The Cenegenics TimesBalancing Life & ExerciseMaximize your time and results with five easy steps from Kevin Finnegan, MS, Cenegenics Las Vegas. page 7

The Nutrition & Fitness Department Newsletter

Issue 04 November 2011

Have You Had Your Phytonutrients Today?New section! Dr. Beth Traylor shares how to fight cancer, boost health.

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Risk Factor: Abdominal Fatpage 10

Dr. Raymond Ishman, Cenegenics Philadelphia, gives insight into dangers lying beneath.

Latest From CenegenicsMessage from the CEO/President John E. Adams A great deal has gone on since ourlast issue, from new physician partners and centers to our ongoing investigative research on agerelated disease. In late August, we announced the addition of three physician partners to fuel our expansion eorts and meet rising healthy aging demands nationwide: Dr. Beth Traylor, a Cenegenics Las Vegas clinical physician since 2005 and President of our nonprot Cenegenics Education and Research Foundation; Dr. Tim Patel, a Cenegenics Las Vegas physician since 2006 and Vice President of our Practice Development; and Dr. Elissa Calapai, a Cenegenics Boca Raton clinical physician since 2007. We also launched Cenegenics Phoenix in Septembera 1,300-square-foot center in Scottsdale, AZ. Dr. C.B. Daniel, who has been a Cenegenics aliate physician since 2007, relocated from Tennessee to partner with us to open the center. In October, we opened Cenegenics Boston, thanks to a partnership with Dr. Lars Boman who has been with us since 2008. Along with that, were constantly sharpening the skills of our age-management team. This summer we furthered our multi-tiered educational approach, adding Grand Rounds for Cenegenics nutrition/exercise counselors. Centered on the latest research published in medical journals, these bimonthly sessions will ensure the best in patient management and help our team better understand complex nutritional/tness issues. Our rst data study manuscripta collaborative work with Dr. Ernst von Schwarz, professor of medicine at UCLAs David Geffen School of Medicinewas accepted for publication. It will be published in the esteemed Journal of Geriatric Cardiology. Visit our news/blog site at CenegenicsPost.com. And be sure to visit and "like" our Facebook Fan Page and "follow" us on Twitter. The official Cenegenics Facebook page:

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Message from the CMO Robert Willix, MD Cenegenics Boca Raton The Body's FuelIts a fact. Oxygen is to the human body as gasoline is to a carburetor engine. That's why oxygen consumption studies are a valuable tool for screening cardiovascular health. Cenegenics performs an oxygen consumption test using a bicycle ergometer, which is the safest testbut not a substitute for cardiovascular stress testing. It does help us determine how physiologically healthy a patient is. Three factors limit oxygen consumption: the heart, lungs and muscles. The clinician and exercise physiologist can get a great deal of data about the bodys dynamic function and body weight effects on energy and lung capacity to properly prescribe an exercise program based on muscle strength.

The amount of oxygen brought into the body per minute is a dynamic measurement of the amount of blood the heart puts out. For every 1 liter of oxygen consumed, the heart puts out approximately 5-6 liters of blood. If the VO2 in liters per minute is less than 2 in a man and less than 1.5 in a woman, there is a concern: Low cardiac output state and the potential for not only deconditioning, but a risk factor for cardiovascular disease. Dividing that number by the body weight: A VO2 of less than 25 ml/kg per minute could represent deconditioning, but it often represents a early warning sign for heart disease.

Looking at the oxygen pulse (oxygen amount consumed in liters per minute divided by the heart rate): A number of less than 8 in a woman and less than 10 in a male is a strong predictor of cardiovascular disease, provided the patient isnt on a beta blocker or some other medication. The higher the oxygen consumption, the wider the heart rate variabilitythe space between a resting heart rate and maximum achievable heart ratethe healthier you are. Keep on training!

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THE CENEGENICSTIMESMessage from the EditorJenn Zerling, MS, CPT Cenegenics Beverly Hills The holiday season is here and many of you will be celebrating with family, friends, colleagues and clients.So here is something to think about. Per the National Institute of Health, you can gain an average of 1 pound minimum per year during the holiday season. But popular belief says Americans gain an average of 8 to 10 pounds a year during the holidays. This is not true. Yet, if you gain even a pound a year, you're more likely to be overweight throughout your life. Why? We often dont take the weight off after the holidays and continue to gain more weight over the years. To combat the possibilities of weight gain this holiday season, instead of eggnog and pumpkin pie, help spread the love of fitness and good nutrition by gifting those you love with healthy food options such as a fruit parfait with Greek yogurt and fresh granola or dark chocolate covered strawberries. Be light on the sauces and introduce healthier cocktails to your guests such as wine, wine spritzers, light beers or mixed drinks that do not involve fruit juices. I always suggest that people dont drink their calories. Also, consider giving away gifts that symbolize fitness such as a Polar Heart Rate Monitor, Kangoo Jumps, Spin shoes, a package of personal training, a 1-hour massage or a gift card to a sporting goods store or to Whole Foods/Trader Joe's. Year end symbolizes a time to reflect on the goals youve hopefully reached in 2011 along with the goals you set for 2012. Consider setting goals that may be more about you and not only about work! Your new breath of vitality is one which you should continue to enjoy in the years ahead. This coming year should incorporate fun with new adventures that bring a fresh and interesting life. Ring in the New Year with a solid plan of action to live a healthy and fit life! Here's to a healthy you!

Coming Soon!Check out the future issues for more on our exciting newsUp next: Read a compelling interview next issue with New York Times best-selling author, Dr. Jeff Life. He is a Cenegenics physician partner and author of "The Life Plan." Learn the latest on innovative research and breakthrough science, presented at the November Age Management Conference. Cenegenics is launching an employee wellness program in 2012, similar to what our patients use. Our Corporate Wellness Program guides employees in an improved level of health via education and Lifestyle Coaches to motivate them to live healthier. Maybe a smart idea for your business. Connect with your lifestyle counselor at CenegenicsLivingOnline.com.

We love hearing from youand welcome any suggestions or feedback you may have. Email them to me at jzerling@cenegenics.com.

Every person should own a Polar heart rate MonitorGet a Polar heart rate monitor delivered with your nutraceuticals. Just talk to your service coordinator or lifestyle counselor.Clear Training Guidance: Know You're Improving Your Fitness & Burning Fat

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The EnergyPointer shows if the effect of your training is fitness improvement or fat burning Displays calories burned Comes with comfortable textile transmitter and coded heart rate transmission to avoid cross-talk

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TA-65About TA-65 TA-65 is a proven telomerase activator* that was discovered by California biotech company Geron, and licensed to T.A. Sciences. The patented supplement targets one of the primary causes of aging, shortened telomeresthe protective end-caps of DNA at both ends of every chromosome. Cells divide daily, creating a problem as the years march on. With cell division, telomeres grow shorter, eventually altering the chromosomes and leading to cell death or senescence (cellular aging where cells malfunction and can no longer divide). How is TA-65 made? TA-65 is a naturally occurring single molecule found in the ancient Chinese herb Astragalus. T.A. Sciences has developed a proprietary process to refine and purify TA-65. Our process begins with tons of plant material harvested from selected farms in one small region in China. In our plant extraction facility, the raw Astragalus root is chopped up and refined. After initial extraction, the base ingredient is further purified and then sent to an outside government testing facility where it is tested for purity, heavy metals, and pesticides. The product is then sent to a FDA-certified, state-of-the-art, laboratory for final purification that ends up with 90+% pure TA-65. Why not simply buy Astragalus extracts in a health food store? Astragalus extracts can be found in most health food stores, but such products contain little or no TA-65. We tested 4 commonly available Astragalus extracts and none of them contained any measureable amounts of TA-65 (the test assay is accurate to one part per million). Our proprietary production process starts with 3 tons of plant material and ends up with capsules that we guarantee contain 5mg of TA-65.

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FITNESSInterval Training: Bigger Fat-Burner Than Traditional TrainingAnthony F. Ferrara, BS Cenegenics New York

Research shows short bouts (~20 minute) of interval training were more effective for weight reduction.In a 2007 study that compared two groups, the steady-state group burned more than twice the calories of the interval group but the interval group lost 450% more body fat in the end. You burn more calories through interval training vs. continuous aerobic exercise because of the intense bursts of energy. Alternating between the two allows your body to process lactic acid build-up, which allows you to burn fat at a faster rate. Interval training consists of short bursts of intense exercise (10 seconds to 3 minutes long) followed by a recovery period. Interval training improves cardio fitness and reduces body fat. The N.S.C.A.* recommends interval training at specific work-to-rest ratios: for example, a high-intensity work load involves a sprint for 10 seconds, and a 1220 second recovery using the ratio 1:121:20 OR sprint for 1 minute and recover for 3-4 minutes respectively (1:3 or 1:4).

Another example is sprinting for 20 seconds and recovering for 60 seconds when using a ratio of 1:3. Fat is burned faster with interval training 1-2x/week. Consider changing the work-to-rest ratios to prevent overtraining and reduce the risk of injury. A.C.S.M.** recommends a well-rounded cardio program that includes low, moderate and high intensities in different combinations for health benefits and weight loss. ACSM defines exercise intensities using maximal heart rate values along with Rate of Perceived Exertion, which helps the trainee gauge their level of exercise. ACSM guidelines are as follows: Low (60-70% of your maximum heart rate or RPE=4-5), moderate (70-80% of your maximum HR/RPE=5-7) and high (80-90% of your maximum HR/RPE=8-9). A balanced diet should also be incorporated for the best results. Ask your lifestyle counselor to incorporate this into your program.

Fitness References 1. **A.C.S.M.s Guidelines for Exercise Testing and Prescription. American College of Sports Medicine, 1995. 2. Baechle, T. & Earl, R., (2000). Essentials of Strength Training and Conditioning. 3. Brandenburg, J. (2008). Burn 450% More Fat In Half the Time with Interval Training. Primer Magazine. 4. McArdle, W., Katch, F., & Katch, V. (2007). Exercise Physiology, Energy, Nutrition & Human Performance. 5. *National Strength and Conditioning Association. 6. Quinene, Paula. (2011). Why Does Interval Training Burn More Fat? LiveStrong.com 7. Robergs, R.,& Roberts, S. (1997). Exercise Physiology: Exercise, Performance, And Clinical Applications. 8. University Of Guelph. (2007). Interval Training Burns More Fat, Increases Fitness, Study Finds. ScienceDaily. 9. Waehner, P. (2011). Cardio Workout Program for Weight Loss About.com Healths Disease and Condition. 10. Waehner, P. (2011). Burn More Fat with Cardio Exercise About.com Healths Disease and Condition. 11. Wilmore, J., & Costill, D. (1994). Physiology Of Sport And Exercise.

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NUTRITIONFood Additives to AvoidNick Balestriere, NASM CFT / ACE AFT Cenegenics Boca RatonFrequent consumption of these chemicals can deteriorate long term health and longevity. However, avoiding these chemicals could reduce your risk of: heart disease, damaged chromosomes, tumor growth, pulmonary inflammation, migraine headaches, excess body fat, stroke, behavioral issues, neurotoxicity and cancer. Aspartame (NutraSweet/Equal) High Fructose Corn Syrup Acesulfame K Trans Fat Food Colors BHA & BHT Mono Sodium GlutemateNutrition References Artificial Sweeteners: http://www.ncbi.nlm.nih.gov/pubmed/16507461 Acesuflame k: http://www.ncbi.nlm.nih.gov/pubmed/9449223 Trans fat: http://www.hsph.harvard.edu/news/pressreleases/2007-releases/press03272007.html Artificial Sweetners and BHT & BHA http://www.ncbi.nlm.nih.gov/ pubmed/12160896?dopt=Abstract BHT: http://www.ncbi.nlm.nih.gov/pubmed/21536018 Trans Fats: http://www.hsph.harvard.edu/news/pressreleases/2007-releases/press03272007.html Artificial Colors: http://www.thelancet.com/journals/lancet/article/ PIIS0140673607613063/abstract MSG: http://www.ncbi.nlm.nih.gov/ pubmed/9215242?dopt=Abstract High Fructose Corn Syrup: http://www.princeton.edu/main/news/archive/ S26/91/22K07/

I am surewhen Hippocrates formulated, Let food be thy medicine and medicine be thy food, he had no idea what modern-day foods would contain. Humans have not evolved all that much as an organism since the days of the great philosopher, yet our food source has. I know most of you reading this can remember the time when your parents or grandparents purchased meats from the butcher, produce from the local stand or farm, milk from the milkman and soap or dishrags from the general store. So, what happened? Food became big business. For example, Nestl, Kraft and Pepsi Co. had a combined $202 billion plus in revenue in 2010. To achieve such success, food processing companies like these manufacture products that can be packaged, transported, and maintain marketability. However, since all food is perishable by nature, chemical additives, colors, preservatives and artificial sweeteners were created in a lab to combat the degradation of flavor and appearance.

There are other chemicals to avoid, but the best way to avoid them all is to eat fresh food!

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LIFESTYLEBalancing Life & ExerciseKevin Finnegan, MS Cenegenics Las VegasPrioritize Get innovative Find creative ways to fit training into a tight schedule. Ride your bike to work. Invest in a treadmill and run on it in the evening while your kids play nearby. Take the family to the lake or pool and swim while your spouse watches the kids, then switch places and let your spouse have his/her turn. Focus on quality Before you increase the quantity of your workouts, first increase its quality. A highquality training program is well-rounded. Many individuals make the mistake of doing too many similar workouts. Typically, they do a lot of prolonged, steady, moderate-paced aerobic training and not enough threshold work, speed intervals, technique work and/or resistance training. Connect with your lifestyle counselor for more fitness and nutrition tips at CenegenicsLivingOnline.com. The objective of this suggestion is to identify activities in your typical day or week that aren't as important as your training time so you can cut back on or eliminate them. Eliminate down time Sit down and write out what you do and when you do it in a typical workday. Eliminate any waste or excess that can be addressed to create more training time. If you currently watch two hours of TV in the evening, cut that back to 90 minutes and squeeze in a 30-minute workout. Stay consistent If you dont always have time for what you consider a full workout every day, then at least try to do more than nothing every day. Save the big workouts for weekends or other days when you have less clock pressure, and on the other days, just do something!

Time consuming meetings, lunches and soccer practices can prevent us from finding availability to exercise.Even though lack of time is the most commonly cited excuse for not exercising some surveys suggest that those who exercise regularly are just as busy with their jobs, families and other responsibilities as those who dont work out. So the time excuse is just that: an excuse. Improving our health through exercise and proper nutrition is a time-consuming pursuit, and our lives are busier than ever these days. Balance is an essential characteristic of effective training. Its also an essential characteristic of a healthy lifestyle. Try implementing these tips to help you better balance your training and the rest of your life.

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RECIPE OF THE QUARTERMushroom Sauce ChickenCreated by: Jenn Zerling, MS, CPT Cenegenics Beverly HillsIngredients (Serves 4) 1 tablespoon of olive oil 5 skinless chicken breasts, 5 oz each 3 tablespoons of almond meal 2 tablespoons of minced shallots cup of chicken broth cup of white wine cup of mushrooms sliced and diced 1 sprig fresh tarragon 1 tablespoon chopped parsley Preparation: In a deep skillet, heat oil on high. Coat the chicken with almond meal, add to the skillet, reduce heat and cook on low for 10 minutes or until the chicken is cooked through. Remove chicken breast and put on a hot plate to keep warm. To the same skillet, add the shallots and saut for 1 minute, then add wine and reduce the heat by half. Add chicken broth and heat for 5 minutes until thickened. Meanwhile, in a small pan, saut the mushrooms in a little bit of olive oil. Add tarragon to the mushrooms, along with chicken broth and wine. Cook for 7 minutes. Arrange the chicken on a platter and spoon sauce over it. Garnish with parsley and serve with a side of steamed broccoli and cauliflower and enjoy!

Brady Cooper, BS, CSCS, ACSM-CPT Cenegenics Atlantic CityWhen Chris Woodson of Cenegenics Atlantic City saw his 45th birthday on the horizon, he had to make changes for himself and kids. And he did, losing 20 pounds on his Cenegenics program. I feel energized, healthier and more confident. I wake early with ease, feeling rested and refreshed, ready to take on the world. I feel euphoric, happy and sharper in my thinking. Chris nutrition changed drastically. I now love fresh fruits and vegetables. I used to skip breakfast, but now eat a bowl of fresh organic mixed berries with plain nonfat Greek yogurt, a two-egg organic, omega-3 omelet with fresh organic baby spinach. A sample morning for Chris: wake up at 6 am, drink a bottle of water, take a 30-minute brisk walk, drink a high-protein drink and workout in his home gym. Thanks to a suggestion from my Cenegenics doctor, Rusty Silverman, I tried a new hobby: sculling. A long, narrow boat propelled by one to four people with two oars each. What a workout! I recommend it to anyone who wants a challenge and to connect to nature. Chris works out six days a week, alternating cardio and resistance training. For three days a week, he performs 30 minutes of high-intensity interval cardiovascular. The alternate three days includes upper and lower body resistance training for 60 minutes using p90X. Cenegenics brought satisfaction and fulfillment into my life. I will never be the old couch potato out-of-shape dad who can't run and play with his children.

PATIENT KUDOS

Here's Chris now!

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Featured NutraceuticalIndole-3-Carbinol (I3C) Have You Had Your Phytonutrients Today?Beth Traylor, MD, FAAFP Cenegenics Las Vegas

Mother was right again!You should eat your vegetables.

Eating half of a head of cabbage each day or extremely large amounts of other cruciferous vegetables is what it would take to get the kind of health insurance youre looking forand that is neither practical nor palatable for most people. But if science could replicate the cancer fighting substance in the vegetables and pack them into a pill or capsule, it might actually help save your life. That is precisely what has happened. After isolating the phytonutrient Indole3-Carbinol (I3C), scientists have been able to prepare nutraceuticals of I3C at the proper physiologic dose to help prevent both breast cancer in women and prostate cancer in men. Every non-pregnant woman over 35 years and every man should consider taking pharmacy grade I3C as part of a daily nutraceutical regimen for disease prevention. Ask your Cenegenics Medical Institute physician about the benefits of adding I3C or DIM into your program today.

Plant-based foods, including vegetables and fruits, contain compounds called phytonutrients, which are thought to promote overall health. Specifically, there is a phytonutrient called Indole-3-Carbinol (I3C) and its related sister chemical Diindolylmethane (DIM), present in cruciferous vegetables, such as cabbage and broccoli. If you are concerned about either breast cancer or prostate cancer, you should know that eating these cruciferous vegetables is really good for you. Indole-3-Carbinol has been shown to affect estrogen metabolism in ways that might help prevent breast cancer, and may be critical in preventing or retarding prostate cancer.

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DR SAYS . . .Risk Factor: Abdominal FatRaymond Ishman, MD Cenegenics PhiladelphiaIncreased abdominal fat leads to insulin resistance, putting you at risk for diabetes.Fitness References 1. Calle, EE., Rodriguez, C., Walker-Thurmond, K., Thun MJ. (2003). Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. New England Journal of Medicine; 348(17):16251638. 2. Boekholdt, S., Wareham, N., Luben, R., Welch, A., Bingham, S. et al. (2007). EPIC-Norfolk study. Science Daily. Retrieved August 13, 2011 from http://www.sciencedaily.com/ releases/2007/12/071210163211.htm 3. Dore, G., Elias, M, Robbins, M., Budge,M., Elias , P.(2008). Relation between central adiposity and cognitive function in the Maine-Syracuse Study: attenuation by physical activity. Ann Behav Medicine; 35(3):341-50. Retrieved on August 8, 2011 from http://www.ncbi.nlm.nih.gov/ pubmed/18584267 4. Janssen, I. , Baumgartner, R., Ross, R.,Rosenberg, I., and Roubenoff, R. (2010). Skeletal Muscle Cutpoints Associated with Elevated Physical Disability Risk in Older Men and Women. American Journal of Epidemiology; 159 (4), 413. 5. Whitmer R., Gustafson, D., Barrett-Connor, E., Haan, M., Gunderson E., et al. (2008) Central obesity and increased risk of dementia more than three decades later. Neurology; 30;71(14) Retrieved on August 8, 2011 from http://www. ncbi.nlm.nih.gov/pubmed/18367704 6. Waist circumference and waist/hip ratio are inversely related to cognitive function. (2008). Ann Behav Med; 35(3):341-50. Epub 2008 Jun 27. 7. Central obesity in midlife increases risk of dementia independent of diabetes and cardiovascular comorbidities. (2008). Neurology.;71(14):1057-64.

Most people have at least some acceptance of a bigger belly being part of normal aging.However, if you have increased abdominal fat, you are at increased risk for not only heart disease, but diabetes, Alzheimers disease and even cancer. Multiple studies indicate that increased abdominal fat puts you at risk, with the waist-to-hip ratio being a better indicator than waist circumference alone, or even BMI. Whats surprising is that you may have a high waist-to-hip ratio and not appear to be overweight, and even have a normal BMI. At Cenegenics Philadelphia we call that Skinny Fat. If you fall into this category, you likely have sarcopenia or low muscle mass, putting you at risk for physical disability, like falls.

A big belly in midlife increases your risk of cognitive impairment and dementia later in life. A recent study concluded waist circumference and waist/hip ratio are inversely related to cognitive function. Cancers of the breast, uterus, colon, kidney and esophagus are associated with obesity and abdominal fat. In 2002, about 41,000 new cases of cancer in the United States were estimated to be due to obesity. In men, a high waist-to-hip ratio is associated with low testosterone as well. After menopause, estrogen loss leads many women to take on a male pattern of increased abdominal fat and raises their risk for heart disease significantly. So what can you do to reduce abdominal fat? Follow a low carbohydrate diet focusing on quality protein and fresh vegetables, avoiding rice, bread, pasta, potatoes, alcohol and cerealyes, cereal! Exercise three or more times a week incorporating both aerobic and strength training. Finally, identify and correct any hormonal and metabolic imbalances to allow your body to take full advantage of your exercise and healthy diet.

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HUMANITARIAN EFFORTSInterview with George Shapiro, MDDr. George Shapiro is a physician partner at Cenegenics New York City and a humanitarian for AFYA (http:// www.afyafoundation.org/), Haz-Mat team member in Westchester County Department of Emergency Services, fire surgeon/firefighter for Ardsley Engine Company number 1 and Deputy Chief Police Surgeon for the New York State Troopers. JZ: When did you get involved in the AFYA? GS: A bit over a year ago. The AFYA partners with a network of donor hospitals, health organizations, corporations, and individual households to donate a collection of medical aid to Haiti after the devastating earthquake. Right now we are gathering equipment so that we can start the cath lab as soon as we get one. JZ: How is that going? GS: Its a long process which can take another two years. JZ: Explain what a cath lab entails as far as the equipment needs. GS: We have ancillary equipment: catheters, medications, oxygen, contrast agents, IV bags, stents, angioplasty devices and atherectomy devices. JZ: Where do you plan on getting that? GS: We are associated with multiple hospitals across the country who donate their outdated equipment and supplies to our organization. JZ: What other efforts is AFYA forging? GS: They collect medical supplies, such as crutches, canes, walkers, shower seats, toilet seats, wheelchairs, bandages and fitness equipment (soccer balls, office supplies, kitchen supplies, etc.). They also helped out with the efforts in Japan after the tsunami hit. JZ: While the cath lab is being built up, who covers all the other needs of the organization? GS: Danielle Butin, the founder, actually does most of the projects herself and gets the doctors involved when necessary. Im focused more on the cardiac end. JZ: So, after a year later, are your main efforts devoted to building and finishing your cath lab? GS: Yes. However, the AFYA foundation actually has other projects. For example, Danielle called me for a project in Ecuador in search of echocardiograms to evaluate the cardiac status in patients. I donated 3 machines to them. These machines went to Haiti and other countries in Central America so we can detect heart disease. JZ: Once you detect a heart condition, arent you obliged to treat that condition? GS: Once we diagnose it, there are two things that can happen: (1) They can get brought to the U.S. if they require congenital heart surgery or (2) They can be treated on site. It would be more optimal to have a center on site where they can be treated.

JZ: Are physicians performing heart surgeries there right now? GS: Well, right now, the hospital called CDTI is not presently equipped to perform complicated surgical procedures. My focus is to build this hospital up so they can in the future. There are several hundreds of people who need help and arent getting it. JZ: Are there any government regulations to get this done? GS: This hasnt been an issue. The equipment is sent to Haiti in big crates or duffle bags. JZ: How much time a week do you dedicate to doing this? GS: Its not weekly; its more on a monthly basis: 10-20 hours a month. JZ: Have you been down there? GS: No, I have not been down there yet, but I will be going soon to do inventory on what we have down there and then pull it together. Once I get the cath lab, I will arrange the equipment and procedural training for personnel. JZ: What do you get out of this? GS: I just like to help people, but I dont get any money out of it. Its just what I like to do!

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