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Stress Management and Diabetes

Diabetes, is left uncontrolled, can cause a whole host of health complications such as vision impairment and neuropathy. It is important to adhere to any instructions your doctor has given you to keep blood sugars controlled. Your physician may also educate you on exercise, diet and stress management to keep a balanced and healthy lifestyle.

Anyone who suffers from chronic stress may have many health issues later in life. One condition that may arise is diabetes.  Prolonged stress can either cause diabetes or make it tough to obtain normal blood sugars. Blood sugar numbers usually go up and down depending on what you do throughout the day. If you are fasting your numbers should be less than 100 but could be 180 two hours after eating a meal. Most diabetics must monitor their glucose levels on a regular basis.

People who have diabetes may also feel stressed because of their treatment plan. This is also called, “Diabetic Distress”.  Individuals with diabetes have many things they must do to take care of themselves such as: check glucose levels, exercise, cook and eat healthy meals, maintain a certain diet and take medications as prescribed. This new lifestyle can be very stressful for many people who have diabetes.

Along with Diabetic Distress there are the usual stressors that are a part of life. It is important to find ways to control stress throughout your lifespan. If you are newly diagnosed, the first step to reducing stress is to talk to your physician. Your medical team is on your side and can help you find a Diabetes Educator. These individuals host classes to go over any new information and questions you may have.

When controlling stress, you need to find out what works for you personally. Some individuals like to take a walk in the park, others choose to practice meditation or use a combination of many techniques. When you start to try new practices remember that you may have to try each a few times. The body has to get used to approaches. A qualified stress management consultant can help you to create a stress management plan specifically for you.

A great way to incorporate stress management into your daily routine is through meditation. Choose a certain time of day that you know will work for you. Some individuals find it helpful to meditate before getting out of bed in the morning. Others find it works best at the end of the day when they have finished working. Taking a break at work during lunch can be helpful as well. Once you find the time of day that works best choose your space. You want to find a room in your house that is free from distraction. It will also help to turn off all electronics and the television.

When practicing meditation, remember that there is no right or wrong way to meditate. Some individuals choose to meditate laying on a mat while others sit or stand. Choose a position that is comfortable for you. When sitting for meditation your knees should be lower than your hips to help sustain the position.

Guided meditation is also a great choice for meditation. A trained instructor will guide you through the meditation to help you reduce stress.


Robyn Caruso is the Founder of The Stress Management Institute for Health and Fitness Professionals. She has 15 years of experience in medical based fitness.

pexels-anna-shvets-3962285

The Athlete’s Kitchen

“I used to be skinny when I was a runner in college. Look at me now. My BMI says I am “obese.”

“Despite exercising regularly, I’ve gained weight with menopause … frustrating!!!

“I’ve always been able to manage my weight by eating a little less and exercising a little more. Since I turned 50, that’s not working for me anymore.”   

If any of the above comments sound familiar to you—or your parents or friends, keep reading. I counsel too many mid-life athletes who express frustration about undesired weight gain. Women can younger athletes avoid it?  

heart-stethoscope

Body Fat Promotes Heart Disease

Risk factors for heart disease – elevated LDL cholesterol, hypertension, elevated triglycerides, inflammation, and blood glucose – are all exacerbated by excess body fat, and overweight/obesity itself is considered a risk factor.1-3

Is it beneficial to be a little overweight?

However, there has been controversy about a potential “obesity paradox” in heart disease: the idea that some amount of excess weight either does not pose any risk or is even protective. Unfortunately, the studies that suggest there may be a protective effect of body fat are often the ones that get more news coverage; but this does a disservice to an already overweight and nutritionally misguided public, allowing them to believe that excess body fat won’t harm their health.

Is there really an obesity paradox? Or is it just that BMI is not a good measure of body fat?

Many of these studies have used body mass index (BMI), however BMI, which only takes into account height and weight, is not an accurate indicator of body fatness. BMI does not distinguish between fat mass and lean mass, nor does it take into account fat distribution (visceral fat vs. subcutaneous fat). Many people whose weights are within the “normal” BMI range are still carrying excess fat.

There has been no evidence providing a convincing explanation of how excess fat could possibly provide a cardiovascular advantage.  Plus, there are numerous medical conditions may cause unintentional weight loss, including depression, anxiety, autoimmune diseases, cancers, and digestive disorders. In the elderly especially, a low BMI may be an indicator of muscle loss and frailty rather than an indicator of a healthy low level of body fat. In short, people who are thinner are not necessarily healthier.

Relationship between body fat and heart disease: using better measures than BMI

A new study  is helping to clear this issue up,4 in a cohort of almost 300,000 people in the UK (age 40-69) who were followed for an average of 5 years. Their first analysis puts the optimal range of BMI for heart disease prevention at 22-23 kg/m2. It was a “J-shaped” association, meaning risk rose both above and below the 22-23 range. But the researchers went further. They used multiple measures of body fatness to get a more accurate picture: waist circumference, waist-to-hip ratio, waist-to-height ratio, and percent body fat.

Ultimately, what the researchers found was that using BMI produces different results than the other indicators. BMI was the only one that showed an increase in risk at the low end (<18.5 kg/m2). When they excluded smokers and participants with pre-existing diseases, the increase in risk associated with low BMI almost disappeared.  The more accurate measures of body fatness – body fat percentage, waist circumference, waist-to-hip-ratio, and waist-to-height ratio – showed a clear trend: more body fat, greater risk.4


More body fat, greater cardiovascular risk

The researchers concluded that the obesity paradox observation mainly occurs due to confounding effects of disease and other factors on BMI, and that the “public misconception of a potential ‘protective’ effect of fat on CVD risk should be challenged.”4

As discussed above, a low BMI is often an indicator of disease, rather than an indicator of a healthy weight resulting from healthful eating. The standard American diet (SAD) is fattening. If someone is eating the SAD and is not overweight, there is likely something wrong.

Lose weight permanently on a Nutritarian diet

The dramatic weight loss-promoting effect of the Nutritarian diet contributes to cardiovascular protection. A 2015 study published in the American Journal of Lifestyle Medicine analyzed and reported weight loss results provided by 75 obese patients who had switched to a Nutritiarian diet. The average weight loss was 55 pounds, and very importantly, they kept the weight off. None of these respondents had gained back the lost weight after three years.5

Reprinted with permission from Dr. Fuhrman.


Dr. Fuhrman is a board-certified family physician specializing in nutritional medicine. He is President of the Nutritional Research Foundation and the author of 6 NY Times bestselling books, including The End of Heart Disease.  Visit him at DrFuhrman.com

 

References

  1. Coelho M, Oliveira T, Fernandes R. Biochemistry of adipose tissue: an endocrine organ. Arch Med Sci 2013, 9:191-200.
  2. Tchernof A, Despres JP. Pathophysiology of human visceral obesity: an update. Physiol Rev 2013, 93:359-404.
  3. Benjamin EJ, Blaha MJ, Chiuve SE, et al. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation 2017, 135:e146-e603.
  4. Iliodromiti S, Celis-Morales CA, Lyall DM, et al. The impact of confounding on the associations of different adiposity measures with the incidence of cardiovascular disease: a cohort study of 296 535 adults of white European descent. Eur Heart J 2018:ehy057-ehy057.
  5. Fuhrman J, Singer M. Improved Cardiovascular Parameter With a Nutrient-Dense, Plant-Rich Diet-Style: A Patient Survey With Illustrative Cases. Am J Lifestyle Med 2015.
Male doctor explaining the spine to a senior patient in medical office

3 Curves = Straight: The Importance of Neutral Spine in Exercise

I have been teaching strength training, as well as Pilates based mat and Vinyasa Yoga for over 2 decades. As a former dancer, I know that I was always struggling with having a “flat stomach” or having a “flat back”. Dancers, in trying to achieve that “perfect turnout” and “flatness”, were often taught to “elongate the spine” by “tucking the pelvis” under, which basically leads to a posterior tilt. Unfortunately, this idea is often taught in fitness to the general population. Trainers and teachers alike, some coming from the dance world, will tell students to “protect their back” by tucking the pelvis such as during standing exercises, even bicep curls, or worse, curl their knees into their chest while lying on the ground or bench, and attempting to do a chest press. Students will be so conditioned to this ROUND SPINE and TUCKED PELVIS, that eventually when they stand, this is their posture. Over time, the discs can bulge, and the forward pelvis will eventually lead to lower back pain they were trying to avoid, as well as knee pain and other issues.

I am a reformed pelvic tucker. I advocate neutral spine when teaching, whether it be standing work such as bicep curls, pronated work such as plank and push-ups, or supine work such as leg lowers and overhead triceps.

The spine has 3 curves: the cervical spine (at the neck) has a concave curve, the thoracic spine (back of the rib cage) has a convex curve, and the lumbar spine (lower back) has a concave curve. And if you want to add a 4th, the pelvis/sacrum has a convex curve as well.

Together, this “S” shape is what keeps a body “straight”. Constantly flattening one’s back or pushing one’s vertebra into this position will eventually damage them. Plus you have to learn to CONTAIN YOUR MUSCLES, not force your vertebrae. There is a moment when the base of your ribs and your pelvic bone will feel like they are aligned in the front, like suspenders. Whatever curves are left over should remain.

Sometimes I do my supine abdominal work as well as strength training on a foam roller (pictured at right). This way there is no avoiding working in neutral spine. Plus, the foam roller will target the transverse abdominus as you are struggling to keep the foam roller still while performing exercises such as chest press, chest flies, overhead triceps, single and double leg lowers, etc.

Another bad habit that trainers and teachers tell their clients and students is to “sit on their hands” while performing exercises such as leg lowers. This is BAD for every reason. Your hands have small bones and veins which are easily damaged by sitting on them. Say you are 200+lbs, and you are putting all of your body weight on your hands! This is not good! I often joke and tell my students “I am a guitar player! I am not going to sit on my money makers!” Also, sitting on your hands again causes the pelvis to tuck, and the shoulders to protrude forward. By teaching this, you are telling your clients and students to “slouch”. You have not taught them how to gain strength by maintaining neutral spine. Third, more often than not, the reason the clients are feeling “pain” in their lower back is they are attempting to lower their legs beyond the range where the abdominals are effective. For me, about a 45 degree angle from the top is plenty of work. Attempting to lower one’s legs all the way to the floor and back will usually be out of the range of someone’s abdominal strength. Find a range of motion where the abdominal muscles fell the work, and the lower back is not effected. You can also put your client on the foam roller, or if you do not have a foam roller, place a thin towel under the sacrum to alleviate any pain the floor may be causing, as well as teach neutral spine.

For “plank”, I often joke (as I am a realtor as well) that “if the plank is not straight, I am returning it to aisle 4 in Home Depot”. People tend to hang their heads when something is difficult. I advocate looking a few floor boards ahead while performing plank, as well as push-ups, and to use a side mirror to check that the line of the head, shoulders, ribs and hips are aligned, while keeping the natural lumbar curve. Again, the ribs and hips should feel like suspenders. Push-ups are basically a “plank with an arm bend and straighten”. So it is important not to hang one’s head, especially when the floor is getting close :). (Planks pictured at right)

In closing, remember that you want to teach your students functional exercises that will help them out in the real world. Teaching neutral spine alignment is one of the most important ideas. You would never want to lift a box with a rounded, tucked spine, so why teach clients to “tuck their knees into their chest” while performing chest press? Sometimes it will take some time for a client to undo these bad habits, but in the end, clients will be stronger, and use the transverse abdomens vs poor alignment to perform daily tasks.

Photos courtesy of ANDREW MARK PHOTO.


Kama Linden has been teaching fitness for over 2 decades. She has taught strength, step, Pilates, Vinyasa Yoga, senior fitness, and has worked with clients and students of all ages and fitness levels. She is certified by AFAA Group Exercise and NASM CPT, as well as 200 hour Yoga. She has a BFA in Dance from University of the ARTS.   You can order her new book, “Healthy Things You Can Do In Front of the TV”  on pre-sale on amazon.com, and it will soon be available on BN.com, and Kindle. Visit her website at bodyfriendlyoga.com

pregnancy-heart

The Increasing Need For Trained Maternal Fitness Instructors

The need for trained maternal fitness professionals has greatly increased as a result of the number of fit women who desire to continue with their exercise routine once they become pregnant. The past several decades has provided a large body of evidence that supports the benefit and safety of prenatal exercise in uncomplicated pregnancies, and ACOG and other fitness and medical health organizations recognize the importance of fitness in a healthy pregnancy. Studies have shown that women who continue or even start an exercise program during pregnancy gain less fat weight, have fewer complications during labor and delivery, and return to their pre-pregnancy weight faster than women who didn’t exercise while pregnant.

Knowing what the current evidence based guidelines are for pregnant and postpartum women and being able to work with this population will open up opportunities to create a specialized program that fits their unique needs. Fitness professionals who have training in this field offer skilled support and guidance to pregnant and postpartum women and help them confidently include exercise as part of their lifestyle. Pregnant women are unsure of what exercises and activities they can continue throughout pregnancy and need guidance on how to monitor their routine for safety. As pregnancy progresses, women need strategies for modifying their exercise program as their body changes to maintain a comfortable and safe routine.

For more information on prenatal and postpartum exercise and our CE correspondence course, “Prenatal and Postpartum Exercise Design” please visit, www.ppfconsulting.com

Article reprinted from Catherine’s Maternal Fitness blog with permission.


Catherine Cram, MS, is the owner of Comprehensive Fitness Consulting, a company that provides pre- and postnatal fitness certifications and information to hospitals, health & wellness organizations and the military.

Woman problem holding her hands in toilet

Female Urinary Incontinence: Helping clients move from caution to confidence

According to the National Association For Continence, one in four women over the age of 18 experience episodes of urine leakage. The fact is that many women are reluctant to talk about these episodes. Instead, they opt to secretly plan their lives around the possibility of an accident. Over time, this problem can escalate from simply wearing a panty liner to hypervigilance over the location of the nearest bathroom. (Yes, there are apps for that!) Yet, on average, it takes  6.5 years to seek help for this problem. 

middle aged stretching outdoors

Yoga for Mental Health

Since yoga has been found to help those with diseases and illnesses like Alzheimers, Arthritis, it’s a given that it can help ease mental health issues and disorders. A new review on the health benefits of yoga, published in Frontiers in Psychiatry, with help from researchers at Duke University School of Medicine, found that yoga could be a promising treatment for some mental illnesses.

brain-food

4 Tips to Eat Better To Protect Your Memory

When it comes to aging better, better nutrition is your better weapon because it gives the body the resources it needs while reducing intake of items that irritates and overwhelms. Better nutrition comes from making better not perfect choices more often. So what are those and how can you enjoy them – after all, with age we’ve earned enjoyment, right?!

Did you know that adults (~60-85) with dementia who had more frequent intake of persistent pesticides had worsening cognitive function?[1] It makes sense – both for those with dementia and those seeking to avoid it – as these pesticides irritate, overwhelm and disrupt the body from efficient and effective work, daily. Overtime, eating foods or applying products that contain these pesticides or pesticide residues impact the body’s ability to function better. Thus, there is real value in assessing your diet, supplements, and skincare to see how you do on one of the core 4 principles of better nutrition: quality.

Years ago, I became a Qualitarian and according to research, aging adults should too! Being a Qualitarian means that you focus as much on the quality of what goes in and on your body most often as you do on the other nutrient factors as well as on the source. Here are a few key tips to help you improve the quality of your intake more often.

1. There’s No Perfect Nutrition

But there is better nutrition and it comes from making better not perfect choices more often. That means that you do not need every choice to be organic, but your top foods, supplements, and skincare should ideally be organic more often.

2. Whole Is Better Than Pieces & Parts

Today there are a lot of ways to get in nutrients but not all of them deliver better nutrition. For example:

  • Packaged foods that are made of refined ingredients – pieces and parts like “flour” “protein isolate” “Nonfat” or “syrup” – that then have fortifications like minerals, vitamins, and probiotics present nutrients but not in the form or balance of nutrient found in whole, minimally processed foods.
  • Packaged foods that have whole foods but also have added nutrients – those added nutrients are less likely to be in a form found in food, or presented in balance with other nutrients the way they would be in food.

3. Some Assembly Required

Let’s be real, we often need nutrition fast, but this doesn’t mean compromising on the nutrition quality. By assembling ingredients – like spreading almond butter on a pear, or popped corn onto which you add olive oil, a pinch of sea salt and toss in a serving of hemp seeds – rather than purchasing a ready to eat item like a fruit and nut bar or flavored pre-popped or microwave popcorn – you get better nutrient balance, can monitor quantity better, and can make your choices full of better quality nutrients from whole foods.

4. Get Enough Coq10

Read about this nutrient that is critical to healthy aging, including brain health and memory.

Want help making better not perfect choices more often to support healthy aging? Join The Better Nutrition Membership and get real support (from me) and unlimited access to exclusive members only content including tools to help you assess your current nutrition, keep what’s already working, and better tools to help you act better not perfect more often.

Originally printed on ashleykoffapproved.com. Reprinted with permission.


Ashley Koff RD is your better health enabler. For decades, Koff has helped thousands get and keep better health by learning to make their better not perfect nutrition choices more often. A go-to nutrition expert for the country’s leading doctors, media, companies and non-profit organizations, Koff regularly shares her Better Nutrition message with millions on national and local television, magazines and newspapers. Visit her website at ashleykoffapproved.com.

 

[1] http://www.sciencedirect.com/science/article/pii/S0160412014003250