Tag Archives: exercise

Feeling the pressure

Posted on May 20, 2014 | 1 comment

May is National High Blood Pressure Education Month, a time to raise awareness about the diagnosis, health effects, and treatment of high blood pressure, also called hypertension. This is important because approximately 70 million U.S. adults have hypertension. Of those, almost 40% don’t even know it, which means they are not seeking treatment.

Another 30% have prehypertension, blood pressure that is above normal but does not meet the criteria for hypertension. Prehypertension is appropriately named since most people with this diagnosis eventually develop hypertension—unless they take steps to lower their blood pressure.

High blood pressure is a contributing factor to many heart attacks and strokes and is associated with type 2 diabetes, heart failure, and kidney disease. Hypertension is called the “silent killer” because it often has no symptoms yet it leads to serious health outcomes.

Here are some steps to help you celebrate National High Blood Pressure Education Month:

1. Know your numbers

Your blood pressure includes two numbers, both measured in millimeters of mercury (mmHg). The top number, systolic, is the pressure in your arteries while your heart is contracting and pumping blood. The bottom number is the diastolic pressure, which occurs between beats when the heart is relaxed. Both numbers are important for assessing your risk of health problems.

Normal blood pressure is less than 120 mmHg systolic and less than 80 mmHg diastolic. Blood pressure that is 140 mmHg and higher or 90 mmHg and higher is considered hypertension. If your blood pressure is between 120–139 mmHg systolic or 80–89 mmHg diastolic, you have prehypertension.

2. Get it down

If your blood pressure is above normal you should take treatment seriously. Lifestyle changes including eating a healthy diet, regular physical activity, weight control, and quitting smoking are all effective and essential for lowering blood pressure.

There are also several good medications that your doctor can prescribe to lower your blood pressure. Take them as directed and don’t forget that they are designed to work with healthy lifestyle habits.

3. Keep it down

The aim, of course, isn’t simply to reduce your blood pressure using drugs. Your ultimate goal should be to keep your blood pressure low without relying on medications, all of which have at least some negative side effects.

The best way to maintain a normal blood pressure is through daily exercise, eating a healthy diet, losing weight if you are overweight, and quitting smoking. A good place to start is the DASH diet, which is high in fruits, vegetables, and fiber and low in sodium and added sugar.

The DASH diet has been shown to lower blood pressure and lead to weight loss. It is also consistent with recommendations to prevent and treat many other health problems, including diabetes and high cholesterol.

Since blood pressure tends to increase with age, even if you have normal blood pressure you should take steps to prevent high blood pressure in the future. Adopting a lifestyle that includes daily physical activity, healthy eating habits, managing stress, and not smoking is essential for preventing high blood pressure.

Additionally, these same health habits will help you prevent most other chronic disease including diabetes, heart disease, and many cancers. It turns out that celebrating National High Blood Pressure Education Month can also help you celebrate good health in general.

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Yesterday was National Chicken Dance Day. And that is good news for your health.

Posted on May 15, 2014 | Leave a comment

I can’t believe I missed it!

Yesterday was National Chicken Dance Day! Aside from being a favorite of children and wedding DJs, doing the chicken dance can help you meet physical activity goals to improve your health.

According to the 2011 Compendium of Physical Activities, doing the chicken dance could burn as many calories as participating in an aerobic dance class.

Chicken dancing isn’t  specifically listed in the compendium, but it probably falls under category code 03031: general dancing (e.g., disco, folk, Irish step dancing, line dancing, polka, contra, country).

This type of dancing is listed at 7.8 METS, which is a geeky exercise scientist way of saying that you could burn about 10 calories per minute doing the chicken dance. Note: This is a rough estimate, of course. The actual amount depends on your body weight and how vigorously you do the dance.

That may not seem like much, but it’s a lot more than you would burn sitting at your desk at work or on the couch watching TV at home. So, why not celebrate (belatedly) National Chicken Dance Day by getting up and shaking your tail feather during breaks at work and TV commercials at home!

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The physical activity report card is in. We pretty much failed.

Posted on May 14, 2014 | Leave a comment

The spring semester just ended at the university where I teach. Which means my colleagues and I have been busy evaluating our student’s progress and submitting grades.

About this time, another report card came in from the National Physical Activity Plan evaluating physical activity in U.S. children. The results aren’t good. In fact, we pretty much failed! This is the topic of my Health & Fitness column in the Aiken Standard this week.

 

It’s probably no surprise that the majority of Americans are not active enough. Only about half of adults meet even the minimum recommendation for physical activity of 30 minutes per day, five days per week. Compounding this problem is the fact that many people spend much of their time at work and home being sedentary—some spend over 12 hours per day sitting!

Low levels of physical activity is associated with an increased risk of heart disease, stroke, some cancers, and, of course, obesity in adults. Becoming more active is probably the most important change a sedentary person can make to improve their health. The impact is similar to a smoker who quits.

What may be surprising is that this is a problem for children, too. Less than half of children ages 6–11 are active for 60 minutes per day. Among teenagers, it is less than 10%! The health effects of too little activity in kids is similar to that of adults.

The combination of inactivity and obesity can lead to “adult” diseases such as type 2 diabetes in young people. For this reason, some experts predict that this generation of children may be the first ever to die at a younger age than their parents.

Current recommendations call for children under the age of 18 to attain at least 60 minutes of moderate-to-vigorous activity at least five days per week. In younger kids this can be achieved through active play. In teens it is more likely to include organized sports and games.

The National Physical Activity Plan is a set of recommendations, programs, and initiatives designed to promote an active lifestyle at work, school, and home for all Americans. It was established by an alliance of health professionals and researchers.

This group recently released a report card on physical activity for children and youth that graded the success of efforts to promote activity in several areas. The results show that we are failing to meet even minimum goals and recommendations. Here is a summary of that report card:

Overall physical activity: D-. Only 42% of 6–11 year old children and just 8% of kids ages 12–15 meet the 60 minutes per day activity goal.

Sedentary behaviors: D. About half of all children spend more than the recommended upper limit of two hours of screen time, which includes TV, computer, and video games, per day.

Active transportation: F. Just over 10% of children walk or bike to school regularly.

Physical education in school: C-. Only about half of children attend at least one PE class per week.

Based on these grades, American children are not getting enough physical activity. But it isn’t fair to say that our children are earning these grades—it’s the adults who are failing! Most children are at the mercy of parents, teachers, and other adults who decide how they will spend their time at school and at home.

The report card shows that we are either not allowing our kids to be active enough or limiting opportunities for them to move and play. This isn’t necessarily a conscious effort, but is likely a consequence of the physical activity habits of adults that our children adopt.

Given the importance of regular activity for growth, development, health, and even academic success, getting our kids to be more active should be among our highest priorities. This requires both individual action and organized community efforts to make physical activity and exercise a part of every child’s day.

And while we are at it, we (the adults) should make this same effort. Perhaps the failing grades on the recent report card will motivate us.

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Stealthy Healthy Eating

Posted on May 6, 2014 | Leave a comment

My Health & Fitness column in the Aiken Standard this week is about the many processed foods that include added nutrients, primarily vitamins, minerals, and fiber, to make them healthier. While this seems like a good thing—helping people get enough essential nutrients, even if they eat a poor diet—there are drawbacks to using these foods instead of eating actual food that contains these nutrients.

What if there was a way to get the benefits of eating vegetables without having to eat any vegetables? This may be a dream for millions of American children and adults who don’t eat enough vegetables.

Thanks to creative food processing, the healthy components of vegetables can be added to many foods, including soda, candy bars, and other sweets. Books and websites contain recipes for adding pureed vegetables to brownies and other baked goods. There is even a new line of prepackaged pureed vegetables to use!

The recommended intake of vegetables ranges from one cup per day for young children to 3 cups for adults. A simpler guideline is to fill half of your plate with fruits and vegetables at each meal. The goal should be to eat a variety of vegetables throughout the week.

There are plenty of good reasons for people to eat vegetables. Most vegetables are a low-calorie source of essential vitamins and minerals. The dietary fiber found in vegetables (and fruits and whole grains) plays a role in maintaining a healthy body weight, lowering cholesterol, and reducing the risk of some cancers.

Fiber is increasingly added to processed foods including granola bars and energy bars. It is possible to get up to half of your daily recommended intake of fiber by eating a single Fiber One bar. That is the equivalent of a cup or more of most vegetables! Considering that many of these snacks are essentially candy bars, they are a tasty way to get fiber.

Vitamins and minerals have long been available as supplements and added to certain foods, including products made from grains like pasta and bread. But now you can get vitamins in many soft drinks, many of which have as much sugar as soda. And calcium is added to a variety of foods from breakfast cereals to snacks.

There are, of course, some benefits of doing this. People who don’t eat a healthy diet can get enough essential nutrients through these products. Some of these foods are low in calories so they can help people who are trying to lose weight.

While these “hidden” nutrients may seem like a good solution for people who don’t eat enough vegetables, this form of stealthy healthy eating may have some negative consequences.

These processed foods may be high in sugar, fat, and calories which could contribute to weight gain. The fact that these foods are designed to taste good—many include chocolate—may lead people to overeat. Aside from excess calories, eating far too much fiber could cause GI discomfort or other health problems.

More concerning, though, is the fact that these foods set an expectation that healthy foods should be sweet. This is particularly problematic in children, who may avoid eating vegetables (and other healthy foods) in favor of sweet drinks and snacks that contain the same nutrients.

Additionally, getting vitamins, minerals, and fiber through processed foods keeps people from learning how to make healthy choices and prepare real food. This has consequences for developing healthy eating habits in both children and adults.

Focusing on getting individual nutrients over eating a variety of healthy foods is thought to be an important cause of the current obesity epidemic. Relying on processed foods with added vitamins, minerals, and fiber may be doing more harm than good to your health.

The bottom line is that you should get your nutrients from real food and balance what you eat with daily physical activity. Remember, good health comes from making smart choices, not from a bottle or a box!

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How to win at losing: What to do when your diet ends.

Posted on April 28, 2014 | 1 comment

In the past few weeks several community and fitness center-based weight loss programs have ended. Since many diets and exercise programs last 12–15 weeks, this time of year marks the end of many programs. During this time many people have met personal weight loss goals through individual diets and “biggest loser” type programs. (I have written about competition-type weight loss programs in the past here and elsewhere.)

One of these is the Team Lean program at the Y. This year over 1,600 people from the Aiken and Augusta area participated in this 12-week program that included weekly education sessions and weigh-ins, a strong group dynamic, and monitoring to prevent rapid, unhealthy weight loss. The average participant lost almost 10% of their body weight, which is sufficient to promote improvements in blood pressure, cholesterol, and diabetes.

This level of weight loss is common among people who participate in individual or group programs. But the real challenge is to maintain that weight loss after the program ends. 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 20 or 30) pounds over and over.

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

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 and revert to their 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 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.

It turns out that they lost weight through a variety of diets and programs. Nearly half lost weight on their own and the other the other half followed of some type of program. Regardless, almost all of them increased their physical activity and modified their diet, suggesting that diet and exercise together are important for successful weight loss.

There is also variety in how NWCR members 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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Go outside and play!

Posted on April 7, 2014 | 1 comment

If you are like most people, you have probably spent much of the day indoors, probably sitting. In fact, this is likely how you spend most days. According to one survey, the average American may spend up to 15 hours per day sitting at work or at home. If you subtract sleeping, this accounts for nearly the entire day!

Prolonged sitting has been linked to negative health effects that are similar to those of not exercising. Even among people who do exercise, those who spend more time sitting tend to have more health problems than those who are more active during the day. Consider yourself lucky if you have a job that keeps you active.

The good news is that you can offset the health effects of sitting too much. Taking short breaks at work can improve attention and productivity. In fact, many time management and productivity techniques include periods of focused work separated by breaks. Using these breaks to get up and move is good for your body and your mind. The same is true at home—getting off the couch during TV commercials can have the same benefits.

Even greater benefits can be gained from dedicating more time to be active, especially regular exercise. 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.

Being active in a natural environment seems to have an even bigger impact on mental health. This is the topic of my Health & Fitness column in the Aiken Standard this week.

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.

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, go outside and play!

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HIIT me, again!

Posted on March 10, 2014 | 3 comments

The next time you are at the gym sweating through an hour on the elliptical machine or going for a long run to improve your fitness, think about this: you may be able to get the same benefits with just a few minutes of exercise. It’s not as easy as it sounds, though. The exercise has to done at a very high intensity, often in short intervals.

This type of exercise is called high-intensity interval training (HIIT), which involves multiple bouts of very intense exercise separated by periods of rest or light exercise. I have written about this type of training previously, but new research and the popularity of HIIT training programs warrant revisiting this topic in my Health & Fitness column in the Aiken Standard this week. And although high-intensity training is effective for improving fitness and burning calories, it may not be right for you.

Exercise to improve cardiorespiratory fitness typically involves 20–60 minutes of moderate to vigorous exercise done 3–5 days per week. This type of exercise is common for people who are training for an event like a 10k run since it leads to improvements in maximal exercise capacity (called VO2max) and endurance by increasing heart function and promoting changes in the muscle. This type of training is also followed by most people who are interested in losing weight or getting in shape, even if they don’t plan to compete in a race.

Research and practical experience have shown that shorter HIIT sessions can be effective, too. The length and intensity of the intervals vary both in the research and in practice. For example, in one study these intervals were as short as 30 seconds of all-out, maximal exercise separated by rest periods, for a total of just six minutes of exercise per day. Other studies employ slightly less intense (still 90% of maximal heart rate) intervals for a total of 20 minutes of exercise per session. The results show that HIIT leads to adaptations in the muscle and improvements in VO2max that are greater than that of more traditional, lower intensity exercise.

A study published last month showed that even one bout of high-intensity exercise can promote changes in the muscle that lead to improved endurance. This study compared the effect of four 30-second bursts of very intense exercise separated by four minutes of recovery with a single 4-minute bout of vigorous exercise. Both promoted a similar effect on blood and muscle markers that lead to improvements in fitness. This suggests that both sustained and interval exercise can be effective, as long as the intensity is high enough.

Does this mean that high-intensity training is right for you? It depends on several factors. First, the risk of injury during intense exercise is greater than during more moderate exercise. At the very least, exercise of this intensity is likely to be uncomfortable. Second, exercising at a high intensity may not be a good idea if you are not already in good shape or have other health problems like diabetes or high blood pressure. Third, HIIT may not be the best way for you to meet your exercise goals. If you exercise to lose weight your emphasis should be on duration, not intensity, to burn calories. If you are trying to build endurance for a marathon or long distance bike ride, you really do need to focus on longer duration exercise.

For most people, there is little harm in trying some higher-intensity exercise, even just one day per week. In fact, many group exercise classes are designed to be a high-intensity workout, so this might be a good way to add more intense training sessions to your exercise routine.

 

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Physical activity at school in two infographics

Posted on March 7, 2014 | Leave a comment

This week I came across two infographics explaining the benefits of including physical activity in the school day and ways kids can be active at school.

Having opportunities to be active throughout the day benefits children in many ways, from improving their health, helping them maintain a healthy weight, and promoting learning. In fact, physical activity through recess, structured PE class, and other unstructured activities is absent at many schools. This represents a missed opportunity to teach children about the importance of being active.

According to these infographics, though, engineering activity into the school doesn’t have to be difficult. And including physical activity in the school day makes children believe it is important (which it is) and helps develop habits that will last into adulthood.

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The Role of Schools in Promoting Physical Activity | via Active Living Research

 

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Get 60 Minutes | via Institute of Medicine

 

Now if we could just do something about the quality of school lunches!

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Reducing your risk of heart disease

Posted on February 10, 2014 | Leave a comment

February is Heart Month, an ideal time to assess your risk of heart disease and take steps to improve your health. This is important because heart disease, sometimes called coronary artery disease, is the leading cause of death among adults in the United States. It is responsible for nearly 600,000 deaths each year, mostly from heart attacks. Millions more are at increased risk because of certain biological and behavioral risk factors.

Identifying your personal risk for heart disease and making efforts to improve your heart health is the topic of my Health & Fitness column in the Aiken Standard this week.

Some of these risk factors cannot be changed, such as age, sex, and family history, while others can be altered to reduce risk. These modifiable risk factors include smoking, high blood pressure, high cholesterol, diabetes, obesity, and physical inactivity. While your doctor can play an important role in treating these conditions, there is much you can do on your own to improve your heart health.

The first step is to get a good assessment of your heart health. If you haven’t done so recently, you should see your doctor to have your risk factors evaluated. This includes tests for blood glucose and blood lipids (including total, LDL, and HDL cholesterol and triglycerides), measurement of your blood pressure and body weight, and an assessment of other health factors such as your family history, whether you smoke, and your level of physical activity.

The next step is to treat the risk factors that you have. Depending on the severity and your own personal health history your doctor may prescribe medications to lower your blood pressure, blood glucose, or blood lipids. These medications are most effective when combined with lifestyle changes including good nutrition, exercise, and weight loss. In some cases, poor diet and lack of activity can counteract the beneficial effects of these drugs. Furthermore, these healthy habits may help you reduce the dosage, and limiting the side effects, or stop taking the medications altogether.

The other risk factors—obesity, inactivity, and smoking—really must be treated through lifestyle management. While there are medications that can help with smoking cessation and weight loss, being successful requires making lasting behavior changes. These habits can be difficult to change, and many people have tried before without success. Keep in mind, though, that everyone who is successful at quitting smoking, losing weight, or sticking to an exercise program has experienced his or her share of difficulty. The difference is that those people kept trying until they were successful. You can be successful, too.

Even small changes can have a big impact. Take exercise, for example. The benefits of as little as 30 minutes of physical activity per day are well established and impact heart disease risk in a multitude of ways. Physical activity helps with weight control, lowers blood pressure, improves blood lipids, and prevents and treats diabetes. Think of this as a great health “deal.” By modifying one risk factor—inactivity—you can also promote beneficial changes in four others—obesity, hypertension, high cholesterol, and diabetes. There is no other treatment, drugs included, which can have such a broad impact on reducing heart disease risk!

Of course, there are steps you can take beyond becoming more physically active to reduce your risk of heart disease. The list of beneficial changes you can make to improve your heart health is long, but keep in mind that even small changes can add up to a big benefit. 

Knowing which risk factors are most concerning can help you and your doctor make effective treatment decisions. Quitting smoking, increasing your physical activity (and reducing sedentary time), and eating a healthier diet can lead to improvements in heart disease risk factors and reduced heart attack risk. The best news is that these same changes can also reduce your risk of other serious health problems including many types of cancer, stroke, and lung disease.

 

 

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Honesty is the best policy

Posted on January 27, 2014 | Leave a comment

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

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

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

This type of self-deception is easy to do. Take body weight for example. The current standard for determining if you are at a healthy weight is body mass index (BMI), calculated from your weight and height (kg/m2). It requires a bit of math, so using a mobile app or online calculator is a good idea. A BMI between 18.5 and 24.9 is considered normal, 25-29.9 is overweight, and if your BMI is 30 and higher you are classified as obese. To put this in perspective, a BMI of 30 is equivalent to about 25–30 pounds of excess fat.

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

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

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

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

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

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

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