Category Archives: Health & Fitness

Exercise, when you need it most

Regular exercise is one of the most important things you can do for your health. A lower risk of weight gain, diabetes, heart disease, and some cancers are among a long list of positive health effects of exercise. Lesser known benefits include improved mental health, cognitive function, and greater feelings of wellbeing. Exercise is essential for development of children, maintaining health in adults, and can even reverse some of the effects of aging.

Despite these clear benefits, many people do not participate in regular exercise until they have a medical condition, like a heart attack or cancer, that motivates them to start.  This is the topic of my Health & Fitness column in the Aiken Standard this week.

usca-cardiac-rehab


It is well-known that people who exercise have a lower risk of heart attack and improved survival if they do have one. While immediate treatment of a heart attack using medications and surgery is critical, the truth is that the long-term outcomes are largely based on what happens next. Traditionally, heart disease patients were told to rest and not stress their hearts, a belief that many still hold today. Now we know that exercise-based cardiac rehabilitation programs are key to improving heart health and preventing future complications.

Most cardiac rehabilitation programs include several phases that include monitored exercise, education about nutrition, weight control, stress management, proper medication use, and psychosocial wellbeing. The benefits of cardiac rehabilitation are well-established through research and practice. In fact, many patients credit cardiac rehabilitation with saving their lives, even if they had bypass surgery. Despite this, less than a third of patients who are eligible for cardiac rehabilitation actually attend a program.

Exercise is also known to reduce the risk of developing certain types of cancer, including breast, colon, bladder, lung, kidney, and endometrial cancers. This is due to the fact that exercise causes changes at the cellular and hormonal level that result in reduced inflammation and improved immune system function. Regular physical activity can also improve survival and reduce the risk of recurrence of cancer.

In addition to helping reduce the risk of cancer development and recurrence, regular exercise can help you handle cancer treatment better. To be sure, cancer treatment can lead to extreme physical consequences including loss of weight, muscle mass, strength, and endurance. At least some of this is due to more time resting and less time being active, the effects of which occur within days and get worse over time.

The fitter you are when you begin treatment, the fitter you will be at the end because you have “saved” more strength and endurance in your fitness bank. You simply have more you can lose before you get to a point at which you can’t complete your normal activities. And post-cancer exercise programs are becoming more common as a way to help women recover from cancer treatment and rebuild strength, endurance, and feelings of wellbeing.

Another benefit of cardiac rehabilitation and cancer exercise programs is the support from other heart attack and cancer survivors. Combined with support from medical professionals, family, and friends, these groups become an essential resource for information, comfort, and encouragement.

If you or someone you know has had a heart attack, heart surgery, or a cancer diagnosis, encourage them to ask their doctor about an appropriate exercise program—it is likely to be the best way to improve quality of life. In our area, there is a cardiac rehabilitation program based at the USC Aiken Wellness Center as well as at several hospitals in Augusta. There is also an exercise program for cancer survivors called Livestrong at the YMCAs in Aiken, North Augusta, and Augusta.


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Turning back time with exercise

The benefits of regular exercise for everyone from childhood through old age are well-known. Children who are physically active establish healthy habits and do better in school than their peers who are more sedentary. Young adults who exercise are more likely to be active as they age, reducing their risk of heart disease, cancer, and other chronic diseases.

Older adults can maintain their memory, cognitive function, and ability to complete everyday activities by improving their fitness. At all ages, physical activity helps people maintain a healthy body weight. In many ways, exercise can turn back time on many health and fitness variables that decline with age. This is the topic of my Health & Fitness column in the Aiken Standard this week.

elderly-exercise


Ideally, people would be active throughout their entire lifespan. What is more common, though, is that activity in childhood and young adulthood is replaced by a lifestyle that becomes increasingly sedentary over time. This can lead to a pattern of weight gain and declining fitness.

For many people the consequences may not be immediate, so there is no clear sign that the lack of exercise is having negative effects. But make no mistake, the health effects of inactivity accumulate over time eventually leading to conditions like obesity, heart disease, and osteoporosis.

Aside from the risk of chronic disease, years of inactivity can result in poor strength, endurance, and flexibility. This can lead to increased risk of injury and difficulty completing work and leisure activities. This is particularly true in older adults who are more likely to experience falls, broken bones, and prolonged disability due to poor strength and balance.

It is well-known that strength and endurance decline with age. Fitness decreases about 10% per decade, so that a 70 year-old has lost about half of the exercise capacity they had at 20 years of age. It turns out that this decline in fitness is due more to decreasing activity, not age itself.

Resistance training can lead to improvements in strength at all ages, but the biggest gains occur in the elderly. Beyond the impact on activities of daily living—carrying bags of groceries, for example—strength training can improve bone density. This is of particular concern for women.

Bone density peaks about age 25, so women who exercise achieve greater bone density when they are young. This means they can lose more bone mass as they age before they experience problems. Middle-age and older women can also reduce age-related bone loss by participating in regular exercise. In fact, exercise is essential for the effective treatment for osteoporosis.

There is good news for those who haven’t been exercising. You probably know that people who exercise now are less likely to suffer poor health in the future, provided they stay active. But research also shows that people who are out of shape now but improve their fitness also experience a reduced risk of many common health conditions like diabetes and heart disease.

It doesn’t matter when someone becomes active—the benefits can be realized at any age. In fact, one study showed that older men who begin a vigorous exercise program can improve their fitness to the level they were at 30 years ago. And these changes can occur in as little as six months.

The bottom line is that exercise can turn back time by reversing many effects of aging. Best of all, it is never too late to start. If you have fallen into a pattern of inactivity you can benefit from regular exercise no matter how old you are. So, what are you waiting for?


Nutrition, exercise, and health information can be confusing. 
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When it comes to trans fats, zero is too much!

Nutrition recommendations are often confusing and contradictory. To make things worse, the nutrition information provided on food packages can be difficult to decipher or downright misleading. In my Health & Fitness column in the Aiken Standard this week I share information about trans fats and how zero doesn’t always mean none.

trans-fat-label


Remember when fat was bad and carbohydrates were good? The idea was that eating fat led to weight gain, a problem that could be solved by eating less fat. Then carbohydrates, including bread and pasta, were blamed for obesity and other health problems which led to the low-carb diet craze.

The truth is that all fats and all carbohydrates aren’t necessarily good or bad. Fats come in different forms, some of which have positive health effects and others that are linked to poor health and disease. Similarly, carbohydrates also come in different forms, some you should eat more of and some you should limit. This is why you hear people talk about good carbs and bad carbs or good fats and bad fats. In reality, no nutrients are really “bad” as long as you consume them in reasonable amounts balanced by exercise and other activity.

Nutrition recommendations for good health call for a moderate fat intake (20–35% total calories) with an emphasis on monounsaturated and omega-3 fats, while limiting saturated and trans fats. Olive oil, canola oil, and avocados are good sources of monounsaturated fats. Fish, including salmon and tuna, are high in omega-3 fatty acids. Saturated fats are found primarily in animal products, especially red meat and butter, as well as tropical oils like palm and coconut oil.

Most trans fats come from partially hydrogenated vegetable oils, which are polyunsaturated fats that have been modified for use in frying and in baking (margarine is a partially hydrogenated vegetable oil). While there is much debate about the health effects of the different types of fats, almost everyone agrees that trans fats should be avoided.

The Nutrition Facts panel on food packages also contains information that is supposed to help you make choices that are lower in total fat, saturated fat, and trans fat. Unfortunately, this is not as straightforward as it seems. By law, manufacturers can list trans fat at 0 grams as long as it contains less than 0.5 grams. This means that a food can contain up to 0.49 grams of trans fat per serving even though it is listed as 0 grams!

This may not seem like much, but consider that the American Heart Association recommends limiting trans fat intake to 2 grams per day, at most. You could easily exceed this limit with just a few servings of “trans-fat free” foods. When it comes to trans fats, zero can be too much. It’s no wonder so many people struggle to make healthy food choices!

How can you tell if zero isn’t really zero? One way is to look for “partially hydrogenated vegetable oil” in the ingredient list, which indicates that trans fats are present.

Nutrition information is confusing, to say the least. Even if you know to look at the Nutrition Facts panel on food packages, the information there is not always easy to understand. In some cases, what you see on the label does not reflect what you are really eating.

One step toward making healthy choices is to eat “real,” unprocessed food as much as possible. Fats that occur naturally in food are less of a concern than modified fats that are added in food processing. So, don’t worry so much about fat in meat and dairy and use natural oils, like olive oil. You will likely find that these “real” foods are not just better for you, but better tasting, too!


Nutrition, exercise, and health information can be confusing. 
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Improve your success by treating weight loss or exercise like a project

Almost everyone who starts a weight loss of exercise program does so with good intentions. Many get off to a good start and see beneficial results, at least initially. Unfortunately, long-term success is uncommon.

There are myriad reasons for this, but the way people manage their weight loss and exercise efforts is certainly among them. Think about it: when someone takes on a new diet or exercise program it is usually added to their typical routine. The problem with this approach  is that most people are busy, and there is little extra time in their day. As a consequence, the diet and exercise doesn’t get the time or attention is needs in order for people to be successful.

This is where the lessons of good project management can be helpful. In the workplace a major project is usually accomplished though defining the scope to the project, appropriate goal setting, allocation of resources (including time), and a mechanism to assess progress.

But many people who approach projects this way at work tend not to apply this process to health improvement projects at home. The result is poor planning, setting unrealistic goals, and failure to allocate appropriate resources, including time.

Especially time. Time to set goals, time to plan and prepare meals,  time to exercise, and, perhaps most important, time to assess and adjust the plan along the way.

Many of these problems could be avoided through the same good project management techniques that would be used at work. The idea of treating weight loss, exercise, and other health improvements as a project is the topic of my Health & Fitness column in the Aiken Standard this week.

to-do-list


Think about the last time you tried to do something that was good for your health. Maybe you were trying to lose weight, eat a healthier diet, or start an exercise program. If you are like many people, your attempt wasn’t successful, at least in the long term. In fact, more than two-thirds of adults who lose weight gain it back and about 50% of those who start exercising quit within six months. The problem isn’t so much getting started, it is sticking to the program.

The number one reason why people abandon their diet and exercise is time. Dedicating time for exercise and to plan and prepare healthy meals is challenging. Most people are busy—maybe too busy—with work, family, and other responsibilities, so health improvement tends to take a lower priority.

Perhaps part of the solution is to treat health improvement like you would a project at work, rather than an “extra” activity. Using project management strategies that are common in the workplace could help you dedicate adequate time and resources to your next diet and exercise program. Here are some examples of how you can utilize the methods of one program management model to improve your chances for success:

Initiation

Identify what you need to change, set goals, and determine what resources you will need. For example, if you want to lose weight you should have a goal weight and timeline in mind. You can, and should, set both short-term and long-term goals. Then, think about what knowledge or tools you will need to get started. You should also tell others about your plan and identify people who can provide support.

Planning

This is where you determine when and how you will put your plan into action. If you need information about what to eat or decide to join a gym to exercise, this is the time to put those components in place. Take out your calendar and make time for preparing meals and daily exercise. Make a weekly menu of meals and a grocery list before you go to the store. Set a start and end date for your project, decide how you will monitor your progress, the think about “what if” scenarios.

Execution

Once you have yourself organized, it is time to begin! Hopefully, this is a bit easier since you planned ahead, but keep in mind that you will continuously need to revisit and modify your plan. This is important because one reason why people don’t succeed is that they don’t allow flexibility in their plan; once things go awry, they give up.

Monitoring

As you proceed through your weight loss or exercise program it is helpful to get feedback on your progress. Keeping track of your weight is a simple way to monitor. You can also keep a record of what you eat or what you do for exercise to see how you are progressing. Tying progress to rewards is important for keeping you motivated, just make sure the rewards are consistent with your goals.

Closing

In the office, this is the end of your project and the time when you file everything away and move on to something else. Health improvement projects tend to be ongoing, so this is your chance to review what worked, what didn’t work, and what you need to do to maintain your good health habits. This would also be a good time to get rid of your clothes that are now too big—otherwise you may end up in them again someday!


Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
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When it comes to weight loss, calories count (but don’t count calories)

When it comes to losing weight, calories count. Thanks to a host of wearable devices and mobile apps, counting calories has never been easier. This matters because losing weight almost always means cutting the calories that you eat and increasing the calories that you burn. This concept of “eat less, move more” is the foundation of nearly every effective weight loss program. This is the topic of my Health & Fitness column in the Aiken Standard this week.

fitbit


Modern wearable devices and mobile apps allow you to track your weight, what you eat, and your activity fairly accurately. Many apps can measure the intensity of exercise by using the GPS and accelerometer features of your phone itself or by syncing with a wearable bracelet or belt clip. Some include heart rate to make the estimates even more precise. Using this technology, you can count steps, measure how many miles you walk or run, and estimate how many calories you burn.

Other apps can help you track what you eat. Whether you are counting calories or concerned about the amount of protein you are eating, diet analysis apps can show you what you are really eating. Most require you to enter the foods you eat and the app calculates calories, nutrients, sugar, salt, and water intake based on standard databases. In order to get accurate results, it is important to estimate portion sizes accurately, something that is challenging even for experts. That said, these apps can be useful for tracking what you eat to help you learn about your eating patterns to develop healthier habits or meet specific goals, such as eliminating added sugar from your diet.

Activity trackers and exercise apps are especially popular for improving fitness and promoting weight loss. Both the physical activity that you do throughout the day and dedicated exercise are important for good health, physical fitness, and weight control. This technology can help you know what to do, when to do it, and how much you did at the end of the day.

Even if you aren’t concerned about exactly how many calories your burned in an exercise class or how many steps you took during the day, these devices can help you develop healthier habits. Many people are simply unaware of how sedentary they are during the day or are unrealistic about how intense their workouts really are. For many people, an accurate report of how many steps they took or how many calories they burned is helpful for gauging their success and identifying things they can improve.

While these tools can be helpful, it is important to emphasize the importance of developing healthy habits in order to improve fitness, lose weight, or keep it off. A focus on “micromanaging” steps or calories may cause you to lose sight of the “big picture” changes you want to make. For example, you should strive to be as active as you can throughout the day, even if you have already met your step or calorie goal.

Keep in mind that there are very few people who failed to meet their fitness or weight loss goal because they didn’t have the latest activity tracker or fitness app. Real success comes from making lifestyle changes to incorporate healthy eating and activity habits that you can maintain without constant reminders. While technology can help you make those changes, it does not replace the dedication needed to develop lasting eating and activity habits to promote good health.


Nutrition, exercise, and health information can be confusing. 
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Honesty is the best policy when it comes to your health

Have you ever justified your weight by saying you are “big-boned”? What about your eating and exercise habits? How often do you really eat out? How many days did you actually get to the gym last month? Are you being honest with yourself when it comes to your health? And are you asking others to be honest with you?

Being honest about your health is the topic of my Health & Fitness column in the Aiken Standard this week.


Being honest with yourself is essential for initiating health behavior changes and setting good goals. For example, someone who tells themselves they need to lose “a few pounds” may really need to lose much more and may not take their weight loss as seriously as they should. Convincing yourself that you are doing more exercise than you really are may mean that you won’t see the fitness or weight loss results you were expecting.

This type of self-deception is easy to do. Take body weight for example. The current standard for determining if you are at a healthy weight is body mass index (BMI), calculated from your weight and height (kg/m2). It requires a bit of math, so using a mobile app or online calculator is a good idea.

A BMI between 18.5 and 24.9 is considered normal, 25-29.9 is overweight, and if your BMI is 30 or higher, you are classified as obese. To put this in perspective, a BMI of 30 is equivalent to about 25–30 pounds of excess fat.

Let’s say your BMI puts you in the obese category, suggesting you should lose weight. But then you think about an article you read about how BMI isn’t accurate because you can be considered obese if you have excess muscle, not fat. And then there was the story on the news suggesting that it is okay to be obese as long as you are physically fit. So, maybe you don’t need to worry about your weight!

See how easy it is to tell yourself that you don’t really need to lose weight? In reality, BMI is an accurate method of assessing your body fatness; the inaccuracies reported in the news almost always involve athletes or people with lots of muscle mass developed through physical labor. Be honest…is that really you? It’s also true that people who are fit and fat can be healthier than people who are thin and sedentary, but it requires a lot of exercise to reach that level of fitness. Again, are you really that fit?

Probably the best test is to take a good look in the mirror and be honest about what you see. Try to “pinch an inch” of fat around your belly. One inch isn’t necessarily a problem, but take notice if you can pinch a handful of fat. Measuring your waist circumference (or looking at your pants size) can give you the same information. People who have a high BMI because of extra muscle, like athletes, have thin waists. If your waist circumference is greater than 35 inches ( women) or 40 inches (men), you have excess fat.

This honesty also applies to others, including your doctor. Many physicians are reluctant to discuss weight and weight loss with their patients, and many patients don’t want to hear what they interpret as a personal attack. Don’t be one of those patients! Ask your doctor for an honest assessment about your weight and the impact it might have on your health.

This is a real problem. According to one report, only 39 percent of obese people surveyed had ever been told by a health care provider that they were obese.     To help combat this problem, the American Medical Association has developed resources to help physicians better communicate with patients about their weight.

Making changes to diet and activity habits is a difficult process, to be sure. Telling yourself that you don’t need to make them only delays getting started and can lead to poor health in the meantime. When it comes to your health, honesty is the best policy!


Nutrition, exercise, and health information can be confusing. 
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Preseason sports safety

It’s hard to believe, but preseason practice for high school sports is well underway. Not only does this indicate that summer is winding down, it also means that area athletes are getting ready for the fall sports season. This is an exciting time of year for athletes, coaches, and fans alike. Unfortunately, even the fittest young athletes can suffer injuries (or worse) during preseason training and competition during the season. Among the biggest concerns are the rigorous training schedule, exercise in the heat, and head injury. Fortunately, there are steps that coaches and parents can take to ensure the safety of young athletes during practice and games. This is the topic of my Health & Fitness column in the Aiken Standard this week.

https://www.flickr.com/photos/virtualsugar/4084734655

 

 

 

 

 

 

 

 


Preseason practices typically emphasize conditioning—getting athletes in shape for the season. While coaches may expect players to arrive at practice already in shape, the reality is that many athletes still need to improve their strength, endurance, and flexibility. Preseason conditioning usually consists of vigorous exercise designed to improve fitness rapidly. Many coaches also use this time to “toughen up” the players or to weed out those who are not suited for the sport. For most young athletes this approach is safe and effective, but there is a risk of injury or, more rarely, collapse or death with intense training.

The risk of injury or death is made worse by the high heat and humidity that is common at this time of the year. For this reason, many coaches hold conditioning sessions in the morning or evening, when it is cooler. Even then, exercise alone poses a challenge to maintain a normal body temperature. Adding equipment such as pads and helmets for football players increases the risk for hyperthermia, which is even greater in the sun on a hot day. A high sweat rate makes dehydration more likely, so frequent water breaks are essential. Unfortunately, some coaches may be tempted to limit water breaks in a misguided effort to build toughness. This is absolutely inappropriate! Dehydration and hyperthermia can lead to heat stroke, which can be deadly.

This topic was covered in an NPR  interview  with Dr. Douglas Casa of the Korey Stringer Institute at the University of Connecticut in Storrs, Connecticut. You can also watch a video in which Dr. Casa discusses hydration and preventing heat illness in young athletes.

Another concern, especially among football players, is the risk of concussion. It turns out that concussions are more common than previously thought in football players and repeat concussions, even “minor” ones, can cause long-term problems. New recommendations for all levels of football call for better assessment of athletes who suffer head injuries and prevent injured athletes from returning to play. This in important during practices as well as games. While the focus is on football, nearly all sports that involve contact have a risk for concussion.

The topic of concussion is addressed in this video of a lecture given by Dr. Kevin Guskiewicz, Professor of Exercise and Sport Science at UNC-Chapel Hill and MacArthur Foundation “Genius” award winner.

These risks can be reduced by good year-round conditioning, altering practices to reduce heat injury risk, education to reduce the likelihood of concussion, and careful assessment when concussion is suspected. These responsibilities fall on the coaching staff and the certified athletic trainers who should be present at all practices and competitions. Certified athletic trainers have the knowledge and skills to assess environmental conditions and monitor athletes for signs of heat stroke, concussion, and other injuries. You can learn more about sports injury prevention and the role of certified athletic trainers in keeping young athletes safe from the National Athletic Trainers Association (NATA). All athletic trainers working in our area at certified by the NATA.

All players should also undergo a physical exam prior to participation in sports. The risk of injury can be further reduced by making sure all players are in shape prior to the start of practice. Coaches should find incentives to motivate their players to build strength and endurance in the off-season. Parents should make sure their young athletes are prepared for the physical requirements of their sport and aware of the risks of participation.

While injury is always possible, the risks can be minimized through careful planning and communication among coaches, parents, athletic trainers, and the athletes themselves.


Nutrition, exercise, and health information can be confusing. 
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Mindfulness matters for making meaningful and lasting health behavior changes

Mindfulness can be described as an awareness of thoughts, feelings, bodily sensations, and the surrounding environment. This is most commonly explored through mindful meditation, a practice that is credited with improving physical and mental health. Beyond meditation, being mindful can help to improve attention and focus in nearly every aspect of life. This is important for making meaningful and lasting health behavior changes. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Mindful brain


Thinking about your actions and the effect they have on your health and the health of others can be good for you and those around you. It turns out that we engage in many health behaviors that are driven more by habit than conscious decision-making. This includes what, when, and how much we eat as well as how active we are, two of the most important determinants of health.

When was the last time you thought about what you were eating? Not just which restaurant to go to or what time to eat, but really thought about what and how much you ate? Chances are, at least some of the time you eat when you aren’t hungry or keep eating even when you are full. You probably also eat foods you know you shouldn’t or don’t intend to, sometimes without even realizing it.

This concept was explored in-depth by Brian Wansink in the 2006 book, Mindless Eating. Based on his research, this book helped to explain the hidden reasons behind what, why, and how much we eat, often without being aware of it. This includes marketing tricks as well as environmental factors, many of which operate outside of our consciousness, that drive our food choices and prompt us to eat.

This is where mindfulness comes in. By making an effort to be cognizant about your own thoughts and sensations as well as the environment you are in, you can at least decrease the instances of overeating and making poor food choices.

Furthermore, we should be aware of how our food choices influence others around us. Research shows that children of parents who eat more fruits and vegetables tend to eat more of these foods than kids without such influence. Mindful eating includes accounting for how our actions and choices can influence the decisions of other family members and friends.

The same is true for how active or sedentary we are. Being active is a choice, sometimes a difficult one, that is influenced by other people and the environment. Most people spend the majority of the day sitting at work and at home, often without thinking about it. This sedentary lifestyle has been linked to an increased risk of obesity and heart disease, so it is relevant.

Sure, it feels good to sit on the couch to watch television. Think about it: is that really the best way to spend your time? At work, taking short breaks to get up from your desk and move can make you feel more alert and energized. Isn’t that worth it?

Similar to eating, our activity choices can influence the actions of those around us. A suggestion to walk to lunch can increase your own activity and that of your friends. Planning to go for a walk or bike ride with your family after dinner is a great way to share the benefits of activity.

When it comes to health, mindfulness matters. Being mindful about what you eat and making a choice to be more active allows you to have a positive effect on your health and the health of those around you.


Nutrition, exercise, and health information can be confusing. 
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Back to school: Make sure kids are ready to learn

Physical activity and good nutrition have long been recognized as essential for promoting good health in adults and children. More and more research suggests that these health behaviors can have beneficial effects beyond health, including how we perform both physically and mentally. The emphasis here is on children in school, but it applies to adults, too. This is the topic of my Health & Fitness column in the Aiken Standard this week, just in time for the first day of school here.

school lunch


Unfortunately, taking time for activity and good nutrition is seen as a luxury or a distraction to learning in most schools. Far from being a distraction, physical activity and healthy eating are prerequisites for learning and academic achievement. In short, these often ignored factors can help make sure children are ready to learn.

Regular physical activity is essential for good health, growth, and physical development, including maintaining a healthy body weight. This last point is important given the epidemic of childhood obesity and related health problems, including “adult” diseases like high blood pressure and type 2 diabetes.

Current recommendations call for all children to get at least 60 minutes of activity per day. This can include activity at school from physical education classes, recess, other classroom activities as well as games, sports, and unstructured play. Unfortunately, most kids don’t get nearly enough activity at school and many aren’t active at home.

Physical activity is also important for academic performance. Research shows that children who participated in an activity program had better executive control, which includes resisting distractions and maintaining focus, improved memory, and doing better switching between tasks. This is particularly relevant for children with ADHD, but the effects can be seen in all kids. These positive changes can maximize class time and lead to improvements in academic achievement, especially math and reading test scores.

Similarly, good nutrition is also essential for health, growth, development, and academic achievement. Eating a good breakfast improves cognitive function, alertness, and academic performance in students of all ages. It should be no surprise, then, that skipping breakfast impairs cognitive function and academic achievement. This is one reason that many schools offer breakfast to start the day or include a healthy mid-morning snack.

The same is true for lunch, too. A good lunch can support learning in the afternoon and gives a chance to teach kids about good nutrition by providing healthy food that, unfortunately, many children may not get at home.

Schools have a unique opportunity to use physical activity and nutrition to promote health, support academic achievement, and teach healthy habits. Since formal nutrition education is missing from most curriculums and PE programs are being reduced or cut completely, schools must be creative to incorporate these essential subjects.

A way around this problem is to make sure children get a chance to move and play, ideally multiple times during the day. This is what recess is for. Teachers can also incorporate activity and nutrition education in the classroom and get away from the idea that kids must be sitting still to learn. As research shows, quite the opposite is true!

Schools are often hesitant to teach about nutrition and activity because it is thought of as a responsibility of parents, not schools. But most parents don’t teach these good habits at home, which affects what happens at school. Despite the obvious benefits, it will probably take years of effort to change this view.

In the meantime, parents can encourage their kids to be active and make smarter food choices at home so they are ready to learn in school.


Nutrition, exercise, and health information can be confusing. 
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What you need to know about sports doping

The use of performance-enhancing drugs has been a serious issue in competitive sports for some time. Notably, the American cyclist Lance Armstrong was found to have “doped” during the years he won seven consecutive Tour de France races and, as a consequence, was stripped of those titles. With the Olympics underway, sports doping is something we are sure to hear even more about. The purpose of this column, which was published in my Health & Fitness column in the Aiken Standard this week, is to explain what is meant by sports doping and describe how a few commonly used substances work to improve performance.
syringe


The use of performance-enhancing substances, also known as sports doping, is nothing new. Sports organizations around the world have launched a concerted effort to catch and penalize athletes, coaches, trainers, and physicians who use or promote the use of banned drugs and techniques to unfairly improve performance. Athletes are tested randomly, and those who are found guilty can be disqualified from events, have previously awarded wins and medals revoked, and even be banned from competing in future events.

The specific substance an athlete might use depends largely on the sport. Endurance athletes may use substances that improve oxygen delivery to the muscle, allowing them to exercise at a higher intensity for a longer time. Oxygen is transported through the blood by red blood cells (RBCs). Increasing the number of RBCs is called “blood doping.” Traditionally, this required an athlete to remove a unit of blood and then reinfuse that blood later, closer to the event. The body replaced the donated RBCs, so the reinfused blood carried extra oxygen to the muscle and improved performance.

There is a newer way for athletes to get the same result without having to donate, store, and reinfuse blood. After a blood donation, the blood oxygen level is lower than normal, causing the release of a hormone called EPO, short for erythropoietin. EPO causes an increase in RBC production. EPO can also be produced as a prescription drug that has the same effect. In fact, most cases of blood doping involve EPO administration rather than RBC reinfusion.

Athletes in events that depend primarily on strength and power need to develop a high level of muscle mass. Anabolic steroids like testosterone have been used for decades to build muscle. This works since testosterone promotes protein synthesis, the key step in muscle hypertrophy. Growth hormone (GH) is another natural hormone that, as its name suggests, promotes muscle growth. Both testosterone and GH can be injected to enhance the response to resistance training. Hormone precursors such as androstenedione or “andro,” which was famously used by the baseball player Mark McGuire when he broke the single season home run record, can also be used to achieve the same effect.

Knowing that the penalties for sports doping can be severe, why would an athlete take the risk and use performance-enhancing drugs? Athletes train year-round, usually for decades, to compete on an elite level. After this much training, additional gains in strength, speed, and endurance can be difficult to achieve. Considering that in most elite-level competition the difference between winning and losing can be as small as a few seconds or inches, depending on the event. Some athletes feel that the only way to gain an edge over the competition is to use performance-enhancing drugs.

Athletic competitions like the Olympics are a celebration of human strength, power, endurance, and skill. Hopefully, cases of sports doping in the news won’t overshadow the incredible accomplishments of so many athletes who succeed because of their talent, training, and dedication. We should be inspired, not made suspicious, by their performance.


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