Why exercise should be your first “step”in improving your health

If you are thinking about losing weight, becoming more active, or quitting smoking you are not alone. These are three of the most common health-related New Year’s resolutions. Considering that two-thirds of American adults are overweight, about half don’t meet minimum recommendations for physical activity, and one in five smoke, there are many people who need to change more than one of these behaviors.

Quitting smoking and changing eating and exercise habits to lose weight or improve fitness are among the most difficult behavior changes to make, especially at the same time. Some people focus on one change to begin with. Obviously, changing all three of these behaviors is ideal, but if you are only willing to change one, which should you take on first to have the biggest impact on your overall health?

You might think that quitting smoking would be the most important change to make initially. Smoking is the primary cause of lung cancer and other respiratory diseases such as emphysema and chronic bronchitis. Smoking also increases the risk of most other cancers and is a major contributor to heart attacks and strokes. Quitting smoking greatly reduces these risks with beneficial changes that begin within days of quitting. Despite this, if you only want to change one behavior, smoking isn’t the place to start.

Being overweight is a leading cause of diabetes, high blood pressure, heart disease, and some cancers. If you are overweight, losing just 10% of your body weight (20 lbs. for a 200 lb. person) can significantly reduce the severity of these conditions. Maintaining a healthy body weight can prevent many of these health problems. However, losing weight is not the first change you should make.

I believe that becoming physically active is the most important change you can make to improve your overall health. Decades of research shows that regular physical activity reduces the risk of most chronic diseases including diabetes, heart disease, and some cancers and can extend the lifespan by up to five years. In fact, the health risks of inactivity are equal to or greater than that of obesity or smoking.  Regular activity also improves muscular strength, aerobic fitness, bone density, cognitive function, and memory. There is no other single intervention—drugs included—that has as many health benefits.

Research also shows that the negative health effects of being overweight and obesity are, in part, caused by inactivity and poor fitness. Your risk of death is lower if you are overweight but physically fit than if you are at a “healthy” weight but unfit. Regular exercise can reduce the risk of diabetes in people who are overweight, whether they lose weight or not. Furthermore, studies of “successful losers” shows that daily exercise is a requirement for long-term weight loss, so becoming active now can help you lose weight later.

You should change all three of these behaviors to achieve optimal health. But if you are looking for an initial step that will have the biggest impact, start by becoming more active. A good initial goal is to reduce the time you spend being sedentary (sitting) and to get a minimum of 30 minutes of moderate-intensity activity such as brisk walking each day. You can get greater benefits by participating in more intense exercise, including strength training, three or more days per week. And once you have established a routine of regular activity you will be ready to make other health changes.


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Santa’s exercise plan for functional fitness and health

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. This is the topic of my Health & Fitness column in the Aiken Standard this week.

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 activity can “undo” some of the negative effects of obesity and 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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Too fat to fly! Weight loss tips from the North Pole.

There is a problem at the North Pole! Santa’s reindeer are unable fly, putting his Christmas plans in jeopardy. It turns out that the reindeer are suffering from a common problem, one that you might be dealing with, too. Fortunately, Santa has a solution that can help his reindeer and save Christmas. This is the topic of my Health & Fitness column in the Aiken Standard this week.

toofattofly


According to the children’s book Too Fat to Fly by Doreen Belleville, Santa’s reindeer have gained weight in the “off season.” Too much sitting around and too many snacks and treats have resulted in weight gain to the point where the reindeer simply can’t do their job. Sound familiar? Whether it comes during the holidays or gradually throughout the year, weight gain is common for many people. And, like the reindeer, it often goes unnoticed until it is too late—trying to fit into your old suit or favorite dress, for example.

It’s not just the weight that is the problem. The long, lazy vacation has allowed the reindeer to become unfit. They simply aren’t strong enough and don’t have the endurance to pull Santa’s sleigh. Again, a decline in fitness over time is something many of us experience and we may not notice it until we do something strenuous that makes it clear we are out of shape.

In the book we learn that the solution is both simple and well-known. Santa charges his elves with getting the reindeer back in shape, in terms of both fitness and fatness. The snacks are replaced with healthy meals containing lots of fruits and vegetables. And days spent lying around are now spent in the gym and going for walks outdoors.

Like many of us, the reindeer have a tough time adjusting to their new exercise routine. The treadmills are tricky for them, until they get the hang of it. For many of us, exercise equipment and new types of exercise can be intimidating. But with some guidance from the elves (or a personal trainer) you may find that trying new forms of exercise can really help you, just like it did for the reindeer.

The reindeer followed a diet that emphasized fruits and vegetables. Despite the controversy over which diet is the best, almost everyone agrees that more fruits and vegetables and fewer calories from added sugars will help you lose weight. These foods are lower in calories than many other options, contain fiber to help you feel full, and replace less healthy foods you might otherwise pick. Carrots and apples, what the elves picked for the reindeer, are excellent choices, but pretty much any fruits and vegetables will work. Of course, you should eat other foods in moderation, too, including whole grains, meat, and dairy.

The good news is that the diet and exercise program helped the reindeer lose weight and get back in shape in time for Christmas can work for you, too. While you may not see such rapid results, if you are careful with what you eat and dedicate time every day for exercise, you can lose weight relatively quickly. It’s not easy for people or for reindeer, but weight loss and improved fitness are achievable.

Looking forward, continuing to eat a healthy diet and exercising regularly can save you the trouble of trying to lose weight next year at this time. It is always easier to maintain weight and stay fit than it is to lose weight and get back in shape. I’m sure that’s a lesson Santa will teach his reindeer!


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The one thing

One of the courses I teach at USC Aiken is Health & Behavior Change. In it, we identify the major factors that contribute to chronic diseases and discuss how to modify these risk factors to improve health. Throughout the course, the emphasis is on health behaviors and how to change them for the better.

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For example, smoking is among the most difficult health-related behaviors to change. Obviously, there is the addictive nature of nicotine that makes smoking cessation challenging. Beyond the drug effect, smoking also has a behavioral component. This includes what a smoker does first thing in the morning, after a meal, or on a work break as well as the act of holding a cigarette in his or her hand. Add to that the social aspects of smoking, including the influence of friends and family members, and it is easy to understand why it is a difficult habit to break.

This same principle applies to other health behaviors, including eating and activity. Like smoking, what we eat and our activity level are complex behaviors that are difficult to change. Because of this, losing weight can be as difficult as quitting smoking for similar biological and behavioral reasons. We think of weight loss as being about a diet or exercise program, but it’s really about changing behaviors and habits.

This is a difficult concept to teach, so I have my students learn through experience. Since almost all of my students are non-smokers and most are active and at a healthy body weight, I have them complete a project in which they change some other behavior. They are responsible for identifying a behavior that has a negative effect on their life, coming up with a plan to change it, and embarking on a four-week behavior change experience. Common topics for my students include getting more sleep, packing a lunch to avoid eating out, and dedicating more time to studying.

One student wanted to change her social media habits. As a compulsive social media user, she spent more hours than she realized checking, posting, and commenting on Facebook, Twitter, Instagram, and others. Her goal was to limit her social media time so that it didn’t interfere with classes or studying. One of the steps she took was to turn off the notifications that alerted her to new activity. This was helpful, but she still found the habit of checking her phone hard to break.

In a conversation, she noted that the one thing that would help more than anything else would be to switch her phone off during the day. This way she would have her phone if she needed it, but it wouldn’t be so easy, or tempting, to use it. Despite knowing the most effective strategy—the one thing—that would help her, she never did it.

I thought this was an excellent example of something that is common in making health behavior changes. In many cases, people probably know the one thing they need to do to be successful but for a host of reasons, they don’t do it. This may lead people to make other changes that aren’t nearly as helpful. While even the smallest behavior modifications can help, successfully losing weight or quitting smoking really does require making big changes.

This goes a long way in explaining why quitting smoking, losing weight, and changing eating and activity behaviors can be so difficult, even when people know what they need to do. There is no easy solution for this problem, but finding someone to hold you accountable for making the necessary changes and sticking to them is a good start.


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Maintain, don’t gain, this holiday season.

Now that Thanksgiving has passed the holiday season is in full swing. In addition to spending time with family and friends, the big events of the season involve shopping and eating. The bad news is that this will almost certainly result in big numbers on your credit card bill and on your bathroom scale. 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. This is the topic of my Health & Fitness column in the Aiken Standard this week.

christmas-cookies


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.
  2. 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.
  3. 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.
  4. 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.
  5. 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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A Thanksgiving dinner that is good and good for you.

This is Thanksgiving week, and people throughout the country are planning a feast that includes traditional dishes and family favorites. Even though many of these are not the healthiest choices, they make an appearance on the table each year. For many, Thanksgiving dinner is a day marked by overindulgence and  poor nutrition choices.

In an effort to make Thanksgiving dinner healthier, recommendations for modifying or replacing traditional dishes are a common theme in magazines, on the morning TV shows, and on the web. While these suggestions are meant to be helpful, I’m not sure they actually serve to make a significant impact on health. In fact, the foods we eat and the way we eat them may be the healthiest part of a traditional Thanksgiving dinner. This is the topic of my Health & Fitness column in the Aiken Standard this week.


thanksgiving-dinner

After all, Thanksgiving is one day, and if there was ever a day to give yourself license to indulge, this is it! Of course, trying new foods and cooking techniques is always good, but the impact of replacing the butter in your mashed potatoes with fat-free sour cream or taking the marshmallow topping off Granny’s famous sweet potato dish for one day isn’t realistically going to make you any healthier in the long run.

The truth is that if you eat a healthy diet every day, or even most days, and you have an active lifestyle you can get away with a day—or weekend—of overeating. (Obviously, you should always follow dietary restrictions for any medical conditions you have.) The problem comes when Thanksgiving dinner is yet another unhealthy meal in addition to the others that week or month.

Some of these recommendations are worth trying, for sure. Making an alternative to a traditional dish can get your family to try new foods they might not otherwise consider. And cooking using different ingredients or techniques on Thanksgiving can give you ideas for other meals, too.

However, focusing on modifying your Thanksgiving dinner may distract you from appreciating the greatest potential health benefit of this meal. Given the current confusion about how much and what type of carbohydrates and fats we should eat, there is an increased push to get us to eat less processed food and more real food.

For many of us, Thanksgiving dinner is one of the only times we cook and eat real food. A real turkey, vegetables, and home-made dessert are a huge improvement over the processed foods most of us eat on a daily basis. While we eat turkey at other times, it is almost always in a processed form such as ground turkey or deli meat, which frequently includes other additives. Cooking and eating a whole turkey is, for most families, relatively rare. So is eating a meal that doesn’t come from a restaurant or isn’t heated in a microwave.

Additionally, Thanksgiving dinner is shared simultaneously around a common table (and maybe a kids’ table, too). All too often, meals are consumed away from the family table, frequently at different times. The benefits of eating together as a family are well-known, and can have a positive impact on nutrition, psychological well-being, and health in general. Maybe Thanksgiving dinner isn’t about the food as much as it is the company. Why not make this a habit at other meals?

This week, let’s all give thanks for family, friends, and a shared meal. Let’s also take a lesson from the day and try to prepare and eat more real food as a family. This may be the best part of Thanksgiving. That, and a second serving of pumpkin pie!


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Tomorrow is Healthy Lunch Day. Here’s why it matters and why you should do it every day.

Tomorrow is National Healthy Lunch Day, an event promoted by the American Diabetes Association to raise awareness about the need to make healthy choices at lunchtime. We all know that eating breakfast is an important way to start the day. What we may not appreciate is the role a good lunch plays in promoting good health, from helping with weight control to managing diabetes. A healthy lunch can also affect your focus and attention, helping your performance at work or school.


lunch

A healthy lunch is important for treating and preventing many health problems. Diabetes is a perfect example. Perhaps the most important aspect of managing diabetes is to control blood glucose levels throughout the day. Obviously, eating a meal will raise blood glucose. But eating a meal that is relatively low in carbohydrates, especially sugar [https://drbrianparr.wordpress.com/2016/02/29/sugar-and-your-health/], can provide energy without contributing to a spike in blood glucose. The glycemic index (GI) is a useful tool for selecting foods that have a lower impact on blood glucose. Keep in mind that the amount of carbohydrates you eat is important, too, so focusing only on GI isn’t enough. This is especially important for diabetics who take medications, including insulin, to help manage their diabetes.

The idea that eating lunch promotes weight loss sounds counterintuitive, but it works! Skipping a meal can lead to stronger feelings of hunger later in the day. And if you are hungrier you will likely eat more. So, an appropriate midday meal can help you eat less later in the day. Combined with regular exercise, eating appropriate meals and snacks is an essential aspect of weight loss and weight control.

Eating lunch provides energy and reduces hunger at a time when your breakfast is likely “wearing off.” This may help you feel more energetic and can enhance your attention, focus, and productivity. Of course, what you eat for lunch is as important as when you eat. Lots of sugar can make you feel sluggish, both physically and mentally. Unfortunately, added sugar is a big part of many restaurant meals and convenience foods, so the afternoon slump is a reality for many of us. Limiting sugar in both food and drinks can help you make healthier choices at lunch that can make you feel and work better in the afternoon.

“That afternoon slump you feel may be due to what you ate for lunch.”

A good lunch is especially important for children. In addition to providing energy to support growth and learning, lunch also presents an opportunity to teach children about healthy eating. This is critical since formal nutrition education isn’t part of the curriculum at most schools. Sadly, most school lunch programs provide meals that include too much added sugar and refined carbohydrates, inappropriate for growing and learning kids.

Many adults don’t fare much better with their lunch. For a lot of people, the two key criteria for lunch are that it is quick and convenient. And as we know, quick and convenient foods are rarely considered healthy, so this requires some effort to plan ahead and make careful choices.

What makes a healthy lunch? Pretty much the same recommendations for other meals also apply for lunch: low in added sugar and refined carbohydrates and high in fiber. Your lunch should include vegetables, fruit, whole grains, and protein, all of which are foods that can make you feel full longer. In the end, the effort and planning pay off by making you a healthier you!


Nutrition, exercise, and health information can be confusing. 
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