Friday, September 23, 2016

Adults Benefit from Short Bouts of Exercise

The Centers for Disease Control and Prevention states that adults aged 65 and older should aim to achieve at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity activity each week. This is in addition to at least 2 or more days of muscle-strengthening exercise per week. However, many individuals in this age group don't fulfill the recommendations. The good news is that even small amounts of physical activity can be beneficial.

A study presented at the EuroPrevent 2016 meeting suggested that just 15 minutes of daily exercise can yield a positive response. The conclusion was based on data from two studies involving more than 123,000 subjects. The researchers looked at weekly physical activity records and death rates, and found that as activity levels increased, death rates declined. Subjects classified as highly active had a 35% lower risk of death during the study. However, subjects at the lower end of the activity spectrum--who exercised for just 15 minutes per day--still saw their risk decrease by 22%.

These two studies show that the more physical activity older adults do, the greater the health benefit. The implications of this research are also likely true for adults younger than 65.

Do you meet these activity recommendations currently? If not, you can start by adding in short bouts of exercise until you are achieving the recommended amount of time. If you are meeting these recommendations, congratulations! Keep up the good work and keep in mind that going over the recommendations only yields greater benefits.

Do you know others who are not currently meeting the minimum exercise requirements that could benefit from incorporating more exercise into their lives? Please pass along the findings of this research. If you or anyone you know would like help in achieving the health benefits of exercise, I'd be be happy to meet and discuss some solutions.

The study appeared in the British Journal of Sports Medicine (2015; 49 [19], 1262-67).

Thursday, September 8, 2016

Spin into health

Cardiovascular exercise is vital to keeping our organs healthy, for example, heart, lungs, circulatory system, etc. Cardiovascular or Aerobic exercise is physical exercise of low to high intensity that depends primarily on the aerobic energy-generating process. Aerobic literally means "relating to, involving, or requiring free oxygen", and refers to the use of oxygen to adequately meet energy demands during exercise via aerobic metabolism. Generally, light-to-moderate intensity activities that are sufficiently supported by aerobic metabolism can be performed for extended periods of time. When practiced in this way, examples of cardiovascular/aerobic exercise are medium to long distance running/jogging, swimming, cycling, and walking.

Spinning is a convenient indoor version of cycling that may be more convenient. While attending a spin class is the best way to keep motivated to maintain a high intensity session, there are also online resources that can help you make your own personal spin class. The Global Cycling Network has a YouTube channel, where they have posted 16 spinning workouts ranging in length from 13 to 60 minutes.

Train with Global Cycling Network

Benefits of Cardiovascular Exercise:
  • Improved hormonal profile: ease symptoms of depression and fatigue and release hormones that decrease appetite
  • Increased metabolism: can lead to weight loss
  • Improved heart health: decrease in blood pressure, decrease in bad (LDL and total cholesterol, increase in good (HDL) cholesterol
  • Improved recovery ability
  • Diabetes management: increased insulin sensitivity

Monday, August 29, 2016

Fridge Makeover

We all know that when the healthy choice is the easy choice, we're a lot more likely to make the healthy choice. On the other hand, if the unhealthy choice is right there in our face, we're a lot more likely to go with the unhealthy choice. It's not just about willpower, it's about being human and going for what's easy. Studies have shown that 70% of the food eaten in the home is food that the nutritional gatekeeper purchases for the home. So, it's about going to the store and making healthy purchases and then positioning those healthy options in an easy to see and grab location to actually eat them. One way to do that is through a fridge makeover.
  1. Clean it all out: how does what you've got line up with your meal plans for the week and the way you want to be eating.
  2. Take inventory of what you need and what you have and strategically restock your refrigerator.
  3. Make fruits and veggies highly visible: when you open up the fridge, they're the first things you see. Move fresh items to the front and have them easy to grab and snack on. They're very easy to see and they won't go to waste because you forgot about them in a bottom drawer. 
  4. Move sweets to the back: if you're not always seeing it, you're less likely to eat it as often. You're creating a visual environment to make healthy eating easy and attractive.
  5. Have healthy, low calorie options at the front of your drink shelf: water, milk, unsweetened iced tea; push the soda and sugary drinks to the back of the drink shelf.
  6. Move the condiments to the bottom drawers: This creates an easy to find place for fruits and vegetables in the side shelves. When they're easy to see, it'll make it easier to grab an apple instead of a soda or sugary snack. 
Ultimately an easy way to make your family choose to eat healthier is by changing the environment in which you live, so that the healthy foods are easily accessible, easy to get to, and the unhealthy foods and less healthy things aren't even in the house, or if they are, they're a little bit harder to find.

Friday, August 12, 2016

Walking: Spiced Up

Have you noticed your physician paying greater attention to your exercise habits? Healthcare leaders are calling on physicians and their industry to routinely prescribe exercise, in general--and walking, in particular. For example, the Journal of the American Medical Association (Berra, Ripee & Manson 2015) recommends that clinicians do the following to integrate physical activity counseling into their practices:
  • Make physical activity a vital sign at each clinic visit
  • Ask if the patient exercises regularly or engages in physical activity
  • Associate physical activity with reduced risk of heart disease, stroke, diabetes, and many cancers
  • Write a prescription for an agreed-upon daily physical activity
  • Encourage use of a pedometer and advise recordkeeping
I'm excited about the continued recognition of exercise as a vital part of health. Increasing your exercise frequency can be as simple as walking more. Here are some ideas for how to adapt high-intensity interval training (HIIT) to walking. Which will be your favorite?

High-Intensity Aerobic Interval Walking: Complete up to 10 high-intensity walking intervals lasting 4 minutes each, interspersed with 2-minute relief intervals (walking at a lower intensity). About 1 hour duration

Sprint Interval Walking: Complete 4-6 sprint-walking intervals lasting 30seconds each, interspersed with 4.5 minutes of light walking at a self-selected pace. 20-30 minutes duration

Step-Wise Interval Walking: Start with a relatively easy walking workload for the first 5 minutes, then increase intensity by 15% for 4 minutes and continue to increase intensity every 4 minutes. This program can be halted at a particular intensity or after a specific duration; follow with a cool down walk. 20-60 minute duration

Near-Maximal Interval Walking:
Perform a 5-minute walk at near-maximal intensity, followed by a 5-minute recovery walk; repeat. 20-60 minute duration

Supramaximal Interval Walking: Complete 7-10 sprint-walking intervals lasting 90 seconds, interspersed with 30 seconds of walking at a self-selected slower pace. 20-30 minute duration

Happy Walking!

Sunday, July 31, 2016

Weight Management

I'm excited to announce that I'm working on a new specialty certification from ACE (American Council on Exercise), "Weight Management." I am about 25% through the learning material and the content of the material is a bit of a surprise to me.

It doesn't approach weight loss from a nutrition or exercise prescription, but rather, a more empathetic understanding of people's needs. I've been learning about the prevalence of weight bias. Even among health and fitness professionals, many assume normal weight individuals are "fit", and overweight individuals are "unhealthy." Research shows that one's lifestyle, exercise and nutritional habits, are far more indicative of overall health and longevity than a number on a scale. The certification material stresses the importance of creating a "weight neutral" environment. In a weight neutral environment, goals are set based on controllable factors, such as exercise frequency and nutritional intake. "Exercise and good nutrition are things you can do, weight is something that happens."

The educational materials also stress the importance of acknowledging unmodifiable genetic and previous lifestyle factors, and focusing on maximizing the health of whatever body we may have. I'll keep you updated on the later material in the certification, but for now, focus on the process of maximizing your health and how every day that you continue to make a commitment to your health is a goal achieved!

New research evaluates how many of us live a healthy lifestyle

Despite the billions of dollars spent on gym memberships, diet programs, and low-fat food options, American't don't seem to be getting any healthier. In fact, a recent paper published by the Mayo Clinic (Loprinzi et al. 2016) reports that fewer than 3% of American adults are living a healthy lifestyle.

THE STUDY
The researchers in this study defined living a healthy lifestyle as meeting four parameters: being sufficiently active (150 mins of moderate-to-vigorous physical activity each week), eating a healthy diet (based on a 24-hour recall), being a nonsmoker (serum cotinine level) and having a recommended body-fat percentage (5%-20% for men, and 8%-30% for women). Researchers then examined the association between having different combinations of these characteristics and several biomarkers for cardiovascular disease. The results from the study came from a survey of 4,745 adults.

THE RESULTS
Although many people accomplished multiple lifestyle goals--16% had three healthy characteristics and 37% had two--fewer than 3% met all four. Moreover, 11.1% met none of the criteria. Overall, the survey revealed the following:

71.5% did not smoke.
37.9% consumed a healthy diet.
9.6% had a normal body-fat percentage.
46.5% were sufficiently active.
2.7% had all four characteristics.
11.1% had none of the characteristics.THE BOTTOM LINE
This study does an excellent job of providing four concrete steps anyone can take to achieve a healthier lifestyle: Become a nonsmoker, be sufficiently active, eat a healthy diet, and achieve a recommended body-fat percentage. Of course, as the research reveals, none of these steps are easy to take. However, even small improvements matter, and any effort toward these lifestyle goals--even if it's below the defined threshold--can have a life-changing, or even life-saving, impact.

How many of these lifestyle goals are you currently accomplishing? What changes can you make to increase that number?

Tuesday, June 21, 2016

Exercise and Rheumatoid Arthritis

I wanted to share my personal success story with exercise and rheumatoid arthritis. It has now been 13 years since my diagnosis and exercise has played a very significant role in my disease management.

As the daughter of two avid runners, I grew up running, running, running. In high school, I competed in cross-country, track, and orienteering. I continued to run in college, but chose not to compete in Boston U's athletics initially. I intended to start sophomore year after becoming accustomed to college life.
During the winter of my freshman year, I noticed I was having some difficulty with small tasks, like flipping on lightswitches, typing on a keyboard, and walking around in bare feet. I didn't think much of it, until one January Sunday morning when I stepped out of bed and literally couldn't walk. I felt this ridiculous pain in all the joints of my feet, so standing and walking were incredibly painful. Confused and in tears, I got myself to the ER of Mass General Hospital, where they did a multitude of tests and sent me home without a diagnosis, but in slightly less pain. Days later, I followed up at the Student Health Center, where I received results indicating rheumatoid arthritis, and was instructed to go to a rheumatologist.
My visit to the rheumatologist was depressing. I was 18 years old, surrounded by old patients in the waiting room as well as old people magazines. This wasn't me! The rheumatologist confirmed the rheumatoid arthritis diagnosis and prescribed me Celebrex to take as needed.

Rheumatoid Arthritis is an autoimmune disease in which the immune system attacks the joint linings causing painful swelling. Over long periods of time, the inflammation associated with RA can cause bone erosion and joint deformity. My arthritis manifests itself in my wrists, knuckles, elbows, shoulders, and the joints of my feet. Different areas are affected at different times.

I returned to Boston and continued with school. I had to start running less and took up swimming and limited weightlifting. The weightlifting was tricky, because my fingers were frequently very swollen. I was happy to be learning more and more about fitness, so I could make the appropriate modifications to avoid damaging the inflamed joints further. I started to notice that exercise helped decrease my inflammation and pain.
4 years after my diagnosis, the pain and swelling started to return. I had become wrapped up in my senior year of college, had been exercising less, and had gained 20 lbs. Research has since shown that body fat increases inflammation. My rheumatologist then recommended prednisone and methotrexate, very strong medications that required regular liver blood tests. The medication only helped for a few months before my symptoms returned, and my rheumatologist wanted to add more medications to my treatment plan.
I thought back to when I had managed to keep pain at bay in the past and made a conscious effort to get ample sleep, increase my exercise frequency, and improve my eating habits. I didn't fill my next prescription of prednisone or methotrexate. After about a month of modifying my lifestyle, I noticed a remarkable decrease in my joint pain and inflammation, despite not taking any medication. I later told my rheumatologist, who was supportive, as long as I was managing my joint pain.
Since then, for the past 9 years, I've managed to stay medication free. My current doctor insists that it is because of my active lifestyle, and I agree. Working as a trainer allows me to keep a moderate activity level all day long, so that my joints don't get a chance to stiffen up. My exercise program decreases the inflammation in my joints on a daily basis.

Although I have been active since a young age, it has at times been frustrating and a real struggle. There are still some days when certain joints will be in so much pain that I'm reluctant to get out of bed. However, I know that once I start moving, the pain will decrease; and once I exercise, it will be almost gone. It's doubtful whether I'll ever be fully "pain free," but exercise helps me have a better outcome than anyone I know with RA. The genetics we're dealt don't have to determine our future. We're all working with the body we've got and trying to make the best of it.
Have you had a similar "success story" with exercise and a health condition? Please share your story with me or contact me if you'd like to improve your health.