Ways to get from borderline to better

Q: What’s with these conditions called pre-hypertension, pre-diabetes and pre-cancer? It used to be either you had the condition or you didn’t.

A: Years ago, there was a gray zone between normal and a diagnosis of high blood pressure or diabetes generally referred to as “borderline.” Research has now advanced, showing more clearly that people with these borderline conditions are likely to develop full-blown hypertension or diabetes, and also showing that many cases of full-blown disease could be prevented or delayed with a healthy diet, appropriate weight and activity level. So now these diagnoses of pre-hypertension and pre-diabetes are treated like a red traffic light saying stop what you are doing and make some healthy changes.

Pre-hypertension refers to a blood pressure between 120/80 mm Hg and 139/89 mm Hg. Even blood pressures in this range increases your risk for heart attack, stroke and kidney disease. Risk of developing hypertension can be reduced with weight loss of even 15 pounds, three hours a week of moderate exercise and limited sodium and alcohol consumption. Pre-diabetes refers to a blood sugar of 100 to 125 mg/dL after an overnight fast or blood sugar of 140 to 199 mg/dL after a two-hour oral glucose tolerance test. Development of diabetes can be markedly reduced with a five to 10 percent weight loss (often 10 to 20 pounds) and regular physical activity. Cancer may start as pre-cancerous growths, such as certain colon polyps. These polyps can be removed, but finding them may be a good reminder to see how you can lower your risk of cancer by your lifestyle choices. For example, for colon cancer, lower risk is linked with maintaining a healthy weight; moderate physical activity at least 30 minutes a day; limiting red meat (no more than 18 ounces a week) and avoiding processed meat; limiting alcohol consumption; including plenty of vegetables, fruits, whole grains and beans for fiber and nutrients; and making sure to include adequate calcium in your diet.

Q: Is it true that exercising first thing in the morning burns more body fat?

A: No. Some people assume that if you exercise before eating you will automatically use more body fat for fuel, but that does not seem to be the case. It is true that you don’t have as much glycogen (stored carbohydrate) in your muscles to fuel activity first thing in the morning; however, other metabolic changes following an overnight fast reduce your ability to burn fat for fuel. So overall your endurance and fat loss decrease, possibly by up to 20 to 25 percent; that’s why experts recommend at least a small snack first, preferably something like fruit or a whole grain that provides just a modest blood sugar boost. Morning exercise is great, but fitting it in whenever it works for you is the best time to do it.

Karen Collins in a registered dietician with the American Institute for Cancer Research, a cancer charity that fosters research on the relationship of nutrition, physical activity and weight management to cancer risk.