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Healthnotes Newswire (February 14, 2008)—To address the special nutritional needs of older adults, the US Department of Agriculture (USDA) has now created a graphic representation of an age-modified food pyramid, which highlights the importance of some easy-to-miss nutrients.

The USDA issued a revised Food Guide Pyramid in 2005—the “MyPyramid”—which is customizable through an Internet-based program that takes a person’s body size, gender, and physical activity level into account. While the Internet program has helped many people identify and reach their dietary goals, it hasn’t been as effective for the less computer-savvy 70-and-over crowd.

“The greater than 70-year-old group can be vulnerable to compromised nutritional status,” says Alice Lichtenstein, nutrition expert at Tufts University and codeveloper of the new MyPyramid graphic published in the Journal of Nutrition.

The Modified MyPyramid for Older Adults graphic helps seniors better understand their complex nutritional needs by highlighting several “potential shortfall nutrients” for people over 70. A flag at the top of the pyramid emphasizes that extra calcium, vitamin D, and vitamin B12 might be needed.

Nutrients needed in a senior diet

• Calcium: Low-fat dairy and fortified foods are emphasized as rich sources of this bone-healthy nutrient.

• Vitamin D: Most elderly people don’t get enough of the sunshine vitamin. The skin’s ability to convert vitamin D to its active form diminishes with age, and many seniors shun the sun for fear of skin damage. Older people can increase their vitamin D intake by eating fortified foods; some people may also need to take a vitamin D supplement to ensure adequate intake.

• Vitamin E, vitamin K, and potassium: To help decrease the risk of high blood pressure, stroke, cardiovascular disease, and diabetes, the pyramid emphasizes eating a variety of deeply colored fruits and vegetables such as carrots, spinach, and peppers—which are good sources of potassium and vitamins E and K, as well as other protective nutrients. Icons depict bags of frozen veggies that make preparing and storing these foods easier for older people. Canola and soybean oils are also pictured as rich sources of vitamin E and K; saturated and trans fats are discouraged.

• Fiber: Foods that are high in fiber also tend to be more nutrient-rich. The pyramid shows legumes, whole grains, and fruits and vegetables as great fiber sources.

• Vitamin B12: Vitamin B12 deficiency becomes more common with increasing age, as many people lose the capacity to produce stomach acid, which is necessary for its absorption. It might be wise to take a B12 supplement or talk with your doctor to determine if B12 injections would be beneficial.

• Fluids: The “thirsty cues” also diminish with advancing age, leaving seniors vulnerable to dehydration. As a reminder to stay hydrated, the pyramid shows a row of water glasses. A good rule of thumb is to drink eight 8-ounce glasses of water per day.

The Modified MyPyramid for Older Adults also emphasizes the importance of staying physically active in later years.

It is important to consider that while many nutrients might be lacking in a senior diet, others could be too plentiful. With fortification of foods and widespread use of multivitamin preparations, some seniors may get too much folic acid, which can mask the laboratory diagnosis of vitamin B12 deficiency, potentially leading to neurological damage. “It is preferable to get essential nutrients from food rather than supplements,” Lichtenstein says; this can decrease the risk of overdoing certain nutrients.

“On the other hand, elderly people with low stomach acid may need to take a vitamin B12 supplement,” said Alan R. Gaby, MD, chief science editor for Healthnotes. “Food-derived vitamin B12 is poorly absorbed by people with low stomach acid, whereas vitamin B12 in supplement form is well absorbed.”

Since many seniors take medications that may be impacted—positively or negatively—by adding supplements to the mix, seniors should look for a healthcare practitioner knowledgeable in nutritional medicine to help them be aware of potential nutrient and drug interactions and make appropriate recommendations for nutrient supplementation.

(J Nutr 2008;138:5–11)

Healthnotes Newswire (February 14, 2008)—Kids’ diets are notorious for their lack of fruits and vegetables and for their abundance of highly processed, high-sugar, high-fat, high-calorie foods, so it might come as no surprise that their diets come up short in important nutrients, including calcium. A new study found that kids between ages 4 and 18 don’t get enough calcium, and much of what they get is from high-fat dairy foods like ice cream and cheese.

Calcium is the most abundant mineral in the human body, and although 99% of it is in the bones and teeth, it plays a critical role in the normal functioning of every cell in the body. The calcium we get in childhood and adolescence is important for achieving normal growth, developing strong bones and teeth, and ensuring healthy bones later in life, when low bone density (osteoporosis) can lead to high fracture risk.

The new study, published in the Journal of Pediatrics, included 7,716 kids between 2 and 18 years old. Their dairy intake was compared to amounts recommended by the US Department of Agriculture’s (USDA) “MyPyramid,” and their calcium intake was compared to the Institute of Medicine’s levels for Adequate Intake (AI).

Children from two to three years old met MyPyramid guidelines of 2 cups of milk per day (or the equivalent amount of nonmilk dairy foods), but none of the other age groups got the 2 to 3 cups per day recommended for kids their age. High-fat dairy foods accounted for one-half of younger kids’ dairy intake and more than one-third of older kids’ dairy intake. Children from two to eight years old met AI recommendations for calcium intake (500 to 800 mg per day), but 9 to 18 year olds did not achieve their recommended intake of 1,300 mg per day.

Previous studies looking into children’s nutrition have yielded similar results: they’re not getting as much calcium as they should. “This is just the tip if the iceberg,” commented Julianne Forbes, a naturopathic doctor who does nutritional work with children and adults. “It is very likely that kids are not getting optimal amounts of a wide array of minerals and other nutrients—they’re simply not found in the super-processed diet many children and adolescents eat.”

In the United States, about 50% of people’s dietary calcium comes from dairy foods, and institutions that make and promote public health policies have historically recommended eating plenty of dairy foods to ensure they get enough calcium. A high-dairy diet, however, raises some concerns, because many dairy foods—such as ice cream and flavored milk and yogurt—have lots of added sugar, and others—such as most cheeses and cream-based sauces and toppings—are high in saturated fat.

Calcium sources—beyond dairy

While milk is a good source of calcium, some people are unable or choose not to eat dairy foods, and for them, other options can be just as healthy. Nondairy calcium sources include green vegetables like broccoli and kale, soybeans and tofu, canned fish with the bones, sea vegetables, molasses, and figs.

“I try to encourage people to eat and feed their children a very rounded diet, and not to rely solely on dairy for calcium,” Forbes added. “Cooking green vegetables helps increase the availability of their calcium, and using a little vinegar on them increases calcium absorption. Not all kids will eat greens, but parents can keep trying, offering other things they might like, such as nori and other seaweeds, sweet potato, toasted sesame seeds, tofu, and figs. It helps if they don’t have access to sodas and chips and other non-nutritious foods, so parents have to think about improving their own diets as well.” She also pointed out that adequate vitamin D—from sun exposure and dietary sources, such as cod liver oil—is critical for good calcium absorption and use.

(J Pediatr 2007;151:642–6)

Healthnotes Newswire (February 14, 2008)—Lycopene—a powerful antioxidant found in tomatoes—has gained notice for its role in strengthening the immune system, preventing macular degeneration and cardiovascular disease, and for fighting cancer. Findings from several studies suggest that lycopene supplements and eating tomatoes and tomato-based foods may protect against prostate cancer. Now a new study suggests that lycopene supplements might slow prostate gland enlargement and reduce symptoms in men with benign prostate hyperplasia (BPH).

BPH, a noncancerous enlargement of the prostate gland that affects many men over 50 years old, causes symptoms ranging from a weak urinary stream and frequent urination (especially at night), to severe and painful urinary urges. Although there does not appear to be any relationship between BPH and prostate cancer, hormonal changes that occur with aging might contribute to both.

The new study, published in the Journal of Nutrition, included 37 men between ages 45 and 70 with BPH. They received either a supplement providing 15 mg of lycopene per day or placebo for six months. At the end of the study, the men who took lycopene had no change in the estimated size of their prostate glands. In contrast, the men who did not take lycopene experienced increasing enlargement of their prostate glands. Taking lycopene was also associated with greater improvement in BPH symptoms.

“This study provides early evidence that lycopene might help men with BPH by slowing the enlargement of the prostate gland and reducing symptoms,” commented study coauthor Hans-Konrad Biesalski of the Institute of Biological Chemistry and Nutrition at the University of Hohenheim in Stuttgart, Germany. “For the majority of men who experience mild symptoms of BPH, eating more tomatoes and tomato-based foods is a safe and inexpensive way to possibly modify the course of their condition.”

Lycopene is one of the reasons that tomatoes have a rich red color. It’s a pigment in the antioxidant carotenoid family. Small amounts of lycopene are also found in watermelon, pink grapefruit, and guava.

Three raw tomatoes or 1/2 cup of tomato sauce provide about the same amount of lycopene as the supplements used in this study. People who can’t eat tomatoes or don’t like them would need to eat 10 ounces of watermelon or 6 1/2 pink grapefruits to get a similar amount. Men with BPH might also consider adding soy foods, onions, and garlic to their regular diets, and getting plenty of exercise to stave off increasing enlargement and worsening symptoms.

(J Nutr 2008;138:49–53)

Healthnotes Newswire (February 14, 2008)—Before heading to the kitchen, remind yourself that you can lighten up (and lose weight without trying) by merely cutting calories you won’t even miss. Instead of full-fat mayonnaise, reach for fat-free. Instead of whole milk, get acquainted with some very tasty nonfat substitutes. For most full-fat dairies, dressings and dips in the marketplace, there are acceptable alternatives. You name it, they make it with a lower fat and calorie profile, and it tastes good.

Review your recipe file with a fresh eye. Rethink your kitchen experience—from the way you cook it to the type of pans you use—and apply these slimming solutions.

1. Nonstick: Stock up on nonstick pans for baking and grilling, breads and cookies, sautéing and even for soup. Nonstick is one of life’s little pleasures because you don’t need oil. Instead use a little cooking spray, wine, water or juice.

2. Method: Bake, broil, grill, poach or sauté foods instead of deep-frying.

3. Reduce: Simply reduce the amount of fat and/or sugar in your recipes. For example, replace half the oil with applesauce or fruit puree for an equally moist muffin or cake; use one-third less sugar in cakes or cookies and use dried fruit, not sugar, to add sweetness to cereal. Experiment with sucralose (Splenda) for baking.

4. Baste: Instead of basting the turkey with butter or margarine, cut the saturated, and especially trans fat, by basting with flavorful vegetable broth, white wine or orange juice (my personal favorite!).

5. Lean: Buy the leanest cuts of meat and trim all visible fat before cooking. Pam Ofstein, eDiets Registered Dietitian and Director of Nutrition Services, recommends ground round, at least 91% lean. Lighten it up even more by replacing one-third of the beef with ground turkey breast. Just be sure to buy turkey breast—“ground turkey” could also contain skin and dark meat, nutritionally no better than ground beef.

6. Dairy: Buy low-fat and nonfat varieties of milk, sour cream, yogurt and cheese. Low-fat buttermilk works great as a substitute for whole milk in any recipe. Nonfat evaporated milk works famously in dishes calling for cream, like sauces, pies, ice cream and, of course, in tea and coffee. Don’t confuse “evaporated” with “condensed” milk, which is heavily sweetened with sugar.

7. Chocolate: Why deny yourself the sensuous pleasure of chocolate when there’s cocoa? Three tablespoons of cocoa and one tablespoon of canola oil has less saturated fat than one ounce of baking chocolate.

8. Eggs: When cooking, just substitute two egg whites for one whole egg (the fat, cholesterol and most of the calories from eggs are in the yolks). I make my “famous” frittata for two with six whites and two whole eggs, cutting calories without losing flavor. My secret: Add a clove of minced garlic, plus herbs and spices and one-third cup of low-fat buttermilk.

9. Crumbs: Substitute crunchy cereal for higher calorie commercial bread crumbs. I like to use crushed corn flakes or Grape Nuts.

10. Cut: Make servings smaller. Americans suffer from “portion distortion” and think everything needs to be bigger to be better. Use smaller plates, and make that cake serve 12 instead of 8.

Healthnotes Newswire (February 7, 2008)—Since you are reading a weight-loss article, it is safe to assume you want to lose weight. I bet you are anxiously looking for tips “to do” and a diet to “go on,” which are essential to successful weight loss, but those aren’t the only things that you need to know.

Why? Most women have spent an average of 20 years “dieting,” so another safe assumption is that we know a lot about what to do right. However, little attention is usually given to what not to do. Apply this list of things not to do to your healthful regimen, and spare yourself many of the pitfalls that derail most dieters.

• Going on any diet that you cannot adhere to for the rest of your life: Be careful when deciding what nutritional plan you want to follow, as it should be a manner of eating that matches your tastes, budget, and lifestyle. You should model all of your future nutritional plans closely after how you lost the weight in order to keep that weight lost for good!

• Believing that you will eat cabbage soup—or any other low cal, monotonous fare—every day for the rest of your life. If a particular odd “diet” is something that you can barely stomach, it isn’t realistic to think you will eat that way for the entire time it takes to lose all the weight. It certainly won’t teach you much about how to live healthfully for the long-term. Just say NO to cabbage soup and other such funky diets!

• Not drinking enough water: You should drink at least 64 ounces of water every day, and for overachievers, drinking up to half your body weight in fluid ounces a day is recommended (for example, a person who weighs 150 pounds would drink 75 ounces). Early man packed up all his belongings when his water supply dried up and relocated to another area where water was plentiful. They knew they couldn’t live without it. Yet, we have water in our kitchen faucet, and ignore it all day. Water is all that you need to drink.

• Consuming processed foods more often than fresh foods: Again, think how early man lived and what he ate. Eating as close to natural is the best way to ensure that your body is as healthy as possible.

• Not being aware of the nutritional benefits or detriments of what you consume: Lettuce is a great choice to eat, but spinach and other darker leaves have more nutritional benefit than the iceberg variety. If you are going to eat, get the most bang for your buck!

• Starving all day: When you finally get around to eating, it is usually something unhealthy and it gets stored as energy later, rather than burned as energy now! You totally mess up your metabolism if you do this!

• Thinking of exercise as a chore instead of a way to improve your health and life, And not scheduling exercise as a vital part of your day and week: Exercise is a “get to,” not a “have to.” It is a joy to move your body and get your endorphins flowing. They truly are nature’s reward for demanding physical fitness of ourselves. Push yourself; you will be amazed at how it feels!

Healthnotes Newswire (February 7, 2008)—People with diabetes may be able to reduce the risk of a common and uncomfortable complication of the disease: they may avoid painful foot ulcers by monitoring the temperature of their feet. According to a new study published in the American Journal of Medicine, this kind of care may reduce the risk of foot ulcers by more than 30%.Constant blood sugar elevation causes the nerve damage (neuropathy) responsible for diabetic foot ulcers. Neuropathy reduces the feelings of pain or inflammation, making it difficult for people with diabetes to notice inflammation or skin injuries. Unfortunately, if even a minor skin tear is left untreated, it can develop into a serious ulcer.

In this 18-month study, 225 military veterans with diabetes who were at risk for foot ulcers due to nerve damage, foot deformities, or prior foot ulceration were randomly assigned to receive either standard therapy—which consisted of therapeutic footwear, education, regular foot care, and a daily structured foot self-inspection—or standard therapy plus the use of an in-home infrared skin thermometer to measure the temperature of several spots on their feet twice a day.

During the study, 8.4% of the people developed foot ulcers—14 from the standard therapy group and 5 from the skin thermometer group. People in the skin thermometer group had a temperature difference of 4.8 times greater in the region of ulceration during the week before the ulcer appeared than did a random sample of 50 people who did not develop ulcers. People in the skin thermometer group were one-third as likely to develop ulcers as people in the standard therapy group.

“Self-monitoring is necessary to identify early warning signs to reduce the incidence of diabetic foot complications and the associated decrements in quality of life and high resource costs,” said David Armstrong, DPM, PhD, and colleagues from the Rosalind Franklin University of Medicine and Science in Chicago, Illinois. “Sadly, the ability of the most motivated patients with diabetes, their family members, and even health care professionals to identify ‘early warning signs’ is limited. Self-evaluation of temperature seems to offer a mechanism to identify an early sign of injury, when there is still time to avert a wound.”

Foot ulcers can be painful and costly but the incidence can be reduced with disciplined foot care and attention to early warning signs such as inflammation or injury. Additionally, Armstrong and his colleagues recommend using the simple and inexpensive skin thermometer to reduce foot ulcers in high-risk patients. People with diabetes should speak with their physician or a diabetic educator about measures they can take to reduce their risk.

(Am Med J 2007;120:1042–6)

Healthnotes Newswire (February 7, 2008)—Research has shown that healthy vitamin D levels may protect against osteoporosis, cancer, and multiple sclerosis. Now there is evidence that vitamin D may help protect against a potentially dangerous rise in blood pressure that occurs in some people as they age.In a study published in the American Journal of Clinical Nutrition, researchers found that as many as 60% of whites and more than 90% of blacks who participated in the third National Health and Nutrition Examination Survey had insufficient blood levels of vitamin D, which is obtained through the diet or produced in the skin by the effects of the sun.

Researchers also looked at the association between vitamin D, blood pressure, and age and found that people with lower blood levels of vitamin D had significantly higher increases in systolic blood pressure (the top number of the blood pressure reading) as they aged than did people who had healthy levels. In fact, the age-related rise in blood pressure was 20% lower in people who had healthy vitamin D levels than those who did not, suggesting that vitamin D deficiency may play a role in high blood pressure development.

Several other research studies have suggested a role for vitamin D in reducing blood pressure, according to the study’s authors. One study showed that daily doses of 400 IU of vitamin D plus 600 mg of calcium significantly reduced blood pressure in elderly women by more than 9% after eight weeks, while treatment with 600 mg of calcium alone reduced blood pressure by only 4%.

“There is not enough evidence for vitamin D preventing hypertension to make this global recommendation; however, since vitamin D insufficiency is highly prevalent in the United States, it might be a good idea to take a vitamin D supplement given the strong evidence in preventing osteoporotic fractures,” said Vin Tangpricha MD, PhD, assistant professor of Medicine in the Division of Endocrinology, Diabetes & Lipids at Emory University School of Medicine.

Dr. Tangpricha and his colleagues hope for improved methods to detect and treat vitamin D insufficiency in adults in the United States and especially in blacks. The authors also note that further studies are needed to determine vitamin D’s effect on blood pressure and if giving all patients vitamin D will help lower blood pressure.

People with a family history or other risk factors for high blood pressure, including being older than 65, should have their blood pressure checked regularly and should talk with their doctor about dietary factors that may help protect against this condition.

(Am J Clin Nutr 2008;87:136–41)

Healthnotes Newswire (February 7, 2008)—Many studies have shown that fruits, vegetables, fiber, and fish are the key components of a diet that is most likely to prevent cancer. Eating red meat (beef, pork, and lamb) and processed meat (hot dogs, sausage, cold cuts, and many lunch meats) has been shown to increase the risk of some cancers, and now a new study, published in PloS (Public Library of Science) Medicine, adds evidence in favor of cutting down meat-heavy meals.In this study, nearly 500,000 men and women between ages 50 and 71 who were enrolled in the National Institutes of Health–American Association of Retired Persons (NIH–AARP) Diet and Health Study filled out health and lifestyle questionnaires upon enrollment and were monitored for cancer diagnosis for an average of 6.8 years.

People who ate the most red meat, defined as all types of beef, pork, and lamb, had a 51% higher risk of esophageal cancer, 24% higher risk of colorectal cancer, 61% higher risk of liver cancer, and 20% higher risk of lung cancer than people who ate the least. People who ate the most processed meat, defined as bacon, lunch meats, cold cuts, ham, and sausage and hot dogs made from beef, pork, and poultry, were 20% more likely to develop colorectal cancer and 16% more likely to develop lung cancer than people who ate the least. The study did not specify what effects meats like unprocessed poultry or ham might have on cancer risk.

Eating for cancer prevention

• Get your veggies: A few foods like green tea, tomatoes, and cruciferous vegetables such as broccoli, cabbage, Brussels sprouts, and kale have received a lot of attention for their anticancer effects. Scientists think that these effects are due to their high content of special cancer-fighting antioxidants and other compounds.

• Get your fiber: Fiber-dense foods including beans, lentils, nuts, seeds, and whole grains might prevent cancer by binding and helping to eliminate toxic, cancer-causing substances in the digestive tract, and by helping to keep blood sugar levels normal.

• Be picky about protein: People—usually vegetarians—who rely on legumes, nuts, and whole grains for protein generally get more fiber and tend to eat more fruits and vegetables than people who eat meat. A number of studies have found that vegetarians have lower cancer rates than nonvegetarians.

• Meat addicts, mix it up: Choose vegetarian options more often to reduce the number of meaty meals. And try replacing red meat with more fish or white meats. Many of today’s meat substitutes, such a products made from vegetable protein, can be found in easy, prespiced packages that are much harder to distinguish than skeptical meat-eaters might think.

“Many of the people I work with are trying to move toward a more healthful eating plan by trying more vegetarian dishes,” commented Mary Saucier Choate, author of the book and class series Better Eating for Life and a registered dietician who heads the Food and Nutrition Education program at the Co-op Food Stores in Hanover and Lebanon, New Hampshire. “A powerful first step toward this is simple—eat more dried beans and legumes. These do double duty as a vegetable and a source of protein (as well as fiber, folate, and trace minerals). I encourage people to choose convenient, low-sodium canned versions and add them to salads, soups, and pasta sauces to “beef” them up without any downside for health.”

(PloS Med 2007;4:online publication)

Healthnotes Newswire (January 31, 2008)—For pregnant women, energy boosters such as nutritious beverages, protein snacks, and exercise may be a safer option than caffeine. A study in the American Journal of Obstetrics and Gynecology reports that drinking caffeinated beverages might increase miscarriage risk. “The main message for pregnant women is that they probably should consider stopping caffeine consumption during pregnancy,” says De-Kun Li, MD, the study’s lead investigator. “This research provides clearer and stronger evidence that high doses of caffeine intake during pregnancy can increase the risk of miscarriage.”The new study included 1,063 pregnant women who were members of the Kaiser Permanente Medical Care Program. The women were interviewed early in their pregnancies regarding their intake of caffeine-containing beverages (including coffee, tea, soft drinks, and hot chocolate) and about pregnancy-related symptoms like nausea and vomiting.

Women who drank 200 mg of caffeine per day—the amount found in 10 ounces of coffee or 25 ounces of tea—or more were over two times as likely to have a miscarriage than were those women who didn’t drink any caffeinated beverages. Drinking less than 200 mg per day also raised the risk, but to a lesser extent.

Caffeine crosses the placenta and may interfere with normal growth of the unborn baby. Most healthcare practitioners advise pregnant women to limit their caffeine intake, but until now specific recommendations about caffeine consumption during pregnancy couldn’t be made.

Women with morning sickness are known to be less likely to miscarry, and many of these women might also avoid caffeine because of their nausea. This has led to confusion about whether women with morning sickness are less likely to miscarry because they avoid caffeine or because they have healthier pregnancies overall. The new study helped to sort this out, finding that caffeine increased miscarriage risk—regardless of the presence of morning sickness.

Many pregnant women struggle with decreased energy during their pregnancies, especially during the first trimester. Thankfully, there are safer options than using caffeine that can help boost energy during these months.

Energy lifters for the mother-to-be

• “Perk up with natural energy boosts like a brisk walk, yoga stretches, and snacking on dried fruits and nuts,” suggests Tracy Flanagan, MD, director of Women’s Health, Kaiser Permanente Northern California.

• Keep blood sugar levels up with small, frequent meals and snacks that include a protein source like a hard boiled egg, slices of lean deli meats, a protein bar, or a fruit and yogurt smoothie.

• Make sure to get plenty of rest—this is key to avoiding the need for an artificial energy spike.

• “Stay hydrated by replacing caffeinated drinks with more nutritious fluids,” offers Michelle Palmer, certified nurse-midwife. “Lemon water is a refreshing pick-me-up.”

(Am J Obstet Gynecol doi 10.1016/j.ajog.2007.10.803)

Healthnotes Newswire (January 31, 2008)—In many parts of the country, wintertime is too cold for jogging. It gets dark early, which brings on the blues. You’re annoyed by all the layers of clothing you have to wear. Gym workouts lessen: You start eating more junk food and going out less. You start to get fat. Ugh, winter!I have some strategies to help you avoid a winter exercise funk. It’s not always easy, but if you have a plan and focus on these tips, they’ll help counter the winter blahs.

The following are proven methods that have worked for my personal training clients and me. You don’t have to use every one; just pick a few and run with them. The mind responds best when it’s not inundated, so select the few that feel right.

• Hire a personal trainer: Just for the winter, hire a personal trainer and make sure he/she trains you once or twice per week. You’ll get the benefit of a structured workout program, as well as someone to monitor your progress and motivate you to achieve a more fit body, while everyone else around you is getting fat. I like this tip, not just because I’m a trainer, but because when human beings fork over some cash, they want to get their money’s worth. If you can’t afford it, get a buddy and pay for joint sessions with the trainer to lower the price tag.

• Get a workout partner: If you can’t find a friend, post a message on your gym’s bulletin board. Find someone who has similar goals and try to work out with this person at least twice per week. Keep a workout journal and try to improve on anything you achieved in the summer. If you know you have to meet someone at the gym or for a tennis game at a specific time, you’re bound to be accountable. This tip is really valuable on those cold, dark evenings after work when you’re tempted to go home and munch on chips before dinner. Amazing things start to happen if you work out when you don’t feel like working out. You increase your internal strength and dedication, and it slowly starts to catch fire.

• Join a club: There are many runners clubs, walkers clubs, etc. Find one that appeals to you. You’ll look forward to the camaraderie and scheduled activities. You may just find yourself leaner and more athletic by the end of winter¡Xwith a few more friends as well.

• Scale back on workouts: If you do find yourself slipping into a winter funk, simply cut back on your workout time. For example, if you’ve been consistently working out for an hour, three to four days per week, cut back to 30 minutes. Don’t worry, you won’t get out of shape—you’ll stay in shape. This simple technique will make going to the gym much less intimidating during the dead of winter.

• Consider getting some equipment for your home: You don’t need a fully operational gym—just some dumbbells, a jump rope and a workout tape for those nights when you have trouble getting to the gym. Remember, we’re looking for every opportunity to keep you on the right track. Your mind will play games with you during the winter, so you need to have strategies that will work for YOU.

• Workout in the morning before work: I know it’s cold and you may have to get up earlier, but if you can manage three morning workouts per week, you’ll accomplish several things: You’ll stimulate your metabolism for the rest of the day; decrease your appetite; and most importantly, get your workout out of the way and start your day with a success. I discovered the power of winter-morning workouts in the days when I trained for half marathons. I found that if I ignored my “I don’t feel like doing it” attitude and did it anyway, I had an incredible feeling of self empowerment for the entire day.