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Arthritis

Stress and Arthritis

Many people believe that arthritis can only come from physical activity in your body, and it certainly does, but what others tend to forget, or simply don’t know, is that an individual’s mental health is a huge factor in arthritis as well. A study in 2009 by researchers at the Centers for Disease Control and Prevention claimed that people who experienced traumatic events during their childhood, which included physical or emotional abuse, had a much higher risk for developing rheumatoid arthritis compared to individuals who did not experience trauma.

Can Stress and Anxiety Actually Worsen Symptoms of Arthritis?

Some researchers claim that there is a direct relationship between a person’s stress response and inflammation in their body. Author Andrea W.M. Evers, PhD, took blood samples from 80 rheumatoid arthritis patients once every month for six months to measure the correlation between the stress hormone and inflammatory cytokines, and found that it played a main role in the amount of arthritis severity. Releasing cytokines in your body are the cause of inflammation, and exhibiting various levels of stress can also cause these specific molecules to be released, which eventually will promote inflammation and pain. Evers concluded that “patients who have a tendency for more worrying reported slightly more disease activity, more swollen joints, and more pain.”

Identifying the Root of Your Stress

As an individual becomes diagnosed with arthritis, their emotions can become extremely overwhelming. They may grow frustrated, uncomfortable, or in some cases, become very depressed. It becomes harder to perform normal daily tasks like putting on socks, cooking food, climbing stairs, and even just walking for some people. Their daily routine has become altered, and while some people can handle the change in lifestyle, others find it harder to cope and their stress can actually make the physical pain worse. Being able to identify where the arthritis is coming from in the body and developing a plan to improve it is the first step to reducing the stress associated with this disorder.

Tips for Handling Stress with Arthritis

Learning how to cope and finding ways to relieve tension can improve an individual’s quality of life physically and emotionally. One tip to handling stress would be to stay as active as you can throughout the day. Many people who have arthritis are often fearful of performing exercises simply because they worry it might make the pain worse or damage the joints, however, physical activity can actually improve the symptoms of rheumatoid and osteoarthritis. Daily activities like swimming and walking can reduce stiffness and stress on the joints while releasing endorphin hormones, (the hormones that make you feel good), ultimately improving the pain associated with arthritis and putting you in a better mood altogether.

Another tip would be to eat right so your body can fight inflammation. This tip seems like common sense, however many people don’t know which foods to eat and which ones to avoid. Some foods to start including in your every day diet are salmon, berries, and leafy green vegetables. Foods to avoid are red meats and vegetable oils, mainly because they contain omega-6 fatty acids which actually cause inflammation instead of reducing it.

Becoming more aware of your arthritis and coping with it appropriately will relieve pain in the body, resulting in an all-around happier and healthier you.


Lauren Adkins is a senior at Rowan University studying Health Promotion and Wellness Management. She is currently an intern at The Stress Management Institute and has a passion for helping people live a healthier lifestyle and improving their well-being. Lauren has also volunteered for a program at Rowan called “Get-FIT,” where she worked with individuals with developmental disabilities and promoted a happy, healthy, and fit lifestyle for them. Other than working towards a degree, Lauren enjoys spending time with family and friends, painting, and listening to music in her free time.

References

https://www.arthritis.org/living-with-arthritis/comorbidities/depression-and-arthritis/stress-rheumatoid-arthritis.php

https://www.everydayhealth.com/rheumatoid-arthritis/living-with/rheumatoid-arthritis-stress/

heart-stethoscope

Aligning with Medicine

I’ve been to the mountain. Yes, I’ve been in the world of medicine. I’ve run my programs in hospitals, collaborated with physicians to address chronic disease, and spoken at medical conferences on topics ranging from “emotion and the patient” to “the healing powers of synergy.”

Between you and me, I’ve been to nicer mountains. While I have nothing but praise for doctors, when we lift up the medical curtain, the overall system, the collective mindset, and the impotence of the treatment of chronic disease provide an open door. For who? For fitness professionals, and I say that with qualification.

The challenge in great part is a naivete. Our “industry” is not well versed in the living dynamics between medical institutions, health insurance, and pharmaceuticals, so these lobbying giants are viewed by personal trainers as purely corrupt, as the evils that plague our population. Yet, when the mirror of honesty is confronted, the limitations of conventional exercise and eating are not by any means the panacea trainers profess them to be in the midst of a population struggling with health compromise.

YES, THERE’S AN OPPORTUNITY BUT . . .

. . . it requires a re-education, an enhanced skill set.

Physical therapists are not thrilled with the idea of personal trainers working to address muscular imbalances and injury recovery. Nutritionists approach trainers who coach their clients nutritionally with caution. The trainer is not deemed a player on the Allied Health Care Team.

We therefore hear assertions from “trainer island” with limited foundation.

“Insurance should pay for our client sessions, after all, it pays for medical treatments that don’t work.” Wow, is that a slippery slope, one I wouldn’t approach if it showed up in my backyard and I was equipped with anti-slip cleats.

“Doctors should refer clients to us.” That is best responded to with a simple, “why?”

“Doctors don’t care about their patients.” There’s a globalized bias that fails to account for a system that makes “exploration of the client condition” one of the greatest challenges in the field, regardless of the physician’s heart.

* * * * * * The opportunity lies in humility, in a willingness to step up and learn, and in providing a true complement to the system that is flawed. It isn’t an “us or them,” but it also shouldn’t be a one way street of elusive referrals. It’s a recognition that we have the per-session time to invest. We can gain the trust of clients. We can see clients regularly and facilitate programs that require joint responsibility.

The most important piece of creating an industry wide recognition of the trainer’s power is perhaps the dismissal of ego, the acknowledgement that trainers deemed competent in prescribing safe and effective exercise, have not learned to address metabolic imbalance, hormonal disruption, and inflammatory issues that underlie the most common conditions.

It’s in the spirit of betterment that I’ve committed to learn and teach, to isolate practices fully within the trainer scope of practice that address the sources and causes of the plagues that impact 65% of our adult population. It’s time, not to urge doctors to respect trainers, but for trainers to create a legitimate platform of respect, one where chronic dis-ease is treated as a self-induced condition with patient / client empowerment as the greatest vehicle for true opportunity, as the vehicle for collaborative respect, a vehicle for the trainer to serve as a bona fide health catalyst.


Phil Kaplan has been a fitness leader and Personal Trainer for over 30 years having traveled the world sharing strategies for human betterment.  He has pioneered exercise and eating interventions documented as having consistent and massive impact in battling chronic disease.  His dual passion combines helping those who desire betterment and helping health professionals discover their potential.  Email him at phil@philkaplan.com

 

senior-exercise-trainer

Exercise and Dementia: Thinking Differently about Thinking

Many people are aware of the devastating effects dementia and Alzheimer’s disease (AD) has on families. I know this devastation personally, as my mother suffers from advanced stages of AD. It is very sad to have only the body present of someone you have known and loved your whole life! This article will discuss some of the newer developments in understanding and possibly reducing the disease, as well as the positive role exercise may have in slowing the onset and development of symptoms, and disabilities for any form of dementia.

The impact on family units and caretakers is even greater and can’t be measured by financial impact. Dementia is a group of symptoms that affect mental tasks like memory and reasoning. Dementia can be caused by a variety of conditions, the most common of which is Alzheimer’s disease. Alzheimer’s disease accounts for 60 to 80 percent of dementia cases (http://www.alz.org). Much of the recent attention to professional football players and the repeated brain trauma is due to the increased incidence of dementia, not Alzheimer’s. Dementia is characterized by loss of memory, intellectual capabilities and executive functions.

Alzheimer Concept.According to the Alzheimer’s Association, in 2015, 5.3 million Americans are believed to have this incurable disease. The cost of Alzheimer’s to the U.S. is $226 billion, and this figure is estimated to more than quadruple to $1.1 trillion by 2050 unless some major discoveries are made. It is the 6th leading cause of death behind heart disease, strokes, and cancer but it is the only one that cannot be prevented. One in three seniors will die with some form of dementia. Alzheimer’s is far more prevalent in women, with about 3.2 of the 5.1 million people, or 2/3rds, being women. The Baby boomer generation should cause the number of those affected to swell to 7 million, which may double by 2050. (http://www.alz.org/facts/overview.asp).

Factors Associated with Alzheimer’s Disease

While no one really knows exactly what causes Alzheimer’s disease (AD), there are several factors that are highly associated with it, and even some treatments that seem to slow its progression and onset. The two most prominent factors associated with AD are age and family history.

After age 65, the risk of Alzheimer’s doubles every five years. After age 85, the risk reaches nearly 50 percent. A type of AD is known as early onset or younger onset. This term actually is used for two types, a risk and deterministic form. Both may start in someone’s 30s or 40s and if someone has the gene it is 100%. This “determined” form is rare, accounting for only 5% of the total cases. Research has shown that those who have a parent, brother, sister or child with Alzheimer’s are more likely to develop the disease. The risk increases if more than one family member has the illness.

Biomarkers of Alzheimer’s Disease

  1. APOE genes
  2. Neuro-tangles associated with the Tau protein
  3. Beta amyloid plaques- a protein clump found in the brain- disrupting communication
  4. Inflammation
  5. Decreased brain size

(http://www.alz.org/research/science/alzheimers_research.asp)

When diseases tend to run in families, either heredity (genetics) or environmental factors, or both, may play a role. There are two categories of genes influencing a person developing a disease: risk genes and deterministic genes, both of which are present in Alzheimer’s disease.

Risk genes increase the likelihood of developing a disease, but do not guarantee it will happen. Researchers have found several genes that increase the risk of Alzheimer’s.  Apolipoprotein (APOE)-e4 is the first risk gene identified, and has the strongest impact on disease risk. APOE-e4 is one of three common forms of the APOE gene; the others are APOE-e2 and APOE-e3.

Those who inherit one copy of APOE-e4 have an increased risk of developing Alzheimer’s and those with two copies have an even higher risk, but still not a certainty. In addition to raising risk, APOE-e4 may tend to make symptoms appear at a younger age than usual (early onset). Scientists estimate that APOE-e4 is implicated in about 20 to 25% of Alzheimer’s cases.

Brain Size and Function

We often associate brain size with cognitive capacities and for the most part this relationship holds true. While it is very difficult to measure any increase in mass due to neuroplasticity, we can measure increase activity in the brain due to exercise, or decreased activity from AD and other dementias.

How can Exercise and Diet Help

senior-exercise-trainerIt is important to understand some of the limitations of exercise and diet in helping either dementia or AD. First of all, one must separate non-Alzheimer’s dementia from Alzheimer’s, and then must understand what stage of AD the individual is in. Finally, one must realize if the symptoms have already manifested (onset), and then monitoring the progression.

Exercise has a more pronounced effect on helping decrease progression and even reversing some symptoms with non-Alzheimer’s dementia.  In addition, the earlier someone is able to perform preventative actions, the greater the effect those therapeutic actions will have. Exercises that really activate the brain such as dance, yoga, and new sports or techniques are the best for prevention.

By exercising regularly throughout your life you will lower your incidence of getting Alzheimer’s by 50% and by doing mental exercises with the physical exercises may lower your chances by 70%! This reduction would not apply to those with deterministic genes but it would for others.  Some researchers believe exercise can both delay onset and reduce symptom severity no matter what the cause.

Aerobic exercise in particular causes a release of brain derived neurotropic factor, which has been labeled as “Miracle Gro for the Brain” by the author of SPARK, John Ratey, M.D. In addition, aerobic exercise causes some angiogenesis or the development of additional circulation to the brain. When the brain cells receive more blood, they get more oxygen, and thus function better.

Other side benefits of exercise are the muscle strengthening and enhanced balance and activation of postural muscles. Many Alzheimer’s patients will be at risk for falls and disturbed gait patterns. A consistent exercise program can delay and slow these issues even in somewhat advanced stages.

The dosage is the same as that for the general public or 150 minutes of moderate activity a week. It is important not to push an Alzheimer’s patient into exercise. Many AD victims can become agitated quite quickly and the stress is unwarranted. Simply walking is the best exercise. Make sure the walking path is smooth and not filled with obstructions or difficult terrain.

In an article from Science News, “Walking slows progression of Alzheimer’s”, Cyrus Raji, Ph.D., from the Department of Radiology at the University of Pittsburgh in Pennsylvania, mentions, “We found that walking five miles per week protects the brain structure over 10 years in people with Alzheimer’s and MCI, especially in areas of the brain’s key memory and learning centers. We also found that these people had a slower decline in memory loss over five years. 

The type and magnitude of exercise needs to be carefully monitored with advancing Alzheimer’s or dementia but in those with mild cognitive impairment, a “healthy dose” of both resistance and aerobic exercise is advocated.


Dr. Mark Kelly Ph.D., CSCS, FAS, CPT has been actively involved in the fitness industry spanning 30 years as a teacher of exercise physiology at academic institutions such as California State University, Fullerton, Louisiana State University, Health Science Center, Tulane University and Biola. He was an exercise physiologist for the American Council on Exercise, a corporate wellness director, boot camp company owner and master fitness trainer.

couple coastline

Healthy Aging: Establishing a Vision for Your Future and Planning for Success

I have never stopped believing in the power of a vision that captures one’s imagination and fuels a deep seated passion to make a difference in life and leave legacy of contributions that is remembered long after we are gone. The idea of creating a vision that fuels my desire to live life fully forms the foundation for a life that is built on purpose and serves to open doors of opportunity for others as well.

In the context of aging healthfully we can draw from the idea that “pulling us forward’ is an inner desire to NOT live life on the “edges” but become completely engaged and energized by what it is that we do on both the professional and personal levels. I believe in the power of a vision that yields purpose and also creates a deep sense of responsibility and accountability to one’s goals. This idea of creating a vision is at the heart of how I view my life now. I have spent a lifetime making decisions about both personal and professional matters that were limiting and not empowering. When I finally created my vision I learned I had become committed to my purpose and felt free to live my dream without fear –or reservation.

Here is my vision as it is currently written: “Healthy aging is a consciousness issue. It is not merely the death of our cells but is a complex and dynamic process that is grounded in change as life unfolds for each of us. The challenge as I see it is discovering the potential that lies within each of us to become all that we were meant to be mentally, physically and spiritually. This potential can carry us to living lives of fulfillment, peace, and prosperity if we remain present during each moment of our lives – living consciously. Learning about who we are from the ‘inside –out’ while acting upon our choices in the present moment, enables and empowers us to live a life of great accomplishment. This is my vision of a world that is possible.” Implied in this statement of purpose is the idea that my health and my evolving needs as I grow in time are dependent on the present circumstances as I understand them.

Supporting this vision is what I call my ‘core beliefs’ that define WHO I am as a human being – and as a professional. Some of these beliefs are:

  • Everything that we desire in life comes through relationships.
  • The mind of man is unlimited in its potential and responds to specific demands made upon it.
  • The “Triple Win” (created by me in the 80’s); “As I help you win, we win; as we win those we touch win.”
  • The purpose of life is to discover, develop and share our natural gifts.
  • What we put out in terms of energy and actions comes back to us multiplied. (Karma)
  • The rewards in life are directly proportional to your service to others.

My values are clear. Without my health I can accomplish nothing in my life. This notion fuels my desire to train mentally, physically and spiritually each and every day in order to expand the borders of my consciousness and be of service in ever expanding ways.

I have lived in my “shell” a long time and now I feel the presence of growth in all areas of my life. These articles are helping me to clarify my message and become more than I ever dreamed possible. It is about time after all I have lived 66 years, right? The programs I develop around these ideas will form the nucleus of what it is I am here to do (including publishing my book – no excuses!). I am also going to be “pushing back” a bit against the increasing influence of technology in our lives because every moment we spend tweeting, texting, checking our iPhones and communicating constantly online pulls us away from the ‘moment’ – the present – and this is only point of power through which we can change our lives for the better.

The world is “attached” to technology now and we no longer acknowledge each other – we are just too busy!  Make the time to meditate, imagine, feel, think and enjoy your life. If prayer works – pray by all means. Making time to take the “inner journey” everyday will make a world of difference in how you view and live your life – now and in the future. This work has paid off in spades for me. I am running faster and getting stronger everyday because I have taken the time to be with “me”. I have begun to prioritize my needs as they become apparent to me so that my life continues to move forward with meaning and purpose enabling me to be able to maximize the time I have left – whatever that turns out to be. (Remember the 6 minute mile on my 80th birthday?) Be strong and know that you have something unique in you that only you can give the world. Let your light shine and see what happens!

Article reprinted with permission from Nicholas Prukop. 


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.

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Trainers and Nutrition

It was 1995.  I sat on a panel at the Club Industry conference in Chicago and made a fully convicted argument that “personal trainers MUST talk about nutrition.” I had been told by assorted experts, club owners, and educators that ‘it’s illegal for trainers to talk about nutrition.’ Absurd.

In referencing that event from 20 years ago, I’m realizing how far we’ve come in the field of personal training. I’m also reminded of the Diet Ginger Ale Lady.

I was in the checkout line in Publix supermarket and the woman in front of me had only 3 items. She had 3 cases of diet ginger ale. Period. The cashier eyeballed her purchase and quipped, “you must like diet ginger ale.” The response was surprising.

“No, I don’t like it at all, but it’s a great diet!”

Now the visibly overweight cashier’s ears perked up, “Diet? How does it work?”

“Well, the ginger gives you all the nutrients you need and the carbonation makes you feel full, so for two days you only have diet ginger ale. On the third day you have all the soup and salad you want. You repeat the 2-day 3-day regimen until you’ve lost the weight.”

I was sure somebody was going to show up. Maybe the FBI. At the very least, the local police. After all, if it’s “illegal” for personal trainers to talk about nutrition, this woman had to be committing extreme violation!

No cops came. No SWAT Team or sting operation. The diet ginger ale lady left with her purchase and went on her way.

I share this to make a point. The advice people are receiving related to nutrition runs from relatively sane to outwardly dangerous. If we are going to guide our clients toward health, we have an obligation to help them make better choices.

I understand why some opted to believe that nutritional advice from trainers violated the law. Personal trainers without nutritional credential should NOT be prescribing diets, nor should they be recommending supplements. There are far too many risks, and in that, there have been lawsuits and judgments.

Let’s not, however, go to a full pendulum swing and prevent trainers from speaking truth.

I said earlier we’ve come a long way, and we have, and many trainers have become educated in nutritional practices, have aligned with software programs or continuing education courses, and the stigma is lessened significantly.

That doesn’t mean I believe the entire field of personal trainers should be spewing the nutritional beliefs they most attach to.

While many trainers have become responsibly educated, others haven’t and that presents a challenge.

My anecdotal experience has shown me that many personal trainers with limited education in clinical nutrition, marry themselves to one of two approaches and those approaches become a blanket touching each and every client.

  1. They adhere to the old school teachings of “calories in vs. calories out” and reference mathematical formulas to estimate “ideal” caloric intake.
  2. They profess that a bodybuilding type plan, generous in protein, and ample in both meals and energy substrates, is the way to go, failing to recognize the uniqueness of each client.

Many today scream Paleo, others yell Keto, and there’s very little unity.

Here’s my suggestion. While science will reveal new subtleties in food intake for specific groups, demographics, and performances, and food will continue to change as genetic modification, commercial livestock rearing, and food preservation techniques will challenge nature, the basics of “The Macro” won’t change.

  • Amino acids are the building blocks of tissue and we obtain them from dietary proteins.
  • Essential fats are essential with a host of vital benefits.
  • Starvation is NOT an effective weight loss strategy.
  • Processed foods will disrupt pancreatic hormones and metabolic processes if consumed often over time as staples in a nutrition plan.
  • Sugar intake can lead to a host of chronic and debilitating conditions If it isn’t well managed and kept modest at best.
  • Natural (organic) foods, grass-fed, pasture raised, and wild caught are going to provide more of nature’s “life force” than anything removed from sunlight, anything chemically modified, or anything hybridized for resistance to pests or weeds.

The bullet points are nothing but generalities, and this doesn’t pretend to be a complete list of important points, but a trainer equipped with some consistently valuable guideposts for their clients seeking health and betterment are certainly more powerful than those who avoid nutrition altogether.

Dr. Joel Fuhrman, Physician, Nutritional Scientist New York Times, Best-Selling Author

There are a great many leaders opening new doorways in the field of nutrition. One of them is Dr. Joel Fuhrman. We’re privileged to have him sharing his powerful insights at the MedFit Tour stop in Irvine, CA on February 9. It’s only one of the many reasons you should attend.

Dr. Fuhrman will share eye-opening research about the impact of fruit, specific vegetables, fats, and common foodstuffs on human health. . . and I guarantee two things. One, you’ll be blown away as so much of his study reveals the misinformation that plagues our population. Two, you’ll be far better equipped to deliver thrilling outcomes for your clients, whether you train athletes, regular folks, or the chronically afflicted.

Dr. Fuhrman is only one of a dozen extraordinary speakers slated to share insights in the wide-open and opportune field of Medical Fitness.  It’s the future. It should be a part of yours.

P.S. Here’s a gift, see Dr. Fuhrman live on video for free. Click here to access.


Phil Kaplan has been a fitness leader and Personal Trainer for over 30 years having traveled the world sharing strategies for human betterment.  He has pioneered exercise and eating interventions documented as having consistent and massive impact in battling chronic disease.  His dual passion combines helping those who desire betterment and helping health professionals discover their potential.  Email him at phil@philkaplan.com

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Five Reasons Why You Want to Eat Carbohydrates

As the New Year starts, I hear way too many athletes vowing to “knock off carbs” for their nutrition resolution. Most intend to eat less sugar (OK). Some plan to cut out bread, pasta, potato and starchy foods (not OK), and others plan to also limit fruits and veggies (bad idea). The reality is, carbs should be the foundation of your sports diet.

Carbs 101

By carbs, I mean primarily fruits, vegetables, beans and grains. But little is wrong with a sprinkling of added sugar (less than 10% of your total daily calories) or enjoying a meal with refined white flour (as long your other meals include whole grains). To be sure we are all on the same page, let’s define this much-maligned word “carb.”

  • Carbohydrates include both sugars and starches. They are biochemically similar. For example, green peas (and other veggies) are sweet when young; their sugar converts into starch as they mature. Unripe bananas (and other fruits) are starchy when young and become sweeter as they ripen. Their starch converts into sugar.
  • Both sugars and starches are equal sources of muscle fuel. Whether you eat a starchy potato or sugary candy, the digested end-product is the same: glucose.
  • Glucose feeds your brain, gets stored as glycogen in muscles (for fuel during hard, extended exercise) and also in the liver (where it gets released, as needed, into the bloodstream to prevent your blood sugar from dropping).
  • Some carbs are more nourishing than others. Added sugars (white sugar, maple syrup, honey, agave, gels, chomps, sport drinks, etc.) lack the vitamins and minerals that invest in good health. Fruits, veggies, beans, and dairy, however, are health promoting sources of carbs. Obviously, you want to eat more of the best and less of the rest.
  • Physically fit athletes easily metabolize sugars and starches. Unfit people, however, often end up with high blood sugar and pre- or Type II diabetes.Note: Most messages to cut out carbs are targeted at unfit people, not athletes.

Reasons to keep carbs in your sports diet

Here are five reasons why you, a physically fit athlete, want to include carbohydrate in your sports diet.

  1. Carbohydrates fuel muscles. Athletes who restrict carbs pay the price: “dead legs” and inability to exercise at their best. If you routinely train hard 4 to 6 days a week, carbs should be the foundation of each meal. Here are the International Olympic Committee’s research-based carb recommendations for an optimal sports diet:
Amount of exercise/day gram carb/lb. body wt gram carb/kg body wt
1 hour moderate exercise 2.5 to 3 5-7
1-3 h endurance exercise 2.5 to 4.5 6-10
>4-5 h extreme exercise 3.5 to 5.5 8-12

For a 150-lb athlete who trains hard 1 hour a day and remains somewhat active the rest of the day, the target intake should be 375 to 450 grams carb/day. That’s at least 90 g (360 calories) carb per meal and 50 g (200 cals) carb at each of two snacks. This is more carbs than in the ever-popular (low-carb) breakfast protein shake with a few berries, a lunchtime spinach salad, and a dinner with a pile of broccoli but no rice. Here’s what 375 grams of carbohydrate looks like (without the protein and fat that balances the diet):

Breakfast: 1 cup dry oats (50g) + 1 banana (25g) + 1 T honey (15g)

Lunch: 2 slices whole wheat bread (46g) + 1 can Progresso lentil soup (60g)

Snack:  1/3 cup raisins (40g) + 1 Tbsp dark chocolate chips (10)

Dinner:  1.5 c cooked brown rice (65g) + 14-oz bag frozen broccoli (20g)

Snack: 8 ounces vanilla Greek yogurt (20) + 1 Nature Valley Granola Bar (30)

While I am sure many of you are rolling your eyes right now and thinking, “I could never eat that many carbs without getting fat,” this is an appropriate carb intake, believe it or not, and these 1,500 carb-calories can fit into your day’s 2,500+ calorie budget. I invite you to be curious and experiment. How much better can you train with an appropriate carb intake?

  1. Carbohydrates are not fattening. Despite popular belief, carbohydrates are not inherently fattening. Excess calories at the end of the day are fattening. Excess calories of carbs (bread, bagels, pasta) are actually less fattening than are excess calories of fat (butter, salad oil, cheese). That’s because converting excess calories of carbohydrate into body fat requires more energy than does converting excess calories of dietary fat into body fat.
  2. Avoiding carbs can lead to food binges. By routinely including carbs in your daily sports diet, you take the power away from them and will be less likely to binge. That is, if you “cut out carbs” but then succumb to eating the entire breadbasket and the mountain of pasta when at a restaurant, you are doing what I call last chance eating. You know, last chance to eat bread and pasta so I’d better stuff them in today because my no-carb diet restarts tomorrow. (Ugh.)
  3. Quality carbs (fruits, vegetables, grains and beans) promote a healthy microbiome, which reduces the risk of heart disease, diabetes, and cancer. Fiber-rich carbs feed the zillions of microbes that live in your gut. These microbes have an incredible influence on your mood, weight, immune system, and overall health. Every major medical association recommends we consume a strong intake of fruits, veggies and whole grains. Do athletes on a low carb diet miss out on these health benefits? TBD.
  4. Carbohydrate adds pleasure to your sports diet. Is something wrong with eating some yummy foods, like pasta and bagels? How about chocolate milk for a fun recovery food? Given that 10% of daily calories can come from refined added sugars, most athletes have about 240-300 calories (60 to 75g) of added sugar a day in their calorie budget. You can easily ingest that sugar via sport drinks, gels, and sweetened protein shakes. You can also enjoy one or two cookies or a slice of birthday cake—guilt-free.

Carb abuse is the bigger problem than carbs in moderation. The easiest way to prevent carb abuse is to eat satiating breakfasts and lunches (with carbs + protein) that fill your tummy, prevent afternoon hunger, and curb cravings for sugary sweets later in the day. Preventing hunger minimizes the cravings that give carbs a bad name in the first place. Give it a try?


Nancy Clark, MS, RD 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 www.NancyClarkRD.com. For her popular online workshop, see www.NutritionSportsExerciseCEUs.com.

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Pulmonary Hypertension and Mind/Body Medicine?

To understand how Pulmonary Hypertension reacts to Mind/Body Medicine, you must understand what is going on biologically. Mind/Body Medicine, such as meditation and exercise, can help to give these clients a better quality of life. As a fitness professional, it is important to know how, when and why you are using certain mind/body modalities.

Pulmonary Hypertension is a very rare disease of the lungs and right side of the heart. Sometimes there is no known cause except a change in the cells that line the pulmonary arteries. There is no cure, so managing the disease is the best most people can do. Some clients may be on multiple medications, which is normal. The changes in the pulmonary cells cause the artery walls to be thick and stiff. Extra tissue may form and the arteries may become tight. Young individuals usually become diagnosed by the age of 36 and women are diagnosed more often then men. Each year, 10 to 15 people per million are diagnosed in the United States. It is important to note that life expectancy is about 3 to 5 years if not diagnosed and treated.

Hypertension, as most people know, is a blood pressure which is 130–139 over 80–89. Individuals with hypertension can usually come off of medications with eating healthy and exercising. There are instances where the client will never stop taking medications,  due to genetics. The client can eat healthy and exercise, but the blood pressure does not come down. A primary doctor may try to get the blood pressure under control, but can’t.

In this situation, the individual would be sent to a Cardiologist who specializes in Pulmonary Hypertension. There are four types of Pulmonary Hypertension and they each have their own symptoms and treatment. It is important to obtain a doctor’s clearance before working with this population.

Types of Pulmonary Hypertension

Group 1: Pulmonary Arterial Hypertension
This group is usually classified as having no known cause. It can be genetic or develop from someone having Lupus, Scleroderma or HIV. Symptoms for this classification can be chest pain, dizziness, fatigue, inability to exercise, low blood pressure, chronic cough, shortness of breath, swelling or swollen legs.

Exercise is very important for this group by strengthening the heart and lungs. Clients will initially go to cardiac rehab for four to twelve weeks. When rehab is over, remember to obtain a clearance prior to working with your client. Start your client out by doing their cardiac rehab program.  The goal is to strengthen the heart and help the client to build cardiovascular endurance.

Group 2: Pulmonary Hypertension due to left lung disease
The heart does not pump blood or relax effectively. Medications are used for this group to help lung functioning. Blood pressure medicine and diuretics may also be prescribed. The physician may also ask their client to lose weight or use a CPAP if they have sleep apnea.

Group 3: Pulmonary Hypertension due to lung disease
This group of individuals may have COPD, Interstitial Lung Disease, Sleep Apnea, chronic high altitude exposure, and pulmonary fibrosis. Treatment consists of improving lung function, proper sleep breathing and staying away from high altitudes.

Group 4: Chronic Thromboembolic Pulmonary Hypertension
In group four, clients have blood clots in the lung. The blood clot restricts blood flow causing hypertension. It is important to work closely with the client’s physician for this type of hypertension.

Overall, exercise is thought to be good for individuals with Pulmonary Hypertension. There are, however, some guidelines to follow. Clients should never over exercise or become overheated. If you are working with someone who presents with symptoms, do not exercise upper and lower extremities at the same time. Exercise in extreme hot or cold environments should be avoided.

Stress management techniques will not help with bring blood pressure or heart rate down. For these clients, it is important to concentrate on the symptoms. Many individuals with Pulmonary Hypertension develop anxiety, depression and chronic stress. Clients may sit in a chair or lie on the floor for mind/body classes. It depends on what is comfortable for each client. It is important that the client knows to not get discouraged because they are not seeing a drop in blood pressure.


Robyn Caruso is the Founder of The Stress Management Institute for Health and Fitness Professionals. She has 18 years of experience in medical based fitness.

References:

  • http://www.tsmihfp.com
  • https://pulmonaryhypertensionnews.com/pulmonary-hypertension-who-classification/
  • https://phassociation.org/medicalprofessionals/consensusstatements/exercise/
  • http://pulmonaryhypertensionrn.com/types-of-pulmonary-hypertension/
Health Care Collage Words Medicine Background

How Do You Define Health?

Health can be defined in a variety of ways.

  • The absence of disease.
  • The absence of symptoms of a disease.
  • The ability to achieve a specific health goal. (Weight loss or reduced medication)
  • The ability to achieve a specific life goal. (Travel or dance at your granddaughter’s wedding)

There’s no right or wrong definition of health. It’s all what’s of most importance to you. However, unless you take a moment to reflect on and define it for yourself, you may by default be guided by your physician’s goal for your health.

Their goal is well-intended and certainly well researched, however, without the understanding what’s most meaningful to you in terms of your health, you’re likely following a standard protocol. They may get you 90% of the way to your health, not realizing it’s the last 10% beyond the standard protocol that enables you to achieve what is most meaningful to you.

As we’ve entered into a New Year when health goals are more at the forefront of our minds, it can be an inspirational time to determine what health means for us.

A vision helps you determine what you’re aiming towards.

You can then communicate a clearly defined vision with your health care providers, so they can support you in achieving your goal.

So, what does this look like?

As a nutrition coach, I always take new clients through this process.

What goal comes to mind first?

Generally speaking, the most popular answer is weight loss. But nobody wants to lose weight just to have a lower number on the scale. It’s about what they can do when they’re at that lower weight. (Walk up the stairs without being winded, not need a seatbelt extender during a plane ride or feeling comfortable in a bathing suit on your anniversary vacation.)

Because I work primarily with individuals that have autoimmune disease, the motivations are much deeper. The obvious would be less pain, more energy and increased mobility. But when truly getting to understand each person, they share that they want to regain the ability to walk down the driveway to get the mail, have enough energy to do their own grocery shopping, or reduce pain so they can sleep better at night.

The latter goals have such great detail that your care team will want to get onboard in setting you up for success.

From here, you can best determine what providers and services you need most to achieve health in your terms.

This may also prompt them to offer more options for you in achieving your goal. It could be as simple as suggesting a session with a physical therapist to a mediation app that’s been helpful to other patients in managing pain.

Bottom line, you need to first define your vision for health and then clearly communicate that vision with your healthcare team – ideally starting with your primary care physician – so you can be supported with the best path to your health success.

Join Alene for her upcoming webinar with MedFit Classroom:


Alene Brennan has been featured in USA Today, Philadelphia Inquirer, Huffington Post and Mind Body Green. Alene overcame debilitating migraine headaches through diet and lifestyle and is now once again using a “Less Pharm, More Table” approach is managing her diagnosis of Multiple Sclerosis. Alene holds four certifications: Nutrition Coach, Yoga Instructor, Personal Trainer and Natural Food Chef. She also completed specialized training in nutrition for autoimmune disease specifically the Wahls Protocol and the Autoimmune Protocol. Since receiving her MS diagnosis and seeing first-hand the power of using diet and lifestyle to create a healing environment in the body, she dedicated her virtual nutrition coaching practice to helping people with MS and autoimmune dieseases take back control of their health. Visit her website, alenebrennan.com.