I am not working and still have the same appetite. You really made me stop and think."

We had asked Regine for an update - and we've just heard from her again, with very good news:

"I have been riding a stationary bike 6 miles a day and I have already lost 4 lbs.! My clothes are once again loose and I am one happy camper!

I have been through the wringer and to gain weight to boot was just a horrible experience for me. Once I started doing my 6 miles of bicycling per day, and I saw the changes in my body, I got back my self-esteem. The last thing I thought of was that the change in my activity schedule allowed that weight to creep up on me. The solution seemed so simple when you gave it to me - and the fact that I could see the changes so quickly was exactly what I needed to continue to do it.

So many times those of us who experience severe stress forget the healthy alternatives that exercise offers us. Sure, 20 minutes or more of strenuous bicycling is hard, sweaty work but the results prove that a tiny commitment can make a big difference. We women often have little time left over for ourselves. I have made the commitment to take those 20 minutes of bicycling a day, because I've found out how important they are."

We applaud Regine for her success and her resolve to continue - and thank her for allowing us to tell her story.

These days, pregnant women are encouraged to stay active - though the specifics of that recommendation depend on each woman's individual situation. But if your doctor has given you the go-ahead, your next question may be "Where do I find maternity biking shorts?" FitMaternity.com (http://www.fitmaternity.com) carries a full line of exercise clothing designed for expectant moms. Also helpful are the well-researched articles on the web site (click on "Fitness tips"), including suggestions about strength

"I had a problem as I passed 10 pounds on the leg weights was that they slipped down over my feet. Although I wear shoes, I have found that wrapping a second athletic sock around my ankles under the weights not only makes them fit better but also cushions the bones from the weights."

Q: I read your book, SWSY, with interest and started your program. My mother-in-law, who is 75 and has osteoporosis, was interested. But her physician recently told her that with her degree of osteoporosis, the exercises might be dangerous as she could break a bone spontaneously as her weights increased or if she "did them wrong." She wrote to me asking for another opinion. How about yours?

A: I'm not a MD and can't second-guess her doctor - someone who has had the opportunity to examine her and assess her condition. However, I can tell you that many women with osteoporosis have followed this program and benefited from it. Perhaps her doctor would be willing to have her begin very conservatively under the supervision of a knowledgeable personal trainer, who can modify the program as needed for her individual limitations. Or maybe your mother would benefit from a second opinion from an osteoporosis specialist who is familiar with recent research on the benefits of strength training.

Q: I'm a runner and have recently switched to a treadmill for the winter. I use a heart rate monitor when I run. I am 42, weigh 127 pounds and am in good health. Various articles tell me to run at various rates. According to the heart rate monitor manufacturer, I should work out between 117 - 151 beats per minute. According to a recent article in RoadRunner Sports online magazine, the rate should be 138. According to Dr. Anderson of Runner's World magazine, I could go up to about 170 beats per minute; an article I read today (in yet another online magazine) also would allow me to run at up to 170 beats per minute. When I run at what I feel a comfortable pace for me (about 11-minute mile pace) my heart rate stays at about 155 - 160. So what's the deal?

A: About your heart rate: There's no single right answer, which is why you're seeing so many answers. I assume you know the standard formula for estimating your maximum heart rate: 220 minus your age. Some people prefer to work out at 60-65% of their maximum heart rate; others like to have more strenuous workouts at 80% or even close to 90% of max. If someone is writing for an audience of athletes, they'd suggest higher heart rate goals (typically 75-85% of maximum than if they're writing for ordinary people who just want to get some exercise to improve fitness and health (60-75% of maximum).

Let's take a closer look at your situation. Since you're 42, the formula (220 minus your age) gives you a maximum heart rate of 178.
60%=107
80%=142
90%=160

Assuming you don't have special health issues, if you can carry on a conversation while you're running (it's okay if you're breathing moderately hard), and if you feel good during and after, you're probably not overdoing it. If you're getting your heart rate all the way up to 155-160, you're exercising at the higher end of the intensity scale, into athletic training. That's fine - provided you aren't injuring yourself. Research shows that it's important for health and for avoiding injuries to have a few easy days on your workout schedule, where you exercise at lower intensity, and to take at least one day off per week.

If you have any risk factors for heart disease, such as a family history of heart disease, you might want to mention your exercise program to your doctor in case he or she wants to make recommendations.

Here are excerpts from a few of the inspiring letters we've received recently. If you enjoy reading them, check out the collection of reader mail on our Web site and in back issues of the Newsletter.

"I am a family doctor in Maine. For years I have been frustrated in my efforts to recommend a good physical program to my patients - many can't afford the cost of a gym or fitness center and others wouldn't go even if they could. The winters make it hard to get out and walk. A friend recommended your book and from the minute I bought it I read it straight through. I started the program myself and am becoming fanatic in my praise for the program (I feel FANTASTIC!) I gave the book and a set of weights to my mother for her 71st birthday as an 'osteoporosis prevention kit', and to my surprise, she loves it too. I keep a copy in each exam room in my office, along with some dumbbells I've outgrown, and advertise it at least once a day. I've received thank-you notes from patients for recommending this to them. Thank you - your program is exactly what this doctor is ordering!"

"I'm thoroughly enjoying the Strong Women Stay Slim program: I'm ignoring the scales and focusing on a healthy life instead of a low weight. This is a real change in mindset for me, and a very exciting and important one. I have a very demanding job, which is structured so as to maximize the stress in my life. I work full time, but combine working from home and in the office - which means I play with my little boy in the day, but am often working at 3am. As well, we have been extending our house for the last six months - constant builder-stress! I need all the energy I can get!

Forcing myself to exercise has already improved my stress management and energy levels - not to mention my relationship with my husband and our sex life! All this in two weeks!"

Sweet and Sour Red Cabbage

This is one of those treasured recipes that's simple enough for every day, but good enough for company. Red cabbage is a traditional accompaniment for pork; however, it makes an excellent partner for any roast. For a stunning - and ultra-healthy! - vegetable platter, serve the burgundy-colored cabbage with green steamed broccoli and bright orange winter squash. If you're pressed for time, buy cabbage that's already washed and shredded.

Ingredients

1 teaspoon oil

1 onion, diced

2 apples, cored and diced

1 small head red cabbage, shredded

1/3 cup flavorful vinegar, preferably Balsamic or wine vinegar

2 tablespoons brown sugar

1 tablespoon caraway seeds (optional)

1/4 teaspoon salt, or to taste

Use a paper towel or spray pump to very lightly coat a large frying pan with oil. Sauté the onion and apples until they're soft, stirring occasionally for about 5-10 minutes. Meanwhile, shred the cabbage and add to the onion and apple. Also add the vinegar, brown sugar and optional caraway seeds, stirring to mix the ingredients. Cover the frying pan and cook at low temperature for about 30 minutes, stirring occasionally. Check often at the end of the cooking period, to prevent burning. You can add water - about 1/4 to 1/2 cup at a time if the cabbage seems to be drying out. Taste, and add salt if necessary.

Yield: 4 servings (these are large servings; if you serve three vegetables, one small cabbage will serve 8)

Each serving:

2 Vegetables

1/2 Fruit

1 Extra