Tag Archives: exercise

Despite the controversy, energy balance still matters.

The concept of energy balance has been in the news again this past week. Unfortunately, the media reports focused on controversial funding for a network of researchers, not on practical information that could help people with weight control. In my Health & Fitness column in the Aiken Standard this week I take the opportunity to explain what energy balance means and, despite the controversy, how it can help you achieve and maintain a healthy body weight.

walking weight loss


First, it is worth explaining what energy balance means. Basically, the energy balance model suggests that your body weight is determined by the balance between the number of calories you consume and the number of calories you expend each day. It is often illustrated as “calories in, calories out” and is the basis for the most basic weight loss advice: eat less and move more.

Now for the controversy. It was recently reported that the Global Energy Balance Network (GEBN), an organization aimed at promoting activity and health, received money from Coca-Cola, a company that promotes the consumption of sugar-sweetened beverages.  Furthermore, the obesity and exercise researchers at GEBN started focusing more on the lack of activity, instead of unhealthy food, as a major cause of obesity. Whether this is truly a real conflict of interest or simply a reality of funding a non-profit health organization remains to be seen.

It is important to note that this doesn’t mean that the efforts of GEBN scientists or the concept of energy balance in general should be dismissed. In fact, the energy balance model is a simple and effective way to explain how weight gain and weight loss occur. In fact, the only treatments we have for obesity focus on changing energy intake and energy expenditure. While some suggest that the “calories in, calories out” idea is too simplistic, it certainly helps people understand why they have gained weight and provides an intuitive guide to losing weight. This is most commonly expressed as “eat less, move more” and is the foundation of nearly every effective weight loss program.

For most researchers, practitioners, and people in general, the focus is typically on the “energy in” and “eat less” parts of the equation. Nearly all diets work by reducing the number of calories someone eats, even if they claim that you can eat as much as you want. Common recommendations to cut back on sugar or fat tend to lead to eating fewer calories, especially if those foods are replaced by fruits, vegetables, whole grains, and lean meats. Since we now know that eating fat won’t necessarily make you fat, the emphasis has shifted to sugar as a cause of weight gain. And sugar-sweetened beverages, including soda, are a major source of sugar for many people, especially children. So, most experts recommend consuming less soda, candy, and other sources of added sugar.

But there is another part of the energy balance model that can’t be ignored—energy expenditure. One goal of the GEBN is to emphasize the importance of activity in achieving energy balance and a healthy body weight. The focus on physical activity makes sense considering that the component of energy expenditure you can control is your activity level. This includes exercise, other occupational and leisure activity, and limiting sedentary (sitting) time, with a goal to be as active as possible throughout the day. The key is to achieve a balance between what you eat and drink and the energy you expend by being active.

The importance of exercise and energy expenditure for weight loss is shown by the members of the National Weight Control Registry, commonly called the “successful losers” because they have lost an average of over 50 lbs and kept it off for over five years. They lost weight by following a variety of diets and programs but nearly all continue to exercise regularly. This suggests that physical activity to promote “energy out” is at least as important as diet when it comes to maintaining weight loss.

In fact, if energy expenditure is high enough, a person could get away with eating almost anything he or she wants. In the 2008 Olympics, swimmer Michael Phelps famously revealed what he ate on a typically day. The amount and type of foods he consumed were not what you would expect from someone so fit and healthy! Without the hours of training he engaged in each day that diet would almost certainly have resulted in obesity and poor health.

Clearly, increasing physical activity is important both for weight control and health in general. But diet matters, too. And while the energy balance model says that there is nothing wrong with having your favorite foods or drinks as long as you are active, most of us could benefit from drinking less soda and moving a bit more. In this way, keeping yourself in energy balance should allow you to maintain a healthy weight without depriving yourself too much. The key is, and always has been, to find a balance between what you eat and drink and the energy you expend by being active.


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More about the benefits of outdoor exercise.

You probably know that exercise is good for you and that going for a daily walk is associated with improved health. A lower risk of weight gain, diabetes, heart disease, and some cancers are among a long list of positive health effects of physical activity. Lesser known benefits include improved mental health, cognitive function, and greater feelings of wellbeing.

What you may not know is that where you exercise matters and that exercise outdoors, especially in nature, can be particularly beneficial. This is not surprising given that being active in a natural environment has been shown to have an impact on mental health.

Indeed, activity outdoors leads to enhanced feelings of energy and diminished fatigue, anxiety, anger, and sadness compared to similar activity conducted indoors. Additionally, some research suggests that outdoor activity may improve attention in adults and children.

I have written about outdoor exercise in the past, but recent media reports on the topic make this a good time to share new research and revisit some the benefits of being active in nature. Which I do in my Health & Fitness column in the Aiken Standard.

jogger in woods


A couple of recent studies, widely reported by the media, highlight some additional benefits of simply going for a walk outdoors in nature as well a possible explanation as to why. In these studies, participants who went for a walk in a quiet, tree-lined area experienced greater improvement in mood—they felt happier—than those who walked along a busy street in an urban area. The researchers also completed brain scans to determine that the difference in mood was related to changes in blood flow in the brain. The finding that being active in a natural environment caused physiological changes that led to psychological benefits is exciting!

Another advantage of exercising outdoors is that you might get a better workout. This is mostly due to the fact that you will likely walk or run faster outdoors, but other factors like wind resistance add to your effort. Research shows that even though people tend to exercise at a higher intensity outside, they don’t necessarily feel it. In fact, ratings of effort are lower outdoors for the same exercise.

This because the pleasant visual stimuli outdoors distracts you from unpleasant sensations of effort during exercise. This is the same reason that listening to music makes exercise more enjoyable and why fitness centers have televisions on the walls or built into exercise equipment. Think of the outdoors as a really big TV screen!

Almost any indoor exercise can be moved outdoors. While walking, running, and cycling are most obvious, resistance training exercises using body weight and many high-intensity interval training workouts can be modified for outdoors. Yoga and aerobics classes in the park are also great ways to promote both the physical and psychological benefits of exercise.

Much of the psychological benefit of outdoor exercise occurs in the first five minutes, so even short bouts of activity are meaningful. It also means that going for a short walk outside when you have a break at work or walking instead of driving short distances can have positive effects. At home, taking the dog for a walk, playing outside with the kids, or doing yard work are good ways to be active and reap the benefits of being outdoors.

Every little bit of activity you do outdoors will have both physical and psychological benefits to help you become and feel healthier. So, get outside and go for a walk!

 

 

 

 

Dive in to aquatic exercise.

There is nothing that feels better on a hot summer day than going for a swim. But beyond being a fun way to cool down, swimming is a great way to get in shape, build muscle, and to help you lose (and maintain) weight. Lap swimming is about as aerobically demanding and burns as many calories as land-based exercise such as walking or jogging. (Obviously, it depends on the stroke you use and how fast you swim). Swimming is also an excellent exercise for injury rehabilitation or for people with conditions like arthritis.

The health and fitness benefits of swimming and aquatic exercise is the topic of my Health & Fitness column in the Aiken Standard this week.

Aqua_Aerobics


The fitness benefits of swimming are well established. Since swimming is a whole-body exercise it uses all of your major muscle groups, building strength, endurance, and aerobic fitness. Highly trained swimmers have VO2max values, considered the best measure of aerobic fitness, that are similar to runners and cyclists. If you have doubts about the fitness benefits of swimming, think back to the last Olympics and how muscular and lean the swimmers looked.

Depending on the stroke and speed, swimming ranges between 5 to 10 METs. (METs are units used to measure the intensity of activity; one MET is equivalent to sitting at rest) For example, doing the backstroke at a moderate speed is about 5 METs while swimming laps freestyle with vigorous effort is about 10 METs.

This range is similar to walking at 4 mph up to jogging at a 9 minute per mile pace. What if you are just spending time in the pool or lake rather than swimming laps? Swimming leisurely is 6 METs, still a decent workout.

Swimming is a great way to burn calories, too. Even at a moderate pace, swimming laps for 30 minutes can burn over 200 calories. The exact energy expenditure depends on the stroke (butterfly is highest, backstroke is lowest) and the speed, but for most people swimming will burn as many calories as spending the same amount of time exercising on land.

There are two major reasons for this. First, water is more dense than air, so you need to expend more energy to move your body through the water. Second, swimming is a whole-body exercise which requires more muscle activity compared to walking or jogging which mostly involve the legs.

You may be surprised to learn that novice swimmers expend more energy per lap than elite swimmers. For example, one study showed that competitive swimmers expend only 280 calories to swim a mile, while less experienced swimmers burn about 440 calories to cover the same distance. The reason for this is that experienced swimmers are more efficient, so they expend less energy.

Aquatic exercise is popular for both therapeutic and fitness purposes, especially for people who don’t tolerate exercise on land well. When you are submerged up to your waist, 50% of your weight is supported; when you are up to your chest, about 75% is supported. This reduces the impact of exercise in the water, perfect for people who have arthritis, osteoporosis, severe obesity, or who are recovering from injuries.

Exercise in the water doesn’t have to mean swimming laps. Water aerobics, aqua walking or jogging, and resistance training using foam “weights” or webbed gloves offer safe ways to increase strength and endurance for almost everyone. Most fitness facilities that have a pool offer group aquatic exercise classes and you can find instructions online for exercises that you can do in your own pool.

If you are interested in using your pool for exercise, you can find information about aquatic exercise in general here and links to suggested exercises here. You can learn more about aquatic exercise specifically for arthritis and fibromyalgia, too.

The hot summer weather makes swimming and other water exercise appealing. But even if you don’t use the time for exercise, spending time playing in the pool or lake can still burn as many calories as going for a walk and is a great way to have fun and cool down!


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Affordable care acts

The Affordable Care Act is in the news again, this time because the U.S. Supreme Court recently ruled on the legality of subsidies offered to help people afford health insurance. Health care has long been an important and contentious topic in both political and social circles. Given the importance that accessing quality health care has for everyone, it is unfortunate that promoting good health has turned into a political debate.

In addition to expanding access to health care, the Affordable Care Act should also make it easier for people to get preventive care. This is important since preventable chronic diseases including diabetes and heart disease, are among the leading causes of disability and death as well as contributing to high health care costs. It turns out that adopting some simple lifestyle modifications can go a long way toward making you and your family healthier, as well as saving money.

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

2013-10-24 15.59.46


Here are a few affordable care acts you can implement today:

1. Move more

Significant health benefits, including weight loss and improved fitness, can be achieved with as little as 30 minutes of activity per day, but more is better. The activity doesn’t have to be “exercise.” It can include walking the dog, yard work, or house work. Research shows that sitting too much is just as unhealthy as not exercising. Spending less time sitting at work, home, or in the car is another easy way to improve health. And getting up and moving for even a few minutes is better than staying seated for long periods of time. Every little bit of activity really does count.

2. Eat smart

Making dietary changes can be difficult, but a few simple changes can lead to big benefits. Eating more real food including fruits, vegetables, whole grains, and lean meats and less added sugar is a good place to start. Fresh fruits, vegetables, and whole grain bread, pasta, and cereals are rich in vitamins, minerals, and fiber and most are low in calories. Eating less added sugar in sweets and processed foods can help you cut down on calories and lead you toward healthier food choices. Controlling portion sizes plays as big of a role in weight gain and loss as the types of food you eat, so pay attention to how much you eat, especially when you eat out. Chances are, it is more than you think!

3. Chill out.

Reducing and managing stress is essential for good health. Uncontrolled stress can lead to high blood pressure, poor immune function, and weight gain. Daily exercise will help, as will using stress management techniques like progressive relaxation. When you can, avoiding stressful situations is wise. Taking time to do something you enjoy each day is a good idea, too. Getting enough sleep (most adults require 7–9 hours) is also important for good physical and mental health.

4. Don’t smoke

Cigarette smoking more than doubles your risk of heart disease and stroke, and is by far the leading cause of lung cancer and other lung diseases. If you smoke, quitting now is one of the most important things you can do to improve your health—and the health of those around you. Nicotine replacement therapy and prescription medications can help, but quitting really does require serious dedication. It’s well worth the effort and the benefits of quitting can be realized almost immediately.

Regular activity, quitting smoking, managing stress, and the types of dietary changes described here can have a profound effect on preventing and treating many health problems. Best of all, these affordable care acts are basically free to implement and can lead to both health and financial savings now and in the future.


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Vocabulary lesson: Exercise, activity, and fitness

When I write about health-related issues 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.

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.

Recent 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. A recent 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.

Start making deposits in your fitness bank

Saving money for emergencies is good advice and important for maintaining quality of life in the event of a lost job or other financial crisis. While this may seem like common sense, many people have been caught without enough savings when they needed it and found it difficult to meet basic needs.

This principle can also be applied to fitness. When you are healthy, you can maintain a high level of fitness. This makes your day-to-day activities easier and serves as a reserve or “bank” to draw on when you need it. Your good fitness now can get you through a health crisis just like saving money can help you through a financial crisis. This health crisis could come in the form of an injury or illness that keeps you from being active for several days or a hospitalization that keeps you in bed for a week, a month, or longer. This is the topic of my Health & Fitness column in the Aiken Standard this week.

The problem with periods of inactivity, like bed rest or hospitalization, is that there are severe physiological effects that occur within days and get worse over time. You may have noticed this as weakness and fatigue after spending a few days in bed with a cold. Muscle strength declines at a rate of over 1% per day of bed rest, and can be 50% lower following as little as three weeks. That 50% reduction in strength could limit a person who was already deconditioned to a point where he or she would have difficulty completing the most basic activities of daily living.

A person who was fit and strong when they went into the hospital would certainly be better off when released. And older adults fare worse than younger individuals. According to one study, the decline in strength seen in older men in just 10 days was equivalent to the change measured after 28 days in men 30 years younger.

It’s not just the muscles that are affected, the bones get weaker, too. In fact, 12 weeks of bed rest can reduce bone density by as much as 50%, exposing patients to a greater risk of fracture. This is due to the reduced stress on the bone from not standing and walking as well as the lack of muscle activity. Two of the most effective ways to build bone density are putting stress on bones through weight-bearing activity and the action of the muscles pulling on the bones from resistance training. Because bed rest eliminates both of these stresses, bone density declines rapidly.

One unique study had healthy young men complete three weeks of bed rest back in the 1960s. They all experienced a rapid decline (over 20%) in their aerobic fitness, but recovered quickly after the experiment ended. These individuals also had their fitness tested again 30 years later. It turns out that the decline in fitness in those young men in three weeks of bed rest was greater than the decline in fitness that occurred over 30 years of aging!

The good news is that most patients are encouraged to move around as much as possible. Some receive in-patient physical therapy or rehab, even after major surgery, to help lessen the effects of prolonged bed rest. It is important to take advantage of these opportunities if you, or a loved one, are hospitalized.

There are many reasons to exercise and be fit, but the most important reason may be to develop a fitness “bank” you can draw on if you become injured or hospitalized. Since the effects of bed rest are seen in people of all ages, everyone can benefit from a good fitness foundation. Just like putting money in the bank, doing a little now can have great benefits later when you need it most.

Finally, some smart advice: First, achieve and maintain a high level of fitness now, just as you would save money for a rainy day. You never know when you will need it. Second, if you are hospitalized, take advantage of opportunities to move, whether that is limited to moving from bed to a chair or if it includes short walks or even inpatient exercise–if the medical staff approves, of course. While many well-meaning friends and family members will tell you to rest and not move, true bed rest is almost the worse thing you can do.

For example, inpatient cardiac rehabilitation targets patients who are recovering from heart attacks and even open heart surgery. The goal is to get these patients up and moving as quickly as possible to prevent long-term consequences of bed rest.


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School gets out, weight goes up. Why now is the time to focus on preventing childhood obesity.

Obesity is a major concern for adults, linked to several leading causes of death and numerous other health problems. What you may not know is that obesity is also a serious health issue for children. It is troubling to note that nearly one-third of school-aged children and teenagers are over a healthy body weight and nearly 20% are considered obese. Remarkably, 10% of infants, toddlers, and preschoolers, are also considered obese.

This is important because the common combination of poor nutrition, physical inactivity, and obesity has physical, psychological, and social consequences for children that frequently persist into adulthood. There are many reasons why childhood obesity occurs and much that can be done to prevent it. Now that school is almost out for the summer, this is a critical time of year to focus on good nutrition and activity to help prevent unhealthy weight gain in kids. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Childhood obesity cartoon


Overweight and obese children are at increased risk for type 2 diabetes, high blood pressure, heart disease and even stroke – conditions usually associated with adulthood. Even if an overweight child does not have these conditions now, he or she is likely on that path. Many experts predict that children born today will be the first generation in history to have a shorter lifespan than their parents due to obesity-related diseases that begin in childhood.

Children who are overweight are also more likely to suffer other consequences including lower self-esteem, social functioning, and academic performance. Overweight children are also less likely to play sports or participate in other forms of physical activity. Considering that the consequences of obesity are made worse by low levels of activity, this creates a cycle leading to poorer and poorer health.

There are numerous potential causes of obesity in children, but the most likely suspects are too little activity and excessive calorie intake, largely because of added sugars. Fewer than half of all kids meet the minimum recommendation of 60 minutes of activity each day and many children spend as much time watching television or playing video games as they do in school. We shouldn’t be surprised that we have a childhood obesity problem!

While poor nutrition and a lack of activity in schools is thought to contribute to the problem, many children get more activity and eat better at school than they do at home. A recent report suggests that children gain more weight over the summer than during the rest of the year. Furthermore, for many kids, fitness gains made during the school year are frequently lost over the summer. Since summer vacation is rapidly approaching, this is a critical time to help our children stay fit and healthy.

The good new is there is much we can do. Ensuring that children get plenty of healthy foods such as fruits and vegetables, reducing the consumption of added sugars, and eating appropriate portion sizes will go a long way to addressing the diet aspect of obesity. Making sure that kids of all ages have opportunities to be active while limiting time spent sitting, especially in front of a screen, are equally important.

Since children don’t make most of the decisions about their activity and diet, it is important to recognize the role that parents, grandparents, and other caregivers play. More often than not, obesity is a family issue. This means that  solving the problem is a family issue, too. Adults should model healthy behaviors by making diet and activity changes themselves. A good place to start is by turning off the TV and going outside to play or for a walk. It’s something all of us—adults and children—will benefit from.

Losing weight is easy, not finding it again is the hard part.

Earlier this week I wrote about tips and tricks from people who are successful losing weight. While some people may make it look easy, losing weight is challenging, to be sure. But maintaining weight loss can be even more challenging.

Many people think that they are finished once their diet or weight loss program ends. The truth is that the end of the diet marks the beginning of the next phase: keeping the weight off. In fact, many people have successfully met their weight loss goal only to gain the weight back later. In fact, some people do it every year, losing and regaining the same 10 (or more) pounds over and over.

There is a practical reason why this happens. In order to lose weight and keep it off people need to learn a whole new lifestyle involving what, when, why, and how they eat as well as daily exercise. These lifestyle changes are difficult to make and can take months or years to fully adopt. In many cases, the weight loss program ends before people make lasting behavior changes. This makes it all too easy to revert to old habits.

While there are literally hundreds of diets and weight loss programs to choose from, “weight maintenance” programs are far less common. The good news is that following the advice of people who are successful at losing weight and keeping it off can help you maintain your weight loss.

The members of the National Weight Control Registry (NWCR) — the “successful losers” have lost an average of 66 pounds and kept it off for over five years the — provide insight into how they keep the weight off. Most report continuing to maintain a low-calorie, low-fat diet and doing high levels of activity. Almost 80% eat breakfast every day, 75% weigh themselves at least once a week, over 60% watch less than 10 hours of TV per week, and 90% exercise, on average, about 1 hour per day.

Many people worry whether they are following the “best” diet or weight loss program. The specific diet may not be as important as what you do when it ends. Notice that the majority of successful losers still control what they eat and nearly all exercise each day. This suggests that going back to the way you ate before you lost weight is unrealistic. And if you aren’t exercising, at least walking, every day already, now is a good time to start.


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Want to know how to lose weight? Ask the experts.

For a great many people, losing weight is a struggle. For starters, selecting a diet to follow or program to join can be a difficult decision. In fact, the great debate about which diet is the best seems to create more confusion than answers. Add to that the conflicting reports about what to do for exercise, and the confusion grows. Then, the real challenges begin. Knowing what to do is relatively easy compared learning a whole new lifestyle involving what, when, why, and how to eat and exercise. Losing weight is hard work, far from the effortless portrayal in advertisements, in which the fat just seems to melt away.

There are some people who make losing weight look easy. No question, these people have to plan to eat healthy meals, dedicate time for exercise, and deal with cravings just like everyone else.  But it seems as though they have figured out the secret of how to lose weight. It turns out that there isn’t really one thing that people do to be successful, but there are some common behaviors that the “successful losers” share. Following the advice of people who are successful at losing weight and keeping it off can help you achieve your weight loss goals.

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


The good news is that this advice is available. The National Weight Control Registry (NWCR) is a collection of information submitted by individuals who have succeeded at long-term weight loss. These “successful losers” have lost an average of 66 pounds and kept it off for over five years, with some losing as much as 300 pounds! Best of all, they share the secrets of their success. Almost all of them increased their physical activity and modified their diet, suggesting that eating less and moving more are necessary for successful weight loss.

Closer to home, I am loosely involved with a local, workplace-based weight loss and fitness program. The comments from the participants about what they are doing and challenges they are facing is especially interesting. The experience of participants in this program supports the findings from the NWCR and provides more specific information about what works.

First, nearly all of the participants have changed what they eat. Some follow a specific diet while others report that they are simply eating less or eliminating certain foods, such as fried foods or desserts. The Paleo diet and eating less processed foods seem to be popular approaches, but participants mention a wide variety of diets and weight loss programs.

Second, almost everyone has become more active. For some, this means going for a 30 minute walk every day while others do more, including exercise at a gym or training for a half marathon. Some participants note that they are progressing from shorter bouts of light intensity activity to longer, more vigorous exercise. This is a natural progression that further increases fitness and energy expenditure.

Finally, many of the participants report that some sort of support has helped keep them on track. This includes social support from coworkers, friends, and families, many of whom have joined in the health improvement process. But support also comes in the form of devices and apps that track and provide feedback about their activity and what they eat. The popularity of these tools suggests that they are helpful, but any method to provide accountability would work.

The bottom line is that the participants in this program, just like the NWCR members, are focusing on “eating less” and “moving more” in some way and relying on some form of support to keep them on track. The good news is, there is no one right way to lose weight. The trick is to find something that works for you, given your current health, interests, and lifestyle.

The prescription your doctor should give you, but probably won’t.

What if there was a prescription your doctor could give you that would lower your risk of heart attack, stroke, and most cancers? What if that prescription could also prevent and treat high blood pressure, high cholesterol, and diabetes as well as reduce your risk of developing Alzheimer’s disease, decrease depression, and improve cognitive function and memory better than any other available treatment? Would you be interested in that prescription?

Imagine that prescription could also help you maintain a healthy body weight, increase your strength, and improve your fitness. And provide all of these benefits without negative side effects. Are you interested now?

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

exercise-rx


That prescription exists, but it isn’t a drug or other medical treatment. It is regular physical activity! Research shows that if you have a low level of physical activity you are at greater risk of dying than if you smoke, are obese, or have high blood pressure or cholesterol. In fact, physical inactivity is now thought to be the leading cause of preventable deaths in the United States.

If you didn’t know this, you are forgiven. Much attention is given to diseases such as diabetes, high blood pressure, high cholesterol, and obesity—with good reason, of course—at the expense of focusing on health behaviors like physical activity. This is partly because of the “education” provided by pharmaceutical companies, who develop drugs to treat these conditions and advertise them widely. But physical inactivity has a huge impact on health, largely because a lack of regular exercise can cause or exacerbate these other diseases. Unfortunately, modern medicine tends to focus medications and surgical procedures, so a low-tech approach like taking a 30 minute walk every day is often overlooked.

Even if you do take medications to treat a chronic condition, regular physical activity is still beneficial. In fact, people who exercise are less likely to require medications for high blood pressure, type 2 diabetes, or high cholesterol. Many people find that they can rely on lower doses of some medications and may be able to stop taking some altogether if they exercise regularly (under the advice of a physician, of course).

May is Exercise is Medicine Month, a time to help everyone recognize the valuable health benefits of regular physical activity. Exercise is Medicine is an initiative focused on encouraging physicians and other health care providers to include exercise in health assessment and in treatment plans for all patients. Unfortunately, the benefits of physical activity and exercise recommendations are not emphasized in medical education. The result is that only about a third of US adults report having received exercise counseling at their last physician visit.

The amount of exercise needed for health benefits is lower than you might think. The Physical Activity Guidelines for Americans recommends that all adults participate in a minimum of 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic physical activity per week. This can be met by going for a 30 minute brisk walk on five days each week. For children, 60 minutes or more of moderate or vigorous physical activity every day is recommended. For everyone, additional health benefits come from doing more, either higher intensity exercise or longer duration activity and limiting sedentary time.

The Exercise is Medicine initiative aims to increase physician awareness of the health benefits of exercise, but it will probably be some time before exercise counseling becomes the norm. In the meantime, you should ask your doctor about including exercise in your personal health care plan. Then, go for a walk!