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Fueling Tips for Single and Double Workouts

/20 December 2023/ All MFN blog/

As one coach aptly stated, “Too many athletes show up for training, but they don’t show up for meals. They might as well not show up for training.”  So true! Pre-exercise fueling makes a big difference in terms of how well athletes can enhance their performance. Food eaten within the hour before exercise does get put to good use, helping athletes train harder and longer. (It also helps curb the post-exercise hunger and sugar cravings that can easily end up as overeating.)

You can only perform at your best if you are well-fueled on a daily basis. Yet too many athletes wonder what (and if) they should eat before exercise. Rowers want to know what to grab (if anything) as they roll out of bed and head to the boathouse. Triathletes ask about how to fuel for their second workout of the day. Runners want a pre-exercise snack that will not cause intestinal distress.

No one pre-exercise food is best for all athletes. Hence, you want to experiment to learn which foods settle best in your body. Here is some guidance for planning effective pre-exercise fueling.

First, take steps to train your gut (not just your heart, lungs, and muscles).

I’ve talked to many athletes (particularly in running sports) who purposefully choose to not eat within hours of exercise as a means to avoid gastro-intestinal (GI) upset. While this may seem like a good idea for the short term, it’s a bad idea if you want to optimize performance for the long run.

The intestinal tract is trainable and can digest food during exercise that lasts >30 minutes. (The gut shuts down during short, intense bouts, so plan to eat 2 to 4 hours in advance of those workouts!) To train your gut, start by nibbling on 50 to 100 calories of crackers, pretzels, or any simple-to-digest carb within the hour pre-exercise. Once your GI tract tolerates that snack, titrate the calories up to 200 to 300—maybe a packet of oatmeal, a granola bar, or an English muffin (with some peanut butter on it for longer-lasting energy). Experiment with a variety of fruits (applesauce), vegetables (sweet potato), and grains (leftover pasta) to learn what works best for your body. You are an experiment of one.

For some athletes, GI distress can be caused by the inability to thoroughly digest specific types of carbohydrates called FODMAPS (Fermentable Oligo-, Di-, Mono-saccharides And Polyols). Common sources of FODMAPs include garlic and onion (found in the spaghetti sauce & garlic bread often enjoyed the night before a big work-out), as well as apples and raspberries. For more in-depth FODMAP information, visit www.KateScarlata.com.

Meal timing matters. When you eat matters as much as what you eat.

Too many athletes eat backwards. That is, they undereat during the active part of their day, only to consume a huge meal before going to bed. Two standard excuses for skimpy daytime fueling include:

  • #1: “I look forward to a big dinner. That’s when I finally have time to relax and reward myself for having survived yet-another busy day.”
  • #2: “I want to lose weight. I can stick to my diet at breakfast & lunch, but I blow it at night. Evening eating is my downfall.”
  • If either scenario sounds familiar, think again. You are going to consume the calories eventually, so you might as well plan to eat them when they can be put to good use.

Morning exercisers want to eat part of their breakfast (granola bar & latte) before they workout and then the rest of their breakfast afterwards (oatmeal, banana & PB). They then want to plan an early hearty lunch at 11:00ish and a second lunch/hearty snack at 3:00ish. The goal of the second lunch is to both fuel the upcoming workout and curb the appetite for dinner so they can then be content to eat a lighter dinner—and likely better sleep than if they had stuffed themselves with a big meal.

Athletes who do double workouts really want to eat a hearty early lunch to refuel from the morning session and prepare for the second (afternoon) session. They’ll have 4 to 5 hours to readily digest lunch before they train again.

You might need to plan time to eat.

Busy athletes who juggle work and/or school plus double workouts often complain they have no time to eat. Sometimes that is true and sometimes they choose to sleep a few more minutes (leaving no time for breakfast) or keep working on a project (leaving no time for lunch). Those are both choices. They could have chosen to make fueling more of a priority.

If you struggle with finding time to eat, plan ahead and schedule lunch time in your daily calendar, or set an alarm for snack-time before your 4:00 pm workout. Maybe you can convert your afternoon coffee into a latte, grab a banana, or eat an energy bar while driving to the gym or reading email? Anything is better than nothing.

If you go from work (or school) to afternoon workout, the extra-large lunch will offer fuel for an energetic afternoon workout. Alternatively, plan to have a 3:00 Second Lunch readily available (apple + cheese+ crackers; half or whole PB & J sandwich; yogurt + granola + banana).

Any fuel—even cookies or candy—is better than exercising on empty. You’ll even perform better after having enjoyed a sweet treat as opposed to having eaten nothing. (Research suggests sugar/candy eaten within 15-minutes pre-exercise can actually boost performance and not simply contribute to a sugar “crash.”)

Final thoughts

For athletes, every meal has a purpose. You are either fueling up to prepare for exercise, or you are refueling afterwards to both recover from the work-out and prepare for your next session. Fueling properly takes time and energy. You need to be responsible! Do not brush off meals and snacks as if they are optional inconveniences in your busy day.

Proper fueling requires time-management skills, particularly for students and athletes doing double sessions. You want to schedule time (rest days? weekends?) to food shop and batch-cook so you can have the right foods in the right places at the right times. You (almost) always find time to exercise; you must also find time to fuel properly.

Nancy Clark MS RD CSSD counsels both fitness exercisers and competitive athletes in the Boston-area (Newton; 617-795-1875). Her best-selling Sports Nutrition Guidebook is a popular resource, as is her online workshop. Visit NancyClarkRD.com for info.

grateful

Gratitude: The Gift of Being Present

/18 December 2023/ All MFN blog/

The holiday season can be a wonderful time for gathering and celebrating with family and friends, but it can also be a source of much added stress.  You may be fretting about any number of circumstances like: how to manage your weight or chronic condition like diabetes during all the “feastivities”;  choosing the perfect gifts and worried if you can afford them; missing a loved one who can’t be with you or who has passed away; or perhaps you feel unwell or someone close has been diagnosed with a disease.

Whatever personal challenges you are experiencing, research shows that grateful people are happier and healthier; can make better decisions; and are more joyful(1).  It’s a skill anyone can learn and benefit from and best of all, it’s free!  

How it Works

An attitude of gratitude bolsters the feel-good neurotransmitters (brain chemicals) dopamine and serotonin.  Feeling thankful and appreciative also boosts the love hormone oxytocin so we feel more connected while it decreases the stress hormone cortisol(2).   

Our day-to-day lives are so busy that we often rush from one task to the next one without being mindful.  Living in the fast lane thrusts us into a chronic state of stress, consistently raising cortisol levels that end up damaging our body cells, organs and systems.  This is a major reason why stress is the silent killer that we all talk about but don’t take seriously enough.  

Slowing down, taking a few deep breaths and being grateful moves us out of the sympathetic state or fight or flight mode and into the parasympathetic state of rest, digest, heal and repair.  This is where our body and mind can relax and rejuvenate so we can sleep better and experience more energy and vitality.  And who doesn’t want more healthy energy?!

Count Your Blessings

When we focus on what we have instead of what we don’t have, it puts us in a positive frame of mind.  We become more content, satisfied and fulfilled.  The ability to notice, appreciate and savor life’s moving parts grows gratitude for better physical and psychological well-being(1,3).

Grateful people count their blessings and look at their lives and experiences as gifts(1,3). We can shift our perspective and explore: “What is this difficult situation trying to teach me?”  “What am I grateful for in this moment?”  

When my family and I were recovering from chronic Lyme, we were all thankful for each other, the support of family and friends and for having the resources to pay for exorbitant out-of-pocket medical expenses.  Gratitude played a starring role in our healing.

Mindfulness

Practicing mindfulness is an effective way to plug into the feeling of gratitude.  Dr. Jon Kabat-Zinn defines mindfulness as “paying attention on purpose in the present moment, non-judgmentally…as if your life depended on it”(4).  

When you think about it, all we really have is the present moment.  Unfortunately, we spend a lot of time and waste precious energy worrying about the future or commiserating over the past.  Focusing on the present moment helps us connect to each other, our thoughts and our own lives so we can become the best version of ourselves.  Each day we have the opportunity to do and be better. 

Cultivate Gratitude

When we are mindful we can be amazed by the power of breath, the body’s ability to heal itself from an infection or injury, the beauty of the blue sky, a pink sunrise or sunset, the miracle of a baby being born, the unconditional love of a pet, the plants and trees that clean the air and provide oxygen, the water that runs out of a faucet or down a cool Rocky Mountain stream… the possibilities are limitless.

Better Health 

Scientific studies show that being thankful and appreciative is associated with less physical illness, fewer aches and pains; lower levels of stress, anxiety, and depression(3, 5); and fostering new and lasting relationships(6).   

Being grateful also expands our scope of cognition so we can be more flexible and creative with our thinking and make better decisions.  This makes it easier to cope with stress and adversity(1).

Unwrapping the Gift

When we are grateful and thankful, we tend to be kinder and more generous.  Gratitude makes us feel good, so we want to do it again and again.  The best part is that it’s easy to get started and can feel the benefits quickly. Research shows that you can start feeling better in as little as 2 weeks by writing in a Gratitude Journal(1). 

Here’s How

Grab a notebook, pad or smart phone and each evening before bed, write 3 things you are grateful for.  Write novel blessings, trying not to repeat the same ones, because the possibilities are endless.  Practice this for 2 weeks and see what happens.  

The best time to get started is now, in the present moment. Today, tell someone how grateful you are for them.  You will be sharing a great gift.

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

  1. Emmons, R & McCullough, M (2003). Counting Blessings Versus Burdens: An Experimental Investigation of Gratitude and Subjective Well-Being in Daily Life. Journal of Personality & Social Psychology.  www.greatergood.berkeley.edu.
  2. Gottfried, S (2016). www.saragottfriedmd.com/thanksgiving-what-gratitude-does-to-your-brain/
  3. Hill, PL et al (2013).  Examining the Pathways between Gratitude and Self-Rated Physical Health across Adulthood.  Pers Individ Dif. www.ncbi.nlm.nih.gov/pubmed/23139438
  4. Jon Kabat-Zinn, Ph.D. www.psychalive.org | videos
  5. Cheng, S et al. (2015) Improving mental health in health care practitioners: Randomized controlled trial of a gratitude intervention.” Journal of Consulting and Clinical Psychology. https://www.ncbi.nlm.nih.gov/pubmed/25222798
  6. Williams, L & Bartlett M (2015). Warm thanks: gratitude expression facilitates social affiliation in new relationships via perceived warmth. Emotion.  www.ncbi.nlm.nih.gov/pubmed/25111881
senior-couple-walking

The Walking Games

/13 December 2023/ All MFN blog/

Walking is the most readily available form of physical activity that most people can do regularly.  As the days turn darker and the temperatures drop, the innate enjoyment of walking outdoors can make regular walking harder as we spend more time indoors. 

The solution? Walking Games. 

These are strategies to bring enjoyment and engagement to indoor physical activity.  Further, these strategies also sneak in some added of brain health benefit with added cognitive challenge and an emotionally enhanced experience beyond what people expect from “walking.”

Brain games alone are not enough.  They can provide some cognitive benefit, but for most of human history, we solved intensely meaningful problems directly related to survival while moving, not sitting on a couch playing a low-stakes brain game or working on a crossword puzzle. 

Likewise, any exercise is good for brain health.  But when you add cognitive challenge to exercise, the benefits multiply.  Conceptually, it’s as simple as considering the difference between the treadmill and a trail for walking.  The latter requires using sensory information to consciously choose where and how to take each step.  

The strategies below are designed to create a “think and move” experience, all while enhancing the emotional response to movement. 

Walking Game 1:  Alphabet Walk

  • Mark off a rectangular or oval space with cones, water bottles, shoes, pillows, or anything else readily available.
  • Within the space, walk to trace letters on the floor with your feet.  Use names of favorite movies, books, musical artists or names of friends, family, or pets or perhaps names of travel destinations.  

The highly variable direction of movement makes the walking more beneficial and the use of letters of cherished names adds cognitive benefit and enhances the emotional state while walking by keeping favorite pop culture offerings or loved ones front-of-mind while moving. 

Walking Game 2:  Balloon Tap Walk

  • Blow up a balloon and gently tap it as you walk to keep it up by “air dribbling.”  

The need to track the unpredictable action of the balloon will result in variable walking speeds and co-coordination of eye-hand movements. 

Walking Game 3:  Balloon Wall Dribble

  • Blow up a balloon and face a wall. 
  • Tap the balloon into the wall and keep tapping it into the wall, adjusting body position slightly side-to-side to move with the balloon.  

Optional add-on for balloon exercises: Use a light-colored balloon and a dark-colored marker. Write letters or numbers on the balloon.  Use it to perform any of the following (in increasing order of difficulty):

  • Call out the letter or number most visible when tapping the balloon.  
  • Call out words in the same categories introduced above in “Alphabet Walk”
  • Using the numbers, designate a left and right hand for even and odd numbers, then tap the balloon with the corresponding hand. Or, perform simple math like addition or subtraction.
  • Combine use of letters and numbers. For example, call out favorite musical artists for letters and use the left-right/even-odd hand tap for numbers.

Walking Game 4:  Bounce, Catch…or Fetch

This can be done strolling slowly through any indoor space or standing still.  Use a ball, a pet’s toy, a pillow, or any object which you can bounce and/or toss and catch.  Bonus brain points for using something without an “easy” shape as it requires more manual dexterity to catch.  And if you drop the object, you get some extra essential life skill movement by fetching it from the floor.  

Wrap Up 

The reason people become less active when spending more time indoors is that the usual ways of moving more indoors are boring – no one is realistically going to take a walk around their house.  However, moving consistently is important to our physiology and our brain health regardless of the weather or season.  

Using these and other similar strategies that you think of can make staying active when spending more time inside more appealing, and that is the key to making it happen more regularly.  You can be an inspired leader to the people you serve when you make things enjoyable, more engaging, and as a result easier to do (so they no longer have to force themselves to do them.)

Brain Health Education for Fit Pros

All physical activity is good for the brain, but the inclusion of specific elements such as coordination, reactivity, partner interaction, attention and memory challenges integrated with physical activity make it even more beneficial. MedFit Classroom’s Alzheimer’s Disease Fitness Specialist course blends current science with common sense to present cutting-edge ideas to optimize the impact that fitness can have in the lives of those you serve who are concerned about or diagnosed with Alzheimer’s.

Article originally printed in canfitpro magazine.

His “800 Pounds of Parents” directly inspired Jonathan’s prolific fitness career. He is a multiple Personal Trainer of the Year Award-Winner (ACE, IDEA, and PFP Magazine), master trainer for the American Council on Exercise (ACE), creator of Funtensity, brain fitness visionary, blogger, international speaker and author. He is the author of MedFit’s Alzheimer’s Disease Fitness Specialist online course.

holidays-xmas

Surviving the Holiday Season

/11 December 2023/ All MFN blog/

The hardest time of year for weight management is from Halloween until Valentine’s Day – temptations are everywhere from home to the workplace and everywhere else you go, people wear more clothes and are more covered up because of the weather, and people tend to exercise less because they are stressed, exhausted, it is cold, and they have very little time.

Here are some tips to manage weight during the holiday season…

Plan ahead

  • Eat something before you go out so that you are not inclined to eat everything or anything in sight.
  • Stock your home, office, and/or car with healthy snacks such as fruit in your home, almonds in your office, and a nutrition bar in your car.
  • Plan on making healthy choices for your meals such as mustard instead of mayonnaise or light Italian rather than ranch dressing.

Manage stress

  • Make a list of stress relieving activities that do not include food or eating such as getting a massage, exercising, listening to music, or talking on the phone.

Party responsibly

  • If you are attending a pot-luck party, bring something healthy so you know there will be at least one healthy choice at the party.
  • Eat small portions of your favorite sweets at parties.
  • Try to fill your plate with mostly fruits and veggies at parties.
  • If you want to try new dishes, only take a taster size portion so that you are not tempted to eat more than you should. Then go back and get more of what you like if you are still hungry.
  • Drink a glass of water after each glass of soda or alcoholic beverage in order to cut beverage calories in half.
  • Focus on socializing with other guests rather than eating the food available.

Keep moving

  • If you know you will not have time to exercise, try to fit other small activities into your day such as parking farther away, taking the stairs, and putting the shopping cart away instead of putting it to the side.
  • If you have a stationary bicycle or a treadmill that you haven’t used for a while, take it out and put it in front of the TV, so you can watch TV when you work out.
  • Take a walk alone or with your spouse, kids, or other family and friends after dinner.

Kristy Richardson is a dietitian and exercise physiologist, specializing in sports nutrition and weight management, She is the founder of OC Nutrition and also works as a nutrition professor at Fullerton College.

References

Cleveland Clinic. (2009). 8 Steps to Surviving the Holiday Weight Gain. Retrieved December 22, 2009 from: http://my.clevelandclinic.org/heart/prevention/nutrition/holidayeating12_01.aspx

Zamora, Dulce. (2007). Holiday weight management; Surviving the Feasting Season. Retrieved December 22, 2009 from: http://www.medicinenet.com/holiday_weight_management/article.html

scale

The Habits of Successful Weight Losers

/8 December 2023/ All MFN blog/

In a national television interview with Barbara Walters in 2014, Oprah Winfrey confessed that not being able to maintain her weight loss was her biggest regret. In that interview, Walters asked Winfrey to finish the sentence, “Before I leave this Earth, I will not be satisfied until I…”

“Until I make peace with the whole weight thing,” Oprah replied. Losing weight is hard; keeping it off is even harder. What is unique about those who succeed? The answer is buried deep in the archives at the Weight Control and Diabetes Research Center in Providence, Rhode Island: The National Weight Control Registry (NWCR), the largest database ever assembled on individuals successful at long-term maintenance of weight loss. Founded in 1994, the NWCR includes more than 10,000 individuals who complete annual questionnaires about their current weight, diet and exercise habits, and behavioral strategies for weight loss maintenance.

Habit #1: Live with Intention

Living with intention eliminates the random approach to weight loss maintenance in favor of the systematic and methodical one that leads to results. The NWCR has shown that, when intention is behind weight loss maintenance, 21 percent of overweight people are successful weight losers. [1]

The longer people keep their weight off, the fewer strategies they need to continue keeping weight off. [2] In other words, weight maintenance gets easier. The longer your clients persist in their intention and behave in accord with that intention, the easier it is for that behavior to “stick” and turn into a habit.

What makes one individual persist at a specific behavior while another individual doesn’t? For starters, the persistent individual has a conscientious personality. In the most recent NWCR study published in 2020, conscientiousness was compared between successful weight losers from the NWCR and non-NWCR weight regainers. [3] The successful weight losers were found to be more conscientious than the weight regainers and scored higher on measures of order, virtue, responsibility, and industriousness. The scientists suggest that being conscientious may help individuals maintain their weight loss by improving adherence to specific behaviors.

In a review of 56 studies that contained 58 health behaviors, researchers at Université Laval in Quebec, Canada and the University of Limburg in The Netherlands found that intention remained the most important predictor of health behavior, explaining 66 percent of the variance. [4] In half of the reviewed studies, perceived behavioral control (believing that you have control over your behavior) significantly added to the prediction.

Habit #2: Control Yourself

Being a successful weight loser requires a lot of self-control, delaying gratification now (e.g., dessert) for the more desirable reward later (e.g., a slimmer waistline, better health, enhanced self-esteem, and happiness).

Compared to typical unsuccessful dieters, successful weight losers are better able to resist temptation, control themselves, and push back against the environment. They restrict certain foods, [5] weigh themselves regularly, [6, 7] and use digital health technology. [8]

One of the key factors of self-control is disinhibition, which literally means not being inhibited. Some inhibition is good, because it prevents people from not giving into temptation and eating whatever and how much they want. High levels of disinhibition are bad, because it leads to risky behavior. Disinhibited eating is a failure to maintain control over eating. The opposite of disinhibited eating is dietary restraint. Several NWCR studies have found that increased disinhibition leads to regaining lost weight. [9, 10, 11, 12, 13] Other studies have found strong relationships between a lack of self-control—impulsivity—and obesity. [14, 15, 16]

Habit #3: Control Calories

Successful weight losers consume fewer daily calories than the general population. Table 1 shows the number of calories the NWCR members consume per day, from the several studies that have reported it, along with the amount of weight they lost at the time they entered the NWCR.

Table 1 – Caloric Intake of Successful Weight Losers

 Calories Per DayPounds Lost
 1,381 [17, 18]

1,297 (women)

1,725 (men)

66

63 (women)

78 (men)

 1,306 (women) [19]

1,685 (men)

63 (women)

77 (men)

 1,390 [20]69
 1,462 [21]124
 1,400 [22]62
 1,399 [23]73
Average

Women

Men

1,406

1,302

1,705

79

63

78

Successful weight losers consume a low-calorie diet of about 1,400 calories per day, with women consuming about 1,300 and men consuming about 1,700 calories per day. By comparison, the U.S. adult population consumes an average of 2,120 calories per day (women consume about 1,820 calories per day and men consume about 2,480 calories per day). [24, 25]

Successful weight losers control calories several ways, including limiting how often they eat out at restaurants, [26] rarely eating fast food, [27] and limiting how many calories they drink. [28] They are also more likely than normal-weight individuals to have plans to be extremely strict in maintaining their caloric intake, even during times of the year when it’s easy to consume calories, like during holidays. [29]

Want to learn about more of the habits of successful weight losers? Check out Dr. Karp’s book, Lose It Forever: The 6 Habits of Successful Weight Losers from the National Weight Control Registry

A competitive runner since sixth grade, Dr. Jason Karp pursues his passion every day as a run coach, exercise physiologist, bestselling author of 10 books and 400+ articles, speaker, and educator. He is the 2011 IDEA Personal Trainer of the Year and two-time recipient of the President’s Council on Sports, Fitness & Nutrition Community Leadership award. His REVO₂LUTION RUNNING™ certification has been obtained by fitness professionals and coaches in 23 countries. His new book, “Lose It Forever: The Habits of Successful Weight Losers from the National Weight Control Registry” is available on Amazon.

References

[1] Wing, R.R. and Hill, J.O. Successful weight loss maintenance. Annual Review of Nutrition, 21:323-341, 2001.

[2] Klem, M.L., Wing, R.R., Lang, W., McGuire, M.T., and Hill, J.O. Does weight loss maintenance become easier over time? Obesity Research, 8:438-444, 2000.

[3] Gold, J.M., Carr, L.J., Thomas, J.G., Burrus, J., O’Leary, K.C., Wing, R., and Bond, D.S. Conscientiousness in weight loss maintainers and regainers. Health Psychology, 2020.

[4] Godin, G. and Kok, G. The theory of planned behavior: a review of its applications to health-related behaviors. American Journal of Health Promotion, 11(2):87-98, 1996.

[5] Wing, R.R. and Phelan, S. Long-term weight loss maintenance. American Journal of Clinical Nutrition, 82:222S-225S, 2005.

[6] Wing, R.R. and Hill, J.O. Successful weight loss maintenance. Annual Review of Nutrition, 21: 323-341, 2001.

[7] Butryn, M.L., Phelan, S., Hill, J.O., and Wing, R.R. Consistent self-monitoring of weight: A key component of successful weight loss maintenance. Obesity, 15:3091-3096, 2007.

[8] Goldstein, C.M., Thomas, J.G., Wing, R.R., and Bond, D.S. Successful weight loss maintainers use health-tracking smartphone applications more than a nationally representative sample: comparison of the National Weight Control Registry to Pew Tracking for Health. Obesity Science and Practice, 3(2):117-126, 2017.

[9] McGuire, M.T., Wing, R.R., Klem, M.L., Lang, W. and Hill, J.O. What predicts weight regain among a group of successful weight losers? Journal of Consulting and Clinical Psychology, 67:177-185, 1999.

[10] Niemeier, H.M., Phelan, S., Fava, J.L., and Wing, R.R. Internal disinhibition predicts weight regain following weight loss and weight loss maintenance. Obesity, 15:2485-2494, 2007.

[11] Butryn, M.L., Phelan, S., Hill, J.O., and Wing, R.R. Consistent self-monitoring of weight: A key component of successful weight loss maintenance. Obesity, 15:3091-3096, 2007.

[12] Thomas, J.G., Bond, D.S., Phelan, S., Hill, J.O., and Wing, R.R. Weight-loss maintenance for 10 years in the National Weight Control Registry. American Journal of Preventive Medicine, 46(1):17-23, 2014.

[13] Lillis, J., Thomas, J.G., Niemeier, H., and Wing, R.R. Internal disinhibition predicts 5-year weight regain in the National Weight Control Registry (NWCR). Obesity Science and Practice, 2(1):83-87, 2016.

[14] Chamberlain, S.R., Derbyshire, K.L., Leppink, E., and Grant, J.E. Obesity and dissociable forms of impulsivity in young adults. CNS Spectrums, 20(5):500-507, 2015.

[15] Fields, S.A., Sabet, M., and Reynolds, B. Dimensions of impulsive behavior in obese, overweight, and healthy-weight adolescents. Appetite, 70:60-66, 2013.

[16] Amlung, M., Petker, T., Jackson, J., Balodis, I., MacKillop, J. Steep discounting of delayed monetary and food rewards in obesity: a meta-analysis. Psychological Medicine, 46(11):2423-2434, 2016.

[17] Klem, M.L., Wing, R.R., McGuire, M.T., Seagle, H.M., and Hill, J.O.  A descriptive study of individuals successful at long-term maintenance of substantial weight loss. American Journal of Clinical Nutrition, 66:239-246, 1997.

[18] Wing, R.R. and Hill, J.O. Successful weight loss maintenance. Annual Review of Nutrition, 21:323-341, 2001.

[19] Shick, S.M., Wing, R.R., Klem, M.L., McGuire, M.T., Hill, J.O., and Seagle, H.M. Persons successful at long-term weight loss and maintenance continue to consume a low calorie, low fat diet. Journal of the American Dietetic Association, 98:408-413, 1998.

[20] McGuire, M.T., Wing, R.R., Klem, M.L., Seagle, H.M., and Hill, J.O. Long-term maintenance of weight loss: Do people who lose weight through various weight loss methods use different behaviors to maintain their weight? International Journal of Obesity, 22:572-577, 1998.

[21] Klem, M.L., Wing, R.R., Chang, C.H., Lang, W., McGuire, M.T., Sugerman, H.J., Hutchison, S.L., Makovich, A.L., and Hill, J.O. A case-control study of successful maintenance of a substantial weight loss: Individuals who lost weight through surgery versus those who lost weight through non-surgical means. International Journal of Obesity, 24:573-579, 2000.

[22] Klem, M.L., Wing, R.R., Lang, W., McGuire, M.T., and Hill, J.O. Does weight loss maintenance become easier over time? Obesity Research, 8:438-444, 2000.

[23] Ogden, L.G., Stroebele, N., Wyatt, H.R., Catenacci, V.A., Peters, J.C., Stuht, J., Wing, R.R., and Hill, J.O. Cluster analysis of the National Weight Control Registry to identify distinct subgroups maintaining successful weight loss. Obesity, 20(10):2039-2047, 2012.

[24] Wright J.D., Wang, C.Y., Kennedy-Stephenson, J., Ervin, R.B. Dietary intake of ten key nutrients for public health, United States: 1999-2000. Advance Data From Vital and Health Statistics, 334:1-4, 2003.

[25] U.S. Department of Agriculture, Agricultural Research Service. Energy intakes: percentages of energy from protein, carbohydrate, fat, and alcohol, by gender and age. What We Eat in America, NHANES 2015-2016, 2018.

[26] Wing, R.R. and Hill, J.O. Successful weight loss maintenance. Annual Review of Nutrition, 21:323-341, 2001.

[27] Thomas, J.G. and Wing, R.R. Maintenance of long-term weight loss. Medicine & Health Rhode Island, 92(2):56-57, 2009.

[28] Catenacci, V.A., Pan, Z., Thomas, J.G., Ogden, L.G., Roberts, S.A., Wyatt, H.R., Wing, R.R., and Hill, J.O. Low/no calorie sweetened beverage consumption in the National Weight Control Registry. Obesity, 22(10):2244-2251, 2014.

[29] Phelan, S., Wing, R.R., Raynor, H.A., Dibello, J., Nedeau, K., and Peng, W. Holiday weight management by successful weight losers and normal weight individuals. Journal of Consulting and Clinical Psychology, 76(3):442-448, 2008.

joint-replacement

Proprioception Training: An integral aspect of joint replacement fitness

/6 December 2023/ All MFN blog/

Proprioception refers to the conscious and unconscious perception of postural balance, muscles sense, and joint position and stability. Basically, it is your sense of where you are in time and space for movement. We have found over the years that the best way to explain proprioception to clients comes from Dr. Eric Cobb at Z-Health Performance Solutions:

“Proprioception is the body’s 3D map of itself in time and space. AKA our movement and awareness map”.

The detail and definition of this “proprioceptive map” comes from several specialized mechanoreceptors (i.e. nerve endings) in the muscles, tendons, joint capsules, fascia, and skin. As fitness trainers as we are usually taught about muscle spindles and Golgi tendon organs when we learn about flexibility training, but there is a lot more to proprioceptive input. You are affecting the proprioceptive input to the brain when you use a neoprene knee sleeve (pressure), kinesiology tape (skin stretch), heat or ice packs (temperature), TENS units (electric), etc. 

Why understanding and training proprioception is important for joint replacement clients

Several conditions can alter proprioception, thus “clouding” the map and degrading movement sense and capability, including pain, trauma, effusion, and fatigue. A joint replacement client also likely had poor motor control of the joint in the first place that resulted in compensatory movement patterns and overuse injury over time. Complicating the matter further, although it may have been necessary, the surgery itself is an “insult” to the musculoskeletal and nervous systems.

To move a joint well, you must be able to feel the joint and surrounding tissue well. An extreme example of what can happen without the sense of touch or joint position is the story of Ian Waterman. A rare neurological illness resulted in his losing all touch and joint position sensation, effectively paralyzing him from the neck down even though the motor control area of his brain and the descending pathways to send movement information to his musculature were fine!

Varied stimulus drives improved mapping

We can improve proprioception in several ways:

  • Reduce causes of proprioceptive “inhibition” (i.e., pain, fatigue, and effusion) – Therefore we need to only move in pain-free ranges of motion, and build muscular endurance.
  • Augment sensory information – We can do this by providing novel sensory stimulus to the affected area such as vibration, kinesiology taping, skin stimulation, pressure, or temperature. 
  • Weight Bearing Exercise Therapy – Loading, appropriately and progressively, compound movements.
  • Motor Skills Training – Exercises to target accurate movement such as multi-directional movements based on visual stimulus.

The important take away is that building a “library” of prior movement patterns is especially important for the post-medical joint replacement client. We want to get their new joint moving in multiple directions, at multiple speeds, under multiple loads.

The concept of proprioception and how to harness it is not only for joint replacement, but also for general fitness, performance, and pain clients! Begin learning a neuro-centric approach to medical fitness and how to work with joint replacement clients with our Joint Replacement Fitness Specialist online course, available through the MedFit Classroom!

Pat Marques is a Z-Health Master Trainer and NSCA-CPT specializing in training the nervous system to improve performance and get out of pain.  After retiring from the Active Duty Army, Pat pursued his education and certifications in exercise science, initially working with wounded, ill, and injured soldiers. During this time that Pat discovered the power of using a neurological approach to training to get out of pain and improve fitness and performance. He currently provides exercise therapy, movement reeducation, and strength and conditioning for all levels of clients at NeuroAthlete, from chronic pain sufferers to Olympic-level and professional athletes.

References:

  1. Lephart, SM and Fu, FH. (2000). Proprioception and Neuromuscular Control in Joint Stability. Champaign, IL: Human Kinetics.
  2. Roijezon, U., Clark, N., and Treleaven, J. (2015). Proprioception in musculoskeletal rehabilitation. Part 1: Basic science and principles of assessment and clinical interventions. Massage Therapy (20).
  3. Cole, J. and Waterman, I. (1995). Pride and the Daily Marathon. MIT Press.
  4. Roijezon, U., Clark, N., and Treleaven, J. (2015). Proprioception in musculoskeletal rehabilitation. Part 1: Basic science and principles of assessment and clinical interventions. Massage Therapy (20).
Nutritional label

The Truth About Macro Counting

/22 November 2023/ All MFN blog/

“I’m so fed up with my weight!”
“I am so uncomfortable in my clothes.”
“My fat clothes are beginning to be too tight!”

If you can relate to any of these statements, are you among the millions of people who have tried counting macros to get yourself back “on track?”