Tag Archive for: exercise

Should You Have a Strict Holiday Eating Strategy?

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Tis the season for gaining weight. It began on Thanksgiving, but we’re in it big time now. If you’ve lost weight and want to make sure you don’t see it again, what do you do? Let’s review some of the research on strategies that people who’ve lost weight and maintained it have used.

The first is a report from the National Weight Control Registry. In order to be a subject in that study, you have to lose 30 pounds and maintain it for at least a year. Researchers took a group of recent additions to the study and asked them specific question on their strategies during the upcoming holiday season at that time, and then tracked how they did. They also recruited a group of normal weight people and did the same thing.

Most of the experimental group said they were going to follow their typical routine as related to diet and exercise plan. In other words, they were going to try to strictly follow their weight loss routine. The normal weight individuals didn’t really have any special plans. Most successful losers did follow their plan although it was more difficult during the holiday season. About the same percentage of successful losers and normal weight subjects gained weight, maintained their weight, or lost weight during the holiday season. The difference was that the successful losers found it more challenging to do so based on their response to survey questions.

Is that the best strategy? Stay the course? Another study on Thursday.

What are you prepared to do today?

        Dr. Chet

Reference: J Consult Clin Psychol. 2008. 76(3): 442–448.

How Your Microbiome Affects Exercise Benefits

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It seems every day, there are several studies on the microbiome and its impact on our health. At this point, they’re preliminary but the picture is emerging that as goes your gut, so goes your health. I’ve picked three new studies to review this week.

As an exercise physiologist who’s done research on this topic, I’ve always recommended exercise as a way to improve control of blood sugar for prediabetics; that’s why this study surprised me. Researchers assigned 39 prediabetic men who had never used medication to either a control group or a high-intensity exercise group for three months. All men in the exercise group had similar improvement in fitness and weight loss. But only 70% of the men demonstrated an improvement in insulin resistance.

The way the responders processed protein and carbohydrates was different from non-responders. The researchers collected stool samples and then transplanted the microbiome of responders and non-responders into a group of mice; the mice responded to exercise in the same way as the man whose microbiome they received. The microbiome somehow responded differently to exercise and modified the expected results.

We don’t know about dietary differences between subjects that might have impacted the outcome because the subjects were told to maintain their current diet, but the results were surprising nevertheless. But I would still give the same recommendation for exercise to all prediabetics. The only difference would be to make sure they tracked blood sugars to see how their blood sugar responded.

What are you prepared to do today?

        Dr. Chet

Reference: Cell Metabolism, DOI: 10.1016/j.cmet.2019.11.001.

It Gets Worse Before It Gets Better

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In last month’s Memos, I talked about many different aspects of exercise including flexibility, strengthening, and the various types of fitness and stamina. There’s one more thing you need to know. But first, a story.

Paula has been having an issue with her ankle and foot. She got it checked out with her podiatrist, and it’s a problem with the tendons in her foot including the Achilles tendon. Yesterday we went to see our favorite physical therapist; he did a thorough examination of her foot, ankle, knee, and hips. He recommended some stretching and strengthening exercises as well as some non-impact aerobic exercise. He then said something important: everything may seem worse before it gets better.

I’m going to tell you the same thing as you attempt to work on your body to help you really live instead of merely being alive: you may feel worse before the work you invest begins to pay off and you start to feel better. That’s one reason I ask you to see your doctor before you begin, who’s familiar with your orthopedic issues as well as any conditions that can be impacted by exercise. That’s why you always check first.

If you can get professional help to help you get started, that’s even better—someone to help you choose the right exercises to fit your particular body and limitations. Get a referral to a good physical therapist or find a certified personal trainer with experience helping people who are less fit; you definitely don’t need one of the no-pain-no-gain goons. It doesn’t need to be a long-term relationship, just advice to help you get a good, safe start. And you can probably work out a routine to do at home if joining a gym isn’t your style, but a short-term membership may be helpful in determining which exercises and types of equipment are best for you. For example, don’t buy an exercise bike without trying different types.

For a while, you’ll probably feel worse, especially if it’s been years since you’ve worked on some of these muscles and joints. You may want to refer to the pain scale on drchet.com. Take it slow and let discomfort be your guide. If you overdo it and you’re in pain, back off, ice or heat and rest, and then get going again with a little more caution. After all, you want to live all your days. The work you put in will generate some satisfaction before you may feel the benefits. Better to take longer to get there than stop altogether. The good news is that once you get over that hump, and it may take many months, you’ll feel better than ever.

What are you prepared to do today?

        Dr. Chet

Maintaining Bone Health

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In trying to live every day we’re alive, I’ve spent a lot of time talking about the ability to move, but it’s not just about muscle. Those muscles connect to bones for the most part, and the bones must be healthy as well. One of the basic tenets of healthy bones is Wolfe’s law, which can be summarized as “function determines structure.” In everyday terms, to have healthy bones you must stress them regularly. Exercise is critical to that effort. But it’s not as simple as that.

Hormones and nutrients are also critical to bone health. Our ability to make hormones and absorb and utilize nutrients diminishes as we get older. Hormone replacement therapy has been controversial, and that’s a discussion a woman should have with her physician. In terms of nutrients, the ones critical to healthy bones are calcium, magnesium, vitamin D, and vitamin K2.

Before increasing any nutrients via supplements, have a bone-density test as well as a vitamin D test. If either test has low results, then taking a combination of the nutrients mentioned earlier would help the bones when combined with exercise. Any exercise that’s weight bearing is beneficial such as walking, but not swimming, with added benefits for weight training.

Maybe the best we can do is to stop the loss of bone mass, but that will help you live better for longer. We’ll move from bones to joints on Thursday.

What are you prepared to do today?

        Dr. Chet

How Flexible Are You?

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Living every day you’re alive requires flexibility. Range of motion in your joints is important to your ability to move, but it can be difficult. As the years add up, touching your toes with your knees locked, whether sitting on the floor or standing, lifting your arms over your head, or even lifting your arms to shoulder level can be a challenge.

Connective tissue tends to tighten as we age; it’s another case of use it or lose it. And when I say age, I mean from teen years on. Later, after we’ve torn ligaments, sprained ankles, been in accidents, and on and on, if we haven’t worked on our range of motion, we can end up restricted in our ability to move. The less we move, the more restricted we can get.

The obvious way to increase flexibility is to stretch. There are dozens if not hundreds of programs online, but I would recommend that you get an examination by a physical therapist who can identify your strengths and weaknesses and prepare a program just for you, taking into account your current level of flexibility and previous injuries. The older you are, the more strongly I recommend physical therapy, because if you stretch too far and damage connective tissue, you’ve just made your situation worse. Another option, especially if you’re younger or more fit, is to try yoga, which is an overall muscle-strengthening and stretching program. Take a class with an experienced instructor so you can get feedback on whether you’re doing the movements correctly.

Stretching is something you should do every day. There’s one area that needs special attention and that’s your core. I’ll cover that on Thursday.

What are you prepared to do today?

        Dr. Chet

Preventing Muscle Loss

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This final installment on muscle focuses on keeping the muscle mass you’ve got. That’s one of the keys to living every day you’re alive: the ability to move at every age. There are three things that are important to hanging onto muscle.

  • Use it or lose it. Actually, you’re going to lose it not matter what, but the degree to which you will is partially dependent on using it. Whenever you can take the stairs, take them. Whenever you can lift something, lift it. While I would hate it personally, it was better when we had to get up and actually walk to the television to change the channel. More today than ever, we don’t take the opportunity to build muscle or increase stamina.
  • Exercise regularly. No matter your age, there’s always something you can do. Orthopedic issues happen as we get older—arthritis in hands, shoulders, hips, and knees, or torn ligaments and cartilages. They can all put limitations on what we can do. We have to work within those restrictions and do as much as we can to maintain and even increase what we have. A session with an excellent physical therapist (ask your doctor if you qualify for some free sessions) or certified personal trainer could be worth the money. It’s never too late to begin. Research has shown that even people over 100 years old can increase strength and stamina.
  • Consider taking essential amino acids every day. While the focus has been on what EAAs can do for people who train hard, the bulk of the research has been done on people 50 and older. It’s clear you can slow down muscle loss and increase muscle strength by exercising regularly and taking EAAs every day. I’ve been taking them the days I lift, but I’m considering taking them every day. In continuing to research the benefits, there doesn’t seem to be a downside to taking EAAs. There’s some preliminary research that indicates that taking EAAs may even be beneficial for pre-diabetics to reduce insulin levels and triglycerides if they exercise regularly as well.

The purpose for the month’s Memos is showing you how to learn to live every day you’re alive. Muscle is critical to that goal. We’ll move on to another important physical component of living next week.

What are you prepared to do today?

        Dr. Chet

Skeletal Muscle: Strength

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This week, we’re turning our attention to skeletal muscle. Skeletal muscle allows us to move and to lift ourselves and other objects. The two primary features are strength and stamina. Let’s begin with strength.

A simple definition of strength is the most weight you could lift once. That could be as little as a couple of pounds, or it could be as much a thousand pounds as some weight lifters have done. To me, as a minimum, strength is the ability to be able to do everyday tasks. We’ll start with the most fundamental, which would be sitting down in a chair or on a commode and then having enough leg strength to stand up. It would be enough to be able to lift a bag of groceries. To lift a hammer to hit a nail. To hold a hair dryer over your head while you do your hair. You can probably think of a few more.

Years ago, I mentioned to my mother-in-law that most women over 65 can’t lift 10 pounds. We lose strength as we age. She had just gotten back from grocery shopping and she picked up a 10-pound sack of flour. She began lifting it up over her head and back down to her lap and said, “Look Chet, I can do that!” She was in her mid-seventies at the time.

Strength can vary by body joints. With two torn biceps, I don’t have nearly the strength in my arms and shoulders as I used to, but I still have pretty good leg strength and pretty good back strength; my exercise routine includes strength training for all those areas.

How do you increase strength? Challenge the muscles to lift more weight than you currently can for any different set of muscles: your shoulders, your arms, your quads, your calves, and of course, there’s your core. I’ll save that for later in the month. Next time, we’ll take a look at muscular stamina.

What are you prepared to do today?

        Dr. Chet

Exercise Your Heart, Part 2

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Did you ever have to hurry to catch a connecting flight? Walk fast or maybe even jog? Were you able to do it?

How about carrying a child who weighs 45 pounds for a quarter mile because she’s hurt her foot? Could you do it?

That’s where your heart reserve comes in: facing challenges that put your heart to the test. Everyday training helps, but getting fitter is also important for those occasions when you need more. If your physician says you can do it, interval training is the solution to building a reserve.

Intervals have been around for decades, and they became a fad with something called High Intensity Interval Training (HIIT). They’re the same thing except that HIIT is supposed to replace all other aerobic exercise to save time. I’m sorry, but it’s just not enough. Doing well on a fitness test isn’t the same as living.

The idea is to exercise as fast as you’re able for 30 to 60 seconds, then rest for one or two minutes, sometimes even more. Repeat the cycle eight to twelve times and you’re done. For some people, walking faster for 30 seconds is enough; for others turning up the intensity on a bike to the highest level for 60 seconds would be the intensity. It doesn’t matter your level when you begin; it will help you build a reserve for challenges. That’s something we all need. Again, you have to check with your physician before exercising to build a baseline or a reserve. It’s one of the keys to living every day.

Think we’re done with exercise? Nope. We’ll turn to those other muscles next week.

What are you prepared to do today?

        Dr. Chet

Exercise Your Heart, Part 1

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In my opinion, the single most important thing you can do to be able to live life at your best is to exercise your heart. Every day. You don’t have to run marathons; you don’t ever need to run at all. You just need to train your heart every day. I’ve broken it down into two components that I’ll call baseline and reserve.

The aerobic baseline for your heart is just that: the level of fitness you need to accomplish every day tasks. The baseline will be different based on your age, your initial fitness level, and what your everyday activities are. That’s as simple as walking across a room and as challenging as being a laborer on a construction site or moving furniture up five flights of stairs.

If there are no orthopedic issues, the simplest exercise is walking or it could be long-distance running or bike riding. The goal is to get your heart rate elevated enough to cause the heart to beat faster than it does when resting. That trains the heart in more ways than I can explain.

The simplest way to describe how to do it’s this way. Walk fast enough so that you have to take a deep breath once in a while but you can carry on a conversation. If you can’t talk, slow it down. But if you can sing, that’s too slow. You can use that across every aerobic type of exercise from aerobics to Zumba. The goal is at least 30 minutes most days of the week.

You also need a reserve and I’ll talk about that on Saturday.

What are you prepared to do today?

        Dr. Chet

Is the 10,000-Steps Goal a Myth?

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One of the things many people do for fitness is try to get 10,000 steps per day. Researchers recently wanted to know whether that many steps really gives a person any health advantage, because the concept of 10,000 steps per day wasn’t based on any real science—it came from a Japanese company who invented a wearable step counter in 1965 and just made up a number that sounds good.

Researchers analyzed data from 16,741 older women who agreed to wear a step counter at least 10 hours per day for at least four days a week during waking hours. They divided the subjects into quartiles based on the number of steps per day. After four years of follow-up, they discovered that hazard ratios declined as the number of steps per day increased. No real surprise there. What was surprising was that there were no additional benefits after 7,500 steps per day; in fact, the mortality began to decline with as little as 4,400 steps per day.

Is the goal of 10,000 steps per day a myth? Not in my opinion; most of us are too sedentary most of the time. The mean age of the subjects in this study was 72. It may be that younger women need more steps to impact mortality because they have potentially more years to live; then maybe after reaching 72, they can scale back. Hard to say. But they looked at mortality only; 10,000 steps per day may have benefits they didn’t examine.

I would have thought walking intensity might have had an impact, but it didn’t in this study. However, another recently published study may provide more insight, especially as it relates to obesity. We’ll take a look on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: JAMA Intern Med. 2019. doi:10.1001/jamainternmed.2019.0899.