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grapefruit salad meal

Eat Well, Live Well, Age Well

Eat Well, Live Well, Age Well will be an entertaining, yet informative webinar based on my new book. I’m a nutritionist, chef, personal trainer, and wellness educator who shows people of all ages how to understand and embrace aging with strategies that help each of us live life to the fullest as we move on in years.

This is a very timely topic, whether we are that aging person, or a youngster entering professions that will have an increased responsibility to cater to a nationwide demographic of an aging population.

Eat Well, Live Well, Age Well conveys that there is no such thing as anti-aging… while growing old is inevitable and should be embraced, all of us can make every day of our lives wonderful through lifestyle habits that work. Living well is the only way to survive and endure aging.

Eat Well, Live Well, Age Well, will teach you that physically, emotionally, and professionally, we all have room to learn and grow. By following the simple concepts outlined in this session you can dramatically reduce the stresses that contribute to energy drain and premature aging.

Eat Well, Live Well, Age Well poses the questions we all have about aging, with practical solutions to follow. What we usually take to be negative aspects of aging will be accompanied and countered by strategies to live well. Fun tips and informative solutions for combating age related issues will be provided.

Eat Well, Live Well, Age Well looks into scientific research that is showing promising results to stave off the ill effects of a diminishing body through food choices, medical intervention, lifestyle and emotional behaviors.  With a positive attitude about aging, and understanding what is going on with you, you can dramatically improve the quality of your life. Mental attitude and how you see yourself today, will play a huge role in keeping you feeling youthful and vibrant in all your days to come.

Join me for this webinar! Click here to register.

Patricia Greenberg, The Fitness Gourmet has 30 years of experience as a Nutritionist, Chef, and Wellness educator. Patricia holds a BS in Nutrition and Food Science from Queens College, NYC, a Culinary Arts Degree, from Le Cordon Bleu in Scottsdale, AZ, and is an ACE Certified Trainer, with a sub-specialties in Sports Nutrition and Senior Fitness. She is also certified as a Dementia Friends Seminar educator through Alzheimer’s LA. She is the author of four books, “The Whole Soy Cookbook”, “Soy Desserts”, “Scrumptious Sandwiches, Salads, and Snacks”, and, “Eat Well, Live Well, Age Well!” She is a regular guest expert on both national television and radio programs, which over the years, has had an impact on the lives and health of thousands of people.

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How Should You Eat During Lockdown?

Has anyone else heard the call of their refrigerator nonstop during lockdown? It’s bad enough that we can’t go to the gym anymore and can wear stretchy loungewear all day, but to have access to your own fridge 24/7? It will be truly impressive if anyone can come out of this without having put on weight… 

Luckily, there are a few simple tricks to try to keep the unhealthy cravings at bay throughout isolation and preserve both your figure and your overall well being. Here’s what to consider the next time you reach for that Sub-Zero handle:

Avoid Snacking

When we’re bored, we naturally gravitate towards eating. It’s something to do that gives a hit of instant gratification and we’re all guilty of eating when we’re not hungry from time to time. Snacks are the worst because it’s hard to know when to stop and before we know it we’ve polished off that bag of Doritos and two tubs of Ben & Jerry’s. Oops.

We’re not saying no snacks are allowed, but instead of letting yourself go wild in the snack cupboard, try cutting back to one morning snack and one afternoon snack and leave it at that. If you simply must nibble on something every hour, opt for healthy choices like raw almonds or dried fruit. Sounds boring, but you’ll get the hang of it if you stick with it.

Stop Eating Lots of Sugar

If there’s one silent but deadly culprit hiding in just about everything packaged, it’s sugar. You already know it’s bad, but how bad? Let’s put it this way: Sugar can damage your heart, add unwanted belly fat, it’s toxic to your liver, bad for your brain, and is linked to cancer. That’s just the tip of the iceberg. If you haven’t ever thought about your thrice-daily desserts before, quarantine is actually a great time to do a little research and rethink what you’re putting into your body. You are what you eat! And we don’t mean sweet. 

Don’t Overdo It on Carbs

Carbs will quickly make you put on weight, so it makes sense to cut back during this period where you’re not as active. Of course, your body needs some carbs, but you definitely don’t need a doughnut with breakfast and a roll with dinner. 

Here’s an easy swap: instead of bringing out the tortilla or potato chips to scoop into hummus, exchange them for some crisp raw chopped cucumber, carrot sticks, or red pepper slices. You may not be a fan of the veggies uncooked on their own, but with the hummus it’s actually really tasty. You’ll feel more energized after this snack as well. A win-win.

Don’t Forget About Fruit and Veg

The best way to boost your immunity? Eat lots of food with natural color. We’re talking ripe red strawberries, dark blue blueberries, leafy green spinach; the works. You can also get lots of Vitamin C from oranges or a morning glass of natural OJ. You want to get as many nutrients in as possible to help your body out during this period where we are all particularly susceptible to illness. Natural, healthy nourishment is always a good idea. 

Skip Deep-Fried, Processed Foods

Fried foods like French fries may be a go-to treat for many, but they should, for the most part, be avoided during lockdown. Although it’s tasty, junk food is really bad for your brain as it spikes your sugar levels, but doesn’t provide any real nutrition. We all know they’re not good for us and just because we have a creeping feeling of despair over being locked indoors all the time does not mean that we should indulge in all of the most unhealthy foods. Trust us, it won’t make things better. 

Don’t Make Every Hour Happy Hour

The home bar may always be open, but that doesn’t mean drinking a glass of wine for breakfast everyday is acceptable. Drinking every day is not only terrible on your body – liver, skin, immune system, it’s also bad for your mental health. Plus, alcohol is made from sugar or starch, so you are drinking many calories without even realizing it. It’s ok, it’s not too late; just put down the glass and walk away slowly…

It’s not easy to eat healthy all the time, but if you avoid these toxic habits, you’ll feel a lot better overall during quarantine. Good luck and stay safe and healthy!

Rae Steinbach is a graduate of Tufts University with a combined International Relations and Chinese degree. After spending time living and working abroad in China, she returned to NYC to pursue her career and continue curating quality content. Rae is passionate about travel, food, and writing for Yummie.



Picture courtesy of Pexels.


Stop Stress Eating with These 3 Simple Steps

Do you often eat as a reaction to stress, anxiety, and other unwelcome feelings? Do you turn to high-fat, sugary “comfort foods” to cope with negative emotions? Discover why you stress eat in the first place, why it works, and some simple steps for doing some damage control.

Some say it’s “stress eating.” Others call it “self-medicating.” Psychologists describe it as “emotional eating.” Whatever words are used, if you often (over)eat to self-soothe negative feelings such as boredom, stress, anxiety, or anger—in other words, for reasons other than hunger and having a healthy appetite—it’s likely you’re a stress eater. Not only does stress eating increase your odds of overeating, my own original research on overeating reveals that Emotional Eating is the #1 predictor of overeating and becoming overweight or obese.1,2

Here’s what stress eating might look like:

For Ann, stress-related overeating episodes often start after work, especially when she’s on deadline with a large project. First, she visits her local supermarket to buy a bag of potato chips, a pint of her favorite ice cream, and a bar of creamy dark chocolate. Then she heads home, changes into comfortable clothes, and turns on the TV. Settling into bed surrounded by her favorite comfort foods—and sometimes, a glass of red wine—Ann begins what she describes as “zoning out”—eating until she feels calmer—often to the point of falling in and out of sleep well before bedtime.

All the while, Ann remains vaguely anxious and distressed about her workload, and dependent on food to manage her darker moods. And she’s concerned her stress eating is keeping her overweight. At the same time, on a not-quite-conscious level, she senses the chips and chocolate allay her anxiety in some way. And she’s right: High-sugar, high-fat, high-carb food (products) do indeed relieve emotional tension. Here’s why.

The Food-Mood Connection

The idea that the food you eat can actually medicate your mood and vice versa—that your mood may motivate you to make certain food choices—was given the scientific stamp of approval in the 1970s when Judith Wurtman, PhD, a scientist at the Massachusetts Institute of Technology, uncovered a fascinating facet of the emotional eating enigma. Call it nutritional neuroscience, psychoneuroimmunology, or the study of food and mood, Wurtman launched a new field of nutrition research that has confirmed what many of us know intuitively: what you eat affects your mind and mood, your tendency to pile on pounds, even the quality of your life.

What Wurtman discovered is this: About twenty minutes after you eat a carbohydrate-rich food (such as bread, potatoes, cookies, or cake), your brain releases a naturally occurring substance called serotonin; in turn, you feel more relaxed and calm. Want to feel more perky? Consume a lean, high-protein food such as fish, and the substance that’s released (norepinephrine) lets you feel more awake and energetic (unlike the kick you get from caffeine, you’re not stimulated, just more alert). And certain fats in food end up as endorphins—substances in the brain that produce pleasurable feelings.3 More recent research, specifically on stress eating, reveals that women under stress experience strong sugar cravings that lead to overeating high-carb, high-sugar foods.4

The Food-Mood Syndrome: It Can Be a Vicious Cycle

Here is where the food-mood link really gets interesting. Since Wurtman’s discovery about the food-mood connection, we also know that the sugary, sweet, or crunchy and fried processed food products that emotional eaters most often choose to get a serotonin high actually contribute to deficiencies in certain vitamins and minerals that can cause your emotions to plummet, leading to a serious case of the doldrums.

In this way, the food-mood syndrome can become a vicious emotional cycle. You’re feeling down, so you reach for, say, a prepackaged brownie. Sure, the brownie’s sugar and white-flour carb content will soothe and calm you, but its high sugar content has a hidden side effect: it actually depletes some nutrients that could help combat depression. In other words, the sweet concoction may somehow soothe your soul, but isn’t it ironic that at the same time, it may also contribute to anxiety, depression, and other unpleasant emotions?

3 Smart Steps to Stop Stress Eating

Want to get the mood-calming, feel-good benefits of serotonin without the vitamin and mood-robbing downside inherent in high-sugar, highly processed foods? Here are three smart, simple, proactive steps you can take to curtail stress-related overeating episodes—without the downside.

Be “B” wise. From dreary doldrums to a deeper depression, various B vitamins—including B1, B2, niacin, folate, and B12—can help you bust the blues. But most B-family relatives are processed out of refined foods, such as white flour. To help defeat depression, “B” wise and consider some especially good B-abundant blues busters found in unprocessed, unrefined grains (oats, millet, brown rice, etc.), fruits, vegetables, beans, nuts, and seeds. Consuming vitamin B–rich greens such as spinach are especially good for overcoming overeating.

Shake the sugar habit. Consuming a lot of refined white sugar both damages and destroys B vitamins in the body; in this way, it contributes to deficiencies. Cut down on, or eliminate sugar from your diet, and depression often lifts—although why this is so isn’t well understood. One theory is that the “high” a person derives from sugar is due to elevated glucose (blood sugar) and feel-good endorphins, which produce feelings of relaxation and euphoria. Conversely, when a diet is low in sugar and high in B vitamins, levels of B vitamins, glucose, and endorphins remain stable, reducing odds of depression.

Sip some tea. Consuming too much alcohol to relax and de-stress can cause the loss of certain B vitamins—and deficiencies of vitamins B6 and niacin, especially, can bring you down. Not only does excessive alcohol consumption reduce the absorption of B vitamins, but it also contributes to protein and mineral deficiencies. The operative words here are “too much” and “excessive,” meaning, the tipping point is different for different people. Consider this: In place of wine to de-stress, try sipping some soothing herbal tea.

Stopping Stress Eating

The science that studies nutrients in the foods we consume, and the way they influence our brain chemistry and emotions, provides a peek into how food and the mind and body work together. By being aware of whether you “feel” like eating to assuage stress or to appease a healthy appetite, each food you choose to eat may be looked at as an opportunity to fine-tune your moods and emotions, while nourishing your body.

In other words, the key to being a success at stopping stress eating is making a commitment to eating for feel-good feelings, when you have a healthy, authentic appetite for food, and when you’re anticipating the pleasure and experience of true mind-body nourishment.


Article originally printed on integrativeeating.com. Reprinted with permission from Deborah Kesten. 

Deborah Kesten, M.P.H., is an award-winning author, specializing in preventing and reversing obesity and heart disease. Her expertise includes the influence of epigenetics and diet on health, Lifestyle Medicine, and research on the Whole Person Integrative Eating dietary lifestyle to treat overeating, overweight, and obesity. She and her husband, behavioral scientist Larry Scherwitz, Ph.D., collaborate on research and writing projects. Her latest book, “Whole Person Integrative Eating” was named the “Winner” in the Health category by the 2020 Book Excellence Awards.



  1. Larry Scherwitz and Deborah Kesten, “Seven Eating Styles Linked to Overeating, Over- weight, and Obesity,” Explore: The Journal of Science and Healing 1, no. 5 (2005): 342–59.
  2. Deborah Kesten and Larry Scherwitz, “Whole Person Integrative Eating: A Program for Treating Overeating, Overweight, and Obesity,” Integrative Medicine: A Clinician’s Journal 14, no. 5 (October/November 2015): 42–50.
  3. Judith J. Wurtman, Managing Your Mind and Mood through Food (New York: Rawson Associ- ates, 1986).
  4. Danielle Marques, et al, “Sweet craving and ghrelin and leptin levels in women during stress” Appetite, Vol 80, September 1, 2014, 264-270.

Five Steps for Leveling Up Your Mindset

The perspective from which I want to discuss this topic today has to do with cultivating a mindset that actually allows you to reach your goals.

It’s easy to get fed up with your current situation – whether it be weight, a job, finances, a relationship or otherwise – and say to yourself “I’m done! Things are about to change!”

But then they don’t.


Coronavirus and Type 2 Diabetes

There is plenty of news in the media which says that the COVID-19 is harmless for a healthy individual. They also mention that people with underlying conditions are sensitive to the disease. One such underlying condition that many have is Type 2 Diabetes Mellitus. According to sources, Tom Hanks testing positive for COVID-19 caused panic… that was because this popular actor is also a Type-2 diabetic. 

Why are Diabetic People More in Danger?

A healthy person and a diabetic person are at the same risk of catching the infection. The difference is how the patients deal with the virus. A diabetic patient has a higher chance of facing complications. A person with diabetes will face severe symptoms if they get COVID-19. Diabetes fluctuates the level of glucose in your body. Because of this, diabetic people with COVID-19 have severe inflammation and swelling.

Tips to Protect Diabetic Patients from the Coronavirus

Being a diabetic or the caregiver of such a patient will be stressful for you. Social distancing is the only you can avoid getting the disease. In case you are wondering how to practice social distancing here are a few tips:

  1. Avoid going outdoors, and only do so if it is essential.
  2. Avoid visiting a sick person, whether they are Coronavirus patients or those suffering from any illness.
  3. Try working from home. Discuss this with your employer and try gaining their support in this regard.
  4. Avoid gatherings and large crowds. These include cinemas, restaurants, clubs and bars.
  5. Maintain your blood sugar levels in normal range. That is because people with optimum levels of blood glucose have fewer complications.
  6. Regularly wash your hands. Follow guidelines on the internet about properly washing your hands. If you do not have access, try sanitizing your hands as an alternative.
  7. Avoid hospitals and try contacting your doctor through the phone.
  8. Keep yourself aware of the symptoms of the Coronavirus disease. If you observe any such symptoms, immediately call your general practitioner.


The government suggests shielding advice to all diabetic patients. It meant that all people vulnerable to the disease stay at home for almost 12 weeks. During this period, you should avoid all face-to-face contact. You must understand the risks that you are putting yourself into if you do not take precautions.

Terrance Hutchinson is the Owner of Your Best Lifestyles Fitness and Nutrition. He is a Certified Personal trainer specializing in Exercise Therapy, Corrective Exercise, Sports Nutrition, and Corporate Wellness. He an author of 3 books, he has his own podcast, he has contributed articles to major newspapers and magazines, Terrance has spoken at health events, webinars, seminars, hospitals, schools, doctors offices and has been featured nationally syndicated television platforms. Terrance has clients in many states and counties and is looking to help others bridge the gap between the medical and fitness industries. To learn more about Terrance, visit yourbestlifestyles.com


Health and Disease Spans: Can You Change It?

Sam is a 90-year-old client of mine who comes into the clinic every day, walks for 30 minutes on the treadmill, then jumps on the elliptical for 15 minutes following by another 15 minutes on the stationary bike. After he’s done with his cardio, he knocks off 10 pull-ups, unassisted, and then he finishes the rest of his strength program. He feels energetic and enjoys spending time with his family and friends. On the other hand, Bob, a client who came in a few months ago, is 62 years old, sleeps in a recliner most nights because his back pain is too severe to stay in bed. He is an attorney working long hours with high levels of stress. His long hours keep him from exercising on a regular basis, he is a borderline diabetic and has recently started Lisinopril to control his newly diagnosed hypertension.

What’s the difference between my two clients? Sam has experienced a long and successful health span. At 90, his disease span has barely started to show. Bob, on the other hand, has an early onset disease span. He is losing his function and productivity while experiencing a slow and steady decline into the abyss.

There are several factors that influence the onset of one’s disease span. Factors such as genetic predisposition, lifestyle choices and sleep patterns are just a few examples that will influence the shape of your disease span curve. Often, the inter relatedness of influencing factors dictate our life’s outcome. By understanding our history, recognizing the triggering events that have occurred over time and managing mediators affecting our health, we are in the unique position to have a positive impact on our health/disease span curve.

Regardless of your previous lifestyle choices, you can create a big change. It is amazing how quickly our bodies respond to positive changes. In as little as 30 days, I have seen people decrease their need for medication, increase their energy, improve their sleeping habits and become more engaged in their personal relationships. Remember Bob, in 45 days he was off his pain medication, sleeping in bed and played 9 holes of golf which is something he hadn’t done in 5 years. It is essential to understand your lifestyle history to take the necessary steps in making a well-rounded change. Success begins when you work with the right professional to re-write your story which will in turn elongate your health span, shorten your disease span and result in dying young at a ripe old age.

Join Dr. Herkimer for his free webinar, Your Lifespan vs. Your Diseasespan: Where Do You Fall?

Jim Herkimer, DPT, MS, ATC  has been involved in health, fitness and rehabilitation for over 35 years. He is currently the CEO and Executive Director at Sports Conditioning and Rehabilitation (SCAR) in Orange, California. SCAR is a wellness and rehabilitation clinic providing a continuum of care for individuals through the life span. Throughout his career, he has had the opportunity to help a variety of athletes and individuals from all walks of life reach beyond their potential. 

Eric Chessen 1

Is Fitness for ASD for Me…Let’s See…

Is that hip tracking properly?

 Is he planning on flopping down to the mat after this next hurdle?

 Does Adam know what exercise is after these forward hurdle steps?

These are the series of questions that reverberate in my head as Adam completes the set of low hurdle steps as part of his warm-up. They’re the same questions that need to be mentally noted and checked off throughout a session with an individual on the autism spectrum.

Picture courtesy of Eric Chessen.

Fitness for special needs populations, particularly the autism and neurodiverse demographics, is gaining both awareness and more professionals are entering the sphere of practice. Some still overlap the autism spectrum disorder (ASD) population with other neurobiological disorders such as Downs Syndrome. They are different. And they need to be approached accordingly.

The most current statistics from the Centers for Disease Control (CDC) show an autism diagnosis occurring at 1 in 59 children. The statistics for teens and adults with autism are more difficult to find, though many individuals have been diagnosed retroactively as the criteria for diagnosis has changed/broadened with the DSM V (Diagnostic and Statistical Manual of Mental Illness Vol 5). Some of the most common, if not readily discussed, areas of deficit for those with ASD are gross motor deficits and low muscle tone (a catch-all phrase).

By way of intrepid professionals and dedicated parents/caregivers, the field of fitness for individuals with autism has grown in the last few years. As is the case across the fitness/wellness arena, programs and practices vary with no official standard or code of practice for those providing exercise programs to individuals with ASD.

Given the number of children, teens, and adults affected by autism and the evident need for professional fitness services, this is a burgeoning specialty area. While sport-specific, even vocation-specific training has existed in the fitness profession for decades, fitness programming for the ASD population is new and requires some important considerations.

Working with the autism population in a fitness capacity requires being a specialist turned generalist turned specialist. Allow me to expand on that.  A fitness professional working with the ASD population, ideally, has a conceptual background and practical skill set to assess movement skills and provide appropriate progressions and regressions for various exercises.

The adaptive/behavior challenges inherent to autism require more than a great fitness program “on paper”/in theory. Not only are the previously noted movement and strength deficits significant considerations, but behavior issues (off-task, maladaptive) must be addressed. The “Greatest Program Ever” is no match for a 17-year old who refuses to budge from lying face down on a yoga mat in the corner of the room.

So here we move from specialist to generalist; gaining an awareness and working knowledge of how different challenging behaviors present in the autism population, how to effectively manage those behaviors within scope of practice, and then how those behaviors may present with specific individuals. Some of our athletes (term used universally) with ASD may be off-task, wandering around the room for ninety-four percent of the session, while others are cooperative to a remarkable degree.  Understanding motivation and reinforcement both generally and with specific application to each individual is a necessity here.

Cognitive deficits are another hallmark of autism that requires both global and specific understanding and working knowledge. Our athletes with autism tend to be literal thinkers, having a great amount of difficulty with abstract concepts or directions that include analogies. “Run as fast as a Cheetah” won’t have the same connotation for an individual with ASD as it does for the neurotypical population. With respect to cognitive functioning we have one priority; ensure that our athletes are able to follow our directions to the best of current ability.

Fitness and Medical Fitness professionals considering working with the ASD population may find that the instructions, cues, and even the exercises they rely on with most clientele don’t quite work for individuals with autism. While the general best practices approach to strength, stability, and motor planning still apply (strengthen the large muscle groups first, build a healthy movement pattern before adding load), the path towards success may wind a bit.

In our Autism Fitness™ Certification Level I, we have a consistent cornucopia of professionals with backgrounds in fitness, occupational and physical therapy, behavior therapy, pediatrics, recreational therapy, and education (not to mention parents of individuals with ASD).  Each attendee brings in their own knowledge and experience with autism from their professional vantage point. The keys to success are taking the best practices from each area of ability (physical, adaptive, and cognitive), and having strategies that have wide-ranging application. Again, specialist-generalist-specialist.

Odds are that if you’re reading this or have been researching fitness programming for autism, a parent or school has approached you about running a 1-to-1 or group program. You may be starting next month, or next week, or in two hours. So I’ll spend the last of this article providing some practical, go-to strategies within each of the physical, adaptive, and cognitive (PAC Profile™) framework.


Focus on basic, essential movement patterns (pushing, pulling, crawling, squatting, carrying, and locomotion)

Have appropriate progressions and especially regressions for each exercise

Don’t add variety where it is not needed. Keep programming as simple as possible.


Let the athlete know what they’ll be doing and what’s coming after that. Anxiety levels tend to be high among those with ASD. Providing a “what’s happening next” can deescalate.

Provide opportunities for choice; “Do you want to do push throws or overhead throws first?”

This establishes that the athlete will be doing one of those two throws AND they get to choose which one

Use contingencies; “First hurdle steps, then you can take a break for a minute.” This creates a natural timeline and enables the athlete to know the specific beginning and end of the sequence and what the expectation is.


Label the exercise and demonstrate. Avoid extraneous language.

Teach exercises one at a time. Use a lot of repetition.

Fitness is a life skill, one that is tremendously needed by the autism population of all ages and ability levels. For professionals who choose to offer fitness services to those with ASD, it is imperative that best practices, all around, be used. When we know what we are looking at, what outcomes are realistic, and what strategies to employ, we can meet our athletes where they are at and enhance quality of life.

Eric Chessen, M.S., is the Founder of Autism Fitness. An exercise physiologist with an extensive background in Applied Behavior Analysis (ABA), Eric has spent nearly two decades developing and implementing fitness and adapted PE programs for individuals of all ages and ability levels. Eric is the creator and Lead Instructor for the Autism Fitness Certification and has presented at TEDx on the subject of fitness for those with ASD. He is also the Co-Founder of strength equipment company Stronger than U. He is New York native and very new resident to Charlotte, NC.

gym training, young man and his father

Exercise for Atrial Fibrillation

Here are some things to look for when working with a client with Atrial Fibrillation (A-fib).


What types of medications are they on? Calcium Channel Blockers, blood thinners (Coumadin)? These may have an effect on the intensity and type of exercise performed. You know that people who have A-fib are at increased risk for strokes, and may have hypertension and get dizzy more often. The medications – while they may help with some factors – may preclude a well-designed exercise program just because they may not tolerate some types of exercise.

What are the exercise goals? Are they wanting to tone up? Lose some weight? Get stronger? Train for a tennis match or 5K? This would help in structuring the program. The type / intensity / duration are all dependent on what the client wants. If they are just coming off surgery or a new prescription – this is important to build the foundation (which you know).


Does the doctor have any contraindications for exercise? Usually, it’s not to “overdo”, which means building up a program. I read a good article by Dr. Bill Sekula on a program for A-fib. It’s essentially a “step down, time up” program, where patients go from a few minutes of exercise a few times per day – to building up to an hour of exercise one time per day.  However, I am going to recommend more of an ITP (interval training program) that concentrates on moderate strength programs (using the 40-50% rule similar to cancer patients), so they don’t use the Valsalva maneuver while lifting, but still use a progressive resistance approach. 


Monitoring with a HR monitor, and having good hydration status are both important. Of course, you probably have them using the smart water bottle. Because of the heart dynamics and possible Coumadin Rx, the hydration is important. I assume you do a HR variability test with your client. This may be a very important test to do, as over time it may be instrumental in reducing A-fib occurrences.

I like the article by Dr. John Mandrola on the amount of exercise. He states that A-fib is completely controllable through specific lifestyle changes. He states that low inflammation exercise (high intensity endurance / triathlon, etc.) training needs to be modified, as do other lifestyle issues. I really like the discussion on inflammation, which may be one of the biggest issues in cardiac care of late. He talks about the “J curve” of exercise and that the more intense actually increases the odds ratio (OR) for sudden cardiac events and other abnormalities related to A-fib. 

I think he is on to something, and you should look into some other lifestyle aspects such as meditation and heartbeat regulation through mindful breathing and relaxation. I know that excess stress, lack of sleep and poor diet have effects on the electrical system, including SA node and conductivity. Regular relaxation may do a LOT to improve the normal sinus rhythm and reduce resting HR to a more manageable level. 

Dr. Mandrola also recommends regular monitoring of BP, keeping the use of warm exercise clothing due to peripheral circulation issues, and not overheating. 

I like the issue of ITP and progression.  I also am more of a fan of modified strength training for most clinical conditions.  I think it would work for AF because if you think of the strength of contraction during exercise (even moderate) – it will have a strong steady beat during exercise (in most cases).  

Eric Durak is President of MedHealthFit – a health care education and consulting company in Santa Barbara, CA. A 25 year veteran of the health and fitness industry, he has worked in health clubs, medical research, continuing education, and business development. Among his programs include The Cancer Fit-CARE Program, Exercise Medicine, The Insurance Reimbursement Guide, and Wellness @ Home Series for home care wellness.



  1. https://www.everydayhealth.com/hs/atrial-fibrillation-and-stroke/afib-exercise-safety-tips/
  2. https://drbillsukala.com/tips-for-safe-exercise-with-atrial-fibrillation-af-or-a-fib/
  3. http://www.drjohnm.org/2014/05/exercise-over-indulgence-and-atrial-fibrillation-seeing-the-obvious/



The Commodification of Medicine and Fitness: The Good, the Bad, and the Ugly

The need for medical and fitness services/products continues to grow. In the United States, and around the world. The corporate and industrialized delivery of medical and fitness products/ services continues to grow to meet increasing demand. Innovations in medical diagnostic technologies, surgical procedures, biomaterials, and medicines help individuals live longer, and with a higher quality of life. Technology and scientific research are propelling fitness product/service innovation with digital activity monitoring apps . . .