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Stress Management in the Modern World

It’s exhausting being a human today – there are over one million Google hits per day for the word “stress”. Good and bad stress is a part of the human condition and it can be real or imagined and it is certainly a broad societal issue. By making a positive “next step” in managing your stress you can avoid becoming worn out by the journey of life.

Stress was first described in 1915 and the theory states that we react to threats with a general discharge of the sympathetic nervous system, priming the person for fighting or fleeing. Biologically, physical activity gives the body a chance to practice dealing with stress. Physical Activity releases mood-elevating endorphins, self-confidence and improves your sleep. Studies show that one can access the REM state (the most restorative phase of sleep) quicker on days you include physical activity. Under stress, our raised heart rate and blood pressure but tensions in our arteries and cause damage. Chronic stress which goes on longer than 20 minutes contributes to heart attacks just as acute stress does. It also causes constriction of the blood vessels, dilation of pupils, auditory exclusion and decline of peripheral vision. As the body heals this damage, artery walls scar and thicken which can reduce the supply of blood and oxygen to the heart (occluded arteries). Since the brain uses 20% of the oxygen delivered by the heart foggy-thinking may result. Stress can also cause the telomeres to shorten and erode. The telomeres protect the end of the chromosomes and if they shorten too much, they cannot multiply and die off resulting in quicker aging.

The President of the Salk Institute, Elizabeth Blackburn, and the recipient of the Nobel Prize states, “We’ve found that the better your telomeres are protected, the less chance you’ll have of getting any of the big diseases.” She suggests to stop the erosion, do physical activity of various types and don’t have long-term stress.

Begin to take charge of your thoughts, your emotions, your schedule, your spending, your environment and the way you deal with problems – especially family system challenges. Ask yourself, is it worth my health? Is this situation/person worth negatively impacting my health? Choose to be happy – it can boost your emotional well-being as stated in studies published in the Journal of Positive Psychology. Be mindful of good and hard-earned accomplishments and enjoy your small victories. Appreciate the simple pleasures, devote time to giving, make a point to listen to the other person’s ideas and UNPLUG! Ferris Bueller said – “Life moves pretty fast. If you don’t stop and look around once in awhile, you could miss it”.

Hamlet said, “There is nothing good or bad…but thinking makes it so.” Positive thinking is medicine and every thought can enhance or diminish our health, happiness and stress level. Dr. Robert Sapolsky of Stanford proposes in his book Why Zebras Don’t Get Ulcers, “If you are a normal mammal, stress is the three minutes of screaming terror in the jungle which either it is over with OR you’re over with. Perceived threats spark the same physiological survival responses (fight or flight) that crocodile attacks do.” Our modern-day stressors have changed. Fighting off prehistoric predators and trying to find food are replaced by juggling deadlines, multitasking and always being “connected” and available. Modern day saber tooth tigers are bills, traffic, family pressures but our bodies react the same way without the natural release that we would get from fighting or fleeing. Try not to turn to sugar and caffeine which can result in swings in blood sugar levels, limit alcohol to one drink per day and try to achieve a balanced, clean diet on most days of the week to even out your beautiful life.

The United States Government has suggested 150 minutes per week of physical activity in addition to two days per week of strength training for 20 minutes and stretching every day. There are many meditation, relaxation response and calming apps which you can download to have with you and use when you are having a challenge with managing stress. Sit and stand tall and do not “slump” as this can cause shallow chest breathing which can trigger the fight or flight response. Try not to make important decisions while under undue stress as this may result in poor or faulty decisions.

A 2016 study by the American College of Sports Medicine stated if workers do not have emotional resilience skills and habits to help support them during stressful times, their productivity declines. Work-related requirements such as precision and accuracy, problem solving, interpersonal communications as well as speed and quality of work output will suffer. We  need to adjust to change without disruption or difficulty while maintaining good functional capacities. We need to bounce back without breaking and without giving in, giving up or breaking down. Stress Management is an integral component of Global Employee Health and Fitness Month (every May) healthandfitnessmonth.org and as the Architect of this initiative I felt passionately about including this component along with nutrition and physical activity, to give each and every worker the opportunity to go home “whole.”

Each and every day when confronted with stress, think about what advice you would give to a friend and then take this advice yourself!

Diane Hart, Owner of Hart to Heart Fitness, (www.harttoheartfitness.org) is a Nationally Certified Fitness Professional, Personal Trainer, Health Educator and is current President of the National Association for Health and Fitness (www.physicalfitness.org) founded in 1979 by the U.S. President’s Council on Sports and Fitness. 



The Importance of Stretching

I remember the first time I figured out what my piriformis was, and how having a tight piriformis and IT band affected my movements. I had just started running hard core. As a former dancer, we stretched our hamstrings, inner thighs, the “dancer muscles”. But a piriformis or IT band was not something a DANCER experienced as this was not a muscle that was targeted in ballet, or other forms of dance.

The PAIN, was a knot in the right side of my hip/tush. It began to radiate all the way down the side of my right leg. It even affected my lever length so that the right leg felt “shorter”. I eventually learned how to do stretches such as “parvritta trikonasana”, and a bastardized version of pigeon on my back to target this muscle group (the external rotators).

Also, as a swimmer, and runner, my calf muscles will get super tight. This eventually pulls on my achilles tendon. Having torn my right achilles tendon in a freak accident in 2002, I can tell you keeping the achilles tendon happy can make the difference between being able to walk or not. Hand to foot calf stretches both standing and supine, as well as forward bend, and parvritta trikonasana, will take care of the problem. I also flex my foot against a wall before starting my run.

If my knees ache, it is usually because my quads are tight. I start with alternating kick ups from down dog into lunges to warm up. I also do natarajasana, which provides me an open angled quad stretch.

My students will often have problems targeting their abdominals. Tight hamstrings and hip flexors are usually the problem. I will do a “half lunge” where they press through the psoas to release it, then stretch the ham/calf in a forward bend while flexing the front foot, and keeping the standing knee right under the hip.

For other hard to read groups, such as under the shoulder blades, nothing beats a foam roller. I body surf along the foam roller, and hold until the knot dissipates. I have a chapter in “Healthy Things You Can Do In Front of the TV” complete with photos to describe how to target key muscles.

Stretching is often a forgotten, and yet necessary part of fitness. It makes the difference between proper kinesthetic alignment and gait, or movement that is off-balance, which can cause injuries. Not to mention, it just feels good before or after an intense workout. It also aids in recovery, so that you can be ready for your next challenge. Even die-hard couch potatoes need to stretch. And many stretches can be done at work or at home. See my lovely book for more examples of how to keep your body functioning at its best.

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.  Her new book, “Healthy Things You Can Do In Front of the TV” is now on sale on Amazon, Barnes & Noble, and Kindle.

purple ribbon for the world alzheimers day

The Weather of Alzheimer’s

When you are organizing an event, say, the Tacoma South Sound Alzheimer’s Walk, there can be an illusion that all moving parts are in your control, leaving you thinking: this event will be successful/fantastic/memorable (insert your favorite adjective here) so long as I check off all items on my to-do list.

We could view life as an event. The event. So the narrative goes, as long as I check-off all of the items: be respectful, do good, establish a career and so on, then I will be successful or (insert your favorite adjective here).

In today’s early Autumn event, there is at least one piece that remained uncheckable. The weather.

The weather, with all of its unknowns and impulsivity is similar to a diagnosis of Alzheimer’s.

During a two-hour period of time, 11 a.m. to 1 p.m., there was as much variation in the sky as there were people populating Todd Field, at the University of Puget Sound.

The sky was a solid sheet of arctic blue separated only by two main air streams. Within a matter of minutes, the sky shifted to an admiral blue populated by picture-book clouds and rays of sunshine. The imperceptible breeze shifted to barely detectable rain droplets.

A mildly warm autumn afternoon became disguised by a frigid rain storm too gusty even for an umbrella. In between the dramatic changes were the smaller ones too, warm became cold when some cumulus clouds blocked the now feeble sun, rain became stinging stones.

Miniature purple cowbells chimed. Pieces of synthetic orange, yellow and purple flower petals swirled in the air and decorated sidewalks. Bubbles were attempting to be blown from wands. Umbrellas flipped inside out. The announcer suggested over the loud speaker: 1-milers to the left and 2-milers to the right. Do I go left or right? Make a decision.

In the early stages of diagnosis, one may be hesitant or resistant to know more about Alzheimer’s.

For a moment, wicked freezing wind and sharp sideways rains, laughter, then silence.

You may feel anger toward or shame about a diagnosis.

Drop. Drop. Drop. The rain seems to be subsiding.

When you process new information about your diagnosis it is important to do so at your own pace – one that feels comfortable for you.

Round the corner and the sun shone.

Knowing more about Alzheimer’s can reduce the stigma and increase one’s confidence.

The sun shined and the sky lit up blue – presenting shades ranging from sapphire to cobalt to indigo. And then there were beeping cars like flashes of thoughts. Skies shifted across the gray spectrum from cinder block to pewter to forged iron much like the emotional processing of how one can feel so alone.

Then there were straight away streets, friendly faces and familiar feelings in an oh so unfamiliar state of being.

Experiences with Alzheimer’s, unlike the weather, is a checkable item.

Underneath the unknowns there is comfort in knowing and deliberate calm wrapped around impulsivity.

Adrienne Ione is a dynamic, mindful, high-fiving, cognitive behavioral therapist, certified dementia specialist and senior personal trainer. Founder of Silver Linings Integrative Health, a company with an aim of promoting health, fitness and wellbeing opportunities for people to thrive across the lifespan.

Adam Presses

Life as we Grow It: Fitness as a Life Skill for Special Needs Populations

“Kettlebell and the sandbag,” Nico states as I’m preparing for him to do squats.

“You want to do farmers carries?”

“Yes,” he says in a soft voice but with an assurance that tells me he’s not just randomly calling out an object in the room.

“Awesome. Yes, you can definitely do farmers carries right after this set of squats, okay?”

“Yes,” he says, in the same low but definitive tone. I’m thrilled. Farmers carries involve roughly 3 steps; Pick something(s) heavy up, carry them while maintaining an upright, healthy posture, and put them down with control, sometimes with less control than other times. Farmers carries have fantastic generalization to other life skills, yes, carrying things of course, in addition to maintaining trunk stability and gait pattern (think climbing two or three flights of steps).

When we consider fitness as a life skill rather than something individuals with ASD and related special needs either “like” or “don’t like” the focus becomes less on “if/should” and more on “how/what.” We’re not just talking about young populations either. Fitness over the lifetime has immense benefits for both short- and long-term development, both proactive and reactive qualities.

That fitness and physical activity are only for young populations disregards the true value of progressive movement programs. As we age, the importance of strength, stability, and motor planning increases, as these are skills that degenerate with age and dis- or non-use. The result is costly, both in quality of life and financially. Consider the healthcare costs for a 55 year old individual with pervasive Autism Spectrum Disorder (ASD), diabetes, and compromised mobility. Two out of these three complications are entirely avoidable. They are also, with the proper fitness and nutritional interventions, reversible.

Quality of life can be a general, not-certain-what-we-mean-by-this-but-sounds-good term unless we consider it with respect to what those in our care can do and what skills will allow them to be more independent, healthier (physically and emotionally), and enable them to connect with others (building community) in meaningful ways. We also want to consider stress levels and longevity. What does life look like and feel like for a non-verbal individual in his/her 20’s? 30’s? 60’s? How can we ensure the best possible present and future for them?

Let’s take away “Doesn’t like to exercise.” Let’s get rid of that. In fact, I don’t even know what that means. Our definitions and perspectives on exercise programs may a “little” different. I get this interaction a lot;

“Kevin hates exercise.”

“What do you mean by exercise?”

“Oh, well we had him run on the treadmill for five minutes and he hated it and doesn’t want to do it again.”  

The fault isn’t in the trying. There is no fault. There is, however, a lack of information about the components of an appropriate fitness program. So here are the rules;

  • We use exercises that will have the greatest benefit/generalization to life skills. These include squatting, pushing, pulling, carrying, and locomotion.
  • We get a baseline understanding of what an individual can currently do.
  • We progress exercises and movements once an individual demonstrates mastery.

What do we do? What do we doooooooooooooo? What exercises do our athletes need? What’s age appropriate? Are there super special special needs exercise?

The thing about fitness is that we’re doing it with human beings (goat yoga being a hideous exception). Since we’re doing it with human beings, we’re looking at human movement patterns and our individuals with ASD and related special needs are no exception.

The key is learning to what degree an exercise or movement needs to be simplified (regressed) or made more challenging (progressed). This is where baseline comes into play. If where know where our athlete is starting with an overhead Sandbell press, we can decide on an appropriate course of progression, maybe increasing the weight by 4lbs once they can complete 10 repetitions independently.

Understanding how each movement relates to quality of life is helpful. So let’s review that.


  • Maintaining healthy posture when sitting/standing
  • Increasing low body strength for walking/climbing (stairs, etc.)
  • Sustaining healthy posture
  • Prevention of low back pain
  • Increased trunk/core stability


  • Shoulder stability when reaching/placing items overhead
  • Trunk stability and postural control when holding weighted objects
  • Increasing general upper body stability for fine motor movements


  • Development of upper back muscles to decrease forward posture
  • Increased range of motion for shoulders
  • Trunk stability when opening doors, dragging laundry bags
  • Increased control when grabbing objects from above or below


  • Being able to move objects from one place to another independently
  • Increasing postural control and strength endurance (the ability to do a task for a longer period of time)
  • Gait patterning
  • Groceries/laundry/boxes/etc.


  • Getting from point A to point B with minimal discomfort
  • Establishing coordination and motor planning for multi-step activities and ADLs (cooking, taking out the garbage, showering)
  • Decreasing latency (catching the bus, getting to the car in less time)

The reasons why our Autism Fitness programming focuses primarily on developing strength, stability, and motor planning in these movement patterns is because these are the most common deficits and will have the greatest short- and long-term benefit for our athletes. We want to build a physical ability and progress as the athlete demonstrates their improved capabilities.

Programming, for individuals and groups, should include each of these exercises at a level of challenge where the athlete can perform the movement safely and with good technical form. We don’t just have our athletes move a lot, but coach healthy movement. This is why regressions in exercises are so critical and why we spend so much time with them in the Autism Fitness Level I Certification seminars.

As professionals working with and enhancing the lives of individuals with ASD and other developmental disabilities, there is a responsibility to provide life-enriching skills and opportunities. So much of this can be found in effective fitness programming. In both reducing the instances of health complications and increasing independent life skills, we can used the development of strength, stability, and motor planning to help build our athlete’s futures.

Photos provided by Eric Chessen.

Eric Chessen, M.S., is an Exercise Physiologist with an extensive background in Applied Behavior Analysis. Eric provides on-site and distance consulting worldwide. He is the founder of Autism Fitness®, offering courses, tools, resources and a community network to empower support professionals to deliver adaptive fitness programming to anyone with developmental deficits to create powerful daily living outcomes that last a lifetime.


Neuroplasticity and the Aging Brain

One of the greatest concerns for the aging population is cognitive decline which leads to loss of independence as well as an extreme burden on the caretakers.  Individuals worldwide are fearful of being diagnosed with any of the various cognitive issues: Dementia, Parkinson’s, Alzheimer’s, and other forms of cognitive debilities.  In 2015 there was an estimated 47 million people living with dementia and this number is expected to triple by 2050.  In 2014, the Alzheimer’s Association reported that they believe there is sufficient evidence to support the link between several modifiable risk factors and a reduced risk for cognitive decline and sufficient evidence to suggest that some modifiable risk factors may be associated with reduced risk of dementia. Specifically, that regular physical activity and management of cardiovascular risk factors (diabetes, obesity, smoking, and hypertension) reduce the risk of cognitive decline and may reduce the risk of dementia. The Association also believes there is sufficiently strong evidence to conclude that a healthy diet and lifelong learning/cognitive training may also reduce the risk of cognitive decline.

Positive association between aerobic exercise or CV fitness and executive functions is highly consistent but cannot determine causality.  Aerobic exercise (AE) has shown moderate to medium sized effects on executive function and memory. Resistance Training (RT) has improved executive function and memory. Combined AE and RT has the biggest (potentially synergistic) effect. It has been proposed that the physical and cognitive exercise might interact to induce larger functional benefits.  Larger benefits on cognitive test performance were noted for combined physical and cognitive activity than for each activity alone.  “Claims promoting brain games are frequently exaggerated and at times misleading. … To date, there is little evidence that playing brain games improves underlying broad cognitive abilities, or that it enables one to better navigate a complex realm of everyday life (Consensus statement, 2014).

Neuroplasticity is the brain’s ability to reorganize and rebuild itself by forming new neural connections. The more neural pathways you have, the more resilient your brain is. Neurogenesis is the process of creating new neurons (brain cells).

Contrary to popular belief, neurogenesis continuously occurs in the adult brain under the right conditions such as with exercise.  Substantial benefits on cognitive test performance were noted for combined physical and cognitive activity than for each activity alone. It was also noted that the physical and cognitive exercise together might interact to induce larger functional benefits.  “We assume, that physical exercise increases the potential for neurogenesis and synaptogenesis while cognitive exercise guides it to induce positive plastic change” (Bamidis, 2014).  To maximize cognitive improvement, combine physical exercise with cognitive challenges in a rich sensorimotor environment that includes social interaction and a heaping dose of fun.

Brain health is becoming extremely important as individuals live longer.  Today there is much more information available on how to train the aging brain.  Three great resources are:

Dianne McCaughey Ph.D. is an award winning fitness specialist with more than 35 years experience in personal training, group exercise, coaching, and post-rehabilitation. She is a master trainer for multiple companies and practices and teaches optimal wellness emphasizing the mind, body and spirit. She works with special populations and focuses on posture, gait, balance and corrective exercise programs for better function and health.

Cody Sipe, PhD, has an extensive background in the fitness industry with 20 years of experience as a personal trainer, fitness instructor, program director, exercise physiologist and club owner. He is currently an Associate Professor and Director of Clinical Research in the physical therapy program at Harding University. He is the co-founder and vice president of the Functional Aging Institute (FAI).



Why is Breakfast Really That Important?

Brain health is directly related to blood sugar levels (glucose homeostasis) in the body.

The information in this article is taken from the American Academy of Sports Dietitians and Nutritionists (AASDN) continuing education course “The Science of Nutrition.”

There are so many misconceptions and misinformation about nutrition. Everyone wants to believe they are eating to properly fuel their body and prevent disease. There is one clear path to learn how to separate fact from fiction when it comes to nutrition information. For some reason, many people prefer to follow the nutrition fads, instead of trying to understand how the body works. The best path to optimal nutrition is to learn how the body responds physiologically to food.  When you understand how the body works, then you will understand how to fuel the body properly.

So, is breakfast important? Is Breakfast important from a physiological standpoint? What should you eat for breakfast? Let’s explore how the body works to answer these questions.

If we define breakfast as the first meal consumed at the start of our day, then yes, breakfast is very important.  As you may have heard, it is the most important meal of the day for most people. One reason why is Glucose Homeostasis.

Glucose homeostasis is one of the highest levels of homeostatic control in the human body. Normal fasting blood glucose in a healthy individual is between 70 and 100 mg/dl. This range is regulated primarily by the hormones insulin, glucagon, epinephrine, and norepinephrine.

Many cells in the body have insulin receptors which bind insulin allowing glucose to enter the cell. These cells are known as insulin-dependent cells and most cells in the body are insulin dependent. Insulin acts like a key, opening the door so the cell can let the glucose enter.

Although most cells in the body are insulin dependent, there are also some non-insulin-dependent cells that do not have insulin receptors (red blood cells, nerve cells, cells involved in vision, etc). These non-insulin-dependent cells are quite different in that insulin has either little or no effect on glucose utilization or uptake. Another distinguishing factor is that these cells can only use glucose as an energy source. So nervous system and brain cells, vision cells, and red blood cells need a healthy level of glucose available in the blood stream in order to function properly and remain healthy.  They can’t store glucose in the cell, but having glucose available at all times is imperative for proper cell function and cell health.

These cells are particularly at risk for damage when blood glucose levels in the blood stream are not within normal range for any extended period of time. Therefore, prevention of damage to these cells requires glucose levels to be maintained within the homeostatic range. This homeostatic control helps to explain why conditions like Diabetes are so dangerous. If the body is not able to naturally maintain normal blood glucose levels, critical cells in your brain, nervous system, eyes, and blood will be damaged.

The glucose time curve refers to a finite amount of glycogen that can be stored in the body and the processes that occur when glycogen stores are depleted. We know that glycogen is stored in the liver and if adequate carbohydrates are consumed to maximize liver glycogen storage, this glycogen can provide about 12-16 hours of glucose for non-insulin dependent cells. Once this glycogen is depleted the body must produce glucose from other sources.

Let’s say that a normal, healthy individual consumes a healthy, carbohydrate rich meal at 6 pm. The meal should provide adequate glucose for about 4 hours, taking the individual to about 10 pm when this individual goes to bed. During the evening, while sleeping, the body still requires glucose which can be obtained from liver glycogen stores. Assuming this individual gets an adequate 8 hours of sleep, this individual wakes at 6 am and only has about 4 to 8 hours of glycogen remaining in the liver. This makes a healthy, carbohydrate rich breakfast important.

If breakfast is skipped, then somewhere around 10 am the body starts to search for other means of obtaining the vital glucose to sustain the cells that must have it.  The only option is a process called Gluconeogenesis which is the making of glucose from non-carbohydrate sources in the body. The body will break down stored proteins to obtain glucogenic amino acids and convert them to glucose. The body CANNOT make glucose from stored fat.

During gluconeogenesis, the body is getting the needed glucose, but at a very high cost. The nitrogen that is removed from the amino acids must be excreted from the body. Also, the primary location for the body to obtain whole proteins for gluconeogenesis is skeletal muscle. This muscle that we have worked so hard to build and maintain is now being catabolized for survival. This is so dangerous that the body will only allow it to occur for up to 48 hours. At that point, so much damage has been done that the body moves to another metabolic process that steals amino acids form muscle tissue to survive known as Ketosis. However, brain and nerve cells cannot use the “fake” glucose and damage to the brain, blood and nervous system begins.

So, the bottom line?  DO NOT SKIP BREAKFAST… skipping breakfast starves and damages your brain, nervous system, blood, and eye cells.  It is vital to eat healthy carbohydrates for breakfast, especially if you are going to exercise in the morning, to make sure you have plenty of circulating glucose in your blood to feed your non-insulin-dependent vital cells.  Eat a breakfast that includes foods like oatmeal, whole grain breads, whole grain cereal, and fruit.  FEED YOUR BRAIN!  Preserve it, don’t starve it.

Interested in learning more? Gain a fundamental understanding of science-based nutrition concepts in the course The Science of Nutrition. The goal is to allow you to be able to better separate the science-based food and nutrition information from the plethora of misinformation, to properly advise and communicate about nutrition with your clients.

Compiled by June Chewning. June M. Chewning BS, MA has been in the fitness industry since 1978 serving as a physical education teacher, group fitness instructor, personal trainer, gym owner, master trainer, adjunct college professor, curriculum formatter and developer, and education consultant. She is the education specialist at Fitness Learning Systems, a continuing education company.



Beyond Modifications: Bringing all of Yoga’s Tools to People with Arthritis

For over a decade, I have been researching the effects of yoga for people with arthritis. As many people envision, this includes a lot of modifications, adjustments, and extensive use of props. We work with students to find versions of each asana that remain true to the essence of the pose, working within any movement limitations without creating pain or joint discomfort.

But when we teach yoga to people who have arthritis, we don’t strive for a magical asana sequence that will address arthritis in a particular body part.

Yoga is a holistic process. When we make the mistake of thinking about yoga as if it were physical therapy, we lose what makes yoga a unique therapeutic process. Instead, yoga can go hand-in-hand with modalities like PT, as complementary processes.

Researchers lose something when looking only at an asana sequence and its effect on the joints.

Instead, our job is to get the joint issues out of the way, through support, use of props, compassion and awareness, so that yoga can work its magic on the whole person- body, mind, and soul.

Just as yoga can improve overall physical fitness for healthy individuals, it can improve fitness for people with arthritis. But with this population, the stakes are even higher. Yoga can improve balance, which prevents dangerous falls. Yoga practice can enhance flexibility, which allows individuals to maintain mobility over time. Improved strength means greater joint stability. Improved strength means a reduction in the muscle loss that accompanies some forms of arthritis. Improved strength means an increased ability to participate in everyday activities that can be challenging as joints deteriorate.

But a yoga practice has the potential to bring much more to the lives of people with arthritis. Yoga allows those with a chronic, disabling disease to realize what their bodies CAN do. It fosters a connection to their bodies which may have been lost during years of disease progression and reduced activity. Yoga can teach students to be present in the moment, and to adjust to their bodies needs on a particular day, without judgment. Arthritis changes every day, and this skill serves our students every day, even if they don’t get on the mat.

Yoga also helps our students to relax and to be mindful. Having a chronic disease is stressful, and stress can exacerbate that disease. The relaxation and meditation practices of yoga can break the cycle of stress reactivity.

Yoga classes connect people with arthritis to others who are striving and thriving… people who are living a full and active life, whatever journey they have taken to arrive at that place.

And yoga changes other behaviors. When people start to feel connected, they want to do other things in the name of self-care. They eat healthier foods, go for a walk outside, make time for themselves, and some even make an effort to be more adherent with their medical care.

When we think about bringing the tools of yoga to the arthritis community, let’s be sure to look beyond the modification of asana as a goal. Our goal is to make the asanas possible, so the totality of yoga can come through to our students, safely and effectively.

Reprinted with permission from Dr. Steffany Moonaz.

Dr. Steffany Moonaz is a yoga therapist and researcher and serves as Assistant Director of Academic Research at the Maryland University of Integrative Health. Dr. Moonaz is working to bring yoga to people with arthritis in communities around the country, as well as educating yoga teachers and yoga therapists about the unique needs of this population. She currently leads Yoga for Arthritis teacher training programs nationwide and serves as a mentor for several emerging researchers who are working to study the effects of yoga for various health conditions.

sugar cubes

The Debate: Is Sugar Evil or OK for Athletes?

Sugar is a total waste of calories. I don’t touch the stuff.

I have such a sweet-tooth. My day is grim without some sugar in it.

Before I compete, I eat a spoonful of honey to boost my energy.

If you are like most of my clients, you are confused about the role of sugar in your daily sports diet. The anti-sugar media reports sugar is health-erosive, yet sports nutrition researchers claim sugar is performance enhancing. That might leave you wondering: Should I eat sugar or avoid it?

To address this conflict, I’ve summarized a sugar debate published in 2018 in the Journal of Progressive Cardiovascular Disease. The article, critique, and editorial do a good job of examining the question: Have the ill effects of those toxic white crystals in your diet been over-emphasized? Here is some information to help you better understand the two sides to the Sugar Wars debate.

Sugar is Evil(1)

Sugar is not an essential nutrient. Our bodies can make sugar (glucose) from the dietary fat and protein that we eat, or by breaking down our body’s muscle and adipose tissue.

• The average American eats about 100 pounds of sugar per year; that’s 2 pounds a week and contributes abundant empty calories.

• Populations with a high intake of added sugars tend to have health issues. Reducing added sugar to less than 10% of total calories reduces risk of overweight, obesity, and tooth decay.

• Dietary sugar drives up blood sugar. Routinely consuming 150 sugar-calories each day (i.e., one can of soda) increases the risk of developing diabetes by 1%. Much of this sugar is hidden in packaged foods.

• Metabolizing added sugar (with no nutritional value) requires vitamins and minerals. With very high sugar consumption (and low intake of other nourishing foods), one could become nutrient depleted.

• Trading empty sugar calories for nutrient-rich calories is a no-brainer. Limiting sugar intake does not harm anyone.

Sugar is OK for People Who Are Fit(2)

• Sugar consumption increased from less than 10 lbs. per person per year in the late 1800’s to about 100 pounds per person per year by World War II. Consumption remained relatively flat until 1980. Our health also improved between 1880 and 1980—so is it fair to say that the increase in sugar hurt our health?

• Sugar (and starch—a string of sugar molecules linked together) is in breast milk, dairy foods, fruit, honey, potato, wheat, corn, quinoa, and all grains. People around the globe have consumed these “carbs” for years. So why now do sugar and starch suddenly become responsible for creating human obesity and diseases?

• The fear-mongering terms of unhealthy, toxic and poisonous are simply unscientific. People who lack knowledge about physiology accept this disease-mongering, anti-sugar rhetoric. But the fact is no one food is healthy or unhealthy.

• Our present state of poor health is not because our diets are unhealthy or that we consume sugar, but because we are physically inactive. Low levels of physical inactivity reduce our ability to metabolize sugar optimally, and that explains the true cause of obesity and metabolic diseases.

• In terms of diabetes, blood sugar, not dietary sugar, matters. The rise in blood sugar that occurs after eating is not pathological but rather the failure of the muscles and liver to take up the sugar. That is, it’s not what you eat, but what your body does with what you eat.

• Physical activity affects appetite and energy intake. If we are too inactive and live a sedentary lifestyle, energy intake gets dissociated from energy expenditure. We can easily eat more calories than we burn. Lack of physical activity negatively impacts metabolic health.

• A maternal effect impacts both pre- and post-natal development. Children of inactive mothers are born increasingly predisposed to inherited childhood obesity and Type II Diabetes. This increases with each passing generation.

Concluding comments(3)

Lack of physical activity, more so than sugar, is the greater threat to our health. Given that so many people are overfat and underfit, a diet low in sugars and starches is likely a good idea for them. But for sports-active, fit people—who are at lower risk for heart disease, diabetes, and obesity—sugar and carbs are not toxic but rather a helpful way to enhance athletic performance. The one size diet does not fit all.

No one is suggesting that athletes should eat more sugar, but rather understand that, as an athlete, you can embrace a sports diet that includes an appropriate balance of carbohydrate (sugars and starches) in each meal. Strive for a healthy eating pattern that includes 85% to 90% quality foods and 10% to 15% whatever. Some days, whatever might be an apple; other days, it might be a slice of apple pie.

Addendum: If you are fearful sugar will harm your health, note that fear-mongering relies on cherry-picked scientific information that can prove what the messenger wants to prove. Fear-mongering messengers have created a general distrust of Big Food, and have shaped opinions that support raw foods, super foods, whole foods, organic foods, and clean eating. While a plant-based diet based on unprocessed foods with no added sugar is ideal, I commonly see athletes who take the advice to the extreme and eat “too clean” (orthorexia). That is not healthy, either.

My suggestion: Enjoy a balanced variety of foods, in moderation. The US Dietary Guidelines recommend limiting added sugar to less than 10% of your total calories (about 250+ sugar-calories per day for an active woman who might require about 2,500+ calories a day) Enjoying a daily small sweet seems better than routinely “cheating” with sugar-binges. Does the age-old advice to enjoy a balanced variety of foods—with a sprinkling of sugar, if desired—seem a reasonable goal?

Nancy Clark, MS, RD, CSSD counsels both casual and competitive athletes at her office in Newton, MA (617-795-1875). Her best selling Sports Nutrition Guidebook and food guides for marathoners, cyclists and soccer players offer additional information. They are available at NancyClarkRD.com. For her popular online workshop, see NutritionSportsExerciseCEUs.com.


This article is based on information from the Journal of Progressive Cardiovascular Disease (August, 2018)

  1. DiNioloantonio JJ, O’Keefe JH. In critique of “In Defense of Sugar: The Nuance of Whole Foods. https://doi.org/10.1016/j.pcad.2018.07.006
  2. Archer E. In Defense of Sugar. https://doi.org/10.1016/j.pcad.2018.07.013
  3. Lavie CJ. Sugar Wars -Commentary From the Editor https://doi.org/10.1016/j. pcad.2018.07.007

Resistance Training: Principles and Planning

As I have grown in my own understanding of strength training over the years, I have  come to realize that many people are aware of the need to develop strength but appear to miss the point when applying their efforts to the actual process. I have observed over the years that men tend to want to “load up” their exercises and do minimal repetitions (maximizing the resistance) while women tend to work with very light weight and do greater numbers of repetitions.

Both approaches are not wrong but in applying their effort in this way they will both get minimal results. Men tend to get fatter in the abdominal cavity and women tend to gain fat mass in the hips and thighs – and eventually arms. Both approaches will not solve the “fat storage” problem and I suspect the frustration both groups feel grows ever time as each attempts to change the outcome by going with what they “think” will work.

I feel that if I can highlight the PRINCIPLES of resistance training while identifying the underlying benefits of a successful resistance training program I will hopefully “shed light” on the mystery of getting a “lean body” which we all seem to want.  Lean and strong beats fat and weak any day -doesn’t it? I know it does because I am able to say that after 30 years of weight training I AM lean and strong! Would you want that too? Of course!


RESISTANCE: Applying a predetermined  “load” to a particular muscle group in order to create a deficit of stored energy and allow the muscle to respond to the “stimulus” by “adapting to the load presented” – and getting stronger over time. The muscle grows in size and strength by responding to increased loads and gives the joint more stability while creating a more flexible and adaptable joint.

REPETITIONS: The number of movements around the joint that create the result. The lower the number of repetitions – the greater the load. The higher the number of repetitions – the lower the load. Repetitions can range anywhere from (6 for “power sets” to 15 for “endurance sets”. The number of sets one can do will determine how quickly – or slowly – the muscle will respond to the stimulus. When it can no longer perform the movement (1-3 sets for beginners to 4-6 – or more – sets for experienced individuals) it has reached a “failure point”.

EXERCISES: The number of exercises is determined by the condition of the individual and the outcome desired. The form (body weight, machine, free weights) the exercises take is determined by the experience, knowledge and acquired skill of the individual. The process is always dictated by the conditioning and “readiness” of the person to train and MUST always include the safety and effectiveness of the exercises selected. Examples of exercises are: Leg extension, calf extension (seated or standing), shoulder press, chest press, back – rowing or pulldown, arm curls, lunges, and squats.

SPEED/TIMING: Timing refers to the speed with which we do the movements needed. The 2/4 count is a common tool used to either “speed up” or “slow down” the movements. (2 is for raising the weight and 4 for is for lowering the weight slowing the movement). Each has value but the faster we do the movements the more likely we are to increase the risk of injury. The heavier the load the more speed will have to be employed to “move the weight”. The lighter the load the slower the movement can done increasing fatigue and allowing the muscle to respond over time to the stimulus. Do a movement that is comfortable for you and remain in control of both the positive and negative resistance.

RANGE OF MOTION: The principle of range of motion comes into play when we attempt to move a heavier “load” through a “full range of motion” when our muscle is unable to do it without assistance from another joint. A classic example would be a standing arm curl where we are applying a weight against our bicep and attempting to raise the weight to our shoulders without using our back or lifting with our shoulders. I see this all the time. If you can’t “curl the weight” slowly – at the elbow for example – without assistance the weight is too heavy.

PROGRAMMING: Programming applies to the overall effort – and the result one is attempting to achieve. Starting with lower weight and doing more repetitions correctly is always preferable since safety must come first. The muscle develops over time and then additional “reps” can be applied with higher resistance since the muscle “adapts to the loads” over time. Patience is important and “going slowly” at first is always advisable. Weight training can show results in as little as 30 days so keep going!

THE PRINCIPLE OF ADAPTATION: This principle is the most important to keep in mind. All muscles get stronger over time if consistent effort is made and the issue of safety is always kept foremost in mind. My own training is now focusing on high numbers of repetitions while maintaining the weight I have been using to this date. The endurance and power issues are  being addressed in this manner since I am older now and my goal is to “maintain” my existing lean muscle mass”. We should ALL want to maintain our lean muscle mass since it is the most active tissue in our bodies – and burns lots of calories! The aging process WILL have a long term – and negative – effect if we do nothing!


Do “something” every week for the rest of your life when it comes to building – and maintaining – your existing lean muscle mass. Strength and endurance decline with the years – especially after the age of 40. The process actually begins in our 30’s but accelerates in our 40’s and beyond. I am fighting for a lean and strong body every time I train with weights.

I am building ENDURANCE through massive numbers of sets and reps. I am creating more POWER and STRENGTH through increased loads. I am increasing my CAPACITY when I keep the time between sets down to 30 seconds or less. I don’t waste time sitting or talking with people. I don’t allow myself to be distracted (no PHONE). I work toward the completion of my weight training workout in under an hour and fifteen minutes twice a week.

Scheduling time to work on building muscular strength and endurance is critical to a healthy and fit body. Your commitment to creating and maintaining your existing lean mass is VITAL so start with 2-3 days and build your program to suit your needs. Consider all your options (machines, free weights, body weight exercises etc.). Seek guidance from a fitness professional to assist you in planning your training especially if you lack proper training and experience – better “safe than sorry”!

Set a firm schedule for yourself and stick to it! I strength train on Mondays and Thursdays – and train HARD each time. I want to keep what I have as long as I can – and enjoy every minute at the same time! You should too! Find a way and commit yourself to your purpose and NEVER QUIT!


Strength training is vital to a healthy and fit body as we age. Without our muscles we WILL become frail and weak – and our spine will collapse along with our ability to take care of ourselves – which I never want to experience. I see this outcome every day and walkers are becoming more commonplace for the “elderly”. I NEVER want to be called “ELDERLY”. That to me is the kiss of death. Remember after the age of 40 “all bets are off”. If you haven’t been active and developing your body before that age then get started and don’t waste a minute – or even ONE DAY.

Once the time is gone it can never be recovered. I am off to do my weight training for the start of my week and I can’t wait to “get to it”. My energy levels will go up and my attitude will be positive – and happy. I will accept the challenges of my day and start my week off on the “right foot”. Will you do the same? Only you can answer this question. I am guessing that if you do all you can today to get stronger – your body – and your mind – will be forever grateful that you charted a course that will forever keep you young and vital – and that is priceless!

Nicholas Prukop is an ACE Certified Personal Trainer & a Health Coach, a fitness professional with over 25 years of experience whose passion for health and fitness comes from his boyhood in Hawaii where he grew up a swimmer on Maui. He found his calling in writing his first book “Healthy Aging & You: Your Journey to Becoming Happy, Healthy & Fit” and since then he has dedicated himself to empowering, inspiring and enabling people of all ages to reach for the best that is within them and become who they are meant to be – happy, healthy and fit – and be a part of a world where each person can contribute their own unique gifts to life.

If you need help in designing a fitness plan, you can contact Nicholas Prukop via email at runningnick@sbcglobal.net or read his inspiring book Healthy Aging & YOU.