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Exercise is Medicine

What if there were a pill that could combat all of today’s chronic illness, including heart disease, stroke, diabetes, obesity, and even breast and colon cancer? And what if this pill had mountains of data and literature backing its effectiveness to help every patient? Surely everyone in the United States would be taking this drug, either to treat an existing illness or to prevent one.

The Exercise is Medicine initiative (www.exerciseismedicine.org) is a collaboration of the American College of Sports medicine, the leading authority on physical fitness as it relates to health, and the American Medical association, the largest association of physicians in the United States. Their goal is simple: to encourage physicians to treat exercise as a vital sign by assessing every patient’s physical activity program at every visit. If the initiative is successful and physicians begin to expect their patients to be more physically active, this will produce the expectation among patients that they will be asked about their physical activity levels. This, in turn, will encourage patients to be more active on a daily basis and lead to better health outcomes. Sounds simple right?

However, it’s no secret that physicians are pressed for time, and many may be reluctant to take chances with their patients if they are not sure they will see positive outcomes. It’s also well known that many American’s don’t like to exercise. In fact, a little over half of all Americans surveyed admit they don’t meet the current recommendation of 150 minutes per week of moderate activity (i.e. brisk walking). So how do we reconcile some of these differences?

Randy Glasbergen

Randy Glasbergen (2005)

It is essential that physicians initiate the Exercise is Medicine campaign. Research shows that when a patient has “Doctor’s Orders” to exercise rather than a recommendation, he or she is much more likely to comply with an exercise program. To help doctors tackle the lack of time barrier, a physician can assess their patient’s physical activity status by asking one quick question: “How many times in the last seven day’s have you exercised for thirty consecutive minutes?” If the patient answers less than or equal to twice, the physician can write a prescription for exercise using the prescription form found on page five of this document. Doctors who prescribe exercise can expect to see their patients lose weight, have lower systolic and diastolic blood pressures, higher HDL and lower triglycerides, and lower fasting blood sugar, to name just a few. If there is any concern over the patients’ safety while exercising, a prescription to a health and fitness facility with a qualified staff may be advisable.

From the patients’ perspective, those who have “Doctor’s Orders,” to exercise are much more likely to do so. Therefore, those patients begin to take an active part in owning their health — a foreign concept to many with chronic disease. And aside from better lab reports and happier physicians, the benefits of being a physically active patient could mean having less pain and taking less medication to control high blood pressure, cholesterol, and diabetes.

Exercise truly is medicine. There are mountains of research showing its ability to treat and even reverse many of today’s chronic conditions. Physicians and patients can visit ExerciseIsMedicine.org to find out about the appropriate dosages. Finally, physicians who assess physical activity levels and prescribe exercise can enjoy improved patient outcomes, and help patients begin to take ownership of their health.

Feature image by C.Y.Li via Flickr

http://chapelboro.com/lifestyle/health-wellness/exercise-is-medicine-2/

If You Only Do One Thing For Your Health

…Exercise!

Our society is plagued with diabetes, hypertension, cancer, arthritis, fatigue, depression, anxiety and excess pounds, to name a few. For those of us who have eaten too much and moved too little for far too long, we’re not pleased with the results. But tackling multiple ailments at once? That’s quite a feat. Where does someone who wants to see change even attempt to begin the process?

Exercise.

I consider this article more of a report on a video that someone so graciously shared with me recently. I already knew the great benefits of regular exercise, and here at the Duke Center for Living at Fearrington we truly believe that exercise is medicine. However, the statistics and research data can be mind-numbingly boring for even the fitness professional, much less the average American in search of real solutions for every day ailments. “23½ Hours” by Dr. Mike Evans is such a simple, yet captivating, summary of this notion that there really is one single and simple solution for better health, no matter how many ailments or health risk factors you may currently have, and that solution is exercise.

In the video clip above, Dr. Evans refers to exercise as an “intervention”, truly categorizing it as therapy for disease. In the research studies that he analyzed in an attempt to find a one-size-fits-all kind of treatment for patients, he came across the following effects that exercise alone can have:

  • 47% decrease in pain and disability in patients with knee arthritis
  • 50% decrease in dementia and Alzheimer progression
  • 58% decrease in the progression of diabetes
  • 41% reduction in the risk of hip fractures in post-menopausal women
  • 48% reduction in anxiety
  • 30% reduction in depression, but up to 47% reduction in depression with extra time exercising
  • 23% decrease risk of death
  • #1 treatment for fatigue
  • Universal response: “improvement of quality of life”


These effects, among many, many others discovered through vast quantities of research studies, are all the result of simply 30 minutes per day, possibly one hour. And we are not talking high intensity interval training, boot camp workouts with a personal trainer, or hours in indoor cycling classes. Most of these studies are based solely on walking. That’s it, plain and simple, walking for 30 minutes per day. Can this news get any better? I’m glad you asked, because yes, it can! Those 30 whole minutes do not even need to be consecutive minutes! If a hectic schedule means breaking it down into two 15 minute walks or three 10 minute walks, then you still get credit for the day.

Sounds too good to be true, right? Like the magic pills and special gimmicks on Saturday morning television? I like writing about simple solutions because people “get” simple. People can “do” simple. A solution that addresses innumerable conditions cannot be found on a shelf, infomercial programming or in a bottle in pill, tablet or chewable form. This solution comes from within, a drive to just get up and move a little more today than yesterday. This solution comes from limiting the sitting, sleeping, working, eating, shopping, television surfing, reading and caring for children, significant others and parents to a mere 23 and a half hours per day and allowing yourself a whooping 30 minutes to give your body something it needs and even craves.

Take advantage of this gorgeous spring weather and take a lap or two around the block. Your body will thank you!

http://chapelboro.com/lifestyle/health-wellness/if-you-only-do-one-thing-for-your-health-4/

The "Fat Burning" Zone

People looking to lose weight often think that long sessions of cardiovascular exercise are the best way to spur weight loss and jumpstart their way to health. Treadmills and ellipticals adorned with charts that display the mythical ‘fat burning zone’ that dictate how hard the user should be exercising serve as a guideline for many gym-goers.

However, things are not always as they seem to be.
 
During exercise, your body has two primary sources of fuel: carbohydrates (in the form of glucose) and fat. Let’s take a look at the difference between the two.

Glucose is the preferred energy substrate for a few reasons. First, it is readily available. Glucose is stored in the muscle, liver and blood, meaning it can be accessed at a moments notice. Also, glucose can be used either aerobically (in the presence of oxygen), or anaerobically (without oxygen).
 
To use fat as a source of energy, several things must happen first. The person exercising must achieve a steady state of exercise where oxygen is readily available. Basically, you must be exercising at a pace that allows you produce a sustained effort over long period of time. Also, oxygen can only be used in an aerobic state. This is why many people mistakenly think that cardiovascular exercise is the best way to shed fat.
 
The truth is, whenever you’re exercising, you are not limited to one form of energy substrate. There is a constant mix of fat, glucose and phosphate being used as energy. You are never using just one source of energy to exercise; it will always be a combination of different sources.
 
However, these sources of energy can be directly influenced by two factors: Intensity and duration. The greater the intensity of the exercise, the more reliant you’ll be on glucose, while lesser intensities will provide a greater ratio of fat use.

Exercise intensity also directly relates to the second factor, duration. Working at a very high intensity means that your body is relying almost exclusively on carbohydrates for energy and working in anaerobic state. High intensity combined with lack of oxygen to the muscle cells results in fatigue very quickly. This is known as ‘hitting the wall,’ the point where you can no longer sustain the intensity you are at, when you must either drastically decrease your exercise intensity or stop completely to catch your breath. Training at high intensity levels requires an individual to walk a very fine line, and being able to push themselves to the bring without going over. This type of training is very effective for cardiovascular training.
 
Another thought to consider when trying to ‘burn fat’ is quality vs. quantity. You can walk at a slow, low intensity pace for 40 minutes and use fat as your primary energy source. Conversely, you can workout at a high intensity for 20 minutes at a high intensity and use a mix of fat and carbohydrates for energy. The high intensity workout will use more total calories than the low intensity stroll, with the added benefit of taxing both the aerobic and anaerobic pathways, therefore improving your aerobic capacity much more so than the low intensity walk.

Yet another oft-overlooked tool to enhance weight loss is weight training. The combination of aerobic exercise and weight training is better than aerobic exercise alone in the fight to lose weight. Plus, muscle is much more metabolically active than fat tissue. At rest, muscle burns roughly three times as many calories than fat tissue.
 
Last, but not least, don’t forget the role diet plays. There is a saying that is as true today as it was 50 years ago: ‘you can’t out train a crappy diet.’ If you’re doing all the right things in the gym and still aren’t getting the results you want, give your diet a hard look. Heavily processed and packaged foods, whole milk dairy products, sugary drinks, alcohol and foods loaded with refined flour are not doing you any favors. Eating fresh fruits, vegetables, beans (not the canned kind), nuts and seeds are much better for you. Basically, if you can grow it, you should eat it.
 
Finally, don’t let the graph on the treadmill dictate how hard your workout is or what your heart rate should be; find an activity you enjoy doing, and do it often. If you prefer a more moderate intensity workout, that’s fine, but don’t be afraid to kick it up a notch once in a while; the results may surprise you.

http://chapelboro.com/columns/the-fit-files/the-fat-burning-zone/

Exercise: Decrease Hunger Pains, Increase Safety

Reason #5,989,432 to Exercise: Decrease Hunger Pains, Increase Safety

I have started to work out yet again at a wonderful location in Pittsboro that focuses on wellness from a medical perspective and learned something new from my personal trainer this week: See Below!!

       There are multiple studies that are linking exercise to suppressed appetite, which means a double-whammy for calories as you burn them during exercise and consume less in your diet. 

The University of Campinas found that exercise increases two specific proteins in your hypothalamus that are responsible for appetite control. The presence of these proteins in the part of the brain that receives information from hunger hormones, such as leptin and insulin, allow your brain to become more sensitive to signals of hunger and satiety. This means that you are more accurate in your assessment of when to eat and when to stop.
Additionally, there is a concern that increasing exercise will initiate the feedback loop of calorie replacement, causing you to consume more calories post-exercise. The Institute of Health and Biomedical Innovation found that participants who burned an extra 500 calories a day during the course of the study began to feel fuller quicker at each meal. 
Lesson learned from the above-mentioned studies: exercise regularly and listen to your body as it pertains to hunger and satiety. Taking care of your body with regular exercise, as well as healthy meal choices and portions, allows your body to become more efficient in secretion, delivery, and absorption of vital nutrients, enzymes and hormones.
 
Ellen Thornburg
Exercise Physiologist
 
With that said I have a goal for the next three months and would like to have partners join me in my quest. Interested in working out together particularly on Tuesdays for Zumba class send me an email at prichardson@gallowayridge.com
 
Source:
www.realage.com
http://chapelboro.com/columns/enjoy-life/exercise-decrease-hunger-pains-increase-safety/

Zumba…OMG!

Am I the last person in the Triangle to participate in “The Original Fitness-Party” better know as Zumba?

I actually took my first Zumba class two weeks ago and loved it. In my class there was a mix of ages from 20 years olds to baby boomers to seniors. There was this wonderful senior taking the class and guess what….she was 81 years old!  Needless to say, I am heading out to take the class again this evening at 5:30 and have added this salsa, merengue and hiphop music dance craze to my to-do list every Tuesday.  Do I have goals with taking this class? Yes: my goal is to increase my cardio efforts, breathing, lose 2 dress sizes……..yes, I did share……and to tone in areas that are not so friendly anymore. 

If you haven’t taken a Zumba class yet, I strongly suggest you find a location in your community and join in. It’s so much fun, and the music and dance moves make the hour go so quickly. The moves can be modified if needed, and when you finish you feel the workout, but not in a bad way. I had more energy when I finished the class than I did when I started. 

Go Zumba!!!  Who wants to join me for a class next week? Just shoot me an email at pat@chapelboro.com. See you on the dance floor!!

http://chapelboro.com/columns/enjoy-life/zumba-omg/

Ramblin’ Rose Triathlon

I read an article recently analyzing the anxiety most women have about wearing a bathing suit in public. It seems that for the vast majority of women, specifically 87% of those interviewed for the article, the biggest source of fear is . . . other women.

This statistic should come as no surprise. With respect to most every decision that affects women, be it child birth issues, parenting, career choices or what clothing and accessories they adorn their bodies with, it’s women themselves who are the harshest critics.

As to the bathing suit matter, I myself am guilty of scrutinizing my fellow females and passing judgment. This is not something I’m proud of, but in the interest of full disclosure, I’ll admit it to be true. I spend an inordinate amount of time at the beach and the pool analyzing what other women are wearing and critiquing their selections.

Oh, don’t be so shocked. I’ve talked to my friends about it and they all do it too. In fact, I’d even venture to guess that you are all similarly at fault. 87% of us wouldn’t be so worried about what other women are going to think if we ourselves weren’t doing some of the judging. They say women dress to impress other women. Perhaps. My take is that women dress to look at least as good as, or better than, other women.

Because the truth is, as much as I may critique other women’s bodies and wardrobe choices, I judge myself the hardest. Why is it that when women look at their reflection they don’t see their best features but a magnification of their flaws?

In any event, my own dissatisfaction with my body is the primary reason I began exercising regularly several years ago. It wasn’t a concern for my general health and fitness that was the impetus, it was the desire to continue to wear a two-piece bathing suit into my 40’s. Again, I’m not particularly proud of this, but it is what it is.

But this absurd vanity has led me on a journey I would not otherwise have taken, and it has been a good one so far. I have met people I would not otherwise have met, participated in events I would not have given a second thought to just a few years ago and reached far beyond my comfort zone to discover a whole new subculture of triathletes.

This past Sunday I had the good fortune to participate in my second triathlon, this one a very different race than my first. This super sprint distance triathlon was part of the Ramblin’ Rose series of women-only events. The purpose of the Ramblin’ Rose series is to celebrate the empowerment of women and benefit charities that are focused on enabling women and girls.

At the Raleigh Triathlon there were approximately 850 female participants. Ages ranged from 10 to 69. Race officials estimated that for every race participant there were on average 5 to 6 supporters. In short, I was one of a whole lot of people!

My first triathlon was serious and competitive. Also a little intimidating. Pretty much everyone there looked like they had walked straight out of the pages of some athletic magazine. Not so at the Ramblin’ Rose event. Sure there were some serious athletes. But there were also a good number of pretty average-looking women — women for whom athletics might be an infrequent indulgence rather than a way of life. There were even some women who didn’t look like they could handle a sprint from the parking lot to the starting point, much less make it through a swimming, biking and running course.

It was a true cross-section of society – women of all colors, ages, shapes and sizes. Women at the top of their game, and women who, quite honestly, really need to rethink their decision to wear spandex and forego the extra support sports bra. There were many women there who had never before participated in such a strenuous exercise. But for one reason or another, each of these women chose to rise above whatever physical or emotional hurdles were in her path, give up her Sunday morning and put herself through the challenge of a triathlon.

With that many race participants, the event was a little nerve-wracking. Lots of bodies moving in close proximity are not always a good, or a safe, thing. But the beauty of this event was the atmosphere. It was one of camaraderie. It was celebratory. Women (and men) helping each other out, encouraging each other, cheering each other on. From those athletic few who came in first to the last huffing and puffing stragglers trudging to the end, every single effort was hailed a success.

After crossing the finish line, I watched hundreds of happy racers and their ecstatic family members and friends, smiling, hugging each other, marveling and rejoicing in their amazing accomplishment. And it didn’t matter to anyone about clothing choices or body shapes. It didn’t even matter that some really shouldn’t have been wearing spandex and definitely should have gone for the extra support sports bra.

These women of all colors and ages and shapes and sizes were all winners and they were all beautiful.

http://chapelboro.com/columns/just-another-day/ramblin-rose-triathlon/