HEY SAM: My doctor recently told me that I’m at risk for high blood pressure and placed me on blood pressure medication. What’s the best way to augment my workout routine in this situation?

A: People who participated in a regular yoga program experienced a natural drop in blood pressure, according to new research from the Washington University School of Medicine. The study, published in HIV Medicine, followed 60 HIV-positive adults over the course of a supervised, 20 week yoga program. Resting systolic and diastolic blood pressures were reduced more in the yoga group than in the control group, despite no greater reduction in body weight, fat, or overall quality of life.The best part? T4 levels were not adversely affected.

Practicing yoga is an intelligent idea for other reasons, too. (more…)

I was recently diagnosed with peripheral neuropathy. I still have feeling in my fingers, but I’ve lost most of the feeling in my toes. Do you have any advice on ways I can manage this condition through exercise or supplementation?
—Lee, Cheyenne, WY

Peripheral neuropathy causes pain (sometimes described as tingling or burning) and numbness in the hands and feet. While HIV is one cause of the condition, it’s certainly not the only one. Diabetes and cancer treatments (such as radiation or chemotherapy) are also common causes. Sometimes the condition improves with treatment of the underlying cause, sometimes it doesn’t. (more…)

Don't try this at home, kids.

I recently started working with a trainer. I’ve always had trouble putting on muscle mass (called “scrawny” in high school).  My trainer told me that doctors sometimes prescribe testosterone for people with HIV. Do you think this is something I should consider? Would it help me put size on faster? —Rob, Pasadena, Calif.

Most people know that testosterone (like growth hormone) is an androgen that your body produces, so you need to see a doctor to determine if your natural levels are in keeping with a “normal” medical reference range.  This is really the first question you should be answering, i.e., “are my natural levels of testosterone too low?”

It may also be worth kicking around some questions developed by St. Louis University to screen for androgen hormone deficiency. You can answer the questionnaire here

If your natural levels fall below the normal reference range, you should weigh your options. There are many new delivery methods available—from patches, gels and creams to injections—so be sure to have a robust discussion with your provider.

Incidentally, there are other many hormones which can be screened by your doctor, including thyroid hormone, growth hormone, and free/total testosterone. These levels could also be checked and taken into account before making a decision.

I’d do everything you can to enhance your natural levels of testosterone. Make sure that you are eating a balanced diet, taking a multivitamin, getting enough sleep, and avoiding excessive caffeine, alcohol and nicotine. While it’s true that supraphysiological levels of testosterone and growth hormone will increase lean body mass, reduce fat, and improve well being—the long-term effects are largely unknown.

Also, ask your trainer to customize your workout. For instance, there’s some evidence that “multiple joint” exercises, (such as the bench press and squat) may play a role in higher levels of post-workout testosterone in the people who do them.

I’m trying to tone up for a trip to Hawaii. In addition to doing cardio, which are the best supplements on the market, in your opinion, for fat loss? I’m not interested in “fad supplements” but only supplements which really work.

When it comes to losing weight and fat loss, there are four fat loss / appetite supplements worth your consideration. Don’t worry, they’re not ephedrine or Ma Huang.

Chromium picolinate is a nutritional supplement that works to increase the efficiency of insulin to optimal levels. It’s been has been shown to help regulate blood glucose levels. Stable blood glucose levels may keep you from entering “fat storing” or “starvation” mode.

The amino acid carnitine helps to lower triglycerides and has been shown to help mobilize brown fat tissue. This is usually taken between (not with) meals.

Hoodia gordonii is a leafy, spineless succulent plant used for centuries by bushmen to suppress appetite while making long treks across the desert. It was the primary ingredient of the late Anna Nicole Smith’s product, Trim Spa. However, real hoodia is sometimes difficult to find.

The amino acid glutamine helps to preserve lean muscle mass and reduce cravings for sugar. It should be taken between meals.

And don’t forget caffeine. It’s old skool, but it totally works.

Used alone, supplements will not produce results. But when used intelligently in concert with a regular exercise regimen and a clean diet, these supplements may prove useful to you as you work to shed a few extra pounds.

I HATE THIS TIME OF YEAR. I love Girl Scout cookies (who doesn’t?) and I am often guilted into buying them by my office co-workers. This year I have 8 boxes of Thin Mints and 3 boxes of Samoas—11 boxes total!! WTF!? What am I supposed to do with all of these cookies? —Sick of Samoas

I LIKE THEM TOO, but let’s face it: ever since the Girl Scouts took the trans-fat out of the recipes, they don’t taste nearly as good. Sort of like how you expect the bride’s wedding dress to be freakishly white, but instead she comes down the aisle wearing a “neutral gray.” The same holds true for the taste of the new Girl Scout Cookies. So your first line of defense when you’re under pressure to buy: Remember: they don’t taste as good anymore.

Second, you’re getting ripped off. I don’t understand how a “box” of Samoas can equate to 15 TINY cookies. And is it just me, or do the cookies themselves seem to be shrinking each year? My point is, you’re getting much less cookie for your money. If you’re addicted to Thin Mints, a better value would be had by trying the Keebler brand Grasshopper cookie, which is nearly identical in shape and flavor.

If you’ve already caved, then rationing is one way to put some control on your inner cookie monster. If you’ve already purchased the cookies, take one or two boxes of your favorite cookies and put them in the freezer and limit yourself to one every other day, or whatever you feel is reasonable. If you have problems controlling your consumption of the cookies, try my concept of Zen Cheating.

Give away the cookies to your local food bank, church, or community center. Send them overseas to our military personnel. Take them to an expecting mom. Or the next time you fly, bring a box for the flight attendants. They almost never receive anything nice from passengers, and it might just get you bumped up to first class.

I’m thinking of buying a weight vest (probably on-line). I was just going to get the cheapest one ($99 bucks at Amazon). Is one pretty much like the other, or should I look for certain features in a weight vest?

There are several different weight vests on the market, varying in price. I favor the X VEST, because it is used by Navy Seals and professional athletes. It’s comfortable at most speeds and body movements. The two-piece clamshell design has nylon surfaces with a elastic, velcro waistband and adjustable height and width so as to not affect arm motion, balance, or breathing. It’s also the most stable of the brands I’ve seen, moving very little even during fast running. There is a pocket for keys and a wallet, and it comes in 12 to 84 pound models. Price is $179, (800) 697-5658; www.thexvest.com

Two other options may be of interest to you if you want a slightly less expensive version. They are the Uni-Vest, which is non-adjustable, but provides a one-piece neoprene and nylon construction that enables a secure fit. The vest uses flexible, half-pound rubber weights that contour to the human form and could be safer than the X VEST’s metal weights if you’re uncoordinated. But there’s no place to put keys. Price: $69, (888) 556-7464; www.performbetter.com

The WalkVest is designed for use just with walking, and the sleeveless, cotton vest with midsection pockets hold up to 32 thin steel bars weighing each .5 pounds for a total of 16 pounds of resistance. The cotton construction provides a relatively comfortable fit, and because of the natural fibers, it’s cooler than neoprene vests. I wouldn’t recommend this vest if you plan on any running, because it bounces at all speeds above a simple walk. Straps aren’t made from velcro and must be tightened often. A rear pocket holds keys. And the vest only includes four pounds of weights with the first order. (You have to buy more if you want them).  Price: $85, (877) 925-5837; www.walkvest.com

HEY SAM:  I do cardio to burn fat. I know my body adjusts to the type of cardio. Do I have to keep changing the type of cardio I’m doing to get the full effect? —Arsh, Los Angeles

You’re right. The body adjusts very quickly to exercise. Interval training (or “high intensity interval training,” sometimes referred to as “HIIT”) is very effective at reducing body fat.   If you’ve stopped seeing the results you want, then it’s time to mix up the program.

One way to do this is to alternate your longer-endurance cardio days with high intensity interval training.

Here’s how a typical week might look:

Let’s say you do a few miles on the elliptical machine at a high resistance on Monday.
On Tuesday, you could do HIIT intervals.
Take Wednesday off.
Do a long slow (but steady) uphill climb on Thursday, and intervals again on Friday.
Use the weekend as an opportunity to cross train (play a sport, go skiing, walk outdoors, etc) and/or take one of your weekend days off.

An interesting fact about intervals: they’re super effective at getting rid of body fat, but scientists haven’t figured out yet which length of intervals (short, medium, or long) work best. So, cover your bases and mix up the length of the intervals themselves, too.

HEY SAM: What’s a deadlift? —Tristan

The dumbbell deadlift, properly performed, is an excellent exercise to develop the back, core, glutes and hamstrings. To perform this exercise, observe the following training points:

1. Stand with feet about 8-inches apart and a dumbbell at each side of your feet.
2. Knees slightly bent, back straight and head up, bend at waist and grasp the dumbbells with both hands. Inhale on the way down.
3. Exhale and stand erect with the dumbbells in both hands while arms are locked out.

Lower weights to the floor with legs bent and inhale.  Remember to keep your abdominal muscles contracted throughout the movement to develop a strong core.

HEY SAM, I’m trying to lose 50 pounds but I seem to be in a rut. Can you tell me what I should be doing differently? —Karen, Long Beach, CA

Karen, life never stands still. If you’re not moving forward, you’re moving backward. Keeping a fitness journal is one of the best ways to ensure that you move in a positive direction.  You have to set goals for yourself and continue to strive for positive results.

The best way is to keep a personal fitness journal.  I like to use a small spiral bound book of lined recipe cards. (more…)

HEY SAM:  You mentioned “shocking” the muscles when you work out and doing different exercises. Does that mean that every time you work out, it’s good to always change your workout, or should you be consistent and change your workout routine every couple weeks? -Joseph, Los Angeles

The body responds rapidly to any weightlifting or exercise routine. Yes, it’s important to continually challenge your muscles by “mixing it up.” When I train clients, I make sure to change up their routine (on average) every 4 weeks (or every 8-12 workouts).

The theory behind this is called “periodization” which means that workouts should be periodically changed to make them effective.

You can “periodize” your weight workouts by trying these 6 steps, in order:

• CHANGE THE ORDER. Do your current workout backwards. For example, if you generally finish by training abs, on your next workout, start with abs and work backwards.
• CHANGE THE REP PATTERNS. If you generally lift in four sets of 12, consider changing your rep pattern to an inverted pyramid (i.e., 12, 10, 8, 6, then 12) or change the number of repetitions for a given set from 12 to 15, or 20.
• PLAY WITH THE WEIGHTS. If you’ve become accustomed to a certain weight on an exercise, try reducing the weight and working with higher rep patterns with extremely strict form. Or if you’re using light weights, try “upping” the weights to heavier amounts and doing fewer reps (again, with very strict form).
• CHANGE THE EXERCISES. Probably the most obvious thing to do is to do different exercises to hit the same body parts. For example, if you’ve been doing squats, try lunges or the leg press instead.
• CROSS TRAIN. Remember that the goal of weight training, for most of us, is not to become a competitive bodybuilder, but for “real life” strength. Cross train your muscles, using circuit training, “boot camp” like classes, “core” classes, and other types of training that brings resistance work to a new level.
• TRAIN YOUR WEAKNESSES. I’m a sucker for a good pull-up, because they are by far my worst exercise. But I manage to do several pull-ups every day in my quest to improve. What are your body’s weaknesses? Be honest about them, then hit those areas in the gym with rigor and fierce dedication.