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Pre-diabetes – A Wellness Opportunity To Help

There is an opportunity for wellness and wellness coaching to impact the lives of millions of people in a life-saving way. 79 million Americans are estimated to have a condition called pre-diabetes. Usually symptom free, without intervention they will develop full-fledged Type II diabetes within ten years and possibly endure physical damage to their heart and circulatory system along the way. Yet, according to the American Diabetes Association, if a person is successful at lifestyle improvement they can completely avoid the onset of diabetes 70% of the time.

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The Power of Blueberries

Evidence shows this fruit is jam-packed with antioxidants and phytochemicals that may help prevent and slow the progression of chronic diseases.

It’s rare to encounter a client or patient who doesn’t enjoy the taste of blueberries (Vaccinium spp). But beyond their tangy sweetness and the fact you can pop them into your mouth one by one or incorporate them into many recipes, blueberries offer a wealth of health benefits.

Blueberries are rich in antioxidants and phytochemicals that research has shown are associated with cardiovascular and cognitive health and cancer and diabetes prevention. Their popularity is on the rise in North America. And the production of fresh and processed blueberries has grown steadily by an average of 20% every two years since 2008.1 Between 2005 and 2012, North America’s blueberry fields increased 74% from 71,075 to 123,635 acres. British Colombia has the most acres in cultivation, while Michigan has been a world leader in production volumes of both fresh and processed blueberries for many decades.

Nutritional Properties and Antioxidant Composition
Dietitians have stressed the importance of incorporating low-fat, fiber-rich, and nutrient-dense foods into their clients’ and patients’ diets for decades. “Everyone should be aiming to reach their recommended amount of fruits and vegetables for optimal health, and blueberries are an easy and delicious way to help you reach your goal. Just 1/2 cup is considered one serving of fruit, and they require no slicing or peeling—plus there’s no waste,” says Joanne Tehrani, RD, communications manager for the US Highbush Blueberry Council. Blueberries are an excellent source of fiber, vitamins A and C, potassium, and folate.2 One cupful contains 14% Daily Value of fiber. Moreover, blueberries are one of the richest sources of antioxidant phytonutrients.3 Blueberries’ diverse range of phenolic compounds, such as anthocyanins, quercetin, kaempferol, myricetin, and chlorogenic acid, contributes to their overall antioxidant capacity.4,5 (Antioxidant capacity, measured by a chemical laboratory analysis technique called oxygen radical absorbance capacity is one of several methods that doesn’t account for bioavailability, distribution, and metabolism of a product’s ingredients.) “Blueberries also have a rich diversity of different anthocyanin species—like 26 different anthocyanins—whereas some other berries may feature only two or three different anthocyanin species,” says Mary Ann Lila, PhD, MS, director of the Plants for Human Health Institute and a David H. Murdock distinguished professor at North Carolina State University, who has spent 18 years studying various Vaccinium species.

Read the full article at Today’s Dietitian…

From October 2014 issue, Vol. 16 No. 10 P. 42; written by Jasenka Piljac Zegarac, PhD. Reprinted with permission.

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Breast Cancer and Exercise

October is National Breast Cancer Awareness Month, when pink ribbons remind women to schedule their mammograms and honor those who have died from or survived breast cancer. According to the National Cancer Institute, one in eight American women (12.3%) will develop invasive breast cancer during her lifetime.

Healing Mind, Body & Spirit

Alone in a Las Vegas hotel room, it happened – a turning point in one’s life that suddenly changes everything forever.

Ray, a 73-year-old retiree, was having a stroke. From his pre-med studies he knew what was happening and what needed to be done. Crawling to the phone, Ray spoke with the front desk staff and requested emergency personnel. When the paramedics arrived, he instructed them on procedure. Later Ray would learn that his stroke was hemorrhagic and had missed the speech portion of his brain by mere centimeters.

After completing physical therapy at St. Jude’s Hospital in Fullerton, CA, Ray wanted to continue exercise therapy. He knew what physical movement had done for him – he felt strong, healthy, and functionally fit. However, at the completion of his program, Ray was turned away. He kept returning, requesting additional exercise therapy, but was told his time there for over because his insurance reached its maximum. Discouraged, Ray found himself in a parking lot where he spotted a business card. The card had the logo for a local community center. Ray called the number and was pleasantly surprised to learn that the center had a personal training staff that worked with clients who survived medical catastrophes, such as strokes and heart attacks.

Ray and I first met in July 2011. He drove a specially designed car and walked with a cane as well as a brace on his leg. One half of his body was rendered completely paralyzed from the stroke. Ray’s gait was extremely slow and he could only walk for a few moments at a time before stopping to rest.

At that initial meeting, I tested Ray’s strength by giving him a light free weight to lift. As he attempted a shoulder press, his left hand shook uncontrollably. For the first several months, Ray and I worked together privately. As the room we were working in was a children’s classroom that contained many toys, we used whatever props were available to improve Ray’s fitness level. Sometimes, I would utilize other objects, such as a small stress ball. We started with basic hand exercises, such as ball squeezes. To improve fine motor skills, Ray picked up small objects with his fingers. As Ray’s motor skills increased, the objects became smaller and smaller, until they were plastic-wrapped caramel candies. Ray reached the point where he was able to unwrap the candies with no assistance.

Ray & JuliaOur exercises also involved hand-eye coordination, such as tossing and catching an under-inflated ball to each other, as I kept running to different parts of the room so that Ray was challenged to located me and then throw the ball in my direction. We also used the under-inflated ball with Ray in a seated position, as he placed the ball between his ankles and lifted it with his legs. Ray was also able to perform basic strength training exercises with free weights, such as bicep curls, hammer curls and chest flys. He was getting stronger and was now able to remove his leg brace and walk for short periods of time. I was amazed at what I was seeing.

After several months, Ray astounded the members when he graduated to the main gym floor and started working out on the machines with the general population. He was now performing leg presses, chest presses, hamstring curls, abdominal curls, lat pull-downs, back extensions, tricep and inner/outer thigh exercises. Ray’s gait had improved tremendously and he now walked all the way into the gym with substantially reduced rest periods.

We were ecstatic on the day Ray had feeling on his paralyzed side for the first time in years. This was a historic milestone and demonstrated the power of healing. Everyone who had seen Ray in his early days were inspired and uplifted as they witnessed a truly remarkable transformation.

IDEA Fitness Journal featured Ray’s story in its November/December 2012 issue.

Ray discovered us by Divine intervention, since physical therapists and allied health personnel do not currently refer patients to Certified Personal Trainers.
Certified Personal Trainers, like many professions, encompass a wide array of specialties. Most people think of us working with the general population, devising exercise programs with goals of weight loss, toning and body building. They know us through aquatics classes, Zumba, yoga, boot camp and Pilates.

What most people do not know is that a significant portion of our client base are actually medical patients who have survived strokes, cancer, heart attacks, polio, joint replacement, Muscular Dystrophy, electrocution, fatty liver disease, diabetes, and lesser known genetic diseases such as Charcot-Marie-Tooth Disease.

Since 2007, the vast majority of my clients have been in this category. With the Baby Boomer generation entering retirement, these trends will continue well into the future. And as the fitness industry moves toward regulation, requiring mandatory certification or professional license, we look forward to the day when we take our rightful place in the healthcare continuum, providing patients with ongoing exercise therapy long after physical therapy is completed. In this way,
clients like Ray, whether mobile or homebound, will receive desperately needed services.

We do not know yet if our titles will be Licensed Fitness Trainer (LFT), Licensed Personal Trainer (LPT), or Licensed Fitness Professional (LFP). No matter what, we will continue to provide necessary and ongoing services to patients who need us the most. Through the Medical Fitness Network, we hope to reach this greatly under-served population. I believe that Ray’s transformation is a miracle. Body, mind and spirit are healed and every day hope springs eternal.


About Julia

julia-lombardoWith a degree in Mass Communications/Broadcast Journalism, Julia has written for national magazines, interviewing actors Tony Danza (Who’s the Boss?), Joe Mantegna (“Criminal Minds”) and Paul Sorvino (“Law & Order”). Julia has written restaurant reviews, cookbook reviews, professional biographies, award show brochures, press releases and promotional pieces. She edited the book “Helping Hilda,” and has written educational columns for a dentist and chiropractor. In the voice industry, Julia narrated books on tape, on-hold voice messaging systems, radio sound bites, and cable television. Her degree in Broadcast Journalism allows her to write scripts as well as narrate them.

Julia started running in 1997 and completed her first marathon in 2000. While spending many hours in several gyms, fellow members approached her with exercise training questions, which convinced Julia to become certified. After much research, Julia chose the American Council on Exercise as her certifying organization, and obtained her ACE Certified Personal Trainer designation in 2006.

Immediately, the Facilities Supervisor for the City of San Dimas called and asked if Julia would develop the city’s first Strength Training Class for seniors. She did, and in 2007 “Strength Training Fundamentals for Seniors,” began, launching her into group fitness right out of the gate. The class, comprised of active, inspired and motivated seniors, was an eye-opener into the generation that survived the Great Depression and would try virtually any exercise until mastering it. The class was so popular that residents were requesting that it be opened to the 30-54 age groups as well.

In 2008, Julia officially earned her ACE- Group Fitness Instructor designation and continued on to provide exercise training services for all ages, in community centers, privately in clients’ homes, and in women’s gyms. Julia has worked with “Medical Fitness” clients more than any other group. They have survived the following medical conditions: Stroke, heart attack, cancer, polio, obesity, Muscular Dystrophy, electrocution, Charcot-Marie-Tooth Disease, Hypertension, Diabetes, Fatty Liver Disease, joint replacement, post-physical therapy patients and more.

“What is incredibly satisfying about working in this field is starting with a client who is severely limited and watching the transformative power of exercise,” she says. Her client, Ray, found amazing success. “Ray had suffered a hemorrhagic stroke and could barely walk. The left half of his body was completely paralyzed. In the beginning, he and I worked in a private room with basic exercises. Ray’s stride improved; his strength and endurance increased. Over time, Ray advanced to the main gym with the general population, who were blown away by his astounding transformation. Ray had feeling on his paralyzed side for the first time in years!”

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Sugar Coating Helps Determine Cancer Cell Survival

Every living cell’s surface has a protein-embedded membrane that’s covered in polysaccharide chains—a literal sugar coating. A new study found this coating is especially thick and pronounced on cancer cells and is a crucial determinant of the cell’s survival. Consisting of long, sugar-decorated molecules called glycoproteins, the coating causes physicalchanges in the cell membrane that make the cell better able to thrive, leading to a more lethal cancer.

muesli with fresh fruits as diet food

To Eat—or Not to Eat: The Pre-Exercise Question

What should I eat before I exercise?

That’s the question athletes of all ages and abilities most commonly ask when I’m presenting a sports nutrition workshop. While most people expect a simple response, such as “Eat a banana” or “Have a slice of toast,” the answer is actually complex and depends on many factors. After all, we are each an experiment of one.

The following information can help you figure out the best way to fuel your body before you exercise.

Does what you eat within 30 minutes of exercise offer performance benefits?

Your body can actually digest and use the food you eat before you exercise as long as you are exercising at a pace you can maintain for more than 30 minutes. Research also suggests that eating a snack just five minutes before moderate exercise can improve performance compared to exercising on empty. Yet, if you will be doing intense exercise—an erg test, track workout, or heavy weight lifting session, you should experiment to determine the best time to eat. You will likely feel more comfortable allowing two or three hours for your pre-exercise food to digest and empty from the stomach.

Will pre-exercise food cause heartburn or nausea?

While many people can comfortably tolerate pre-exercise food, others experience stomach distress. If the food you eat within the hour pre-exercise “talks back to you,” figure out:

  1. Does the discomfort happen if you allow two or more hours for the pre-exercise food to be digested?
  2. Does the type of food cause the problem? That is, do a few pretzels settle well but a cup of yogurt feels acidic?
  3. Did you eat too much? Would half a bagel with a skimming of peanut butter digest better than the whole bagel?
  4. Are you doing very high intensity work? If so, your stomach will shut down and your body will want to get rid of the contents….

What if I exercise in the early morning, before my stomach is awake?

If you drag yourself out of bed to exercise at early o’thirty, before your body and your mind are fully awake, you might not want to eat much of anything. I know of chocolate-breakfastmany rowers, runners, swimmers, and ice hockey players who eat their breakfast the night before. That is, instead of eating a bowl of cereal at 5:30 a.m., they enjoy it at 10:00 pm, before going to bed. This food helps them wake up in the morning with a normal blood glucose (blood sugar) level, and provides energy for an enjoyable and effective workout.

What if pre-exercise food contributes to diarrhea and undesired pit stops?

Food generally takes one or two days to travel through the intestinal tract. Hence, an undesired pit-stop during a long run on Sunday might relate to food that you ate the day or two before. That is, if you ate an unusually large bowl of high-fiber bran cereal on Saturday when carbo-loading for the Sunday long run, you might end up wishing you’d carbo-loaded on low-fiber corn flakes or Rice Chex. Or maybe that bean burrito on Friday night caused the problem? You can try tracking your food and fiber intake, looking for suspicious patterns.

In general, exercise speeds up intestinal motility. With time, most bodies can adjust if you train your intestines to handle pre-exercise food. For example, one runner started by nibbling on one pre-exercise pretzel, and then two, and gradually built up his tolerance to the suggested 100 to 300 calories of carbs consumed within the hour pre-exercise. He enjoyed the benefits of feeling stronger at the end of his runs.

Should I purposefully not eat before I exercise because I want to lose weight while I exercise?

towel, dumbbells, apples and water bottle isolated on whiteOne client reported she didn’t eat before she went to the gym because she was exercising to burn calories. Why would she want to add calories to her diet? Wouldn’t that defeat the main purpose of her workouts?

Think again: If you consume 100 to 300 calories before you workout, you will be able to exercise harder, at higher intensity and burn more calories than if you schlep through the session on fumes, with little enthusiasm or enjoyment. (Plus, you will not be as hungry afterwards and will be able to refrain from over-indulging.) Trust me, the plan to exercise-on-empty is hard to sustain; it is not fun. Just notice the drop-off in attendance at the gym between Jan. 1 and Feb. 1…

Food is fuel. As an athlete or a fitness exerciser, you need to fuel your body appropriately—including pre-exercise. Just as you put gas in your car before you take it for a drive, you want to put fuel in your body before you embark on a busy day. Be as nice to your body as you are to your car, please!

By eating nothing before my morning workout, won’t I burn more fat?

You may have heard you can burn more fat during low-level “fat burning exercise” if you do not eat beforehand. Yes, you might burn more fat than carbohydrates, but burning fat differs from losing body fat. You lose body fat when, at the end of your day, you have created a calorie deficit. That is, you will lose body fat (weight) if you have eaten only 1,800 calories by bedtime, even though you burned off 2,200 calories during the day. By fueling pre-exercise, you can have a better workout—and perhaps burn more calories than if you were to run on fumes.

To lose body fat, I suggest you fuel adequately by day, so you will have energy to enjoy an active lifestyle, and then lose weight at night by eating a lighter dinner. Fueling by day and dieting by night (so you lose weight when you are sleeping), is far preferable to restricting by day only to over-indulge at night due to extreme hunger.

Can training on empty enhance endurance?

Some recent research suggests that highly competitive athletes might be able to enhance their performance if they train under-fueled a few times a week. These depletion workouts can alter muscle metabolism so that the muscles are able to compete better when fully fueled.

If you want to “train low,” be sure to do your important high intensity workouts when you are well fueled. You cannot (enjoyably) exercise hard when you are running on fumes. Your performance will suffer unless you do some high quality hard workouts when you are well fueled.


From The Athlete’s Kitchen; Copyright: Nancy Clark, September 2014

wheatiesBoston-area sports nutritionist Nancy Clark, MS, RD offers one-on-one consults with both casual and competitive athletes. Her private practice is in Newton, MA (617-795-1875). For information about her Sports Nutrition Guidebook (2014) and food guides for runners, cyclists and soccer players, see www.nancyclarkrd.com. For online education, see www.NutritionSportsExerciseCEUs.com