Health Education: exercise

Showing posts with label exercise. Show all posts

A blog post on weight loss worth a share

I read a post today and shared it on Facebook and twitter, but I really like it so I am going to share it here also.    I am familiar with the science and the scientists that this blogger refers to, and I trust her interpretation. I want to add 3 things. <ul><li>Exercise, as I say every chance I get, is essential for good health. One cannot live well without it - and just like medicine, it only works when you 'take it' and you should 'take it' every day.</li><li>Pay attention to tip number 5.  They are talking about Volumetrics and my personal style of eating (but they don't call it that or refer to me!!}.   Note that there is evidence that what you eat matters to your overall health, if not your waistline.</li><li>Remember, science is not about facts.  We observe, test, interpret and trust the evidence that we have today.  Someone can observe something different tomorrow.  Science is supposed to be a work in progress, and it is.</li></ul><div>Review the post on weight loss tips that are supported by science written by Alice G. Walton <a href="http://www.forbes.com/sites/alicegwalton/2013/09/04/the-6-weight-loss-tips-that-science-actually-knows-work/">HERE.</a></div> PS< I am still here!  My dissertation writing is the most insane hardest thing I may have ever done (to be fair, I collected and analyzed my own data  - twice (2 studies) (but can you believe I lack skill in making written arguments!)... anyways, I will be back, sporadically at first and more consistently in the future.

A blog post on weight loss worth a share

I read a post today and shared it on Facebook and twitter, but I really like it so I am going to share it here also. I am familiar with t...

4:55 PM

What's your plan B?

**** post note.  I have been working on my 12 mile bicycle ride. (I am riding a mountain bike on the street -  they aren't fast on the street).  See how I my speed increased almost every time!   This is a fun, challenging way to survive a vacation from running.  Look at the column on the right, and start at the bottom.  I started at 12 mph and increased to 13 mph. <div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj2gWOgL-JUUNVB-aPD5iKkFWARUzVSaRuAJCFkFW93l73EL0wIcAFcay9Mici5RJApmmzl2kWHFECTuvL7445srXhuzTTJ4tOUAtPY9AP7kOMtUa7fioXfxIelsVOkMi8bSK1fkCc3CC4g/s1600/recovery.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="580" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj2gWOgL-JUUNVB-aPD5iKkFWARUzVSaRuAJCFkFW93l73EL0wIcAFcay9Mici5RJApmmzl2kWHFECTuvL7445srXhuzTTJ4tOUAtPY9AP7kOMtUa7fioXfxIelsVOkMi8bSK1fkCc3CC4g/s1600/recovery.JPG" width="640" /></a></div> **original blog post: No, not for birth control... your exercise plan B. What do YOU do if you can't do what you planned to do?  What do YOU do if you can't do your planned exercise for one day?  What if you can't do it for weeks or months? By now, you should be convinced that exercise is not something you do because you want to lose a few pounds (though it sure helps) but something you do to prevent disease, boost your mood and to age successfully (not normally - successfully).  In other words, exercise is not meant to be temporary.  It benefits you for as long as you do it (like healthy eating). So if you have plans for a walk at the park and it rains, what is your plan B?  If you planned to swim, but a thunderstorm or faulty equipment closes the pool, what do you do instead?  Do you have a list of options for your plan B? What if the activity you prefer, for me its running, is one you have to rest from?  IF you like to swim and tear a muscle in your shoulder that will take months to heal, what will you do for your exercise? It is best to have more than one exercise - not just for plan B days, but in general.  This is because the body acclimates and what was once challenging can become ineffective.  The body needs variety  - could be little things like tempo, speed and terrain - and big things like alternating biking, swimming, running, walking, aerobics, sports, etc . My usual routine is 5 days of running (with changes in place and pace) and two days of swimming (w/ 2 routines) and 2 days of weight training.  YES, that IS nine days.  You are very astute.  I swim and weight train on the same day. Cycling is my plan B as is 'extra' swimming and step aerobics.  On a recent walk date, my friend and I got rained out, so we went to the mall and WALKED.  Corny, but effective.  When the pool closes unexpectedly, I go to another pool, or I cycle or do some indoor cardio activity at the gym.  Sometimes I lift weights at home if the gym is closed on a weight train day.  ETC Something else you might consider - especially if you are using exercise for weight control or perhaps, stress control, and you have to stop your high intensity exercise.  How do you handle the change in calorie burn that comes from decreased intensity? You have a few options.  You can switch to low impact activities and do them longer, sometimes twice as long.  You can work on making that low impact activity, like cycling, walking or swimming happen FASTER. You can do the lower impact/low burn activity for the same time that you did your favored higher burn activity and choose to eat less - or you can do the low burn activity for the same duration and accept that you'll gain a few pounds.   (For me, I don't have more time to spend - but if I choose a 12 mile cycling routine, I can try to do it faster (even a few seconds) each time.  I would not be increasing distance, just pace.  For swimming, I could stick with my time limit, 50 minutes and try to get in more laps -so more distance)  MOST important take home message - YOU DECIDE.  Take control and be ready with your plan B list.  You decide how you'll adapt to the change and you decide that this adaption does not include quitting. <div class="separator" style="clear: both; text-align: center;"></div>

What's your plan B?

**** post note. I have been working on my 12 mile bicycle ride. (I am riding a mountain bike on the street - they aren't fast on the s...

8:16 PM

Depression, Pills and Trying Something New

"If one medicine doesn't work, why take another?"  She asks rather simply.  Maybe it isn't the pill that's the problem but treating the illness WITH pills.    I am NOT a physician.  Still, every time I hear the latest commercial for the antidepressant medicine Abilify - I get sort of freaked out.  The side effects are intense and listening to them makes me well... depressed!  Uncontrollable movements, high blood sugar, coma, death....    I cannot  (and do not) suggest that anyone taking a medicine stop doing so.   But I would consider whether a different strategy - LIKE EXERCISE - is worth trying, or adding.    Instead of asking your doctor or psychiatrist if "abilify is right for you" maybe ask if you could do something BESIDES take more pills.  It could well be that "exercise is right for you."    It's just a thought... well, it is more than a thought because there is scientific evidence that exercise reduces depression in some people.  There is no money in it - you don't have to go to the doctor to get an order for it, or pay the pharmacist to pick it up - but you sure have to own it. It doesn't work if you don't do it.  And like the medicine you take - its generally needed at LEAST once a day.

Depression, Pills and Trying Something New

"If one medicine doesn't work, why take another?" She asks rather simply. M aybe it isn't the pill that's the pr...

6:59 PM

The Perfect Mix for a BEST DAY

One day last week and again yesterday, I was able to run before class, lift weights after class -go to a meeting, then go swimming after the meeting and then do some studying.  In other words, my three big cognitive or mental activities were split up with exercise, not just physical activity (walking from one to the other would be physical activity).  Instead, I set time aside to systematically increase my heart rate and tone my body, lungs and heart.    This is my ideal type of day.  I will as often as possible break my mental activities up with little walks or some activity.  Because of the mix it up routine I feel confident saying that I am at the 95th percentile of productivity. By this I mean, if you assessed 100 people on level of productivity, only five of them would be more productive than me (and maybe less!).

The Perfect Mix for a BEST DAY

One day last week and again yesterday , I was able to run before class, lift weights after class -go to a meeting , then go swimming ...

7:48 PM

Why Exercise is Essential

<div class="MsoNormal">  Here is the most important thing that you need to know about exercise – and it applies to either weight loss or weight gain.  Exercise matters because it has an impact on body weight; specifically, body weight ratio.  Most basically, our body weight is composed of fat mass and fat free mass (sometimes referred to as lean body mass).  Fat free mass involves several components, including, bones, muscles and water.  When you change your body weight, it is essential for good health and calorie expenditure that you increase your fat free mass and/or preserve your fat free mass.            </div><div class="MsoNormal">   Exercise helps you to do so because it builds muscle.  Muscle where most energy is burned.   If you lose lean body mass you may weigh less but have a higher ratio of body fat and this is not good.</div> <div class="MsoNormal">   A person can be overweight and not have metabolic disturbance if they exercise and keep up their fat free mass (they may still have joint problems though).  A person can be thin and have metabolic dysfunction because they have a higher proportion of fat mass.</div> <div class="MsoNormal">   Cardio exercise can certainly keep you toned, but to build muscle I recommend that you consider strength training (resistance or weight lifting) at least twice a week (as the PGA suggest.)</div> <div class="MsoNormal">   I also want to share with you this sentence from the recently released report U.S. Health in International Perspective: Shorter Lives, Poorer Health from the Institute of Medicine and the National Research Council (2012).</div> <blockquote class="tr_bq"><div class="MsoNormal" style="line-height: normal; margin-bottom: 0.0001pt;">[D]ecades of research suggest that avoiding sedentary behavior and engaging in regular physical activity (independent of body weight, body mass index, and dietary habits) exerts its own protective effect on the risk of heart disease and stroke and possibly other conditions, including cancer, depression, and dementia (Lee et al., 2012; U.S. Department of Health and Human Services, 2008a).</div></blockquote> <div class="MsoNormal" style="line-height: normal; margin-bottom: 0.0001pt;"> </div> <div class="MsoNormal">   As the sometimes controversial Robert Lustig, MD says, “exercise is the anecdote for anything that is wrong.”  I agree – and you know that I do.  He also thinks fructose is the root of all evil and that foods that cause the release of insulin are the culprit for our obesity epidemic or the diseases that accompany it.  I am not sure – but he has a new book out that you might like to search for if you are interested.  I agree with him 85% of the time, somewhat less than I agree with Walter Willett (90+%) and a lot more than I agree with that Dr. Oz fellow.  </div><div class="MsoNormal"> </div><div class="MsoNormal">Interested in the full report regarding the poor health of Americans compared to similar countries... click <a href="http://www.iom.edu/" target="_blank">here.</a> </div><div class="MsoNormal"></div><div class="MsoNormal"></div>

Why Exercise is Essential

H ere is the most important thing that you need to know about exercise – and it applies to either weight loss or weight gain. Exercise ...

6:59 PM

MOVE more LIVE longer

After writing a recent post regarding calorie intake and limits, I made a note to myself to come back and remind people about the benefits of exercise.  Sometimes when I am talking about weight control I give the impression that I do not appreciate exercise.  That could not be further from the truth.  Not only do I appreciate it, I engage in it on a daily basis.  Daily - meaning each and every day (with rare exceptions).     I have dedicated many posts to this subject.  You can use the search feature on the right side of the blog on the blogsite to find them.     The Physical Activity Guidelines for Americans can be read in full at the CDC website <a href="http://www.cdc.gov/physicalactivity/everyone/guidelines/adults.html" target="_blank">here</a>.  The guidelines give the type of exercise, the duration and the frequency that is necessary for optimal health. The countless benefits of physical activity are also noted in the document.    It is important to engage in activities that increase your heart rate such as walking, cycling, swimming, running, and playing sports on a regular basis.  One should strive for daily exercise but vary the amount of time spent and the type of activity.  For example, exercise seven days a week, but on some days ride a bike, others swim, golf or walk etc.  Some days you might exercise for an hour and others for only 30 minutes.  The weekly goals are provided on the CDC website.  The second recommendation is strength training - activities that build, condition or strengthen your muscles (e.g.,  weight lifting, resistance training and power yoga).  Balance and core work is also important.  Simply practicing standing on one foot for 30 seconds a few times a week will work.  If that's so easy you could do it all day, try it with your eyes closed or raise your leg higher.     Research has shown that exercise - being physically active - is associated with improved health, both physical and mental, and a decrease in disease, cancer, the effects of aging, and all cause mortality.  Physical activity also improves mood, agility and assists in weight control.      I especially like <a href="http://yourhealtheducator.blogspot.com/2011/07/physical-activity-met-comparisons.html" target="_blank">this post</a> that shows the different levels of expenditure based on exercise types.  And <a href="http://yourhealtheducator.blogspot.com/2010/07/anti-exercise-voice.html" target="_blank">this one</a> that talks about motivation to exercise.      Lastly a little clarification about different terms you might hear.  Even though we often use physical activity and exercise to mean the same thing, they are actually different.    Physical activity is any kind of moving about with your whole body - big movements that you do throughout the day count. Exercise is always physical activity but physical activity is not always exercise!  For example, you are being physically active doing your chores, reaching, bending, carrying - but that is not exercise.  It is still GOOD - better than being still.  Much better.    Exercise is planned action you take to increase your heart rate for a predetermined amount of time.  If you decide to go for a 30 minute walk or jog, you have decided to exercise.    Sedentary behavior is the opposite of exercise and physical activity.  It is what you want to avoid because it is associated with metabolic (under the skin) changes that can make you more likely to get a disease (e.g., diabetes, hypertension).  Sitting around is sedentary behavior - as is lying about - try not to sit for more than an hour without doing some moving around ( aka physical activity!).

MOVE more LIVE longer

After writing a recent post regarding cal orie in take and limits, I made a note to m yself to come back and remind people about the ben...

6:59 PM

The Best Way to Lose Weight

I want to be sure that I didn't  mislead or confuse you, by referring to this old NHIS question in the last post. In your opinion which of these are the 2 best ways to lose weight <blockquote class="tr_bq"> Eat fewer calories  Take diet pills  Increase physical activity  Eat NO fat  Don't eat at bedtime  Eat grapefruit with each meal</blockquote>My point was to draw your attention to how things have changed in the last 40 years and what we know today. In the above list and in any list, the best way to lose weight is to reduce the number of calories consumed.  You must eat less to lose weight - and not because you took a diet pill or because there was grapefruit on your plate.  Limiting saturated fat is a good idea, avoiding trans fat is important. Including healthy oils from plant and fish sources is essential.  The only right answer in that list was related to calories.  BTW, the body doesn't know what time you eat.  But about the physical activity: A person who is physically active is less likely to become overweight than a person who is inactive.  A person who is physically active is more likely to keep lost weight from returning than someone who does not engage in physical activity. A person who meets the recommended levels of physical activity is less likely to die from any cause (over a set time period) than those who do not.  People who exercise regularly are also less likely to become ill from heart disease and some cancers.

The Best Way to Lose Weight

I want to be sure that I didn't mislead or confuse you, by referring to this old NHIS question in the last post. In your opinion which ...

7:22 PM

Deficits and Disorders

A deficit is not the same thing as a disorder and you can have one without having the other.  Today's post regards a term that I first read in a publication from the American College of Sport's Medicine.  I do not know who coined it, or where it originated, but I am very uncomfortable with it.  The acronym is EDD and I will get to that in a moment.    First. How do we define the two words.  What do they mean?  Deficit.  Deficiency.  Before one can be deficient in a "thing" a standard must exist.  The standard is usually an amount of a substance or attribute that is necessary for a system to function.  A system could be a body, a business, the economy and even the food supply.  (I hear there is going to be a corn deficiency)    For the body, it has been established that a certain level of iron is needed to prevent anemia.  Vitamin C protects against scurvy and vitamin D, scurvy.  In the current year (2012), very few persons who live in developed countries suffer from any of the above deficiencies.  We get enough protein and iron, Vitamins C and D.  A greater percentage of persons are low in Vitamin D putting them at risk for bone weakening, but it is still less than a majority of persons.  It is now normal to have adequate levels of iron, D and C.  Normal because most people are sufficient.  The average person does not have a deficiency.    I bring up this normal and average business because I consider a disorder to be something that is NOT the norm/average. I.e. it is 'out of the usual' order.  Dis = "the absence of" order (normal).    This brings me to the term I have dis taste for - Exercise Deficiency Disorder (EDD).  Sounds too much like a disease that someone will try to medicate.  Exercise in a pill.  The ACSM article encouraged exercise specialists to identify children who did not meet the daily requirements (standard) for physical activity.      Children should be engaged in moderate to vigorous exercise for 60 minutes a day.  Clearly I believe that exercise is necessary for health - as I said yesterday, the sine qua non.  I fully support the recommendations for 30-60 m a day.  I agree 100% that the majority of adults and children, worldwide, are deficient in meeting this goal.  However, if the majority of us are not doing it - then the norm is the deficiency.  It is normal.  It is tragic.  We need to do something about it.  But exercise deficiency is not a disorder.  Let's leave the labels for our restaurant menus and not add another diagnostic code with which to label our children.

Deficits and Disorders

A deficit is not the same thing as a disorder and you can have one without having the other. Today's post regards a term that I firs...

7:28 PM

A New Cancer Mindset

We have made significant progress over the years in regards to cancer prevention, identification and treatment. With the help of technology, we are able to diagnose more cancers so the absolute numbers of cases may have gone up. However, the actual death rate for most, but not all, cancers has gone down. The hardest cancer to treat is still lung cancer (and possibly pancreatic), the hardest to differentiate appears to be prostate while the cancer with the greatest cure rate is breast cancer. Here is something else that has had an almost 360* change – lifestyle recommendations for prevention of initial cancer, during acute and or chronic treatment of cancer and to prevent cancer recurrence in original or distal site. By that last bit I mean that sometimes a person is seemingly cured of one cancer only to have it reappear in another part of the body. I wonder if you are going to be surprised by the newer medical advice – maybe it will depend on your age. The research continues to grow and a body of evidence exists to support that what one eats, how much one eats, the weight of a person and the amount of exercise they engage in will affect all of the situations noted earlier. Being overweight WILL increase the risk of cancer in all locations. Eating high fat and high salt foods can affect the inner mechanisms or metabolism of a body and put it at risk for cancerous conditions and exercise is something that is protective. In other words, regular daily exercise creates a system that is better able to fight off disease. Thus, overweight persons with cancer are often encouraged to lose weight – I KNOW – we have the old image in our heads of people getting chemo and losing a bunch of weight – wasting away, but the treatments have changed and even those that do cause loss of appetite are mediated by drugs that treat the side effects. All of us, cancer patients or no, are encouraged to eat a diet that is more plant than meat based and low in saturated fat, processing, simple carbs and salt. As soon as possible after any invasive treatment, cancer patients are encouraged to begin an exercise program. Research exists to support that this lifestyle change can prevent recurrence of cancer. It is therapeutic. It is a change in thinking but it works.

A New Cancer Mindset

We have made significant progress over the years in regards to cancer prevention, identification and treatment. With the help of technology,...

4:51 PM

Let Not Your Limbs Be Idle

Something we hear often when health experts discuss the rising rates of both obesity and diabetes is that the population as a whole has become more sedentary (less active) over time and that this change in activity level is contributing to the problem. In January I mentioned research that supported this assertion and in fact, suggested that even daily runners were at risk for heart disease and other health problems if they spent the rest of their hours being relatively still. A NY Times journalist (Olivia Judson) offered a similar post in February, but she graciously ended her piece with a bibliography of several research studies. One of those studies, Role of Low Energy Expenditure and Sitting in Obesity, Metabolic Syndrome, Type 2 Diabetes, and Cardiovascular Disease. Marc T. Hamilton Deborah G. Hamilton and Theodore W. Zderic, offers insight into what exactly happens when we spend all this time on our bottoms. Ms. Judson suggests that we have 15 hours of time not spent sleeping that we can spend active or inactive. The researchers mentioned above actually did a little reverse science. There is ample data to show what happens to us physiologically when we exercise. We know about heart rates and endorphins, oxidative stress and oxygen consumption, as well as calorie expenditure and sleep stasis – we have no doubt that physical activity, especially frequent and intense exercise – prevents disease and disability. What about the opposite? What happens on a molecular level – what happens inside our cells, tissues and organs – when we are still for extended periods of time? As it turns out – our metabolism changes and we actually use and store sugars and fats in ways that cause harm. I like the phrase that the researchers use when discussing their study – they call it “inactivity physiology”. They admit that there is not a lot of study into this phenomena and that it is a great place to spend some research time and dollars. Hamilton, et al offer four tenets of inactivity physiology – The first is the idea that there is a curve of wellness associated with extra physical activity. We may be at the middle (an average, fit persons) and our health improves or shifts to the right, when we exceed the 30 min of activity/day that is often recommended – but does it shift to the left if we do not even do the 30 mins? (most of us agree this has been shown to be true) . The second tenet is that the episodes of sitting and the episodes of focused physical activity have very distinct effects on our bodies. Meaning, even the most active person’s body has an adverse biological response to being still. The third tenet suggests that the adverse effects of sitting for too long are not simply the reverse of the positive effect of a 30 minute walk. That sounds like tenet two, but I think it to mean something a little different. There may be a specific way that exercise boosts HDL which does not mean that sitting just prevents higher HDL – sitting too long may affect cholesterol in a completely different – but harmful way. The fourth tenet has to do with large groups of people, or cohorts, who are aging together in this sedentary mode and the increases in heart disease, diabetes, obesity and more that will occur in large numbers. It is of vast importance to get these people moving, especially if we are talking about a cohort of third graders! The article is a big read – you are welcome to <a href="http://diabetes.diabetesjournals.org/content/56/11/2655.full">view it here</a>. The take home message however is this – get up and stretch or move about every hour that you are not asleep and you will reduce the negative metabolic actions that sitting too long can activate.

Let Not Your Limbs Be Idle

Something we hear often when health experts discuss the rising rates of both obesity and diabetes is that the population as a whole has beco...

4:59 PM

Exercise Is Medicine TM

I do not personally need any persuasion or convincing to believe that exercise is vital for maintaining optimal mental, physical, biological and intellectual health. I know the research exists however and apply it to my life as I hope you do. There is an initiative however, to incorporate Exercise Is Medicine into our cultural infrastructure so that health care professionals make exercise a recommendation for prevention and treatment of disease. I have joined the initiative and will also link the page so that you can see the many others who have become part of the <a href="http://www.exerciseismedicine.org/supporters.htm">EIM network</a>. The program was begun and is managed by the American College of Sports Medicine. They promote the 5A approach which is also used for treating tobacco dependence. This is basically to advise every patient at every visit to become physically active. (ask, advise, assess, assist, arrange) Here is more information on <a href="http://www.exerciseismedicine.org/documents/EIM_FactSheet_009.pdf">Exercise is Medicine</a>. I bring this up today because as you must have deduced from my recent postings, things have been busy. As complicated and diverse as my work weeks have been I have continued to maintain no less than six days a week of exercise - including running, aerobics, dance, and strength training - I total upwards of ten hours a week of "planned" physical activity. Recently my Mom, noting that I do A LOT - with the blogging and cooking AND working- suggested that maybe I could exercise a little less while things were so hectic. But you see, it is just the opposite! Exercise IS MY MEDICINE and if things are stressful I need more exercise (endorphins) not less :) And that is what I want other people to understand. Not uber exercisers, but the people who tell me that they struggle to get 30 minutes of exercise on 3-4 days a week... (oh and let me just add, my MOM is no couch potato - she waitresses no less than 5 days a week and walks and rides her bike daily as well -) So for the laggards and for me - it can NEVER be a matter of IF you will work out on a given day or within a given week - but, where, when and how. Because my boss requires us to write out our projected work schedule weekly (no 2 days are the same I assure you) it allows me to view my week and find my windows of opportunity. I am fortunate to have a friend who lets me choose our weight lifting days and for my runs, I just make them happen. Classes at the gym are hard to work around, but for the past two Tuesday's I went ahead to class as planned but left about 15 to 20 minutes early so I could go back to work. I.e. it doesn't have to be all or nothing. The Exercise Wagon: While I was writing this post a friend called. During the conversation she told me that she had to get back to her running. She has done this before - gets going good and then things happen and she once again finds herself sedentary. That got me to thinking - it is the opposite of the saying, "you can't have one cigarette or you will relapse." "You can't skip exercise days or you'll become sedentary again." You don't have to exercise 7 days a week, but you do have to keep your schedule - if you miss more than two planned workouts - you are probably going to relapse and will find yourself months later feeling heavy and unfit only having to start the whole thing over. Exercise and calorie moderation cannot be temporary things - unless you want temporary health.

Exercise Is Medicine TM

I do not personally need any persuasion or convincing to believe that exercise is vital for maintaining optimal mental, physical, biologica...

4:43 PM

Odds and Ends

Step Class "oh no!" I have said so many times that lifting weights should be an activity in and of itself and not done simultaneously with any other activity. I have noted times when I have seen people walking or RUNNING with weights in their hands or on their ankles and even considered putting up PSA flyers at local parks to discourage this behavior. WHY? Because it does not work the muscle correctly and because it puts the person at very high risk of overuse injury, especially of the shoulder. Now if you are trying to save time and get a cardio and strength training workout in the same hour, then by all means, in between weight lifting, jog, jump rope, cycle etc - but NOT at the same time. And so this week I watched a woman take an entire step aerobics class with two, three to five pounds weights in her hands. So she stressed her shoulders but didn't challenge her muscles. NUTS! or lack of information - but you cannot claim ignorance, because you just read this post. Testing, testing, testing So we are having too many diagnostic tests. DUH. I am glad anyway to see some popular news sources note that the Xrays, CTs and even blood work have gotten out of hand. I was speaking with a physician this week after that story made the headlines and he agreed with my thought, which is this - before having a "test" one should know the answer to this question, "How will that Xray, Blood Test, Ultrasound, etc - change the treatment ?" If it isn't going to change what the doctor would do, then it is an unnecessary test. Remember, some of those imaging complexes are actually OWNED by the doctor's who send you there. BTW, my aunt and I were talking today about mammograms - and though she is a breast cancer survivor - she too thinks they are over used. Bone Loss Drugs This week a study and an FDA warning were released in regards to long term use of drugs that are meant to slow or reverse bone loss - Fosomax and Actonel are popular examples. The drugs already carry an unusual warning of esophageal damage and jaw bone problems, now there is concern that FRACTURES can occur in the thigh bone of people on these drugs longer than five years. Here again, an example of a drug causing what it is supposed to prevent. The FDA is looking into this matter and persons on the drug are to discuss long term use with their physician. I wrote about the issue of prescribing a medication to prevent a condition that can lead to another condition, some time ago and this is exactly the kind of thing one must worry about. If the medication is given to 30 or 40 year old women because they are at risk for getting osteoporosis which would then mean that they are at risk for getting a fracture (hip and spine) - they will be on the drug for 20-40 years!!! Read more about the <a href="http://yourhealtheducator.blogspot.com/#uds-search-results">osteopenia debate here.</a> Without the Calories??? I almost did a post about the crazy things I heard people say or saw people do this week. Here is one. I was at another doctor's office (this is work related, I am NOT sick :)) and as I waited for the doctor, his office manager, nurse was talking with me. She offered me some cracker like chips out of a large bag( kept on her desk). I think they were some kind of Ritz baked something or another - she said that they were just like chips without the calories !! What? Too funny that she would say that to ME. I had already said, thanks but no I just had my lunch, blah blah blah, when she said that about the calories - to which I had to respond, "Well, I wouldn't quite say that!" Treadmill Grip Hmm, If the incline is so high that you have to hold on to the treadmill for dear life - you are not really working your legs. Additionally, if you run and hold on to the treadmill, well, I don't know - how do you run without your arms? Is it too fast - is it painful? I don't know, but it just can't be right. Weight Machine Mistakes As I said, I saw a lot of quizzical things this week. This one was a lady sitting at a machine where you hold a long bar over your head and out wide, you pull the bar down towards your chest and then release. This is a lateral pull down. Form is so very important in weight training. If you cannot do the exercise while keeping your form, the weight is TOO heavy. This is a mistake most often committed by men, but this woman was all over the place with her body, nearly rocking back and forth hard enough to catapult herself off a runway. So um, that is not effective. Smoker's Say the Darndest Things I am the first person to frown on the use of medication for almost anything, however, it is my job to educate people on the 7 FDA approved medications that are effective in helping people to quit smoking. This week I was discussing one of them called Zyban (wellbutrin/bupropion) and one of the persons in the group said that the medicine had made her hair fallout. Well - everyone else in the room, ALL smokers, gasped and declared that they would NEVER take that pill. (that really isn't one of the reported side effects, but anyways). Cigarette smoking causes lung cancer, heart disease, stroke, insulin resistance, emphysema, wrinkles, SIDS , impotence, infertility, oral cancer - and more and more - which apparently isn't near as scary as hair loss. Do Not Add Salt I am 100% in favor of banning trans fats and of reducing the amount of sodium in processed foods. I am an advocate for getting nutrient content information on every product and dish, store or restaurant, I think that sugary drinks should be taxed to the max, but now I think NYC might have gone too far. Some politician has proposed making it illegal for restaurants to add salt during cooking. Then again, I don't add any when I cook - but seriously, the biggest problem we have is eating too many calories - and though salt can add to blood pressure problems, is it really the cause of most?

Odds and Ends

Step Class "oh no!" I have said so many times that lifting weights should be an activity in and of itself and not done simulta...

5:00 PM

Odds and Ends

Fitness Facility Injuries: This first note is not exactly what I wanted it to be. I just spent my dinner time (I was eating) searching for an article that was referenced in a story only to find it was a book, not a journal and I cannot get my eyes on it. Really sucks. I read an article in an ACSM journal about law suits and treadmills. In that article it said that treadmill injuries were the fifth most common health club liability claim. I do not have access to the full list, but I sure wanted to see what the top four were. When I try to Google - injuries-, I get mistakes instead. Of course, not warming up and using improper form were noted. I am very curious about the other claims, maybe I can find the book at the library. Of note, I imagine some injuries happen on the other cardio equipment, the weight training machines and with free weights, in cycling and in step aerobics class - in fact, someone fell in my class last week! Health Insurance Commercials: I have been noticing health insurance commercials recently - advertisements for private insurance that shows the premiums one might have to pay based on age, gender and such. The commercials show three or more examples and I noticed that above the sentence, woman age 45 (ex.) it says in lighter letters, "tobacco free". I work in tobacco education as my career and I knew that tobacco users paid more than non users, but really hadn't seen that distinction in an ad. To me, that proves more than anything that tobacco causes disease! Chesticles and Shrinkage: I really wish I could remember which show or commentator or host made this statement as they should get the credit for this, but I cannot. Of course, I have been vocal about the negatives of using supplements, protein powders, growth hormones, performance enhancing drugs and steroids. We have almost all heard of roid rage - so we know that steroids are not without significant risks. What I heard someone else say this week was that steroid use also led to chesticles which I will leave you to imagine and that steroids also shrink a man's testicles. I found that ironic of course, especially because some men I see who are really , I mean REALLY, bulked up, walk like they have some significant um, hardware, between their legs. ( I'm just saying......) More Drug Company Shame: News is out that the company that makes diabetes drug Avandia, the one with the warning label for cardiovascular risk, knew about the risks long before disclosing it and in fact, continued to conduct clinical research trials to compare it to another drug that was safer - even when subjects were suffering the consequences. Most Important Statement of the Week: After Bill Clinton underwent a second procedure in regards to his heart disease, he said that he was going to be more "disciplined about exercising every day."

Odds and Ends

Fitness Facility Injuries : This first note is not exactly what I wanted it to be. I just spent my dinner time (I was eating) searching f...

4:45 PM

gestational diabetes

I chose this topic today because a woman I care a great deal about has recently learned that she has gestational diabetes. So what is that and what does it mean? Diabetes is defined as having a blood sugar level over 130 if fasting and 180 if after a meal. When blood sugar levels run high after one becomes pregnant but not before, then it is gestational diabetes. (there are some instances of gestational diabetes however, that fall into the category of previous diabetes that was undiagnosed). There are not always symptoms, but increased thirst, light headedness and frequent urination are a few. A blood glucose test is usually performed during pregnancy. Gestational diabetes can cause problems and it is important to get blood sugar levels under control and to treat the condition with the utmost respect. Gestational Diabetes affects about 4% of pregnant women. It usually occurs and is diagnosed between the second and third trimester. Though only around 30% of women with gestational diabetes develop diabetes beyond pregnancy, there is a 60% chance that this will occur for each woman who has gestational diabetes. There is also increased risk of the infant becoming obese and also developing type 2 diabetes. What this really tells us is that the recommendations to maintain a healthy weight, to eat frequent, consistent, small meals and to exercise are universal and paramount. Women who are diagnosed with this condition, often because of screening during their sixth month, must control their blood sugars. When diagnosed, the mother should receive a referral to a certified diabetes educator who will assist in meal planning. How one eats can do a lot to prevent blood sugar spikes and thus less need for insulin to be secreted. Exercise can also reduce blood sugar, however, there may be a need for exogenous insulin and if so, special education on how to use the medicine is needed as well. No other diabetes medication is considered safe during pregnancy. Insulin and exercise are both known to lower blood sugar levels. Pregnant women should not start new vigorous exercise, but are usually able to continue with the same physical activity level they had before they become pregnant, unless of course they were sedentary. Walking is usually considered a safe activity. All women who are pregnant and especially those with these risks, should maintain regular prenatal care and get direction from their provider on what exercise is best and how often it should be done. With regard to controlling blood sugar through nutrition; frequent, small meals are suggested. Complex carbohydrates, whole grains, fruits and vegetables as well as lean proteins are recommended. It is also noted that saturated fat, fried and greasy foods should be avoided. Pregnant women are also encouraged to consume 20+ grams of fiber each day, and to drink plenty of water. As you can see, these suggestions are pretty much the same as those for the general population. These guidelines can reduce weight gain and prevent chronic disease. Women with gestational diabetes are also encouraged to monitor their weights. I cannot emphasize enough that this is not a disease to tackle on your own. The baby and the mother are at risk for problems - birth problems, growth problems and still birth. The risk is greatest if the diabetes is not controlled. This is different than being diagnosed with DM2 and twenty years later having a heart attack from it - the adverse outcome can happen within months if the condition is not taken seriously. Risk factors and etiology: There are some risk factors, but please note, many cases of gestational diabetes are in women who did not have the named risk factors. If you are curious, they include - being overweight prior to pregnancy, being over age 25, having had gestational diabetes during a previous pregnancy, having a family history of diabetes, and being a person of color. The disease develops (etiology) during the course of a normal pregnancy phenomena. When pregnant, the placenta itself makes hormones. The hormones have many effects but one is to reduce the impact of the mothers insulin on her blood sugar level. The idea is to increase nutrient flow from the mom to the baby and in so doing the mom might be at risk for low blood sugar, so the body is trying to prevent that outcome by interfering with natural insulin response. However, sometimes that back fires and the mothers blood sugar is too high. Usually the mother will begin to produce extra insulin (from the pancreas) to account for this change, but in gestational diabetes this extra insulin does not move the blood sugar out of the blood stream. The infant's pancreas is also working so that when the infant has too much blood glucose, it will release insulin. The glucose passes through to the baby but the mom's insulin doesn't. Glucose or blood sugar that cannot be used is stored as fat. The baby is at risk for a condition in which it has too much fat (macrosomia) at birth and it will continue to be at risk for obesity and diabetes after birth. All this being said, controlling the blood sugar of the mother, through smart eating and exercise can prevent these adverse outcomes. A woman with this condition should take advantage of any and all resources made available to them by their OBGYN. To control the blood sugar, testing is required. Certified Diabetes Educators, both nurses and dietitians can educate on how to test blood sugar and use insulin if needed. Blood testing cannot be avoided. The baby may also undergo fetal monitoring, ultrasound and other tests as the pregnancy progresses. At birth the baby will undergo some testing to make sure his or her blood sugars are normal. Again, the baby will be at risk for obesity which is a big factor in diabetes - parents should provide the child with the same healthful diet the mother was encouraged to consume. After birth, the mother will also be tested for some time to see if her blood sugar and insulin response returns to normal. It should because the placenta is no longer there to cause hormone challenges, but again about one third of women will develop diabetes, or may have had undiagnosed diabetes prior to pregnancy. If you have this condition you should read more, as the links below were my resources. Start here: <a href="http://www.cdc.gov/ncbddd/bd/diabetespregnancyfaqs.htm#willmybaby">http://www.cdc.gov/ncbddd/bd/diabetespregnancyfaqs.htm#willmybaby</a> and here: <a href="http://www.diabetes.org/diabetes-basics/gestational/what-is-gestational-diabetes.html">http://www.diabetes.org/diabetes-basics/gestational/what-is-gestational-diabetes.html</a> and here: <a href="http://www.webmd.com/baby/tc/gestational-diabetes-topic-overview">http://www.webmd.com/baby/tc/gestational-diabetes-topic-overview</a><a href="http://www.diabetes.org/diabetes-basics/gestational/what-is-gestational-diabetes.html"></a>

gestational diabetes

I chose this topic today because a woman I care a great deal about has recently learned that she has gestational diabetes . So what is that...

4:48 PM

Is 10 minutes really enough?

In reviewing for a fitness recertification, I came across some information that answered a question I am often asked, except I wasn't really sure it did answer the question. Since then I have been trying to track down some of the many other things that I have read and now I feel like I squandered 30 minutes away when I just should have been blogging outright. The questions I am often asked are what burns the most calories, when does fat get burned and what should one eat to fuel their workouts. A lot of that was addressed in the <a href="http://www.ifafitness.com/downloads/fitabc.pdf">IFA training manual</a>. At the same time, our national physical activity guidelines tell us just to get moving, any amount, any activity, just move. And that is still true. However, there is a difference between training for optimal performance and fitness and being active to reduce your risk of chronic disease. The latter category will be the one that is addressed by 30 minutes of activity 5 days of week, in any block of time you can achieve. Ten minutes - three times a day, will work. And remember,sitting all day, regardless of your regular exercise routines, is NOT a good idea and could have adverse health outcomes. Otherwise I will tell you this. Within the first 15 minutes of aerobic exercise (where the body uses oxygen to burn energy - running, walking, step, rowing, swimming, hiking, etc) the body is using the glycogen or carbohydrate stored in your muscles. After that sustained 15 minutes, the body will be look for fat to burn as energy. As a matter of fact, the fat is burned the most during that first hour and not much more so if you exercise longer. Remember, we are seeking one or two things with this level of activity, to burn fat (calories) and to improve our cardio-respiratory fitness - the ability of our heart and lungs to use oxygen efficiently. So what should you fuel your body with if you are taking an aerobics class, going for a walk or run, or using the gym cardio equipment? Not sugar! And not sports drinks. If you have those things in your blood stream then insulin will be released. That is supposed to happen if you have eaten a simple carbohydrate, but insulin prevents the liver from metabolizing fat. A complex carbohydrate will do you more good. I always choose carbs and protein together for a sustained energy source, i.e. peanut butter on whole wheat bread, but NOT a whole sandwich, just a half or less. Another good choice is peanut butter and apple slices. The best thing to drink before, during and after your exercise is water. If you are an extreme athlete or a long distance runner, football player, etc - you must realize, this message is not meant for you. Lastly, for some people the main point is to burn calories. If that is your goal then just exercise and don't worry about all of these things. Track you calorie burn with the awesome resources available at the Stand Up and Eat site of the Cooper Institute. BTW, they have a great <a href="http://www.standupandeat.org/index.aspx?id=whatsindownloads">download section </a>as well with handouts and such that can guide your progress.

Is 10 minutes really enough?

In reviewing for a fitness recertification, I came across some information that answered a question I am often asked, except I wasn't re...

5:01 PM

Odds and Ends

Because the NFl Pro Bowl is just beginning and playing in the background, let me start with injuries. Sports Injuries Three things lead to this blurb. Today a running friend mentioned that another friend was out having surgery. Someone said, "oh his knee?" and another said, " no, his shoulder." Last night my niece mentioned that she had re injured her meniscus and might have to have surgery again. Both of these persons had these issues from tennis. SO I decided to research which sport had the most injuries. It appears to be football, which is exactly why the men in next week's Super Bowl have opted out of the Pro Bowl. Interestingly, the top two sports for injuries are football and basketball and the top injury for both is the KNEE. Otherwise, injuries are definitely related to contact, to improper form, improper equipment, lack of warm up and over use. Over use injuries are probably more common in tennis and running. Zyprexa Zyprexa is a medication that is considered an anti psychotic and is in the psychotropic class. This means it is a mood altering drug. It is also one of the many drugs in this class that have been shown to cause weight gain. (personally I think we need to educate the patient on weight control if and when prescribing the medicine, but I did not ever see that happen when I worked in the field of psychiatry) Because Zyprexa, made by or sold by Lilly, has been approved for use in adolescents (scare me!) the FDA has now put out a warning about the weight gain and the increase in levels of blood fats. If you are on Zyprexa and develop hyperlipidemia, you are likely to be prescribed ANOTHER drug to treat that condition. That my friends is how polypharmacy gets started. Anyway, the new alert advises that other meds be tried before Zyprexa. We especially do not want our kids on meds for chronic disease conditions before they even graduate high school! Tobacco and Heart Disease February will bring us heart health month again and I will likely write more about that. In the meantime, I have been studying for a February 4th community presentation on smoking and heart disease. Seriously, I have a great article that was forwarded to me by the author, Neal Benowtiz, MD. I have had to look up about 40 words, repeatedly, and feel like I need another couple initials after my name to understand it. But , I can say that chemicals in the tobacco smoke have a significant effect on hemodynamics, viscosity, thrombosis, and endothelial function. Just kidding - well , I mean it is true, but it means that the blood of smokers is thicker, that atherosclerosis (plaque build up) is activated from the chemicals and that platelets are also activated and clump together, putting smokers at significant risk of thrombosis, or blood clot. Smokers have heart attacks and sudden death at much younger ages than non smokers and are more likely to die during heart surgery. Their stents are more likely to clog and blood flow is likely to become impaired a second time. People who live with smokers have a 30% higher risk of heart disease themselves and only breathe 1% of the smoke that smoker's inhale. Crazy right! And heart disease kills 30% of smokers. The other top diseases of smokers are lung cancer and COPD. Walking with Weights No doubt you know that weight training should NOT be done at the same time as the cardio portion of your workout, but can be done alternately. Well, yesterday I saw my favorite local really super gorgeous scuba instructor walking on our popular Sarasota Bridge (only hill in town) carrying two 8-10 weights in his hands. I was aghast. Okay I believe that is it for now...... and for January ... ba bye...

Odds and Ends

Because the NFl Pro Bowl is just beginning and playing in the background, let me start with injuries. Sports Injuries Three things lead to...

4:42 PM

EVERYTHING in Moderation - really? EVERYTHING?

And you know where I am going with tonight's post. It is a funny thing, this mantra of many. Everything in moderation. Where did that come from exactly? (well, I know where it came from, a Greek temple and it was "nothing in excess", but anyway) This is the phrase we like to voice when we either want more of something that we'd be better off without or we want to do less of something we really should be doing more. For example, french fries and ice cream are really NOT something we should have in moderation, but something we should limit, but when we want to eat them we say, "everything in moderation." Physical activity and exercise are things we should do more of - a lot of - every day of - but we see the people who walk or run most days of the week when we don't and shake our heads saying, "everything in moderation." So let us think about the recommendation guidelines from health experts that are meant to improve our health and well being and are based in science. Science of course is dynamic, meaning what we knew 60 years ago does not always mesh with what we know today. It is dynamic, ever changing, and so must we be. I gander to say that even antediluvian postulations did not call for consumption of everything and anything at moderate levels. But we do not have to go back to biblical times to do our work, we can start with the 1800s. Lucky for me, a young woman named Lisa Green who is a student at UF, has a <a href="http://iml.jou.ufl.edu/projects/Fall02/Greene/history.htm">webpage</a> that describes the history of our food guidelines. We are most familiar with the Basic 4, the 4 Food Groups. According to Lisa's history, President Roosevelt had actually commissioned the USDA to create the Basic 7, but that was too complicated. I remember the 4 Food Groups from school. But since then we have have the Food Guide Pyramid (USDA), the DASH diet (NHLBI), the Mediterranean Diet (classified by research and highly recommended), the New Food Guide Pyramid (Harvard -Walter Willett), New American Plate(AICR), the Go Slow Whoa program (NHLBI) and the AHA's recommendations on eating to prevent heart disease. And yes, a two years ago, , the US Government came out with its first recommendations for physical activity. (other agencies have done so for ten or twenty years) Every single one of the aforementioned guides distinguishes food amounts by food type. For example, saturated fats, oils, butters, whole milk and whole milk products and sugars are to be consumed in limited quantities while vegetables, according to Dr. Willett are to be consumed with abandon. Alcohol should only be one or two glasses of the measured amount per day. Trans fats are to be avoided at ALL COSTS and ALL TIMES. Red meat is to be consumed much less and fish much more... I can stop now can't I? No , no I really can't, it is just who I am. The absolute best advice, scientific advice, is to eat a variety of foods with special attention to lean meats or proteins, low or no fat dairy products, whole grains and complex carbs, fish, mono unsaturated fats, many fruits and most vegetables, measured alcohol intake, and little to no saturated fats and sugars. The CDC has great information about fats, and that is a perfect example. We are asked to keep our fat intake between 20-30% of our total daily calories and our saturated fat intake at no more than 10%. They say on this web page that even though some fats are health promoting we STILL need to keep overall intake under 30%. Which is why you cannot eat cups of almonds all day! <a href="http://www.cdc.gov/nutrition/everyone/basics/fat/index.html">http://www.cdc.gov/nutrition/everyone/basics/fat/index.html</a> Fat is just one example. There are very specific and different recommended daily allowances for salt, for fiber, for protein, for carbs, and oh my gosh WATER, which is very individually specific. etc. So if it IS everything in moderation - then it must follow that some things are more moderate than others. Moderation means nothing to excess, but it also means nothing at a level that is considered harmful and that is the real issue. Fats, sugars and alcohol can be harmful at much lower levels than people who enjoy them would like to acknowledge. Additionally, exercise levels have to be much higher than sedentary people would like to believe before considered harmful. Remember the <a href="http://www.health.gov/paguidelines/guidelines/summary.aspx">Physical Activity Guidelines for Americans</a> state: Additional health benefits are provided by increasing to 5 hours (300 minutes) a week of moderate-intensity aerobic physical activity, or 2 hours and 30 minutes a week of vigorous-intensity physical activity, or an equivalent combination of both. With an additional two days of strength training. For most health outcomes, additional benefits occur as the amount of physical activity increases through higher intensity, greater frequency, and/or longer duration and the benefits of physical activity far outweigh the possibility of adverse outcomes. I repeat - Moderation means nothing to excess, but it also means nothing at a level that is considered harmful and that is the real issue. (side note: you can eat the right amount of a food and still get a belly ache and you can do the right amount of exercise and still strain a muscle - we are not talking about these acute things!) (second side note, if you receive this blog in your email, you may have to come to the website to see the links and to leave comments)

EVERYTHING in Moderation - really? EVERYTHING?

And you know where I am going with tonight's post. It is a funny thing, this mantra of many. Everything in moderation. Where did that c...

4:33 PM

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Odds and Ends

Odds and Ends

gestational diabetes

Is 10 minutes really enough?

Odds and Ends

EVERYTHING in Moderation - really? EVERYTHING?

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