Seniors Should Keep Moving

New Research posted in the journal Obesity found that exercise can help improve the daily activities of obese older adults. As people age, especially if they are obese, sometimes they lose the ability to perform day to day tasks or even walk short distances, which can negatively affect their independence. The study focused on balance, flexibility, walking and strength and found that obese seniors improved their mobility and decreased their risk for a mobility disorder when engaged in the exercise program compared to those that just received education. The take home message is that exercise is important at any age and at any weight. Exercise is vital to remain functional and independent, and its benefits must be taken seriously!


The Fame and Fortune of Being a TV Doc

My patients often ask me, “What is like to be ringside for the biggest fights in the world,” or “What is Mike Tyson like?”  Having worked professional fights for over 20 years from Madison Square Garden and Barclay’s to Mohegan Sun and Foxwoods, I have really had a lot of fun being a boxing doctor. It is fun for my patients to see me on tv and I enjoy when they tell me they saw me on HBO or Showtime over the weekend. I have presented on Ringside Medicine at conferences in Beijing, China and Berlin, Germany and of course numerous times in Las Vegas and Atlantic City. Traveling is part of the fun of being a ringside doc but meeting and teaching my fellow doctors around the world has been extremely rewarding and I know I am giving back to this great sport.

Working ringside is really about one thing – protecting the fighter. When do I stop a fight? The golden rule of ringside medicine is to stop the fight when the combatant can no longer adequately defend himself. For example, this happened at a fight I worked at in Yankee Stadium when one of the fighters tore his ACL. Also, at a fight on Long Island when one of the boxers dislocated his shoulder.  I have stopped numerous matches when a fighter’s eye was so swollen he could not see out of it or when a fighter just stopped throwing punches. Rarely will a boxer want to stop a fight and hardly ever will his cornermen (even if it is the fighter’s father) be willing to quit. It is my job to step up, evaluate and stop those fights.
Although I sit in the corner for the fights, I am working and not there to just enjoy the fight. While people are cheering for their fighter to destroy his or her opponent, I am hoping no one gets too badly hurt. I really enjoy the fights and the energy of the crowds is electrifying. However, when one of the fighters is taking a beating, it can be difficult to watch. The crowd does not want the fight to stop and it is only through years of experience and working hundreds of fights that I have developed the sense when it is time to end the fight. I have had great teachers and I thank them for how they have educated me. I am still learning and it is a great responsibility and honor to help protect these courageous athletes.
The glory of being a TV doc is great, but people don’t realize how much we do behind the scenes. The day before the bouts, we examine every fighter from head to toe. We review their blood tests, EKGs, and brain MRIs. The night of the fight we arrive around 3PM and often don’t leave until 1AM. We re-examine every fighter before the fight and again after the fight and of course sit in the corner during the fights. Typically, there are 6-10 fights in a night.  Assuming everything goes well, it is a fun night but exhausting.
Oh, and the question of how is Mike Tyson? He is very nice, but I would have to say the most intimidating person I have ever met in my entire life.
Cutting calories on white background

Not All Calories Are Equal

From a young age we are taught that the key to maintaining weight is to burn off as many calories as we ingest. We also have learned that weight loss occurs when we consume less calories than we expend, and that we gain weight when we eat more than we burn off. However, research over the past decade has shown us that this formula may not be quite as simple as it seems.

A calorie is actually a measurement of heat energy. Specifically, it is the amount of energy  that is needed to raise the temperature of one kilogram of water by one degree Celsius.  This heat energy is what gives our body fuel.  Our calories come from the protein, fat and carbohydrates that we eat. Protein and carbohydrates have 4 kcal/g, fat has 9 kcal/g, and alcohol has 7 kcal/g.

Current research shows us that the source of our calories is extremely important, and that different food groups affect our weight status differently. It is a myth that a calorie is just a calorie. While all calories do have the same amount of energy – 4184 Joules of energy – our body reacts to the sources of calories differently. This is because we digest and absorb various types of food differently. Those foods go through diverse biochemical pathways and affect hormones in the body, which may also affect satiety and hunger.

As stated above, different foods are digested and go through different metabolic pathways, some of which are more efficient than others.  Protein requires a lot more energy to metabolize than fats or carbohydrates. When protein is ingested, it requires more energy to digest and absorb, which uses more energy.  Therefore, the calories ingested from protein are less fattening than carbohydrate or fat calories.

Another benefit to protein is that it increases satiety more than the other macronutrients. Appetite is reduced and less food and calories are consumed, which may lead to weight loss. This just demonstrates that the type of food that you eat is extremely important, and that all calories are NOT the same.

Further, people who eat whole foods rather than processed foods tend to eat less and have less issues with obesity. Whole foods require more energy to break down and digest than processed foods. This is because many processed foods contain refined carbohydrates, which are low in fiber, low in nutrients, and usually have a high glycemic index. Foods with a high glycemic index are digested quickly and rapidly spike blood sugar levels. This causes food cravings and increased hunger and food intake.

Additionally, foods high in fiber are less likely to cause weight gain. This is because more energy is needed to breakdown the food, and much of the fiber is not absorbed into the body but rather is excreted as waste. Therefore, the body is not necessarily getting the amount of calories listed on the label.

The take home message is not to worry about counting your calories to lose weight. The food choices that you make are much more important for both your health and for your weight. Different food sources affect energy expenditure, hormones, and hunger, which all affect satiety and weight gain. Think about what you are eating rather than how many calories you are eating and look at your food a little differently. If you change your perspective, you will ultimately reach your goals and get healthy!


By Denise Groothuis


How to Reach Your Peak Performance

Do you remember a time when you had to sink a 3-foot putt to win a championship, meet a deadline to present a project to your boss, or study for next day final exam? The simple perception or expectation we placed in ourselves to execute a task entails an arousal in our nervous system. The challenge we all face is how much of an arousal is optimum to achieve top performance? The Yerkes-Dodson Law, also known as the Inverted “U” Model, has attempted to help us identify our ideal level of arousal to achieve peak performance.

The Model indicates that feeling high level of tension or feeling too relaxed will not be ideal to achieve our best. Some level of tension is needed to stay focused and attain our peak performance. Identifying what level of arousal is ideal for you, it will depend on three factors: Trait Anxiety; Expectations vs. Acceptance; Focus Ability.

Trait Anxiety

Trait anxiety refers to the general level of anxiety that is experienced throughout all aspect of the individual’s life. State anxiety refers to the specific situation that is tension provoking. A person who has high levels of trait anxiety will be more likely to negatively respond to a particular stressful situation than a person with low trait anxiety. These individuals will more likely see the negative aspects of the upcoming performance and focus on the obstacles. Their mindset will be aligned toward pessimism or putting blame on others. They will be more easily distracted by outside factors, such as: referee’s calls, opponent’s good shots, weather, and opponent’s ranking.

Also, individuals who practice group sports or teamwork are less likely to feel state anxiety. One of the challenges for these individuals is not elevating enough their level of arousal while in practice only to feel not mentally prepared when the competitive arousal increases during competition or project is due. One useful technique is to simulate the real performance to elevate your arousal enough. The more you practice, the better your ability to manage stress.

Expectation vs. Acceptance

When an individual has doubts about his or her abilities to achieve the desired outcome, and such an outcome is important, the level of state anxiety increases. The perceived lack of control increases the level of state anxiety, particularly for those individuals who experience high levels of trait anxiety. For individuals who show low trait anxiety, they will most likely see the positive side of the situation. They will be more optimistic and/or focus on accepting what they can manage instead of being mentally derailed by non-controllable factors, such as zeroing in on meeting self or other’s expectations.

Placing focus on expectations may lead to an elevated increase in arousal. Given that there is no such a thing as a guarantee result, individuals who pursue expectations embark into a zero-sum game whereas winning, and only winning, matters. One of the key attributes successful individuals share is that of learning from defeats. Individuals who learn from unsuccessful experiences have consistently shown to have made persistent improvement in the pursuit of their goals. They focus on process and acceptance rather than expecting that an outcome must happen.

Focus Ability

Before a performance, individuals are either goal or behavior directed. Those individuals who are goal oriented will more likely give a negative interpretation to their arousal by labeling it as anxiety. Those individuals who are behavior oriented will interpret the same arousing situation as excitement. Highly achieving individuals know that focus is a short-lived experience. They understand that increasing focus rests on enhancing the awareness of the moment when loss of focus takes place. It is precisely then when they shift their attention back to the present moment. Unless they know they lost focus, they have no way of regaining it. Meditation has been shown to enhance one’s ability to shift attention to the present moment. Those who consistently practice it have been better able to regain their focus to what it is in front of them rather than being mentally derailed by non-controllable factors.

Chronic Back Pain

7 Important Factors to Overcoming Chronic Pain

Pain is an alarm system designed to alert us of potential danger or damage in our tissues. If pain is not addressed properly in the beginning it can become a serious problem. Pain is considered chronic after being present consistently for at least three months.

You can actually train or program yourself to feel pain.

Your brain and entire nervous system will become conditioned to feel pain. The system gets so sensitized that even stimulus that shouldn’t cause pain, like healthy movement for example, will actually trigger that pathway and you’ll be alerted with pain. The more a pathway in the brain is driven, the easier it is to trigger.

This is similar to learning a new task. At first, it requires more effort and focus. The more you practice, though, the easier it becomes until it is effortless, or second-nature.

So what do we do?

First, as always determine the causative factor. Has it been removed or corrected, have the appropriate changes been made accordingly? This is priority. If the initial problem is still present, it will continue to irritate the tissues triggering the pain response and further conditioning the nervous system. Things like poor posture, repetitive strain, incorrect exercise, overtraining, workstation, prolonged sitting, old trauma, surgery, etc.

Then we must look at the big picture. We must analyze and act on the other major factors that impact not only pain, but all aspects of health:

Movement: Movement is life. Our bodies are designed to move. If we are sedentary, it will lead to a host of health problems. On the other hand, if we are moving incorrectly, with poor exercises, repetitive strain or overtraining, it can be just as problematic.

Diet/Gut health: Unhealthy diet and dysbiosis (imbalance in the gut flora) can lead to inflammation (and countless other problems). This increases the risk of chronic disease and also increases pain sensitivity. Diet that are anti-inflammatory in nature are best. Keep in mind every individual is different and may have specific sensitivities and needs.

 Toxic exposure: Unfortunately in the modern world it is inevitable that we will be exposed to toxic chemicals. There are over 80,000 in our environment! Do your best to be aware of where these substances are found and decrease exposure.

 Stress: The hormonal and neurological changes that stress create can amplify anything negative going on in the body. It’s a killer not to be underestimated and needs to be addressed.

Mindset: Thoughts are neural impulses and can manifest physical change in the body. Changing thought patterns and attitude can be challenging, but incredibly powerful.

 Sleep: This is one of the most underrated aspects of heath. When we sleep is when our cells repair and recover. If we’re not sleeping enough, and if the sleep we are getting is not of good quality, the cells cannot repair and will continue to break down.

These above points may have not been the original cause of the pain but will certainly contribute. The body is one functional unit. Every system works together and affects every other system. Stack the odds in your favor by seeing that all these areas that you have control over are as good as they can be and working for you, not against you.

These can certainly be addressed on your own by educating yourself and taking action. If there are areas that are particularly challenging, there are professionals available who can help.

Passive treatments like acupuncture, chiropractic, soft tissue therapy and massage can help by:

-interrupting the conditioned pain patterns

-calming the nervous system

-rewiring or reprograming healthy neurological pathways

-releasing tension in the fascia and muscles thereby improving movement and nerve communication

-stimulating the movement of blood on a cellular level increasing the supply of nutrients and oxygen and helping to remove waste more efficiently.

This last point of nourishing the cells is so important because if the cells do not have adequate fuel to produce energy, they will not be able to carry out their functions effectively.

If you are suffering with chronic pain and nothing has helped, take a step back and examine these areas. If you feel you need help, there are many resources available. Seek the guidance of a professional who has expertise in the area.

You have the power to change how you feel, but it requires action. The human body is designed to heal. It just needs the right circumstances and materials.

mens health

Breaking the Silence on Men’s Health

It’s important for everyone to take responsibility for their own health. Unfortunately, this is not always the case, especially among men. Research shows that women are 100% more likely to visit the doctor for annual examinations and preventive services than men. June is National Men’s Health month, in which we heighten the awareness of preventable health problems and encourage early detection & treatment of disease among men and boys.

There is a silent health crisis in America. On average, American men live sicker and die younger than American women. The health of men in America is steadily deteriorating, largely due to poor health education, lack of awareness, and culturally induced behavior patterns. This has caused a silent health crisis, whereby men face higher mortality rates than women for 9 of the 10 leading causes of death, in addition to a shorter life span. Today men, on average, die almost five years earlier than women, according to the Centers for Disease Control. Men are dying at significantly higher rates than women for the top 10 causes of death. This crisis in men’s health has very little to do with physiology. It has to do with the tendency of men to not seek care for their health issues. No matter the age, men have issues with things that don’t have every day symptoms, like diabetes, high blood pressure, and cholesterol.

Studies show that an alarming 13 million men have diabetes, while 450,000 die each year from heart disease! While genetics certainly play a role in getting both, so does lifestyle. The same cardio-metabolic risk factors that lead to heart disease, obesity, diabetes, high blood pressure, and other conditions are just as prevalent in men as in women. However, if more men sought diagnosis and treatment for those risks, their chances of controlling or eliminating those conditions would increase dramatically. High blood pressure has been referred to as “the silent killer” because people are often unaware that they have an issue. Have your blood pressure and your cholesterol checked often by your doctor, and closely follow any prescribed treatment they provide. In addition, you should exercise and eat right. By exercising moderately for about 30 minutes per day and eating a well-balanced diet with limited cholesterol and no saturated fats, you will be off to a good start. Always be sure to drink at least 8 glasses of water per day, and limit your alcohol consumption as well.

Along with heart disease, cancer is among the top two leading causes of death among men, with prostate cancer being one of the most prevalent. The prostate gland is prone to three main conditions — 1). inflammation that can cause burning or painful urination, the urgent need to urinate, trouble urinating and other symptoms;  2). benign enlargement that can compress the urethra and slow or stop the flow of urine, a condition that affects about ¾ of men over 60; and 3).  prostate cancer, affecting about 1 in 7 men during their lifetime. As men approach their 40s, familiarity with the prostate gland becomes important. The prostate gland is a walnut sized male accessory sex gland that rests in front of the bladder. It usually enlarges with age and can constrict the urinary tube, thereby causing trouble with urination. Symptoms can include: diminished urinary stream, excessive nighttime urination, increased frequency and urgency.


by Gina Stallone

People on exercise bike

Sweat – The Foundation of Youth?


Today, the closest thing to the fountain of youth is sweat- your own, that is.  If you want to live a longer and healthier life, make sure at least 30% of your physical activity is vigorous.  In other words, make sure you break a sweat.  This means that if you’re getting the minimum recommended amount of exercise per week of 150 minutes, at least 45 of those minutes should be composed of vigorous activity.  According to recent studies, individuals who engaged in vigorous activity for up to 30% of their weekly exercise decreased their mortality risks by 9%.  Those who engaged for more than 30% weekly, reduced it by 13%.  No increases in mortality risks were noted among individuals who completed higher amounts of weekly vigorous activity.

Exercise also helps prevent obesity, by reducing the amount of visceral fat in the body.  Visceral fat accumulates around vital organs- liver, intestines, and pancreas.  Excessive amounts of this type of fat, versus subcutaneous fat found just beneath the skin, leads to coronary artery disease (CAD).  In CAD, stiffening of the blood vessels occurs, decreasing circulation throughout the body- including the penis. Erectile dysfunction is a common symptom of CAD in overweight or obese men.  To improve your physical and sexual health, exercise is paramount.

Examples of vigorous exercise include:

  1. Running or Jogging
  2. Race-walking or aerobic walking at least 5 mph
  3. Hiking/backpacking
  4. Skipping rope
  5. Bicycling at least 10 mph, or uphill
  6. Calisthenics- vigorous effort: push-ups, pull-ups, lunges
  7. Jumping Jacks
  8. Circuit training
  9. Tennis- singles
  10. Field sports (ex: soccer)
  11. Court sports (ex: basketball, racquetball)
  12. Swimming- continuous laps
  13. Rowing- at least 4 mph
  14. Cross-country skiing
  15. Beach volleyball

There are many ways to incorporate vigorous exercise into your regime, and you don’t need a whole lot of time to do it.  Here are some examples of brief high intensity exercise routines:

  1. Elliptical Intervals: 2 minute warm-up, 8 minutes of intervals- first 10 seconds of each minute are at maximal effort, last 50 seconds are easy active recovery.  After 8 intervals, 2 minute cool-down. (Can also use Stair-stepper, treadmill/running, rowing machine… etc.)

Total time = 12 minutes.

  1. Calisthenics Circuit: Jumping Jacks x 1 minute, push-ups x 10-15 reps, lunges x 1 minute.  Repeat 3 times. Total time = 7-10 minutes
  2. Cycling/Spin bike: 5 minutes warm-up, 10 minutes of intervals resistance (climbing) intervals- first 20 seconds of each minute increase resistance (“climb”), last 40 seconds easy “flat”.  After 10 intervals, 5 minute cool-down.

Total time = 20 minutes

As you can see, the time commitment is minimal compared to the pay-off.  Depending on your own fitness level, you may modify the protocols to make them easier or more difficult.  Remember, whatever makes you sweat, will help you live longer and stronger.

by Rima Sidhy

Rima Sidhu is an Exercise Physiologist at Maze Sexual and Reproductive Health.  At Maze, Rima focuses on improving patients’ health behaviors through diet and exercise modifications, in order to assist in the therapy of male sexual dysfunction and improve endothelial function.  She utilizes a lifestyle and behavioral approach to create wellness goals for patients to enhance their treatment outcomes. 


Garcinia Cambogia

What is Garcinia Cambogia and where is it found?
Garcinia Cambogia is small fruit, which looks like a little green pumpkin. It is also
known as a tamarind. It is native to Indonesia, but it can also be found in
Southeast Asia, India, and parts of Africa. The skin of the fruit contains a rind
extract called hydoxycitric acid (HCA), which may interfere with lipogenesis
(block fat) and suppress appetite.

What are the benefits of garcinia?
Garcinia is used for weight loss and to improve exercise performance. It may
suppress appetite. It may also improve mood and sleeping patterns, and aides
with people who are emotional eaters because it affects serotonin levels.

Are there interactions with garcinia and  food or medications?
None known.

Are there side effects from garcinia?
Garcinia can cause nausea, headaches and mild GI discomfort.



What is creatine?
Creatine supplements are used to increase muscle mass and improve
athletic performance, especially in older adults. Creatine is a source of
energy for the skeletal muscles. In fact, 95% of the creatine in our body is
stored in the skeletal muscle.

Where is it creatine found?
Creatine is not an essential nutrient because our bodies can make it. Our
liver, kidneys and pancreas synthesize 1-2g of creatine a day. Creatine
can also be ingested from food. Another 1-2 g come from fish and meats.

What are the benefits of creatine?
Creatine has been shown to be effective for enhancing muscle
performance during brief, high intensity exercise. It seems to increase
muscular power during repeated, short energy bursts rather than for single
event performance. It also might be beneficial in exercise alternating
anaerobic and aerobic metabolism for long durations. It doesn’t seem to
improve strength of body composition in people over the age of 60.
Additionally, for some it may decrease the rate of Parkinson’s Disease and
improve muscle strength in those with muscular dystrophy, and may be
used to treat depression, CHF (congestive heart failure) and bipolar

Are there interactions between creatine and  food, herbs or other supplements?
Creatine combined with carbohydrates can increase muscle creatine levels than
just taking creatine alone.


Fit to Be Fit


High Intensity Interval Training, or HIIT, workouts are a phenomenon sweeping the nation. What is it, and is it safe? Read on!

HIIT is a cardio session that consists of short, high intensity bursts. HIIT can be an incredibly effective way to work out to see the body composition and fitness results that you want, but you need to do it right. Numerous studies have shown that working your hardest is key when it comes to boosting endurance, increasing metabolism, regulating insulin levels, and losing body fat. HIIT routines that involve bodyweight work (e.g. push-ups) or added weight, such as kettlebells, medicine balls, or dumbbells, will tone your muscles while spiking your heart rate. All types of exercise will ultimately help you burn fat by burning calories, but the more intense the exercise, the more fat you will burn. As a result, it is a very effective way of helping people get the “shredded” look.

A true HIIT workout will involve pushing yourself to the max during each set, which should never exceed 90 seconds. These workouts are typically quick and convenient since they are such high intensity; they usually are 30 minutes or less. They can also be done virtually anywhere, with little to no equipment. The only stipulation is that you should rest in between sets. This may not be the first thing that comes to mind with such an intense workout, however, it is imperative. Recovery is essential so that the body works to adapt from the anaerobic (high-intensity) period to the low-intensity recovery period in HIIT. This workload results in high caloric expenditure, which can lead to fat loss.

That fat loss also comes from an increase in metabolism, which is a benefit to any high intensity workout. Research shows that this is due to an increase in post-exercise exercise oxygen consumption, or EPOC. EPOC speeds up your metabolic rate and can result in a metabolic boost for up to 48 hours after a complete HIIT routine! The high intensity cardio raises your metabolic rate to the point where you continue to burn calories even after the session ends—in some cases 15% more.

If weight loss is your ultimate goal, the old saying that you can’t out-train a bad diet is true…even if your workouts are super demanding. HIIT isn’t an excuse to neglect your diet, so keep it clean! By incorporating HIIT training into your exercise regimen and keep your diet in check, you’ll start to see some amazing results!

We’ve put together a safe but killer HIIT workout for you to try. Give it a shot & let us know what you think!


by Gina Stallone