A recent issue of the Annals of Internal Medicine tried to put a nail in the coffin of nutritional supplements. “Unregulated, not safe, harmful, and no benefits” shouted the authors of the Letter to the Editor of the journal. Yet another attempt by physicians and the pharmaceutical industry to put a damper on the use and sale of vitamins and minerals.
It is no secret that we, as men, have failed miserably when it comes to our health. According to The Men’s Health Network (MHN), we die at higher rates than women from the following top 10 causes of death: heart disease, cancer, stroke, chronic obstructive pulmonary disease, accidents, pneumonia and influenza, diabetes, suicide, kidney disease, and chronic liver disease and cirrhosis. If you examine the list above closely, you will notice that most of them are preventable
All the B vitamins are key for energy and metabolism, from B1 to B12, but certain B vitamins also have other super-powers, helping us to relax, sleep better, burn calories, and to absorb other crucial B vitamins.
Health Coaches are trained to take an interesting approach in implementing a plan to help their clients. Successful Health Coaching programs have designs within that let the client set their own path to better health. That’s right. The client is often the one to determine which actions to take in obtaining, or retaining, the next level of better health that they hope to achieve.
Does this sound crazy? Well, if you think about the way things work in the world of sports, it makes great sense. Coaches coach and players play. The “player” in this instance is the client and the client is playing the game of life. It is their life. It is the client’s game to play. A coach’s role is to prepare the player (or person with the desire to improve their health) for action. A coach is there to guide. A great coach is one that asks the right questions; questions that bring awareness to the client’s needs and ultimately provide answers which will empower the client to proclaim their own path forward.
This is not to say a coach does not have a philosophy to which they adhere, or a knowledge base used to guide their clients. Nor does it mean that a coach will not step in and offer a more sensical path if the client chooses a step that clearly is not beneficial, or worse, potentially harmful. It simply means that the client can take the lead in determining the direction of their greatest gift, their own health. Instead of leaning on the coach like a crutch for support, the “player” stands on their own two feet.
Being told what to do and how to act is not a very effective way for making wholesale lifestyle and/or behavioral changes. The growth must come from within. The client must see and feel the importance of each step for themselves. Empowering the client to be aware enough to see the next possible, available, or achievable step is rewarding and the key to long-term growth.
It is common for a Health Coach, especially at the very beginning of the coach’s and client’s time together, to ask the client to simply observe their own behavior. As the great Yogi Berra once said, “You can observe a lot by just watching.” Seems simple, right? It is simple. The path to better health does not need to be complicated.
Pay attention to your own behavior and make note of what you observe. Or better yet, write down what you observe.
…And on and on. These are just a few observable daily occurrences that a coach may suggest keeping an eye on to prime the pump, so to speak.
Asking a client to be a witness to their own life, their actions and how it relates to their current state of health, to be a detective and gather evidence on their own behalf is a sure-fire way to have the client detect their own tendencies, positive and negative, invest in their own progress and unturn areas that can propel them towards improved health.
Brian Prendergast is the Founder and Head Coach of High Five Health and Fitness, and Co-Creator/Co-Host of The Two Fit Crazies and a Microphone Podcast. Brian is a Certified Integrative Nutrition Health Coach, Certified Personal Fitness Trainer and Group Fitness Instructor, and USA Track and Field (USATF) Level 1 Coach and Competitive Masters Runner.
The winter holidays are often a barrage of non-stop feasting that spans from Thanksgiving to the Super Bowl. Week after week, you indulge yourself with goodies, justifying your poor food choices in the name of holiday cheer. You promise yourself to mend your ways as soon as the excitement dies down, but meanwhile the pounds creep on and bad nutrition becomes the new normal. Cleaning up your act is a process, but you can speed it up by taking some proactive steps.
Gifts of food abound during the holidays, and if you are like me, you still have plenty of sweets, snacks and junk food in your fridge and cupboards. To get your diet back on track, begin by banishing the bad stuff. If you cannot bear to throw perfectly good food in the trash, donate to your local food bank or homeless shelter. Or throw one final bash, featuring your holiday stash of goodies as the main course. Clean and organize your refrigerator to make room for fresh produce, filtered water and whole foods. Rearrange your cupboards so that healthy food options are at eye level.
Sugary foods and carbohydrate-laden snacks and meals are holiday mainstays that can wreak havoc with your insulin balance. Going cold turkey on the simple carbs can cause discomfort and cravings that last for two or three days, but it is one of the quickest ways to normalize your blood sugar and reset your metabolism. Adding high intensity exercise can speed up the process. Create a menu plan for your week that includes fresh fruits and vegetables and healthy proteins, and stock your fridge with ingredients. Planning and preparing healthy snacks and meals ahead of time will keep you from being tempted to grab fast food.
The end of the Holiday Season does not necessarily mark the end of the eating season. Valentine’s Day and Girl Scout Cookies loom on the horizon. Prepare for the onslaught by making committed decisions in advance. Instead of preparing special foods for Valentine’s Day, plan a romantic getaway or a movie date night. Ask your sweetie for flowers or jewelry instead of candy. Decide ahead of time to purchase only one box of Girl Scout cookies, and ration them out at the rate of one cookie per day. If you want to help out the Scouts, they accept donations in lieu of a cookie purchase.
Jay Del Vecchio is the Founder and CEO of the World Instructor Training Schools (W.I.T.S.). Jay is an advocate for establishing national standards for the health and fitness training industry.
There are more health claims made about vitamin D than perhaps any other vitamin. Media stories touting vitamin D for this ill or that are common, particularly in the age of COVID-19. We’re also frequently told Americans don’t get enough vitamin D, with surveys showing as many of 40% of individuals have below optimal amounts in the blood. So how do we get vitamin D and what claims are true and backed by research? Let’s take a closer look at vitamin D to flesh out what we know for sure and where more research is needed.
Molecularly, vitamin D is a group of fat-soluble compounds with a four ringed cholesterol backbone. What’s most important to know is that it comes in two forms — as vitamin D2 in food and as vitamin D3 in our skin.
Vitamin D3
Our skin is our primary source of vitamin D, but it begins there as an unorganized and inactive form, requiring UV exposure to convert to usable vitamin D3. Conversion via UV light is exceedingly efficient, and it’s estimated brief exposure of the arms and face is equivalent to ingesting 200 international units day. Conversion varies however with skin type (darker skin converts more), latitude, season and time of day. Infants, disabled persons and older adults often have inadequate sun exposure as well, and the skin of those older than 70 also does not convert vitamin D as effectively. Interestingly, vitamin D also requires temperature to be activated, so you may not get as much of a benefit from sunlight in the winter months as you might expect.
Vitamin D2
Because it is fat-soluble, dietary vitamin D2 is best absorbed with fat in the diet and fish is a common source. Uptake can be negatively impacted by disorders associated with fat malabsorption such as celiac disease, Crohn’s disease, pancreatic insufficiency, cystic fibrosis, short gut syndrome and cholestatic liver disease.
Once activated and in the bloodstream — either by UV exposure or absorption through the diet — the liver converts vitamin D to 25-hydroxyvitamin D (25[OH]D), and then the kidneys further convert it to 1,25 hydroxyvitamin D, the most active form of vitamin D in the body. For this reason, kidney and/or liver problems can also negatively impact vitamin D levels.
Interestingly, all cells in our bodies have receptors for vitamin D, and this has in part fueled the varying claims as to how it might impact health. What we know for certain is that it helps with calcium absorption in the gut, regulating calcium levels via the kidneys, and regulating parathyroid hormone. Vitamin D’s role in calcium regulation and absorption means it has a direct impact on healthy bone growth and turnover. For this reason, you often see it in calcium supplements.
Research has also shown a clear correlation between Vitamin D and muscle health, including research showing improved lower body strength. Some research has also shown vitamin D can help prevent falls in the elderly.
Naomi L. Albertson M.D. is Board Certified by the American Academy of Family Physicians and specializes in the non-surgical management of musculoskeletal problems, sports injuries, concussions, and the treatment of osteopenia and osteoporosis.
Mounting evidence suggests that we may be able to live a longer, healthier life by strategically restricting our energy intake. For many years the scientific community has known that a surplus of energy intake results in the storage of fat, which is linked to chronic disease, and premature death. However, now emerging evidence suggests that restricting calories may be able to slow the rate in which we age. Aging can be categorized as either primary or secondary. Primary aging is considered inevitable at the date of this publishing and is the biological maturing and eventual breakdown that accompanies the years of age beyond 30. Secondary aging comes from external influences such as obesity and lifestyle factors that cause cellular damage and is not part of the natural aging process. (2)
What is calorie restriction? Calorie restriction describes a process where one limits the amount of food they consume. The term calorie is a shortened term originating from kilocalorie and is used as a measurement of food energy. When the body has an excess of calories beyond what it needs to function it stores those calories in our body as fat. Despite the diet industry’s most sincere efforts and propaganda, studies still do not support the effectiveness of one fad diet over another for weight loss. (13) This means, weight gain, and weight loss are ultimately determined by the number of calories consumed, and the number of calories expended.
Earlier we identified obesity as contributing to secondary aging. The scientific community has established that being overweight, or obese dramatically increases your risk of cancer, heart disease, and type II diabetes, among other chronic disease, thereby reducing life expectancy. In fact, people that are 100 pounds or more overweight can expect a life expectancy that is nearly 14 years less than the national average. This is a shorter life expectancy than that of someone who is of a healthy weight and smokes cigarettes. (3, 12) A calorie reduction below what your body is expending results in weight loss, and for those who have a higher than healthy level of body fat, can expect a reduction in not just their weight but in secondary and primary aging.
There are many misconceptions of what constitutes being overweight or obese. A person is classified as being overweight if they have a BMI (body mass index) of 25 or higher, and obese if they have a BMI of 30 or higher. BMI is calculated by dividing your weight in kilograms by your squared height in meters. BMI is likely a fair indicator if you are relatively inactive. If you are engaged in a fitness program or are an athlete, an alternative approach to determining healthy weight is by determining percentage of body fat. A healthy body fat is typically considered to be between 8-22% for men and 20-35% for women (aged 18-34). A classification of obese may be assigned if someone has a body fat percentage of 26% or higher for men and a body fat of 39% or higher for women. (7) As always if you’re not sure where you fit into these metrics see a credentialed fitness professional or consult with your primary care provider.
It is estimated a calorie deficit of 200-500 calories daily is required to achieve healthy weight loss. Two ways to achieve this deficit are to reduce calorie consumption and increase calorie burn (expenditure). Calorie burn can be increased through additional physical activity; however, it should be cautioned that one can consume calories at a far faster rate than physical activity can burn them. As an example, it is estimated that a 180-pound man burns approximately 14 calories per minute jogging (1). As a point of reference, a single Hershey kiss contains 22 calories. The lesson here is to use physical activity in addition to a nutritious diet, not in place of a nutritious diet. (For more information on a nutritious diet visit choosemyplate.gov.) Give special attention to the section on vegetables, especially non-starchy vegetables as they are high in vitamins and minerals and low in calories.
For persons of a healthy weight, calorie restriction appears to offer slowed primary aging. The current school of thought is that primary aging is slowed as a result of a protective cellular reaction triggered by the calorie restriction. There is still much we do not know about the mechanisms responsible for this anti-aging phenomenon and some debate among scientists exists. However, the most common consensus among scientists is that this reaction collectively comes from activating sirtuins, increasing AMPK, impacting MTOR, and an improvement in blood sugar. (8,10,15,16,17,18) If you do not know what any of that means here’s a quick break down but don’t fret if you are not familiar with the lingo.
Regardless of how precisely these mechanisms work or interact what we currently believe and have pieced together is a reduction in calories likely:
The takeaway here is achieving and maintaining a healthy weight is the first step to a healthy lifespan and the incorporation of strategically fasting, may bring additional health and longevity. Fasting has been embedded in our culture in many ways from traditional religious observances as well in the fitness industry, but the question is what scheme and plan will work best for you. Most would agree it’s the health span (length of superior quality of life attributed to good health) more than the lifespan that’s important, and while there is currently no fountain of youth this appears to be a good place to start.
Remember, of course, to consult with your primary care provider before undergoing dietary changes.
Jeremy Kring holds a Master’s degree in Exercise Science from the California University of Pennsylvania and a Bachelor’s degree from Duquesne University. He is a college instructor where he teaches the science of exercise and personal training. He is a certified and practicing personal/fitness trainer, and got his start in the field of fitness training in the United States Marine Corps in 1998. You can visit his website at jumping-jacs.com
References
(-) “When and+ accumulates, such as during scarcity of nutrients especially glucose, sirtuins are activated….”
America is in bad shape. According to the Centers of Disease Control (CDC), 60% of adults are living with one chronic disease and 40% have two or more.(1) Astoundingly, 12% of adults are living with 5 or more chronic conditions(2) including cardiovascular disease, diabetes, obesity, coronary obstructive pulmonary disease and hypertension. A concept people need to understand is that these diseases can be prevented, managed and even reversed with lifestyle choices.
The COVID-19 pandemic has shown a bright light on how our level of health can literally be a matter of life or death. A study of thousands of patients hospitalized with the novel coronavirus in the New York City area found that 94% had one chronic disease and 88% had two or more. The most common conditions included hypertension, obesity and diabetes.(3) In May of this year, the CDC reported that people with an underlying chronic illness had six times the risk of being hospitalized and twelve times the risk for dying.(4)
Now is the right time to take small steps to improve health and build immune resilience with daily lifestyle choices. While there isn’t one diet, exercise regimen, or stress-relieving technique that is good for everyone, there are principles to follow that can boost health and vitality at any age.
There is a huge misconception that our genes determine our health destiny. This simply isn’t true. The study of epigenetics shows that we have the ability to change the expression of our genes by the way we think, feel, move and eat.(5) Each of our daily decisions and choices can increase or decrease inflammation in the body, moving us towards disease or back to health.
Our immune system uses the ancient, biological pathway of inflammation to protect us against injury and infections.(6) When you cut your finger, immune cells are sent to kill invading bacteria and begin the process of wound healing. This is acute inflammation that goes away in days or weeks when the body is healed.
One the other hand, chronic inflammation lasts a long time, from months to years.(2) It’s basically an abnormal immune response that causes damage to cells, tissues and organs. Oxidative stress plays a big role; it occurs when more free radicals are produced within cells than the body can neutralize.(2) As you can imagine, when more damage occurs than can be repaired, health problems crop up.
It is now widely accepted that chronic inflammation is at the root of most, if not all, chronic conditions like cardiovascular disease, diabetes, obesity, hypertension, cancer, arthritis and joint disease.(2)
The good news is that deliberate and healthier lifestyle choices can prevent, manage and even reverse chronic inflammatory disease, the most important cause of morbidity and mortality facing people today.(7) It’s empowering to know that if you have, or want to prevent a chronic disease, you can regain your health and vitality by choosing real whole foods, optimizing sleep, reducing stress, being social, and moving more.
You may be thinking, “How the heck can simple lifestyle decisions address the complexities of chronic conditions?” The body has an innate ability and intelligence to heal itself. You experience it each time you cut your hand; you wash the wound, put a bandage on and don’t have to think about it.
The research also supports it and I have lived it; by utilizing the power of lifestyle medicine I was able to restore my health from the ravages of chronic Lyme disease. You just need to provide the right environment for healing. This is not an easy task, but it can be done with time, effort and a plan.
Changing your lifestyle habits can feel overwhelming. To help you embrace this challenge, think about this analogy, “How do you eat an elephant? One bite at a time!” Any healing journey begins with awareness, learning and exploration; then gradually taking action, one small step at a time.
Start today by exploring lifestyle behaviors that decrease inflammation and can put your health back on track so you can live with less pain, more energy, and greater vitality. A lifestyle prescription to restore health includes:
Be proactive, make one hour a week to learn more by reading books, researching on PubMed.gov, listening to podcasts, attending lectures and webinars so you can find the strategies and practices that work best for you. As you begin to feel better, you will naturally be motivated to continue learning and making better lifestyle choices because healthy feels so good!
Search the free MedFit Network directory to locate a professional near you! MedFit Network maintains a free directory of fitness and allied healthcare professionals who can work with individuals with chronic disease, medical conditions or the senior population.
Cate Reade, MS, RD is a Registered Dietitian, Exercise Physiologist and Functional Medicine Practitioner candidate on a mission to improve functional mobility and health span utilizing the power of lifestyle medicine. She has been teaching, writing and prescribing healthy eating and exercise programs for over 25 years. Today, as CEO of Resistance Dynamics and inventor of the MoveMor™ Mobility Trainer, she develops exercise products and programs that target joint flexibility, strength and balance deficits to help older adults fall less and live more.
References
Physical activity has been demonstrated to positively affect over 30 chronic conditions and is considered the best deterrent of chronic disease in primary and secondary prevention. The main goal of a Medical Fitness Specialist (MFS) in the healthcare continuum is to prevent the onset of chronic disease and bridge the gap between clinical intervention and conventional fitness programs. This is achieved by developing exercise programs for those who have or are at risk for chronic disease or dysfunction, have health conditions that may be mitigated or managed by exercise and activity, are newly diagnosed with a disease and need exercise guidance, or have completed a medically supervised rehabilitation program and need to continue to progress. A fitness professional versed in medical fitness protocols, such as an MFS, can work with those who are at risk for chronic disease.
Scope of practice refers to boundaries set by knowledge, skills, and abilities (KSAs), as well as education, experience, and demonstrated competency, such as a program of study, or an exam to measure proficiency. A basic personal training certification suggests the holder can develop exercise programs for apparently healthy clients. Unfortunately, considering the overweight and obesity rate is near 70%, and 50%-60% of the adult U.S. population has at least one chronic disease, adhering to scope of practice becomes increasingly important, yet at the same time many fitness professionals may be providing services outside their scope of practice, and beyond their level of certification. By accepting a client, the trainer is proposing a safe workout will be developed and implemented, and the client will not be at risk of injury. If advice is given that is not within the trainer’s scope of practice, the trainer and the facility may be subjected to a lawsuit.
An MFS who integrates medical fitness into practice has the KSAs, based on education, experience, and demonstrated competency to conduct pre-participation interviews, perform fitness assessments, and design and implement health and fitness programs for disease management to avoid future injury and to improve activities of daily living. Unlike an MFS, unless otherwise educated, a fitness trainer who promotes medical fitness is not a licensed healthcare provider and does not possess the KSAs to diagnose an unknown condition, suggest supplements, design meal plans, physically touch a client or provide behavioral counseling.
In the United States, medical care tends to focus on treatment rather than prevention. Whereas treatment is given for a diagnosed disease or injury, the goal of prevention is to avoid, improve or slow down the progression of a probable or possible disease or injury. Prevention can be categorized as primary, secondary, or tertiary. The goal of primary prevention is to foster a life of wellness and therefore avoid or reduce the chance of disease or dysfunction. Primary prevention includes immunizations, targeted types of exercise, balanced nutrition and wellness, and education programs. Secondary prevention is managing a symptomatic disease in the hopes of slowing down or reversing the progression. Examples include treatment for hypertension, asthma, and some cancer treatments. Tertiary prevention involves the management and treatment of symptomatic disease with the goal of slowing progression and severity, as well as reducing disease-related complications. Tertiary prevention includes treatment for late-stage cancer, coronary heart disease, and some types of rehabilitation to include orthopedic, cardiac, and pulmonary. Physical activity has been demonstrated to effectively treat over 30 chronic conditions, mostly in primary prevention but also in secondary and tertiary, making it the number one intervention against chronic disease.
Due to the growing incidence of obesity and chronic disease, leveraging the skills of various providers who can collaborate to deliver the best possible care, based on clinical needs, is necessary to manage the complex health care demands of a population with an increasing incidence of comorbidities. Due to a worldwide shortage of health workers, in 2010, the World Health Organization (WHO) recognized interprofessional collaboration as means to mitigate the global clinician shortage, strengthen health systems and improve outcomes. Interprofessional collaboration refers to health care teams, made up of trained professionals with various backgrounds, who work alongside patients and their families to provide high-quality care, based on the needs of the patient. Consequently, as medical providers begin to recognize the need to prescribe evidence-based exercise as an intervention in the management of chronic disease, MFSs, who are on the front line of health care, are trained and educated to be part of a clinical team that complements and leverages the strengths of each team member to improve population health. As health science and technology advance, it is imperative for fitness professionals who work with clients who have one or more chronic diseases to remain up-to-date on emerging fitness protocols. An MFS is required to participate in continuing education in areas including cardiopulmonary disease, metabolic disorders, and orthopedic dysfunction.
Although the scope of practice of many allied healthcare fields overlaps, the role of the MFS is to work with the client’s team of other healthcare providers, while staying within the scope of practice, based on KSAs. Regardless of the collaborative health team, the client’s physician is always the center, and as such should be provided regular updates as to the client’s progress.
An MFS is uniquely qualified to work with individuals within the healthcare continuum. Some KSAs associated with MFSs are:
Check out MedFit Classroom’s 20-hour online course, Medical Fitness Specialist. This course is designed for fitness and health professionals who want to learn more about using exercise as medicine with clients who suffer from one or more chronic diseases. As a Medical Fitness Specialist, you will be able to prevent and/or manage numerous chronic diseases and collaborate with clinicians.
This article was featured in MedFit Professional Magazine.
Dan Mikeska has a doctorate degree in Health Science and a master’s degree in Human Movement, as well as certifications from NASM, ACE, the Cancer Exercise Training Institute and the Exercise Is Medicine credential from ACSM. He currently owns NOVA Medical Exercise and Medical Exercise Academy and is adjunct faculty for A.T. Still University’s Master of Kinesiology program.