Living Lite

New World Health Organization Recommendations for Infants & Toddlers

April 28, 2019

The World Health Organization (WHO), an internationally respected United Nations public health agency, issued its first recommendations for sleep, along with exercise and screen time for children under the age of 5. Applying the recommendations during the first 5 years of life will contribute to children's motor and cognitive developement and lifelong health, according to the WHO.

"Improving physical activity, reducing sedentary time and ensuring quality sleep in young children will improve their physical, mental health and wellbeing, and help prevent childhood obesity and associated diseases later in life," says Dr. Fiona Bull, program manager for surveillance and population-based prevention of noncommunicable diseases at WHO. The Commission on Ending Childhood Obesity had asked for guidance on physical activity, sedentary behavior and sleep in young children.

Children Playing (Photo by: Artaxerxes - Own work ( Children Playing

Over 23% of adults and 80% of adolescents are not sufficiently physically active. If healthy physical activity, sedentary behavior and sleep habits are established early in life, this helps shape habits through childhood, adolescence and into adulthood, according to the WHO.

"What we really  need to do is bring back play for children," says Dr. Juana Willumsen, WHO focal point for childhood obesity and physical activity. "This is about making a shift from sedentary time to playtime, while protecting sleep."

Recommendations at a glance:

Children less than 1 year of age should:

  • Be physically active several times a day in a variety of ways, particularly through interactive floor-based play. For those not yet mobile, this includes at least 30 minutes in prone position (tummy time) spread throughout the day while awake,
  • Not be restrained for more than 1 hour at a time. Screen time is not recommended. When sedentary, engaging in reading and story telling with a care-giver is encouraged,
  • Have 14 - 17 hours (0 to 3 months of age) or 12 to 16 hours (4 - 11 months of age) of good quality sleep including naps.

Children 1 - 2 years of age should:

  • Spend at least 180 minutes in a variety of types of physical activities at any intensity. More is better,
  • Not be restrained or sit for more than 1 hour at a time. Also, sedentary screen time is not recommended. At aged 2, sedentary screen time should be no more than 1 hour. Less is better,
  • Have 11 to 14 hours of good quality sleep, including naps, with regular sleep and wake-up times.

Children 3 - 4 year of age should:

  • Spend at least 180 minutes in a variety of types of physical activity at any intensity, of which at least 60 minutes is moderate to vigorous intensity spread throughout the day. More is better,
  • Not to be restrained for more than 1 hour at a time or sit for extended periods. Sedentary screen time would be no more than 1 hour. Less is better,
  • Have 10 - 13 hours of good quality sleep.

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What Eggsactly is the Story About Egg Safety

March 27, 2019

The media thrives on hype and its latest target is the egg, a low calorie, inexpensive, source of protein and hard-to-get nutrients.* It is now being blamed for heart attacks and premature death.

Happily, the overwhelming evidence from many well-respected studies show that it is ok to eat an egg.

The media has focused on a single new study published in the Journal of the American Medical Association (JAMA) that concluded: "Among US adults, higher consumption of dietary cholesterol or eggs was significantly associated with higher risk of incident CVD [cardiovascular - heart - disease] and all-cause mortality [all causes of death] in a dose-response manner."

However, a well-regarded  review of 17 studies found that: "Higher consumption of eggs (up to one egg per day) is not associated with increased risk of coronary heart disease or stroke."

Further, the recent JAMA study has been criticized for its weak design. Indeed, the authors admitted that they could not rule out other foods or lifestyle issues causing the spike in CVD and death rates. For instance, did the subjects eat eggs with buttered white toast or bacon, as people often do? If so, there is a large body of evidence showing that buttered white bread or bacon would be the more likely offenders in spiking CVD or early death.

JAMA study results stated that there is this flaw. It said: "The associations between egg consumption and incident CVD ... and all-cause mortality ... were no longer significant after adjusting for dietary cholesterol consumption.

In other words, eggs may have had little or nothing to do with increasing CVD risk, while cholesterol may have.

Besides the admitted weakness, in the JAMA study, there are other unanswered questions:

Did the researchers analyze red meat intake? It is well-established that red meat is associated with increased CVD risk and all causes of death, and red meat happens to be high in cholesterol. Could the cholesterol in red meat have been responsible? The JAMA researchers said themselves that they could not tease out all factors leading to the increased CVD and death rates they observed.

Did they analyze saturated fat content? Saturated fat is a more established culprit behind heart disease, according to a Harvard study (among many others) and the American Heart Association.

Cholesterol is in all animal foods. And, we know that foods like red meat are strongly linked to CVD and all causes of death - and are also high in saturated fat.

In short, the JAMA study did not shed any further light on what foods are responsible for increased CVD. While any number of well-respected studies show that it is ok to eat an egg.

* Here are some ways you may benefit from eating eggs...

Protein. Eggs are considered the gold standard against which other proteins are measured. Because of the superior amino acid mix, an egg’s seven grams of protein are absorbed easily and efficiently used by the body. The egg is also low-calorie (74 calories).

Choline. Yolks are one of the best sources of this essential nutrient. Choline is needed for brain development in a growing fetus and may also be important for brain function in adults.

Lutein and Zeaxanthin. These two, important, beneficial nutrients found in egg yolks (as well as kale and spinach) help prevent eye diseases, especially cataracts and age-related macular degeneration. While eggs contain less lutein and zeaxanthin than greens, they are more absorbable because of the presence of fat in the yolk.

Vitamin D. Eggs are one of the few natural sources of Vitamin D, important for the bones, teeth, and possibly reductions in heart disease, cancer and a myriad of other diseases.

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Spring Training: Strength Train for Knee Pain

March 21, 2019

I have knee issues like about everyone else I know. In fact, "about 60 million Americans have knee osteoarthritis and this number will increase by 50% over the next decade," according to The Journal of Injury, Function, and Rehabilitation. I started feeling little twinges by my early 30's. Perhaps being a gymnast and a dancer growing up led to early symptoms. No matter, working with physical therapists and trainers over the years averted any serious pain - until recently.

Three years ago, a torn meniscus required arthroscopic surgery, but my knee pain is back. After some research, I found a review of studies in the journal, BMC Musculoskeletal Disorders, and I learned that certain knee arthroscopic surgery is controversial  because apparently, it can hasten knee degeneration. That can lead to the need for knee replacement within just a couple of years. So I can't help wondering: Should I have undergone the arthroscopic surgery to begin with? There are really no answers. And I can't look back now.

Walking (Photo by: Katherine Tallmadge Collections) Walking

But I'm feeling hopeful these days. Lots of interesting research is showing that exercising certain muscles with heavier weights, fewer repetitions (meaning you exhaust your muscle within 8 to 12 reps) can successfully decrease pain while increasing function, and that includes longer and stronger walking.

I'm especially convinced about these recommendations because a body of evidence is building that "power training" with heavy weights is most effective at building muscle in older people. That's because it improves the functioning of the nerves that power muscle, according to a study conducted by the Norwegian University of Science and Technology. The degradation of these nerves is a major cause of muscle impairment in older people, causing disability and loss of independence.

"Improvements in symptoms and function are directly related to exercise intensity and that higher intensity (if maintained over time) would sustain muscle strength and preserve functional abilities," according to the knee arthritis study. The study continued to state that even with more severe knee arthritis, intense strength training enhances postoperative recovery if knee replacement is necessary.

Quadriceps Muscle Group (Photo by: Quadriceps Muscle Group

Quadricep strength is particularly important.

To that end, I'm working with a physical therapist and trainer (periodically), and have invested in (used) weight machines (Craig's list). I'm exercise biking, and do mat pilates from a YouTube video. It's amazing how much more easily - and with significantly less pain - I can walk after I exercise.

I urge you to do the same!

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