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Active Living for Seniors and Nordic Walking

/23 June 2018/ All MFN blog/

Healthcare professionals working with older adults are routinely prescribing walking, as part of rehabilitation and overall health and wellness programs. There are over 100 research studies identifying health benefits of adding specialized poles to any walking routine. Due to the improved balance, posture, reduce impact off painful joints and improved mood and confidence health, this accessible and affordable activity, urban poling, and especially the use of Urban Poling‘s unique ACTIVATOR™ poles, has become a popular choice for persons requiring help with stability and balance, as well as for older or perhaps less active adults. The ACTIVATOR™ poles are the only ones like it available on the market which have been co-designed by an occupational therapist for maximum safety, comfort and effectiveness, as well as reducing the factors related to falls. —Dr. Agnes Coutinho

Research Benefits

Evidence based research relating to older adults clearly identify poling, with the proper training, as a healthy activity suited for improving quality of life. Proven benefits include:

  • Increase balance & stability
  • Increase in mobility
  • Improve posture
  • Reduce impact off lower extremity joints
  • Improve gait speed
  • Improve strength (poling can engage up to 90% of your muscles)
  • Increase confidence

Short-term and long-term effects of Nordic Walking training on balance, functional mobility, muscle strength and aerobic endurance among Hungarian community-living older people: a feasibility study. Balance, functional mobility and aerobic endurance significantly improved in the Nordic walking group.  This study showed that Nordic Walking is a simple, well–tolerated and effective physical activity for older people in Hungary.1

Effect Of Walking Poles On Dynamic Gait Stability on the Elderly. Texas Women’s University study, which concluded that walking poles provided increased gait stability at both preferred and fast speed.2

Effects of Nordic walking compared to conventional walking and band-based resistance exercise on fitness in older adults. While all modes of exercise improved various components of fitness, Nordic walking provided the best well-rounded benefits by improving upper-body strength, cardiovascular endurance, and flexibility. Therefore, Nordic walking is recommended as an effective and efficient mode of concurrent exercise to improve overall functional fitness in older adults.3

The effects of pole walking on health in adults: A systematic Review. The effects of pole walking (PW) on cardiorespiratory fitness were most extensively studied. The most frequently examined psychosocial measure was quality of life. All studies reported at least one beneficial effect of PW compared with the control group. The results of this systematic review indicate that PW  programs have some beneficial effects on both physical and psychosocial health in adults with and without clinical conditions.4

Diana Oliver is a dynamic business professional with a extensive background in marketing, sales and fitness. She has a passion for promoting the many health benefits of Urban Poling, which stems from her personal experience. Diana combined Urban Poling with other positive lifestyle choices to regain a healthy weight and improve her cardiovascular health following two strenuous pregnancies. Her positive recovery has instilled a drive to help change the face of health care in Canada.  In 2012, she became a certified urban poling instructor and taught classes in her own Pilates business.  In 2014, became a partner in Urban Poling Inc.

References

(1) Viraq et al., 2014

(2) Kwon, Silver, Ryu, Yoon, Newton & Shim, 2006 (unpublished)

(3) Takeshima et al., 2013

(4) Fritschi et al., 2012.

The information in this article is not intended to replace existing rehabilitation programs. The testimonials are those of independent therapists and are not a guarantee of results. The consumer should not rely solely on this publication but should also consult their physician or therapist. Urban Poling Inc. and its employees and representatives do not accept any liability for the information contained in this publication or any damages.

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Does juicing really “detox” the body?

/20 June 2018/ All MFN blog/

Anything that promises detoxification sounds a little questionable – like products that claim to “pull toxins out of your system” or “cleanse the liver.”  The body does have detoxification mechanisms that are working all the time, and both healthful eating and intermittent fasting can accelerate those processes. Several-day juice “fasts” are one way to tap into the benefits of intermittent fasting and enhance removal of toxins from the body, because the body enhances the removal of toxins when not digesting food and burning more fat for its energy needs. Our fat supply stores toxins, and when we lose body fat we release more toxic waste simultaneously. The body also needs adequate phytochemical and antioxidants for the liver to most effectively process fat-soluble toxins so they can be excreted via the urine.

Get into the catabolic phase

We’re always either in a fed state or a fasting state; you’ve likely read about the anabolic and catabolic phases of digestion in my books or articles that discuss toxic hunger. When we are eating, digesting, and absorbing nutrients from food, we are in the anabolic phase; think of it like filling your car’s tank with gas. That is followed by the catabolic phase, between meals, in which our energy needs are met by burning energy that we stored during the anabolic phase.

The catabolic phase is when most healing and self-repair happens, and there is evidence that prolonged time in this fasting (catabolic) state has significant health benefits. Also, these benefits don’t necessarily require an extended, several-day water fast, which is difficult for most people to commit to.

I always say, the longer you live in the catabolic phase, the longer you live. Here’s why: Being in a fasting state shifts the body’s cells away from growth, and instead toward a mode of maintenance and repair.1,2 This repair mode is associated with a reduction in insulin and insulin-like growth factor-1 (IGF-1) production; two hormones that play a huge role in health and longevity.3,4 These hormonal changes lead to reduced inflammation, improved insulin sensitivity and stress resistance, slower cell growth, improved immune function, and reduced oxidative stress.5,6  Fasting also stimulates autophagy, an important self-repair process. Autophagy removes damaged components from cells and tissues.7

Eating right is already detox; calorie restriction enhances the benefits

On a cellular level, many dietary phytochemicals – such as isothiocyanates derived from cruciferous vegetables, sulfur compounds from garlic and onions, and carotenoids from a variety of colorful produce – drive the production of enzymes that enable the excretion of carcinogens and other potentially harmful compounds. This detoxification system counteracts oxidative stress, inflammation, and DNA damage.8  Eating right, in itself, enables valuable detoxification mechanisms.

Caloric restriction adds to this, and has been the one intervention that extends life in a number of different species. Adding periodic calorie restriction to an already nutrient-rich diet could intensify the body’s ability to heal and repair by extending the amount of time in the fasting repair mode and reducing growth-related signals.4  It also can enhance the breakdown and excretion of fat-soluble toxins; lowering the body’s toxic load.

Intermittent fasting

Intermittent fasting or a juice detox could also be a warm-up to incorporating occasional water fasting. Back in 1995, in my book, Fasting and Eating For Health, I discussed my experience of how fasting improved health parameters in my patients. I also co-authored a series of case reports documenting remission of autoimmune diseases following supervised fasting.9  More recently, fasting has been shown to have dramatic regenerative effects on the immune system. Studies over the past few years in animals and humans have suggested that fasting signals the immune system to discard old and damaged cells and generate new cells by increasing hematopoietic stem cells. The reduction in IGF-1 signaling was a necessary factor in this immune boosting. 6,10

Intermittent fasting – usually by reducing calorie intake dramatically a few days per week – is a method for getting some of the benefits of longer-term fasting. Human studies on intermittent fasting suggest it improves insulin sensitivity and promotes weight loss.2,11,12

I recommend incorporating a juice detox into your life, with vegetable juices plus one salad per day for several days, to act as a method of intermittent fasting, to slow aging and prolong lifespan as an easier alternative to water fasting.  Water fasting has a rapidly decreasing effect at removing toxins, as nutrients necessary for the removal also decrease as the fast progresses. Also, juice fasting enables the participants to continue to work and is safer, compared to water fasting, as it prevents dehydration, loss of electrolytes and fainting. It is also compatible for people who must remain on medications, so almost anyone can participate.

Tips for juicing wisely

  • Figure out a timeline you’re comfortable with. You may want to try juicing one day a week, or you may want to try a week-long juice cleanse.
  • Juice should be mostly vegetables, not fruit. Apple juice with a little kale added doesn’t bring much benefit. The maximum amount of fruit in a vegetable juice should be one serving of a low-sugar fruit, such as green apple or berries. The rest should be nutrient-rich vegetables, leafy greens in particular. Lemon and lime juice can be added to flavor your juice without counting toward the fruit serving. Include cucumber, lettuce and celery juice, along with carrots, beets, and some leafy cruciferous greens such as cabbage, kale or bok choy.
  • Follow it up with a health-promoting diet. A few days of juicing can be a great way to reset your taste buds and jumpstart a new, healthful, nutrient-rich diet. However, there is no health benefit of trying to use a juice cleanse as temporary detox, just a break from an everyday junk food diet. This only works if you stick with a Nutritarian diet for the rest of your life, incorporating some juicing and caloric restriction episodically.
  • If you have a serious medical condition or are on any medication, consult a physician before starting a juice detox.

Originally printed on DrFuhrman.com. Reprinted with permission from Dr. Fuhrman.

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

References

  1. van Niekerk G, Hattingh SM, Engelbrecht AM. Enhanced Therapeutic Efficacy in Cancer Patients by Short-term Fasting: The Autophagy Connection. Front Oncol 2016, 6:242.
  2. Mattson MP, Longo VD, Harvie M. Impact of intermittent fasting on health and disease processes. Ageing Res Rev 2017, 39:46-58.
  3. Pan H, Finkel T. Key proteins and pathways that regulate lifespan. J Biol Chem 2017, 292:6452-6460.
  4. Solon-Biet SM, Mitchell SJ, de Cabo R, et al. Macronutrients and caloric intake in health and longevity. J Endocrinol 2015, 226:R17-28.
  5. Longo VD, Mattson MP. Fasting: molecular mechanisms and clinical applications. Cell Metab 2014, 19:181-192.
  6. Cheng CW, Adams GB, Perin L, et al. Prolonged Fasting Reduces IGF-1/PKA to Promote Hematopoietic-Stem-Cell-Based Regeneration and Reverse Immunosuppression. Cell Stem Cell 2014, 14:810-823.
  7. Mattson MP, Allison DB, Fontana L, et al. Meal frequency and timing in health and disease. Proc Natl Acad Sci U S A 2014, 111:16647-16653.
  8. Stefanson AL, Bakovic M. Dietary regulation of Keap1/Nrf2/ARE pathway: focus on plant-derived compounds and trace minerals. Nutrients 2014, 6:3777-3801.
  9. Fuhrman J, Sarter B, Calabro DJ. Brief case reports of medically supervised, water-only fasting associated with remission of autoimmune disease. Altern Ther Health Med 2002, 8:112, 110-111.
  10. Wu S. Fasting triggers stem cell regeneration of damaged, old immune system. In USC News, 2014 [http://news.usc.edu/63669/fasting-triggers-stem-cell-regeneration-of-damaged-old-immune-system/]
  11. Antoni R, Johnston KL, Collins AL, Robertson MD. Effects of intermittent fasting on glucose and lipid metabolism. Proc Nutr Soc 2017, 76:361-368.
  12. Tinsley GM, La Bounty PM. Effects of intermittent fasting on body composition and clinical health markers in humans. Nutr Rev 2015, 73:661-67
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Healthy Aging and You: Technology, Consciousness and the Sedentary Society, Part 1

/18 June 2018/ All MFN blog/

Numerous studies have revealed that on average we check our phones more than 200 times a day and have in fact started to become addicted to “staying connected”. We literally “run into” each other while walking and staring at our phones while texting. It happens every day. In the gym I attend for my training sessions, I see numerous people staring at their phones while sitting on weight equipment oblivious to the world around them. I have unofficially observed that up to 80-90% of the people who are there for physical activity are either listening “to something” through headphones or are reviewing data and/or texting someone. This is an enormous emerging challenge with no real solutions in sight: Sedentary lifestyles and technology. 

With the revelations of Facebook’s role in the 2016 elections we are seeing the unfolding of more personal data being used for all kinds of purposes and it is not going to end anytime soon. My question is: Is it worth it for our future health to be so connected through technology or is there a better balance that can be struck that enables us to “reach out” more effectively? I pose this question in the context of our health not only NOW but in the future as well. I see health issues becoming more prevalent because we are literally “sitting our way to ill health”. Sitting has become the “new smoking”! Is there a healthy way forward or are we “tied to our technology” so that we can never break “the ties that bind us” to a life of no movement?

TECHNOLOGY

The challenge  as I see it is that we are no longer “paying attention” to our lives. We need to understand what is happening in our individual experiences as we go through our day and then can hopefully make appropriate and timely decisions that will effect not only our future going forward – but today as well. The obesity crisis (71% of the population is either overweight or obese according to the latest data), the sedentary society that is now a reality, and the role that advancing technology will play in our lives are critical issues that need to be addressed if we are to find a “healthy way forward”.

As I have observed in my own experience, we are living in Steve Jobs vision of a world tied together through technology and available to us 24/7. He envisioned a world where we could access everything we needed through a phone – and computer. He wanted people to have the  “freedom” to do all that they wanted to do efficiently and with a planned effort through the gifts that technology would bring to each of us. I believe that his vision has become one that is “tying” us to our devices so completely that we are “disconnected” from what is actually happening around us. Life is literally “passing us by” and we are completely “unconscious” to this process.

I have lived 80% of my life without any technological assistance whatsoever. To retain my own power I believe I am the one who gets to “choose” how and when I let my computer and phone assist me. Right now I am struggling with the concept of what I will need to sacrifice in order to have technology help me advance my career as a healthy aging specialist moving forward. I will never “catch up” with all the technological advances that are coming – or be inclined to use all the new gadgets just because “everyone needs the latest model of a device”. That is NOT how I want to live my remaining years. Is this a choice you need to review as well? I want to use my time more toward serving others and staying healthy and fit so that I can enjoy my 70’s to the fullest – and have the greatest impact on people’s lives that I can.

What will your priorities be going forward? Will you really care if you have the most recent technological advancement or will you set other priorities for yourself? Only YOU can decide how you want to integrate the hours of your day with the technology you have and use daily. As a practical matter it is through our choices that we determine the course of our lives and if we choose to spend them staring at our phones life WILL indeed pass us by. We will be sick, fat, and on drugs as we enter the very years that we wanted to enjoy. Is this you now or will you decide to change that future today by making new choices that give you time “to be” the best version of yourself that you can imagine?

CONSCIOUSNESS

I keep coming back to the issue of consciousness because I believe it is a fundamental principle of what healthy aging means to ME and after all isn’t that what matters most? We determine our future by the choices we make today. It really IS that simple. If we choose to spend the hours of our day sitting and staring at a computer screen or smart phone we will create a life of dependence and ill health that WILL dominate our days until we eventually die.

For the past five to eight years my daughter has been fighting the longest and most difficult of fights for her health. Alcohol dependency, health issues of significance and general mishaps (falls, concussions etc.) have created a life that is characterized by hospital stays, ER visits, medical interventions of all shapes and sizes, and numerous appointments with specialists and medical professionals to treat her and get her back on the road to health. I am sure she never envisioned her 40’s being dedicated to her health in such a complex way but she is in a battle for her life now and the outcome is NOT certain. There are encouraging signs emerging but as her father I am very concerned about what IS going to happen to her going forward.

Her situation is not all that uncommon and many of us do NOT realize how close to our mortality we will come before we realize we “could have” or “should have” chosen differently when we had the chance. Lisa’s challenges started to form in her 20’s on both a professional and personal level and she is “unwinding” all of that harm now. I can only love her and wish her well – and let the professionals “do what they need to do” for her to enhance her chances at a full life again.

How will you choose? Will you continue to stare at your phone or will you decide to start living in the “real world”? I want to live in the real world as much as possible and therefore I DO NOT check my phone while training at the gym – it remains in my bag . I do NOT text so I do not need to check for text messages. My latest phone IS a very good phone with incredible capabilities but I will NOT make it the focus my day. I want to smile at people, greet my day with an “attitude of gratitude” and bless my very breath. I awake with gratitude and hopefulness in my heart and carry that feeling throughout the day so my “consciousness” may expand – and not  shrink. Let your consciousness grow beyond its current boundaries and you WILL be rewarded in kind and isn’t that worth all your best intentions?

IN SUMMARY

As I live each day my mind is always focused on my many blessings. I think about Lisa and her continuing efforts to heal and am grateful I don’t have to face such challenges. I get to breathe and think and feel – and BE as alive as I choose to be because healthy aging starts “within us” and cannot be derived from our technology no matter how SMART it may be. On one level Steve Jobs was right. Dealing with the complexities of the modern world DOES require wonderful advancements in technology but at what price? Do we succumb to the “siren call” of the internet or do we USE it as the tool it was meant to be? I don’t think even Steve Jobs would object to that line of questioning, do you? Only YOU can decide your future – what will it be?

Originally published on Healthy New Age. 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.

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.

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Getting Active at Every Age and Stage: Benefits of Nordic Walking

/14 June 2018/ All MFN blog/

With a shocking 70% of children leaving organized sports by the age of 13 and obesity rates on the rise, we know that we need to be introducing our children to activities that they can do across a lifespan, whether they are 5 or 95 years of age!

Join Urban Poling for a free webinar that will walk through some of the most important and challenging stages of life. Learn why Nordic Walking can be beneficial for each age group to ensure longevity and exercise adherence across a lifetime!

Webinar Overview:

  • Shocking Stats & a look into the Sport-Lifecycle Trends
  • What is Nordic Walking?
  • Research supporting Nordic Walking for All Ages and Stages
    • Childhood (3-11 Years)
    • Adolescence (12-18 Years)
    • Adulthood (Pre/Post Natal, Weight Management & Disease Prevention, Pre/Post Hip/Knee)
    • Seniors & Mitigating Falls

This webinar will be presented by Gabriella De Nino, Registered Kinesiologist, CSEP-CPT & NCCP Certified Soccer Coach.

June 26, 12:00-12:45 EST
Webinar Registration ►

Diana Oliver is a dynamic business professional with a extensive background in marketing, sales and fitness. She has a passion for promoting the many health benefits of Urban Poling, which stems from her personal experience. Diana combined Urban Poling with other positive lifestyle choices to regain a healthy weight and improve her cardiovascular health following two strenuous pregnancies. Her positive recovery has instilled a drive to help change the face of health care in Canada.  In 2012, she became a certified urban poling instructor and taught classes in her own Pilates business.  In 2014, became a partner in Urban Poling Inc.

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Alcohol in Sport: How Bad Is It for Athletes?

/12 June 2018/ All MFN blog/

Alcohol has a strong link with sport, be it with sponsorship, beer consumption after a hard workout, or teams enmeshed in a culture of heavy drinking. To address what is known—and not known—about the impact of alcohol on athletic performance, members of Professionals In Nutrition for Exercise and Sport (PINES) organized a session at the American College of Sports Medicine (ACSM) 2018 annual meeting in Minneapolis. Respected researchers answered some questions athletes commonly ask regarding alcohol and sport performance. Here’s what you might want to know.

What effect does a big night of drinking have on sports performance the next day?

Dr. Louise Burke, Head of Sports Nutrition for the Australian Institute of Sport, reported heavy drinking is common after many athletic events. For example, research with rugby players suggests they consumed an average of 13 units* of alcohol post-game, with a range of 1 to 30 units (*One unit equates to 10 grams of alcohol; 5 ounces (150-ml) wine equates to 1.5 units; a 30-ml nip of hard (40%) alcohol is 1 unit; a 375 ml (13 oz.) bottle of 4.8% alcohol beer is 1.4 units.)

What does heavy post-exercise alcohol intake do to rehydration and refueling goals?

Dr. Ron Maughan, visiting professor at St. Andrew’s University, acknowledged a modest amount of alcohol, consumed along with a balanced meal, is unlikely to have a negative impact. Alcohol impairs glycogen resynthesis only a little bit. But in the real world of sports drinking, athletes who drink a lot tend to make high fat food choices—and that can hinder optimal muscle glycogen replenishment a lot! Consuming a balanced meal before embarking on heavy drinking is probably a good idea.

Alcohol is a diuretic. One unit (10 g) of alcohol stimulates the formation of 100 ml of excess urine. The alcohol content of beer is low—and beer has a lot of water—so dehydrated athletes can effectively rehydrate with beer. Whiskey and other spirits, however, cause more water loss than they contribute.

What impact does pre-exercise alcohol have on heat tolerance/dehydration during exercise?

According to research presented by Dr. Doug Casa, professor at the University of Connecticut, pre-exercise alcohol contributes to slower running across a wide range of distances. Anecdotes, more so than much-needed research, link pre-event alcohol with poor sleep, under-hydration, reduced heat tolerance, and decreased mental function. Dr. Casa reported that one major summer road race had 20 to 25 heat injuries one year. The common denominator among those heat-stricken runners was pre-event alcohol consumption. Don’t drink excessive alcohol before an event—especially in the summer heat!

What does heavy alcohol after exercise do to weight and body-fat goals?

Dr. Barry Braun, professor at Colorado State University, said for most athletes, alcohol is a source of unwanted calories. For example, just five Heineken Light Beers add 500 calories—and that’s not counting the pepperoni pizza or nachos that you can easily overeat when alcohol lowers your inhibitions.

What effect does heavy post-exercise alcohol intake have on muscle recovery?

Dr. Stuart Phillips, professor at McMaster University, noted bad things happen during exercise and good things happens during recovery when athletes rehydrate, refuel, and repair (by consuming protein) their muscles. Adding alcohol to the recovery diet slows down muscle repair, protein synthesis, and adaptation processes. Heavy alcohol intake is not on Phillips’ list of best recovery practices for athletes to follow! Yet, he doesn’t begrudge anyone a glass or two of wine. Moderation is the key word.

What does heavy alcohol intake do to sleep?

Dr. Shona Halson, Senior Physiologist at the Australia Institute of Sport, reports that alcohol might help you fall asleep faster, but it disrupts your sleep cycles so you get less restorative sleep. Alcohol alters body temperature, which can affect how well you sleep. It also aggravates snoring (due to relaxed muscles and a lower breathing rate), so your bed partner also gets sleep deprived. Plus, you have to get up to go to the bathroom more often in the middle of the night. None of this enhances athletic performance.

What does heavy alcohol intake after exercise do to muscle soreness, injury, and inflammation? Matthew Barnes of Massey University in New Zealand noted when athletes perform exercise to which they are accustomed, alcohol’s negative effects are less pronounced compared to doing a new form of exercise. That is, after getting battered up in a game, a 200-lb rugby player who is experienced with both sport and drinking could have perhaps 20 standard drinks and still effectively perform a vertical jump! As for inflammation, players who are conditioned to both their sport and to drinking alcohol do not have a significant inflammatory response. But if you are a weekend warrior, watch out…

Why isn’t alcohol & performance better researched?

Indeed, more research would be very helpful, but few research institutions approve studies that involve alcohol + heat. The alternative is to study athletes who have already been drinking. For example, they can track the number of runners in the medical tent who consumed alcohol the night before.

Any words of wisdom?

When asked, Is beer good for runners?, running legend Jim Fixx’s answer was “Sure, if it’s the other guy drinking it.” If you stay sober, you can take advantage of other athletes’ poor judgment!

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 NancyClarkRD.com. For her popular online workshop, see NutritionSportsExerciseCEUs.com.

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Top Ten Things a Personal Trainer Should Know About Working with Eating Disorders

/11 June 2018/ All MFN blog/

Having worked as a certified personal trainer and strength and conditioning specialist early in my career, and now as a certified specialist in sport dietetics who specializes in treating clients with eating disorders who are often over-exercising, I feel it is critical for trainers to have some training about how to deal with their clients with these issues because you will be seeing these clients.  Given eating disorders can present as over-exercise and under-fueling, a personal trainer is in a position to be the first identifier of these issues and can be a key player on an eating disorders treatment team.  I often utilize personal trainers to help these clients develop exercise limits, boundaries, or assist with reiterating the “fueling and hydrating” messages the dietitian may be providing the client.  I have helped in developing a new tool available to those who work in the fitness and coaching field called Running on Empty,an online eating disorders awareness and prevention program for coaches and exercise professionals, through a non-profit eating disorders outreach and prevention organization, Eating Disorders Information Network. I have also invited one of our recovery speakers to share her tips in this article. She is both an ACE certified personal trainer and a recovery speaker for EDIN. She, Kristy Wegert, shares her thoughts as a professional who currently treats clients who are on their recovery path.

A key reference on this topic is the new International Olympic Committee’s position statement on RED-S, Relative Energy Deficiency in Sport. Many of us will work with people with sub-diagnostic cases of eating disorders who may present with many of the negative energy balance physical issues discussed in this consensus statement. Working with an exercising population means helping this population stay in energy balance or eating appropriately to fuel for the level of activity in which they are engaging without harming the body because of lack of energy for basic body systems to function.  All body systems are affected when limiting the body to too little energy to function fully, including the systems visually represented below. It is the job of the eating disorders treatment team, including the exercise professionals, to be aware of this set of possible consequences and treat/refer to treatment accordingly.

A sport dietitian’s top 5 tips for working with the exercising client with an eating disorder:

1. Keep your client in energy balance by reminding them about appropriate fueling, recovery, and hydration. Complex carbs rule before exercise. Encourage your clients to fuel on these before they train vs. training on empty. Common “on the go” examples of this can be as simple as a slice of toast or a higher carbohydrate energy bar. Encourage your client to drink hydrating fluids and even an electrolyte beverage during their training session with you. Also, most active clients need to drink 4 oz. of fluids every 15 minutes. Encourage your client to take these breaks.  Encourage your clients to have a protein recovery choice within 15-45 minutes after they finish their workout.  This could be a glass of chocolate milk or a smoothie with protein.

2. Encourage and educate your clients with a non-diet mentality. This means “All Foods Fit” and that there are “No Bad Foods.” All foods have some energy value and can fit into our performance plan. In fact, when we exercise, we have need to eat more energy. If we adapt the mentality that all foods fit, then we will have less chance of sabotaging ourselves with exercise or restriction.  Check out the references Moving Away from Diets by King, Katrina, and Hayes and Intuitive Eating by Tribole and Resch for more on this way of working with clients.

3. Be aware of different types of eating disorders or disordered eating that may present to you. An individual with Binge Eating Disorder may be a common client seeking a trainer’s help for weight loss. Be sensitive to this type of client’s energy needs, orthopedic limitations, and potential resistance to traditional exercise and Health at Any Size®.

4. If you must take any anthropometrics, make sure you discuss amongst the team who is the best person to take those measurements.Often the dietitian is the best fit on the team to do this, to discuss these results, and to comment on realistic body weight ranges and appropriate food intake to fuel activity with a sport nutrition approach in a way that is focused away from calories.

5. Set reasonable boundaries on movement to include at least 2 rest days per week; sessions not exceeding 1 hour in duration; alternate cardio and strengthening to not over-exercise; consider cross training or varying types of activities to lower risk of over-training (such as outside, non-gym activities like road biking, climbing, kayaking, etc.); encourage gentle and restorative activities during the week as well, like yoga, barre, and Pilates; support varying types of classes (dance, kickboxing, karate, etc.) that have appropriate warm-ups and cool downs and are led by a certified instructor; and lastly, exercise with others who have reasonable exercise boundaries to give one appropriate containment and normal exercise boundaries.

A personal trainer’s top 5 tips in working with an exercising client with an eating disorder:

1. Exercise will bring up past trauma in the body. It can get emotional. Be prepared for some distress and perhaps, some crying. Hence, it is important to consult with the treatment team so you are prepared and can offer the appropriate type of support.

2. Don’t assume that a small person is weak; that a larger person cannot move or has never worked out; that someone in a larger or smaller body doesn’t purge. Bottom line…never assume. Check out the Health at Any Size® movement to learn more about this mindset.

3. Offer privacy when possible. Many people in early recovery feel awkward in their own bodies. Try to help them feel as comfortable as they can during a workout. This may mean taking them out of the traditional exercise environment and away from mirrors, or going outside.

4. Get written permission to speak with therapists, doctors, dietitians, sponsors, partners, and parents. People who are in recovery from anorexia, bulimia, binge eating disorder, and OSFED need well-defined, appropriate boundaries and you may need help from the treatment team in determining this. People who are in recovery need a team to help them.

5. Fitness is about function, healthy lifestyle, and feeling good. No matter what the client asks for, focus away from aesthetics. Have fun! Exercise should be a good time for your clients. Help them have a positive experience!

This article was co-written by Page Love, Vice President of the Board for Eating Disorders Information Network (EDIN) and Kristy Wegert, recovery speaker for EDIN. Originally printed on ED Resource Catalog. Reprinted with permission.

Page Love is a registered dietitian, certified specialist in sport dietetics and nutrition therapist, and runs a thriving private practice specializing in eating disorders nutrition therapy, sports nutrition, and weight management nutrition counseling in Atlanta, Ga.  She served as a clinical dietitian for Atlanta Center for Eating Disorders for 20 years and has run ANAD groups in Atlanta for 25 years, and has served as a consultant to The Renfrew Center and Veritas Collaborative.  She has developed materials for the NEDA, Renfrew Center, and EDIN and has been published in the Renfrew Perspectives, International Journal of Sport Nutrition, and International Journal of Sport Science for Tennis Medicine.  She currently serves as the Vice-President of the board for EDIN, Eating Disorders Information Network.  She also serves as a consultant for the International Women’s Professional Tennis Tour (WTA) and the Men’s Tour, Association for Tennis Professionals (ATP), the Atlanta Ballet, The Atlanta Falcons Cheerleaders, and formerly with the Atlanta Braves.  She has recently co-authored Running on Empty, an online education program for the exercise professional working with eating disorders through Eating Disorders Information Network, a non-profit for the prevention and outreach for eating disorders in Atlanta, Ga.

At 40 years old, Kristy Wegert made some decisions that caused a mid-life career change. She decided after some much needed deep thought, that she was meant for the fitness industry. She holds an ACE Personal Trainer Certification. While she was studying for the ACE exam, she decided to get herself into the industry. There was just no point in waiting (and  she was too excited!) so she became a certified Cycle Instructor. (A little back story: Kristy lost 100 pounds after being heavy most of her life and has kept off that weight since 2008). Kristy loves to exercise and loves being an inspiration to others. Her current passion is to help others in a safe, fun way and watch them transform. Her company, My Workout Buddy, embodies everything she feels is important in the fitness industry…rigorous yet fun physical activity, a well balanced lifestyle, and the safety of a properly educated personal trainer at your side.

References

The IOC consensus statement: beyond the Female Athlete Triad

bjsm.bmj.com › Archive › Volume 48, Issue 7

Running on Empty; A online eating disorders awareness and prevention program for coaches and exercise professionals, Love and Gunter, myedin.org http://www.myedin.org/athletes.html

Moving Away from Diets Hayes, Katrina, and King

Health at Any Size Bacon

Intuitive Eating Tribole and Resch

Sports, Cardiovascular, and Wellness Nutrition dietetics practice group of the Academy of Nutrition and Dietetics Practice Manual:  https://www.scandpg.org/e-learning-and-events/a-practice-manual-for-professionals/

American Council on Exercise Podcast on Why We Eat: https://www.acefitness.org/health/resources.aspx

trainer client squat

Squats: Five Things to Consider

/8 June 2018/ All MFN blog/

The fitness community has some how deemed the squat the king of all exercises. “They” say it’s great for your glutes (Butt), Quads, hamstrings, total body challenge, it’s “functional” weight loss, etc. The list goes on. I’m not saying there isn’t some truth to all those things in the right context. They just aren’t absolute truths like some magazines or trainers may claim. Here’s a list of 5 things to consider when squatting or even deciding if a squat is an appropriate exercise for you.

1. What’s Your Goal? 

What part of your body are you trying or wanting to work?  If you have a specific target area you would like to address, your squat should match that goal. Not every squat is the same or works the same things, especially with each person having different limb lengths (Tibia, femur, & trunk). Picture this, if you squat down and your line of force is further away from your knee joint (Big Moment Arm), you’re mostly working your anterior knee muscles. Conversely, if you squat down and your line of force is further away from your hip joint (Big Moment Arm), you’re mostly working posterior hip/low back muscles. Neither are good or bad, right or wrong. It just depends on your goal.

2. Lever Lengths (Limb Lengths)

Your proportions play a role in how you’re going to squat. If your tibia (shin bone) is a lot shorter than your femur (leg bone), and your trunk (torso) is very long, your squat will look vastly different from a person who has equal length from there tibia, to there femur, and trunk. The goal of the body when it’s standing is not to fall. It’s about keeping your center of mass over your base of support. In order for that to happen, you’re going to have to modify the way you fold up in a squat to not fall over. While you do that, the forces at other joints are going to change, for example hips, knee, spine, etc…  again, what’s your goal?

3. Resistance Profile/ Strength Profile

A squat has a very distinct profile. Relatively balanced at the top of the motion and very hard at the bottom. There are several ways to account for this. Many people think they have to do everything through a “full range of motion”, but you don’t. In a situation like this, you can simply use different loads (weights) at different points in the range of motion to match the profile. For example, at the top of the motion use a heavier weight where your strongest and go down a little bit. Then drop the weight and go down lower where you are weakest with the lighter load. This way you can challenge the full range of motion you have available without sacrificing the load. Your joints will thank you.

4. Holding Dumbbells/KettleBells vs. Bar on Back/Front 

This  is a topic that I don’t think is discussed a lot. If you’re holding a dumbbell/kettlebell while doing a squat, what do you think is going to give out first? Your ability to grip and hold the dumbbell/kettlebell or the tolerance of your whole lower body and spine? Again, it goes back to what’s your goal? If your goal is hypertrophy and/or strength in those muscles then using an appropriate load to challenge them is necessary. I’m not saying you can’t hold dumbbells or kettlenbells, I’m saying this is something to consider. If the bar is resting on your upper back or front, you don’t have to worry about holding it. You just have to balance it.

5. Available Active Range of Motion 

Before you decide to squat, I would suggest checking all the motions of the squat and making sure you have those ranges available to you (Dorsiflexion, Hip Flexion, Knee Flexion, Spinal Flexion, Spinal Extension, Hip Extension, Knee extension, PlantarFlexion). If you see a difference relative to the other side, assuming there is no structural abnormalities, you may want to consider doing an isometric. You can use that as a warm-up. For the isometric, contract into the position of limitation for about five seconds at approximately 50% of effort. Repeat 3-5 times.

I hope these tips will help you, or at least make you think about some things that otherwise you may not have considered.

Dominick Nusdeu has been certified as a Personal Trainer for over 20 years. He holds the distinction of Muscle System Specialist, Resistance Training Specialist, ACE Orthopedic Exercise Specialist, as well formally being one of only 14 Instructors of Muscle Activation Techniques worldwide and was one of only 85 Master Level Muscle Activation Techniques Specialists in The World. Dominick has completed well over a 2000 hours of advanced coursework in biomechanics, exercise mechanics, neuroscience, anatomy, physiology, and muscle function. Dominick is a trainer to the trainers, teaching his highly successful course, “Decision Making 101: From the Table to the Floor.” He currently owns and operates MotionMechanix (MMX), Muscular System Optimization LLC, and MotionMechanix Academy, which was formed out of a need to give fitness enthusiasts and current exercise professionals quality, high level education backed my science, not what’s currently trendy or “cool”.

tai-chi-3

MS and Tai Chi

/5 June 2018/ All MFN blog/

It cannot be stressed enough how important it is to stay active with MS. Movement is the key, even if you are limited in doing so. Exercise has been shown to help with strength, mobility, fatigue and depression. Exercise also has can help develop a positive attitude and make you more likely to participate in group activities. These positive attributes of exercise can really help a patient overcome some of the isolating symptoms of MS.

As someone living with MS, I am always trying to find something new and interesting that may be beneficial to those of us living with the disease. In this installment, we will learn how an ancient art may provide therapeutic healing to those of us living with MS today.

Tai chi, an ancient Chinese tradition that was originally a form of self-defense, has been transformed into a form of exercise that is considered good for people of all ages and fitness levels. Tai Chi is a series of slow movements combined with deep breathing.

Tai Chi is considered to be low impact, meaning that it does not put a lot of stress on the muscles. If you have MS and have tried yoga, but struggle to hold some of the poses, then you may want to try Tai Chi. Much like adaptive yoga, adaptive Tai Chi can be done either standing or sitting.

Tai Chi is thought to have many health benefits for people living with MS, including:

• Improved strength and balance
• Increased energy and mood
• Decreased stress, anxiety and depression

To get started in Tai Chi, it is recommended that you take a class. There are videos available, but working one-on-one with an instructor will give you a great head start. Instructors can also provide safe modifications for your ability level. If you start a Tai Chi class, meet with the instructor ahead of time. Let the instructor know of any physical limitations that you may have with MS, like balance issues.

If your instructor learns your limitations, they will ensure that they teach you a routine that is safe, yet gives you the benefit of the workout. Then, over time, you may feel yourself becoming stronger and be able to take on more of a routine with less modifications.

If you have MS and have struggled in other forms of exercise, it may be time to try Tai Chi. The health benefits associated with the ancient form of low-impact movements can help you with your battle against MS, but make sure that you let your instructor know of any limitations you may have. The key to winning the battle against MS is to stay moving which is exactly what the ancient art of Tai Chi can help you achieve.

Originally printed on MS Focus Magazine. Reprinted with permission from Matt Cavallo.

Matt Cavallo, MPH is a patient experience speaker, author, and podcaster who motivates audiences worldwide with his personal patient experience and genuine storytelling style. At age twenty-eight, Matt was diagnosed with Multiple Sclerosis. Seemingly overnight he went from a fully-functioning, healthy man to someone who was numb from the waist down and unable to walk. As a result of his diagnosis, Matt has dedicated his life to improving the patient experience. Matt is the founder of PatientActivation Network. 

Personal trainer and her client with dumbbells

Metabolic Syndrome: A New Focus for Lifestyle Modification

/4 June 2018/ All MFN blog/

Personal trainers have the opportunity to do more than just help people they train become more active. We need to be prepared to also help our clients implement lifestyle behavior changes related to stress, family history of coronary heart disease, obesity, smoking, high blood pressure and high cholesterol.

A look at what is called metabolic syndrome will help you understand why, even though increasing physical activity levels is the overall best thing you can do for any client, there are additional ways to guide them to a healthier lifestyle. Sometimes you may be able to help them make the changes yourself; and, sometimes you will need to refer them to another health professional like a doctor or dietitian for guidance. Either way, knowing how to help them or when to direct them to someone who is more knowledgeable than you is important. So, first let’s become familiar with the syndrome and the clinical criteria that the doctor uses to diagnose it. Your goal is then to help your clients understand and make the necessary changes so that they don’t progress to cardiovascular disease and the almost certain heart attack heart that will be the end result.

Cardiovascular disease is still the number one cause of morbidity and mortality in the United States and much of this burden of disease can be linked to poor nutrition and a dramatic increase in sedentary lifestyles, leading to overweight and obesity. This increase in weight leads to an increase in the incidence of type 2 diabetes, and blood pressure and cholesterol problems, which are all well-established cardiovascular disease risk factors. The National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III has updated the recommendations for the evaluation and management of adults dealing with high cholesterol, renewing its emphasis on the importance of lifestyle modifications for improving cardiovascular risk. The NCEP has coined the term “therapeutic lifestyle changes” (TLC) to reinforce both dietary intake and physical activity as crucial components of weight control and cardiovascular risk management.

As well as focusing attention on the LDL cholesterol (also called bad cholesterol) levels, the NCEP also identified metabolic syndrome as a secondary target of therapy. Metabolic syndrome (also called insulin resistance syndrome and syndrome X) is characterized by decreased tissue sensitivity to the action of insulin (pre-diabetes), resulting in a compensatory increase in insulin secretion. This metabolic disorder predisposes individuals to a cluster of abnormalities that can lead to such problems as type 2 diabetes, coronary heart disease and stroke. The prevalence of the syndrome has increased 61% in the last decade. It is crucial for medical professionals to identify patients at risk and follow these patients closely and counsel them about making lifestyle changes to lower the risk of type 2 diabetes and cardiovascular disease.

GUIDELINE: According to the NCEP, the criteria for metabolic syndrome includes at least 3 of the following 5 clinical factors

Risk factor Defining level
Abdominal obesity
Men
Women		 Waist circumference
>40 in (>102 cm)
>35 in (>88 cm)
Fasting triglyceride level >150 mg/dL
HDL cholesterol level
Men
Women		  
<40 mg/dL
<50 mg/dL
BP >130/>85 mm Hg
or taking antihypertensive medication
Fasting glucose level >100 mg/dL or diabetes

Source: Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Bethesda, Md: National Institutes of Health; 2001. NIH publication 01-3670.

Millions of Americans at risk for metabolic syndrome can sharply lower their chances of getting this disease by adopting a healthy lifestyle (stop smoking, low-fat diet, weight loss/maintenance and increased physical activity). Without diet and exercise modifications, most patients will eventually fail and progress to type 2 diabetes within a decade and experience a heart attack about 10 years later. Experts recommend a diet reduced in saturated fats (<7%), low in cholesterol (<200 mg/day), high in fiber (20-30gm/day) and reduced in simple sugars. Weight loss of only 5-7% (less than 15 pounds) can make a big difference in health markers like cholesterol and blood pressure. A program that includes daily exercise reaching 85% of heart rate for age is reported to be of benefit too. However, any exercise is better than none, and a target of 30 minutes every other day is a reasonable level for most people.

As a fitness professional reading this, hopefully you are not asking yourself “so what?” but are instead seeing an opportunity to educate and motivate your current clients and to use your knowledge to help attract future clients. The medical community is good at diagnosing this syndrome, but not necessarily equipped to provide patients with the tools to be successful with the lifestyle changes they recommend. There exists a wonderful opportunity to build a partnership with physicians in your area. Most physicians will gladly refer patients to you for help with the all-important exercise and nutrition portion of the treatment program. In many cases, you have more knowledge in this area than the physician who has been trained in tertiary, not preventative, (i.e. most MD’s know very little about diet and exercise since this is not a focus in medical school) medicine.  Often times all that you will need to get a referral is for the doctor to be aware of your existence and to give them an easy way to get the patient to you. A short introduction letter outlining your qualifications and showing your desire to help people make lifestyle changes is a good start. A personal visit to your primary care doctor and others in your area is even better. But, be prepared to take up just a few minutes of their time to introduce yourself, your idea, and leave your letter and cards.

Tammy Petersen, MSE, is the Founder and Managing Partner for the American Academy of Health and Fitness (AAHF). She’s written a book on older adult fitness and designed corresponding training programs. SrFit Mature Adult Specialty Certification is used nationwide as the textbook for a college based course for personal trainers who wish to work with mature adults. SrFit is also the basis for a specialty certification home study course that qualifies for up to 22 hours of continuing education credit with the major personal trainer certification organizations.

References

  1. Centers for Disease Control and Prevention. Early release of selected estimates based on data from the January-June 2003 National Health Interview Survey. URL: cdc.gov/nchs/about/major/nhis/released200312.htm.
  2. Summary Health Statistics Tables for the U.S. Population: National Health Interview Survey, 2016 https://www.cdc.gov/nchs/nhis/SHS/tables.htm 16 Apr. 2018.
  3. Centers for Disease Control and Prevention. Prevalence of health care providers asking older adults about their physical activity levels—United States, 1998. Morbidity and Mortality Weekly Report. 51(19):412-4, 2002.
  4. Huang, Paul L. “A Comprehensive Definition for Metabolic Syndrome.” Disease Models & Mechanisms5-6 (2009): 231–237. PMC. Web. 16 Apr. 2018.