Category Archives: Health & Fitness

What does it mean? A health and fitness vocabulary lesson.

When I write about health I routinely use terms like exercise, activity, and fitness. Some people have asked why I use these different words since they all have a similar meaning. That is an excellent question, since these terms are related they have different applications for health and wellness. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Exercise sign


Physical activity (PA) is defined as any movement produced by muscles that expends energy. Physical activity can be classified as occupational, what you do at work, and leisure-time, what you do in your free time. Occupational PA can vary greatly depending on the job, but it is low for most of us who spend much of our work day sitting. Leisure-time PA is all activity outside of work. This is of great interest to researchers since it reflects how we chose to spend our discretionary time. Physical activity can be measured by questionnaires or using devices such as pedometers, which count the steps you take, or accelerometers, which measure how much you move.

Exercise is a type of physical activity that involves planned, structured, and repetitive movement to improve or maintain physical fitness. Physical fitness, then, is a set of attributes that relate to the ability to perform physical activity and exercise. The components of physical fitness include endurance, strength, and flexibility. Basically, participation in physical activity and exercise improves your fitness and the greater your fitness, the better able you are to participate in physical activity. This is true for completing occupational tasks as well as traditional exercise, such as jogging or lifting weights.

The good news is that both physical activity and exercise have health and fitness benefits. Physical activity can vary in intensity, from light (slow walking), moderate (brisk walking), or vigorous (exercise like running). The 2008 U.S. Physical Activity Guidelines recommend that, at a minimum, all adults participate in moderate-intensity physical activity for 2 hours and 30 minutes per week or vigorous activity for 1 hour and 15 minutes per week along with strengthening exercises at least 2 days per week. You can meet this recommendation by going for a brisk walk for 30 minutes on 5 days per week or running for 25 minutes on 2 days per week or some combination of the two. Additional benefits come from doing more, either higher intensity or longer duration activity.

Vigorous exercise is the best way to improve fitness while moderate-intensity activity is strongly linked to health benefits. Fitness benefits result from adaptations in the heart and muscles, which get stronger and become better able to resist fatigue. These changes also lead to health benefits including lower blood pressure, cholesterol, and glucose as well as helping with weight loss and weight control.

Research suggests that health and fitness benefits also result from light-intensity or intermittent activity, especially if it replaces sitting. At home or at work, the more time you spend sitting, the poorer your health, even if you exercise every day. One study shows that getting off the couch and stepping in place during TV commercials results in nearly 25 minutes of activity per hour and burns about 150 calories, compared to 80 calories just sitting the entire time. You won’t get in great shape doing this, but it will increase your overall activity.

With this is mind, a good recommendation is to reduce sitting time in favor of light activity—stand while you read the paper or walk around while you talk on the phone—and participate in moderate or vigorous activity each day by going for a brisk walk or doing other exercises, including strength training.


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Despite appearances, Santa is probably fit and healthy (thank goodness)!

Since Christmas is only a few days away our attention is naturally focused on one person: Santa Claus. Have you ever wondered how Santa gets in shape for his yearly sleigh ride to deliver gifts to good boys and girls around the globe? Like many elite athletes, Santa does not publicly discuss his training or his fitness. There are certainly no published studies that report his one repetition maximum strength or his maximal oxygen uptake. Given this lack of information, I attempted to make an educated guess about Santa’s training, fitness, and health in my Health & Fitness column in the Aiken Standard, something I do at this time each year.

santa


By all accounts, Santa is overweight. While we don’t know his body mass index, he would probably be considered obese. Furthermore, he appears to have a large waist circumference, indicating a high level of visceral fat. This suggests that Santa is a high risk for type 2 diabetes, high blood pressure, and heart disease. This combination can lead to a heart attack and, possibly, death at a relatively young age.

But Santa has avoided this fate, and seems to be living a healthy life. His secret, no doubt, is regular exercise. There is good evidence that maintaining a high level of physical fitness can reduce the risk of death in people who are obese (and everyone else). Like many athletes, Santa trains in the “offseason” to get ready for his annual Christmas Eve journey.

Santa’s training likely includes endurance, strength, and flexibility exercises. In order to visit every home around the world in one night, Santa moves quickly. This suggests that he has a high maximal aerobic capacity as well as good endurance. This is a result of both high-intensity interval training and long-duration, lower intensity training, similar to what a marathon runner might do. Evidence for his good aerobic fitness is shown by the fact that he flies away from each home with a hearty “ho, ho, ho.” If he were out of shape, he would be too short of breath to speak, much less give such a robust farewell.

Santa must also dedicate training time to improving his strength. His sack of gifts is certainly very heavy and he repeatedly carries it up and down chimneys. In addition to traditional weight lifting, Santa probably also engages in plyometric training, which involves explosive movements that develop muscle power. Santa must also have good flexibility in order to squeeze through narrow spaces and move quickly without pulling a muscle. This is the result of stretching and, likely, other exercises such as yoga.

Santa is also educated about sports nutrition. The cookies and milk you leave for him are more than a reward for delivering gifts at your house. The carbohydrates (sugar) in the cookies help Santa maintain his blood glucose to delay muscle fatigue. Some research suggests that combining carbohydrates with protein is even more effective, so the glass of milk is a good addition. Of course, Santa could have a specialized sports drink, but that doesn’t make for such a good story.

We can learn an important health lesson from Santa. Even though he is overweight, through regular exercise, Santa has reduced his risk of health problems and maintained his fitness at a level that allows him to complete his necessary activities. Like Santa, all of us can benefit from being physically active, whether we are overweight or not. He would likely be healthier and be able to perform his job better if he lost weight, but I’m not about to tell Santa what to do!

 


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Your Health & Fitness holiday gift guide: What you should really give your friends and family this year.

You probably have a friend or family member who is planning to start an exercise program, try to lose weight, or otherwise improve their health in the upcoming year. The right gift from you could help them get a good start on their New Year’s resolutions. With so many options for books, DVDs, exercise equipment, apps, and other gadgets, it can be difficult to pick the right gift. No worries, the Health & Fitness holiday gift guide is here to help you select something that will really help. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Holiday shopping


Most gift guides for health and fitness include things that people might need to get started and succeed on a weight loss or exercise program. Activity trackers are popular for monitoring exercise and providing motivation. Many runners use GPS devices or apps to record and share their runs. A host of websites and mobile apps provide nutrition analysis of meals to help with meeting training goals or weight loss. Almost all of these allow sharing with others over social media networks to foster a group dynamic, providing support, and even a little healthy competition.

All of these apps and devices can be helpful to someone starting a health improvement project and make great gifts. But an even better gift is something that really will help your friends and family members be successful. Here are the Health & Fitness holiday gift ideas:

Time. The most common reason that people quit an exercise program or struggle with weight loss is because of time. That includes time to exercise, obviously. But it also includes time to plan, shop for, and prepare healthy meals and snacks. This year, give the gift of time. Commit to helping your friend or family member plan time to focus on their program and dedicate yourself to taking on some responsibilities to help them do that. 

Help. In addition to helping find time, you should commit to actually doing things to facilitate your friend or family member’s health improvement program. Taking on chores and projects around the house, picking up the kids after school, and helping with shopping and cooking are examples of things you can do.

Support. Anyone who makes a major lifestyle change needs the support of others to be successful. Your role can be to provide encouragement, ask about progress, and take your friend’s program into account when planning meals and other activities together. You should also be ready to provide a gentle (or not-so-gentle) nudge when you see them getting off track.

A buddy. People who take on an exercise program with others are more likely to stick with it and be successful. So get involved with your friend or family member. Going for a walk together during a break at work or developing a healthy eating plan as a family is an excellent way to play along. Chances are, these healthy changes will benefit you, too.

These gifts may not have the wow factor of a shiny exercise gadget, but they are the things that will really help your friends and family members be successful. And that’s the best kind of gift to give. After all, no one ever quit an exercise program or failed at losing weight because they didn’t have the right nutrition app or the latest activity tracker. The real reason people struggle is because of factors like time and support from family and friends in the real, not virtual, world.


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Just in time…tips to prevent holiday weight gain.

Thanksgiving is this week which means the holiday season is upon us. It is a time for spending time with family and friends, shopping, and eating. The bad news is that weight gain between Thanksgiving and the new year is a very real possibility. The good news is that the typical holiday weight gain is less than you might think. The even better news is that this weight gain can be prevented.


First, the bad news. Research shows that, on average, people gain about one pound during the holidays. Even subjects who said they were trying to lose weight over the holidays ended up gaining about 0.5 pounds on average. The problem is that this extra weight is not lost during the spring or summer, meaning that holiday weight gain is a major contributor to the gradual increase in weight, about one pound per year, most people experience over time.

Now for the good news: The weight gain that typically occurs during the holidays can be prevented. Since people tend to gain less than one pound, even small modifications to activity or diet can make a difference. Here are some strategies:

  1. Stay active. The average holiday weight gain could be prevented by walking about one mile, or about 20 minutes, per day. Since time may be a factor, you can turn a shopping trip into a chance to be active by taking an extra lap around the mall or parking further away in the parking lot. Go for a walk before or after a family meal or party—and take your family and friends with you.
  1. Stay away from the food. Most holiday parties include lots of food, and usually not the healthiest choices. You can reduce the amount you eat by limiting your time near the food—literally, fill your plate and move away from the food. Using a smaller plate will reduce the amount of food you take, too. Getting rid of the candy dish on your desk at work or the plate of treats on the countertop at home are also smart ideas.
  1. Don’t drink your calories. Alcoholic beverages, soda, and juice all contain calories and can add up to a big part of your total calorie intake. For example, egg nog can contain over 300 calories per glass. This doesn’t mean you can’t enjoy your favorite drinks, but enjoy them in moderation.
  1. Plan ahead. If you are trying to watch what you eat, have a healthy snack before you go to a party. You will feel less hungry so you will probably be less inclined to eat as much. If you are bringing a dish to the party, make it something healthy that you like.
  1. Focus on family and friends, not food. The holidays are a time to enjoy special meals and events with family and friends, and that should be your focus. You should enjoy your favorite foods and drinks, just do it in moderation.

You can prevent holiday weight gain by watching what you eat and staying active. It is easier to keep the weight off than it is to lose it later, so a little extra effort now is worth it in the long run. Considering that many people plan to exercise and lose weight after the holidays, you could get a jump start on your New Year’s resolutions along with making this a happy and healthy holiday season.


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Diabetes 101: What you need to know

Diabetes is among the fastest-growing health conditions in the United States. Nearly 30 million adults have diabetes, with nearly 2 million new cases each year. If you include prediabetes, which tends to lead to diabetes if untreated, over 115 million Americans are affected. Fortunately, most cases of diabetes can be treated or prevented through healthy eating, weight control, and regular exercise.

Since November is American Diabetes Month, this seems like a good time to raise awareness about the prevention, treatment, and consequences of this serious medical condition.  If you want to learn more about diabetes, a great place to start is American Diabetes Association. This is also the topic of my Health & Fitness column in the Aiken Standard this week.

diabetes


Diabetes mellitus is a metabolic disorder characterized by high blood glucose (sugar) caused by a lack of insulin production or impaired insulin action. The lack of insulin production can be caused by an autoimmune disorder that damages the pancreas. This typically occurs during childhood, as in type 1 or “juvenile” diabetes, but it can occur in adults, a condition called latent autoimmune diabetes of adulthood (LADA). For both types, injected insulin is required to control blood glucose.

More commonly, diabetes is caused by the body’s cells not responding to the insulin that is produced, a condition called insulin resistance. This is called type 2 diabetes and is thought to be caused by some combination of obesity, particularly excess abdominal fat, and physical inactivity.

Diabetes can be diagnosed based on a fasting blood glucose test, taken 8–12 hours after a meal, usually in the morning. Another test is an oral glucose tolerance test in which blood glucose is measured for two hours after drinking a special beverage containing glucose. This measures the body’s response to glucose. The hemoglobin A1C test is a long-term measure of blood glucose control. This is important because the higher the hemoglobin A1C level, the greater the risk of diabetes complications.

For most diabetics, the main treatment goal is to control blood glucose level to prevent serious complications including nerve damage, blindness, infection and amputation, heart attack, and stroke. This is typically accomplished through a combination of diet, exercise, and medications, with varying degrees of success. But “curing” diabetes is rare, so most patients require continued treatment.

Exercise is important for blood glucose control because exercise causes an increase in the uptake of glucose into cells and can improve glucose tolerance and insulin sensitivity. In addition, exercise has the added benefits of promoting weight loss and improving strength and fitness. Both aerobic and strength training are recommended, with a minimum goal of 30 minutes per day, every day.

Meal planning involves selecting healthy foods to help maintain consistent blood glucose levels while meeting energy needs for exercise and other activities. The dietary recommendations for preventing and treating diabetes are almost identical to the general recommendations for good health: Emphasize whole grains, fruits, vegetables, legumes, and low-fat meat and dairy and reduce unhealthy fats, added sugars, and salt. The diet should also promote weight loss and weight maintenance, especially for overweight patients. The glycemic index (GI), a measure of how much a food raises blood glucose, can be helpful in dietary planning, but it is not the only meal planning tool that should be used.

Proper diet, blood glucose testing, medication use, and regular exercise can improve blood glucose control, reduce the risk of other health problems, and improve quality of life in diabetics. In those with prediabetes these efforts can delay the progression to diabetes and may even result in a return to normal blood glucose. In fact, diet and exercise have been shown to be more effective than medications in preventing diabetes. Plus, these lifestyle changes lead to weight loss and improved fitness, benefits that no medication can match.


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The truth about restaurant salads

If you are looking for a healthy option for lunch or dinner at a restaurant, especially if you are trying to lose weight, chances are you will consider a salad. It turns out that at most fast-food and casual dining restaurants, salads may not be the low-calorie or low-fat choice you were expecting. However, ordering a salad can still be a healthy option, as I explain in my Health & Fitness column in the Aiken Standard this week.

Big salad


We think of salads as being a healthy choice because they contain lots of vegetables which are low in calories and high in vitamins, minerals, and fiber. But most restaurant salads are more than just vegetables. At a minimum, you would add salad dressing and many salads also include nuts, fruit, chicken, bacon, or cheese, all of which add fat and calories.

Salad dressing alone can add hundreds of calories. Creamy dressings like ranch and blue cheese tend to be higher in both calories and fat than vinaigrettes. In many cases the salad has more calories than the sandwich or entree you would have ordered instead.

As an example, consider the Premium Bacon Ranch Salad with Crispy Chicken at McDonald’s. This popular salad contains 490 calories and 29 grams of fat. Compared to a Big Mac, which has 540 calories and 29 grams of fat, this salad doesn’t seem like such a healthy option. You could improve the salad by switching from fried chicken to grilled chicken and save 180 calories and 15 grams of fat.

The real problem is the ranch dressing—one packet contains 200 calories and 17 grams of fat. You could skip the dressing altogether, but a more reasonable approach is to switch to the Low-Fat Balsamic Vinaigrette, with only 35 calories and 1.5 grams of fat. Want to really cut calories? The salad with the vinaigrette dressing and no chicken has only 230 calories, almost 300 fewer than the version with crispy chicken with ranch dressing or the Big Mac!

Despite the fact that many restaurant salads have calorie and fat content similar to burgers and other entrees, it doesn’t make them a bad choice. The salad does contain several cups of vegetables, which means it is higher in vitamins, minerals, and fiber than a burger. The salads at McDonalds have about twice as much fiber as most sandwiches.

Think of it this way: the salad may be equivalent to a burger as far as fat and calories go, but it comes with a serving (or more) of vegetables. And the salad is even healthier when you consider that the sandwich would undoubtedly come with fries! One more point: I use McDonald’s as an example here, but the same holds true for salads at other fast food and casual dining chain restaurants.

What if you are at a restaurant and want to order a salad? What can you do to make it healthier? You could order a side salad. Given the huge portions at most restaurants, this smaller serving might be enough. You can also limit the toppings, especially meat and cheese, and choose a lower-calorie dressing. Another tried and true option is to ask for the dressing on the side so you can add just as much as you want. And don’t forget, you can always share one of the large salads with a friend or save half for another meal.

The bottom line is that salads at restaurants can be as high in calories and fat as other “unhealthy” menu items, but they do provide a serving of vegetables you might otherwise miss. And by making a few choices, you can create a salad that is a healthy, low-calorie option.


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Are the additives in your food safe?

Making healthier food choices is something that you should be thinking about every day. Since November 4 is National Eating Healthy Day, this seems like a good opportunity to revisit some advice to help you make smart decisions. Eating more fruits and vegetables, limiting added sugar, and focusing on “real food” instead of processed, prepackaged meals and snacks are always good ideas. One reason for this is to avoid food additives, some of which may be harmful.

food additives


If you have ever read the ingredients on a food package you no doubt realized that much of what we eat isn’t really food. Chemical additives are common in packaged foods as preservatives, coloring agents, flavor enhancers, and even vitamins and minerals. This isn’t necessarily a bad thing, since these chemicals allow food to last longer, look and taste more appealing, and provide essential nutrients. The assumption is that these additives have been tested and proven safe for us to consume. Unfortunately, that is not the case for many commonly used additives.

This may be surprising, but it isn’t new. In the late 1950s Congress required that new food additives must be proven safe before they could be used. That raised the question of what to do with additives that were already widely in use. Since people had been eating these additives with no apparent ill effects the decision was made to classify them as safe, and the “generally recognized as safe” (GRAS) list was created.

Now additives may be approved as GRAS by an expert panel without rigorous testing and FDA approval. One study found that in every case these reviewers worked directly for or had financial ties to the companies that manufactured the additives. This raises serious questions about the process and whether or not the chemicals added to our foods really are safe.

So, are the additives in our food safe? There is no good answer to that question, mostly because the safety studies haven’t been done. However, it is rare that a food additive is removed from the market for health reasons. Most research showing that a food additive may be unhealthy is conducted in animals. These studies often test amounts that are far higher than people would reasonably consume, so they may not predict the health effects in humans. And some additives, such as iron added to cereal or vitamin D added to milk, for example, are widely thought to be beneficial.

To be sure, there are some chemicals in our food that we should avoid, but it isn’t fair to say that all food additives are bad. Even so, eating foods that are free from additives is probably a good idea. Even though each individual additives may not be hazardous, it is possible that exposure to small amounts of several of these chemicals could be dangerous.

Much of our exposure to food additives comes in the form of processed, prepackaged foods, including many restaurant meals. Getting back to basics and cooking using “real” food— fresh fruits, vegetables, and meats—is one way to avoid processed foods. Reading food labels can help, too. Look for ingredients that you recognize as food and avoid additives that clearly aren’t.

Avoiding all food additives is almost impossible. Even foods that don’t come in packages, such as fruits and vegetables, may contain coatings that prevent damage or preserve freshness. Even canned fruits and vegetables will likely have added salt or sugar, so even apparently healthy foods can contain additives. The best way to limit them is to select as many fresh foods as possible and make an effort to check labels for additives.


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Forget about the ghosts and zombies at your door. Watch out for candy dressed up as healthy food on your breakfast table!

Boo! Since Halloween is this weekend, it’s a good time to think about what makes this holiday so scary. It’s not the ghosts or zombies that come to your door in the evening that you should be scared of, though. In fact, you don’t even need to wait until dark to get spooked. You are likely to see the scariest costumes on your breakfast table on Halloween morning—candy and soda dressed up as healthy food!

candy corn


Here are three of the most common frightening “costumes”:

Frozen yogurt dressed up as healthy yogurt

Most people would consider yogurt to be a healthy breakfast. And it is, provided you aren’t getting tricked! Low-fat and fat-free flavored yogurt is almost always sweetened with sugar. This is true for the yogurt tubes that kids love and much of the Greek yogurt that is so popular. Sure, it contains protein and beneficial bacteria, but the added sugar makes it equivalent to frozen yogurt or ice cream in terms of calories and sugar . Some of these yogurts even come with toppings, like bits of chocolate, just like fro-yo! A healthier alternative is plain yogurt with real fruit. Sure, it’s not as sweet, but you will be getting the benefits of eating yogurt without all the added sugar.

Soda dressed up as fruit juice

Many “fruit” drinks contain less than 5% juice but plenty of added sugar, so they are essentially soda without bubbles. For example, the orange drinks like Hi-C or Sunny D are a popular substitute for orange juice, but they are far from a nutritional equivalent. The same is true for other drinks, including juice boxes and pouches, which are commonly part of breakfast, lunch, or snacks. Even scarier is the fact that these drinks are much sweeter than real fruit. Children may develop an expectation that oranges or orange juice should taste as sweet as soda and prefer the sugar-sweetened version over the real fruit. A better choice is to make real fruit and fruit juice, not soda disguised as juice, a part of meals and snacks

Candy bars and cookies dressed up as cereal and breakfast bars

Many popular breakfast foods targeted at children include sugar-sweetened cereals, pastries, and bars. Some breakfast bars and cereals that seem healthy are really candy bars in disguise. Some even skip the disguise and actually look like candy or dessert. Pop Tarts and some granola bars are covered in chocolate or frosting, and favorite cereals often contain marshmallows or are shaped like cookies. No surprise that these foods are as high in calories and sugar as cookies or some candy bars. Worse, a child who is used to breakfast or snack foods that taste like candy or cookies may resist real food when it is offered. Now that’s scary!

While the focus here is on food for kids, it really isn’t much different for adults. Breakfast foods like donuts and pastries are almost always topped with icing and it would be difficult to distinguish many muffins from cupcakes. For many people, coffee isn’t just coffee anymore, but a drink that contains as much sugar and as many calories as a milkshake, sometimes with whipped cream on top. What’s really scary is that this is how many people eat every day.

The good news is that you can make your breakfast healthier without too much effort. While there is much debate about what constitutes a healthy breakfast, there is agreement about what it doesn’t include—lots of added sugar! Look for cereals that are low in added sugars and high in fiber. Include real fruit, fruit juice, and milk (or soy milk) whenever possible. If you have time, eggs are an excellent source of protein and healthy fats. Yogurt is good, too, but watch out for added sugars in flavored yogurt. Whole grain toast or a bagel with peanut butter makes a good alternative to Pop Tarts or breakfast bars.

As a general rule, steer clear of foods that look like dessert. Frosting, marshmallows, chocolate chips, and sprinkles simply aren’t part of a healthy meal!

If you are worried about the big bags of candy that get brought home on Halloween night, keep this in mind.  While eating a lot of candy is never healthy, a typical Halloween candy binge lasts a few days, after which time the candy is gone or the kids are literally sick of eating it.  The long-term effects on your kid’s health (and teeth) can be offset by a good diet, regular activity, and diligent brushing and flossing. The same applies to you, too, if you find yourself digging into the big bowl of candy that is inevitably left over.

 


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Breaking the chain: What you can do to prevent a relapse in your diet or exercise program.

Making changes to diet and exercise habits for weight loss or to improve health and fitness are among the most difficult behavior modifications to make. Being able to change these behaviors now and in the future is a key to success. Since what we eat and our activity become habitual, many people have spent years developing bad habits, so it will take time and effort to change them.

Making lasting changes—think years, not weeks or months—means that these behaviors must be maintained, and success depends on much more than simply following a diet or exercise program. Perhaps the most important tool for promoting long-term behavior change is relapse prevention.

A lapse is a one-time or short-term “slip up” in making a behavior change. For example, a bad day or even a bad week following a diet is considered a lapse. A relapse is a lapse that is continued for so long that you have essentially gone back to your previous behaviors, what some might call “falling off the wagon.” Since getting back on is so difficult, your goal should be to stay on the wagon by preventing a lapse from becoming a relapse. This is the topic of my Health & Fitness column in the Aiken Standard this week.

breaking the chain


No one is perfect, so lapses will naturally occur. While we often think that lapses occur without warning, the reality is that these events are often the last link in a chain of behaviors. This is illustrated by Barbara, a participant in one of my weight loss programs.

After several weeks of success on her diet Barbara faced her first real challenge, attending a catered event after work. She was rushed in the morning getting her kids ready for school and she didn’t have time for her usual breakfast. She settled for a banana and coffee, but she was hungry by midmorning. She spent her lunch break running errands. Instead of grabbing something unhealthy to eat while she was out, she didn’t eat anything. After a busy afternoon, she was tired and hungry when it was time to go to the event. She made her way to the food table and filled a small plate with the healthiest options she could find. But she wound up standing near the food talking to friends, and she ended up filling her plate a few more times with the very things she meant to avoid at first, including desserts.

Barbara’s story is a perfect example of a lapse, both because it is so common and because it demonstrates the chain of events leading up to it. The lapse—overeating at the party—actually started much earlier in the day. Not having her normal, filling breakfast and skipping lunch meant that Barbara was unusually hungry when she arrived at the party. And standing near the food table made it easy for her to go back for seconds (and thirds). Barbara was able to identify the links in the chain that led to the lapse in her diet, allowing her to get back on track the next day and make efforts to break those links in the future.

Like Barbara, recognizing the steps that lead up to a lapse in your diet or exercise program can help you avoid a slip-up in the first place and prevent a lapse from becoming a relapse. In many ways, long-term success is as much about building confidence in your ability to handle difficult situations as it is the number on the scale or the time you spend in the gym.


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Take steps to reduce breast cancer risk. Literally.

Many local and national organizations are busy promoting breast cancer awareness, sharing information about the disease, raising money to support research, and celebrating survivors as a part of Breast Cancer Awareness month. This represents the most visible part of a year-round effort to educate about, screen for, and hopefully cure this devastating disease. Of course, these are all worthy goals that deserve our attention and support. What is often missing are the steps women—especially young women—can take to reduce their risk for, or even prevent, breast cancer. This is the topic of my Health & Fitness column in the Aiken Standard this week.

cancer exercise group


Approximately 1 in 8 women will develop breast cancer. The American Cancer Society estimates that around 300,000 new cases of breast cancer are diagnosed and nearly 40,000 women die from this disease each year. Breast cancer can occur in men, but these cases are rare, so the focus is rightfully on women.

Much attention is given to genetic factors that increase the risk of breast cancer. These include certain gene mutations, including BRCA1 and BRCA2, as well as family history. A woman who has a first-degree relative (mother, sister, or daughter) who has had breast cancer has nearly twice the risk of being diagnosed herself.

Considering that most women diagnosed with breast cancer have no family history, it is also important to try to reduce other modifiable risk factors. This involves making health behavior changes that are probably familiar to most people. Among these is regular exercise.

Regular activity and exercise can lower breast cancer risk by as much as 30%, according to a study of over 3,000 women. The intensity of the activity didn’t seem to matter, so participation in light activity such as housework and gardening was as effective as walking. What did matter was the amount of time spent being active. Women who reported even low amounts of activity showed a 6% reduction in breast cancer risk, but the greatest benefits were seen in women who were active for over 10 hours per week.

Women who exercise regularly also have a lower chance of recurrence of breast cancer. As many as 1 in 5 of breast cancer survivors experience a recurrence within 10 years. Even relatively low levels of exercise may reduce this risk, and women who do exercise have greater rates of survival. The amount of exercise needed to realize these benefits is equivalent to 45–60 minutes of brisk walking five days per week.

Exercise is effective for reducing breast cancer risk because it lowers levels of the hormone estrogen. This is important because estrogen is linked with the majority of breast cancers and is especially relevant for women with estrogen receptor-positive cancers.

Exercise can also reduce the risk of breast cancer by helping with weight control. Excess body fat increases levels of estrogen, resulting in a higher risk of breast cancer diagnosis and recurrence. Regular physical activity is essential for losing weight and keeping it off. Exercise can also help reduce the increased risk of breast cancer that comes with weight gain, something that is common as women get older.

Women who have been active their whole lives have the lowest risk of breast cancer, but it is never too late to start. Women who exercise also tend to handle breast cancer treatment better than women who aren’t active. In fact, post-cancer exercise programs are becoming more common as a way to help women recover from cancer treatment and prevent recurrence.

Other lifestyle changes that can reduce the risk of breast cancer include maintaining a healthy body weight, consuming alcohol in moderation, not smoking, and eating a diet rich in fruits and vegetables. The good news is that these changes will also help you reduce your risk of other cancers, cardiovascular disease, and most other chronic diseases, too.


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