Cheese is one of the most frequently eaten foods in America, the home of obesity and overweight. For health reasons, many individuals are decreasing their meat intake but when it comes to cheese, “no way”! What makes cheese so difficult to eat in moderation or to avoid? It provides the combination of fat which helps you feel satisfied and salt which tantalizes your taste buds. It also contains compounds called casomorphins which are derived from the protein found in milk called casein. Casomorphins attach to the opiate receptors in the brain and trigger the brain to release dopamine, which leads to feelings of reward and pleasure. It is no surprise that cheese consumption has sky rocketed. In 1909 the average American ate less than 4 pounds of cheese per year. Today, an American eats more than 33 pounds annually. It has become a multi-million dollar industry to promote tasty and cheesy high fat foods to the public.
The rising amount of cheese consumed in the United States is directly associated with the obesity epidemic and leading cause of death, heart disease. Cheese is very calorie dense and the majority of calories come from fat. Most of the fat is saturated fat which leads to insulin resistance and elevated cholesterol levels. The typical sodium content per ounce ranges from 175 mg (cheddar) to 450 mg (parmesan) for those concerned about their blood pressure. So why do we eat it? If you are eating cheese for the protein or calcium content, choose healthier choices such as nuts.
Interested in alternatives to cheese?
• Try sprinkling roasted sunflower seeds or chick peas on your salad
• Mix nutritional yeast into your pasta sauces or meat-less meatball recipes
• Find a recipe for cashew cheese or try vegan cheese
• Squeeze fresh lemon on your cooked vegetables for flavor
• Take cheese out of your sandwich and add avocado, roasted red peppers or hummus
It is still important to watch the calorie content when choosing your foods. Good luck!
Carol Penfield MS, NPc is a nurse practitioner and certified personal trainer who specializes in Lifestyle Medicine at Emerald Physicians in Yarmouth. She offers private appointments as well as shared medical appointments for weight loss, which are covered by insurance.



April 24-May 15th
Four Tuesdays from 5:30-7pm
Fee: $135 * 3 FREE Club passes and 10% off a massage with Joyce Hutchings, RN, LMT
Come join us! Each visit includes a brief educational session to help you understand
the science behind aging and physical change, as well as new ways to improve your health and quality of life.

Your Presenters……
Carol Penfield, M.S.,NPc, Nurse Practitioner
Carol has been a Nurse Practitioner since 1994 and has additional training and expertise in the Lifestyle
Medicine fields of arthritis, weight management, nutrition, diabetes and rehabilitation medicine.

Nancy Samotis, LICSW, RYT
Nancy is a psychotherapist and yoga instructor who integrates yoga therapeutics and mind body
principles to help her clients navigate transition and expand their lives in creative and fulfilling ways.

Call or come in to reserve your spot: 508-945-3555

Want to know the “key” to successful weight loss?

Step by step approach to permanent weight loss.

What is the secret to successful weight loss and what does it take to keep from re-gaining? The answer is at Chatham Health and Swim Club, where participants have literally lost a ton of weight. Carol Penfield, owner of the Chatham Health & Swim Club, has applied her specialized medical expertise to help both members and non-members successfully lose weight. Her unique “Weigh to Better Health” team weight loss program not only works; it has also led to a healthier community. Since 2010, during three 6-week programs, 293 participants have lost 1,956 pounds while simultaneously raising over $38,000 to support primary care at Fontaine Medical Center. The enrollment fees for all the participants have been donated to the Cape Cod Healthcare Foundation in order to benefit the health of others in the community.

Carol Penfield, who is an independent nurse practitioner, applies the fundamental principles of a new medical specialty called “Lifestyle Medicine”. Lifestyle medicine offers proven strategies for converting knowledge “I know I need to lose weight” to action “here is my plan”. Solutions to changing exercise and eating habits must be very individualized. For example, a person who enjoys crunchy foods will not be satisfied with a low fat yogurt, or someone who grew up eating comfort foods will not adhere to eating celery!

Three [out of many] principles of the Lifestyle Medicine approach specific to treating obesity are as follows:
First, you must set appropriate goals by asking yourself the following questions:

• Why do I want to lose weight? Choose health-related goals that are achievable and measurable; rather than “because I want to look good” since only 1% of our population is ever truly satisfied with their appearance.

• How important is it, and how motivated am I? You should objectify your answer by using a scale of 1 – 10 (1 = not confident and 10 = very confident). If your confidence level is below 5, then the goals should stay small and be made weekly.

Second, routine exercise MUST be practiced. 95% of people who lose weight and keep it off exercise at least 5 times weekly for an accumulated amount of 60 minutes. Addressing specific barriers to exercise such as pain, time, or finances is critical in order to attain exercise adherence.

Third is accountability. Most individuals underestimate their daily dietary intake and overestimate their activity level, leading to gradual weight gain over the years.
Diet logs and the use of pedometers are excellent examples of objective recording. Reporting in to a group, coach, or medical professional such as Carol Penfield has been documented to improve outcomes.

Most New Year resolutions start to dwindle by the end of February. Successful gains in health will not be sustained by just a resolution once a year. There is another answer…Lifestyle Medicine. Lifestyle Medicine practices have been proven to be extremely successful nationwide by achieving measurable gains in health [including weight loss] over time. Common and critical conditions are treated, such as heart disease, diabetes, hypertension, arthritis, and back pain, as well as obesity. Carol Penfield’s Lifestyle Medicine practice, located on the campus of the Chatham Health and Swim Club, is the first such program on Cape Cod. She helps her patients find that delicate balance when creating attainable goals, in order to minimize discouragement and build confidence. The practice offers on-going individual and group support as well as weekly on-site or electronic check-in options, and is covered by most medical insurances.


By Carol Penfield M.S. Nurse Practitioner, Certified Personal Trainer, Nutritionist
Owner of Chatham Health & Swim Club

The average American gains 10 pounds during the holiday season from Halloween to New Years. Fifty percent of an individual’s yearly weight gain occurs during this festive time. WHY? Social gatherings often include more food choices, larger portions and alcohol that weaken “willpower”. Healthy eating patterns become difficult to maintain. The people who gain the most weight during the holidays are those who abandon their exercise routines.

It is important to first focus your mind on trying to only lose the new weight gained. Dieters often get overwhelmed with an unrealistic long-term goal and therefore prematurely give up on a weight loss regime. Staying consistent and working on a 500-calorie deficit per day will lead to reducing your body fat by one pound per week. This can be achieved through eating 250 calories less and burning 250 calories through exercise daily.

Take the pressure off yourself. Fat does not disappear overnight. Making small changes such as eating one less donut per week can lead to a loss of 3 pounds in a year. Consider walking 8 minutes extra each day and in one year you will lose 4 pounds.

Trying to get your motivation back during the holiday season is another challenge. The following are a few tricks to try.

1) Minimize your choices.
Freeze or give away your leftovers. Consider periodically trying meal replacements such as a Slim Fast shake, nutrition bar, or Weight Watchers meal. With meal replacements, your portions are defined for you and temptation is minimized.

2) Tricks for overeaters used to “volume”.
People who are used to eating large portions can try increasing their vegetable intake. Fill yourself with low calorie vegetables, rather than other calorie dense foods. It has been shown in studies that successful dieters consume greater that 20 vegetable servings per week. Drinking a large glass of water before your meal can also trick your stomach into feeling full.

3) Train your body to be satisfied with smaller portions.
One technique is to try small frequent snacking. Snacking during the day may keep you from getting too hungry and eating more than necessary at the next meal. Fueling your body with small meals will help boost your metabolism. Eating a large volume of food at once, such as more that 1000 calories, will lead to storing the excess as fat. It is important to stay within your total daily calorie allowance when planning snacks. Most individuals will lose weight on an intake of 1500 calories per day.

4) Don’t stop exercising or you will not lose the weight!
Schedule time during your busy day to exercise above your usual activity. Walking is the most common form of exercise chosen. Walking will improve your health and fitness level but many are not exercising at the level it takes to lose weight. Consider trying interval exercises. Interval exercise groups have shown to lose fat at a higher rate than endurance exercise groups. Walking and other endurance exercises do effectively burn calories, but interval exercises have shown to not only burn calories but also boost your metabolism after the exercise regime.
Interval exercising involves alternating between high and low intensity exercises for a specific short length of time. For example, changing the speed of your activity, doing exercise stations or light weight lifting. The exercise to recovery ratio should be 2:1. For instance, if you walk up stairs for 30 seconds your rest portion would be twice as long or 60 seconds before repeating the activity. When doing interval exercises it is important to exercise at an intensity level that you feel is “somewhat hard” or 60-80% of your maximum heart rate.

5) Be accountable.
It is hard to lose weight on your own. Over 100 studies have indicated that people
who join groups or seek periodic professional consults for diet and exercise show the greatest weight loss success. Checking your weight only once a week is recommended.

6) Recognizing stress and depression.
Family and social issues often arise during the holidays. Many individuals overeat or binge-eat to relieve stress. Depression can potentially interfere with motivation to lose weight and it can be treated. Consider seeking professional help to assist in recognizing and possibly treating depression.

Losing weight during the holiday season becomes a “growing” challenge every year. Developing healthy eating patterns, routine exercise and making modest behavioral changes will lead to success. It is difficult to stay motivated and lose weight on your own. Do not give up on trying, your health depends on it!

If you are interested in learning more about losing weight, controlling overeating and fat burning circuit exercises, come to a free workshop on Saturday, January 2th, 10 –11 am, at the Chatham Health & Swim Club, 251 Crowell Rd., Chatham.
Call 508-945-3555 to reserve a seat.
If you are unable to attend, and are interested in a 6-week weight loss challenge starting Jan. 4th with Carol Penfield, Nurse Practitioner and Program Director, call her office at 508-945-7761.

Great News!! There are still good investments, especially your health.

The opportunity to hear good news likely caught your attention, why?
Presently everything you read or watch on T.V. is stress producing. With the troubled economy, the stress level for Americans has increased. Now is the time to evaluate your strategies for managing your concerns and fears in an effective way. It is good news to know that there are options that can help. Although the physical reaction to stress may not go away, you can offset the effects with exercise and healthy living!
Exercise is a natural remedy that helps the body reach homeostasis in a hectic world that is continuously trying to throw us out of balance. Stress related issues are often translated into being “all in the mind”, but prolonged emotional stress can have an adverse physical effect.
When threatened or stressed our bodies produce a chemical response that not only affects our outlook but also has physiological effects. Long-term stress plays a role in damaging the immune system, accelerating aging and chronic disease. Adrenaline (a stress hormone) is produced in the body during stressful times. If it remains in the body, it can produce harmful side affects such as elevated blood pressure, pain and other conditions. When exercising, the body utilizes the excess adrenaline that is produced thereby minimizing damage to the body. In addition, during fitness activities the body also releases helpful natural “feel-good” chemicals called endorphins that give the individual a sense of well-being. Mood elevation is very helpful in offsetting the depression produced by challenging times.
You don’t have to take on the stress alone. During difficult times, people stay closer to home and many individuals become isolated and depressed. Exercising in a health club setting has shown to improve socialization and allow people to feel more like a part of a community. Adhering to an exercise routine gives a sense of accomplishment and sharing this empowers other people to be successful.
More good news……..Exercise gives your mind a break!
Fitness programs provide a “time out” to focus on the activity that you are presently performing and away from daily issues. As you concentrate on proper form or breathing techniques, the mind is unable to wander onto undesirable thoughts. The body becomes energized and creative problem solving may be stimulated. If anger is a concern, the physical release of energy dissipates feelings of frustration in a positive way.
According to CIGNA research (a global health service company) one-third of Americans find that the economy is affecting their health and other studies have shown that as many as 92% of corporate employees are losing sleep. Good news again! Exercised muscles relax better at night and physical fatigue from movement helps improve the sleep cycle. It is evident that individuals hold stress in their bodies in different ways. Wherever the body is weakest, pain, tension or possible injury can occur. Strengthening exercises allow the body to manage physical as well as psychological challenges.
There is even more good news, this time for your finances. Investing in an exercise regime can pay off! Health promoting exercise can help offset the need for expensive medications and/or medical care. It can replace poor coping habits that are costly such as excessive drinking or over-eating.
What kind of exercise is best? For those who are seated all day, consider swimming, walking or a structured fitness class. For individuals on their feet all day, the Nu-step (seated elliptical), cycling or mat Pilates classes are suggestions.
Ready to get started? Most people consult their physician prior to starting to exercise for a stress test. It may be more appropriate to consult your doctor before settling into your lounge chair for a day of “bad news” on the T.V.
Fitness is a necessity not a luxury. You cannot live without your health!

Carol Penfield RN, MS, Nurse Practitioner and owner of Chatham Health & Swim Club.

Your Guests are Gone but your Weight is Not!

Summer on Cape Cod can be very busy for the residents. Guests come and visit and we feel obligated to serve fancy appetizers, dinners and desserts. Why not also go out for ice cream! Cookouts, family gatherings and lots of fabulous seasonal restaurants to choose from also add to the common outcome, weight gain. Now that the fall season has arrived, our outdoor activities are dwindling and before we know it the holiday season will be upon us with new dietary challenges. It is very easy for “life” to get in the way of our attempts to lose weight.

Weight loss must be approached not by diet alone, but coupled with exercise. It has been well proven by the National Weight Loss Registry that 95% of people who successfully lose weight exercise regularly. The challenge is maintaining a fitness program. The most common barriers are; lack of time, convenience, decreased self confidence due to a history of failed attempts, finances, lack of support, and lack of motivation. The most commonly used and most socially acceptable excuse is, “I am too busy to exercise”. Individuals are moving less due to the conveniences of technology but feel busier as they try to keep up with the demands.
There are some strategies that can help. If you are:
• A “multi-tasker”; Try exercising as you catch up with the news on TV or follow-up on emails on your lap top while you stationary bike.

• “Willing to do anything BUT exercise”: If your day gets too busy and you keep choosing other projects or work rather than fitness, then consider exercising first thing in the morning before your day gets away from you.

• “Feeling exercise is TOO BORING”: Does the thought of walking/biking/swimming for 30 – 60 min. turn you off? Try to change the type of exercise you are doing every 5 – 10 minutes. If 30 minutes is too much time then divide your exercise routine into two 15-minute sessions or three 10-minute sessions during the day. A fitness class also offers variety.

• “Fed up and keep giving up”: Being accountable to a workout partner, taking a scheduled class or making an appointment with a personal trainer help keep you on track. If you choose a workout partner, choose one who is more motivated than you!

“Discouraged because it takes too long to burn off a cookie”: Interval or circuit exercise is the choice for you. For example: a 150 pound person who walks 3 miles in one hour burns 270 calories but if that same person jogged for 20 min. at 8 mph they would burn 320 calories in a shorter period of time. Picking a routine that varies the intensity level in a way that you can tolerate helps burn calories faster.

Interval exercise programs are becoming a more effective way of helping people lose weight. Interval exercise is simply alternating bursts of intense activity with intervals of lighter activity depending on your level of fitness. How much you pick up the pace, how often or for how long, is up to you. For example; coupling strengthening exercises with endurance exercises to help elevate the heart rate for short periods of time helps burn more calories in a shorter period of time. Changing the intensity of a regime every 1 – 3 minutes can also help the exerciser who is getting bored or frustrated from not seeing weight loss results. A personal trainer or other expert can help you time the intensity or duration of your intervals depending on the style of movement patterns that you prefer. Establishing your target heart rate is a good resource for assisting you with a base-line plan to perform a routine you can manage.

Interval classes are also available at Chatham Health and Swim Club for members and non-members. Come visit during MOTIVATING MONDAY, the first Monday of every month at 10:30 am for a FREE workshop to help you learn how to adjust your fitness routine or start one!

Workshops are instructed by Carol Penfield RN, MS, Nurse Practitioner who can address any medical concerns you may have.

Now is a perfect time to exercise and lose the weight!


Heart disease remains the #1 killer for Americans. Staying fit is essential for heart health. The heart is a muscle that needs to stay strong and free from plaque buildup for prevention of heart attacks and stroke. Walking is the most common form of exercise practiced. It can decrease the risk factors for heart disease by lowering cholesterol, improving blood sugar control, assisting with weight management, and lowering blood pressure. The recommended amount of exercise for general health is 30 – 60 minutes 5-6 days per week. Walking the same route at the same speed is good for general health but may not continue to lead to improved heart strength. The heart needs to be challenged in order to respond to unexpected “stressors” during the day. For strengthening the heart, adding variations to a walking workout is helpful. This can be accomplished by increasing the speed of the walk, the amount of time walking or the intensity. One example is an interval workout. That can be performed by warming up with a 5 minute walk then increasing the pace to a level that is considered “somewhat hard” for 2 minutes then return to a comfortable walking pace for 4 minutes. Interval walking programs can vary in length but a common technique is to keep the intense portion of the interval workout to be half as long as the recovery time. The intervals can be repeated throughout the walking program. Adding hills and swinging the arms are also options to help increase the challenge of a walking program. For the exerciser that is trying to lose weight, interval-walking programs can also help maximize calorie burning. Fitness studies have shown that this form of exercise can be safe, however, it is important to consult with your healthcare provider or cardiologist prior to starting or changing your fitness routine. Good luck!

Carol Penfield, RN, MS, NPc is a nurse practitioner, certified personal trainer and owner of Chatham Health and Swim Club. She can be reached at 508-945-3555 or