Studies show that risk for Alzheimer’s Disease (AD) is greater in people who consume high amounts of cholesterol, saturated fat, and excess calories and low amounts of fiber, vegetables, and fruits. Just as saturated fat and cholesterol can build up in the blood vessels and form plaques, plaques in the brain compromise blood flow to important parts of the brain.
There are more health claims made about vitamin D than perhaps any other vitamin. Media stories touting vitamin D for this ill or that are common, particularly in the age of COVID-19. We’re also frequently told Americans don’t get enough vitamin D, with surveys showing as many of 40% of individuals have below optimal amounts in the blood. So how do we get vitamin D and what claims are true and backed by research? Let’s take a closer look at vitamin D to flesh out what we know for sure and where more research is needed.
What is Vitamin D and How Do We Get It?
Molecularly, vitamin D is a group of fat-soluble compounds with a four ringed cholesterol backbone. What’s most important to know is that it comes in two forms — as vitamin D2 in food and as vitamin D3 in our skin.
Our skin is our primary source of vitamin D, but it begins there as an unorganized and inactive form, requiring UV exposure to convert to usable vitamin D3. Conversion via UV light is exceedingly efficient, and it’s estimated brief exposure of the arms and face is equivalent to ingesting 200 international units day. Conversion varies however with skin type (darker skin converts more), latitude, season and time of day. Infants, disabled persons and older adults often have inadequate sun exposure as well, and the skin of those older than 70 also does not convert vitamin D as effectively. Interestingly, vitamin D also requires temperature to be activated, so you may not get as much of a benefit from sunlight in the winter months as you might expect.
Because it is fat-soluble, dietary vitamin D2 is best absorbed with fat in the diet and fish is a common source. Uptake can be negatively impacted by disorders associated with fat malabsorption such as celiac disease, Crohn’s disease, pancreatic insufficiency, cystic fibrosis, short gut syndrome and cholestatic liver disease.
Vitamin D in the Body: What We Know It Does
Once activated and in the bloodstream — either by UV exposure or absorption through the diet — the liver converts vitamin D to 25-hydroxyvitamin D (25[OH]D), and then the kidneys further convert it to 1,25 hydroxyvitamin D, the most active form of vitamin D in the body. For this reason, kidney and/or liver problems can also negatively impact vitamin D levels.
Interestingly, all cells in our bodies have receptors for vitamin D, and this has in part fueled the varying claims as to how it might impact health. What we know for certain is that it helps with calcium absorption in the gut, regulating calcium levels via the kidneys, and regulating parathyroid hormone. Vitamin D’s role in calcium regulation and absorption means it has a direct impact on healthy bone growth and turnover. For this reason, you often see it in calcium supplements.
Research has also shown a clear correlation between Vitamin D and muscle health, including research showing improved lower body strength. Some research has also shown vitamin D can help prevent falls in the elderly.
Notable Areas Where the Jury is Still Out
- Vitamin D has been thought to lower the risk of cancer, but currently, there is insufficient evidence to support this, though there are many ongoing studies.
- There is also insufficient evidence showing that vitamin D helps improve autoimmune conditions and respiratory conditions such as asthma, COPD and acute viral respiratory diseases. In a large study from the UK, no association was found between vitamin D levels and risk of mortality from COVID-19.
- Although low vitamin D levels have been associated with an increased risk of cardiovascular disease in some studies, there is no evidence that vitamin D supplementation improves cardiovascular outcomes.
- Similarly, a growing number of trials examining the effects of vitamin D supplementation on pregnancy and birth outcomes show conflicting results, with some showing reduction in risk of low birth weight, but more data is needed.
Naomi L. Albertson M.D. is Board Certified by the American Academy of Family Physicians and specializes in the non-surgical management of musculoskeletal problems, sports injuries, concussions, and the treatment of osteopenia and osteoporosis. A graduate of Tufts University School of Medicine, Dr. Albertson’s interest in bone health, exercise physiology and maximizing performance led her to develop Dr. Ni’s OC2, a bone health and muscle strength supplement for the unique frame support needs of adults over age 35. Visit her website, boneandmuscle.com.
he atmosphere in which you eat—both psychologically and aesthetically—may be one of the most overlooked reasons for overeating and weight gain. Our research has revealed that both the internal and external environment while eating can be a powerful determinant of weight. Here’s why.
The Roles of a Medical Fitness Specialist: Scope of practice, prevention and interprofessional collaboration
Physical activity has been demonstrated to positively affect over 30 chronic conditions and is considered the best deterrent of chronic disease in primary and secondary prevention. The main goal of a Medical Fitness Specialist (MFS) in the healthcare continuum is to prevent the onset of chronic disease and bridge the gap between clinical intervention and conventional fitness programs. This is achieved by developing exercise programs for those who have or are at risk for chronic disease or dysfunction, have health conditions that may be mitigated or managed by exercise and activity, are newly diagnosed with a disease and need exercise guidance, or have completed a medically supervised rehabilitation program and need to continue to progress. A fitness professional versed in medical fitness protocols, such as an MFS, can work with those who are at risk for chronic disease.
Scope of Practice
Scope of practice refers to boundaries set by knowledge, skills, and abilities (KSAs), as well as education, experience, and demonstrated competency, such as a program of study, or an exam to measure proficiency. A basic personal training certification suggests the holder can develop exercise programs for apparently healthy clients. Unfortunately, considering the overweight and obesity rate is near 70%, and 50%-60% of the adult U.S. population has at least one chronic disease, adhering to scope of practice becomes increasingly important, yet at the same time many fitness professionals may be providing services outside their scope of practice, and beyond their level of certification. By accepting a client, the trainer is proposing a safe workout will be developed and implemented, and the client will not be at risk of injury. If advice is given that is not within the trainer’s scope of practice, the trainer and the facility may be subjected to a lawsuit.
An MFS who integrates medical fitness into practice has the KSAs, based on education, experience, and demonstrated competency to conduct pre-participation interviews, perform fitness assessments, and design and implement health and fitness programs for disease management to avoid future injury and to improve activities of daily living. Unlike an MFS, unless otherwise educated, a fitness trainer who promotes medical fitness is not a licensed healthcare provider and does not possess the KSAs to diagnose an unknown condition, suggest supplements, design meal plans, physically touch a client or provide behavioral counseling.
In the United States, medical care tends to focus on treatment rather than prevention. Whereas treatment is given for a diagnosed disease or injury, the goal of prevention is to avoid, improve or slow down the progression of a probable or possible disease or injury. Prevention can be categorized as primary, secondary, or tertiary. The goal of primary prevention is to foster a life of wellness and therefore avoid or reduce the chance of disease or dysfunction. Primary prevention includes immunizations, targeted types of exercise, balanced nutrition and wellness, and education programs. Secondary prevention is managing a symptomatic disease in the hopes of slowing down or reversing the progression. Examples include treatment for hypertension, asthma, and some cancer treatments. Tertiary prevention involves the management and treatment of symptomatic disease with the goal of slowing progression and severity, as well as reducing disease-related complications. Tertiary prevention includes treatment for late-stage cancer, coronary heart disease, and some types of rehabilitation to include orthopedic, cardiac, and pulmonary. Physical activity has been demonstrated to effectively treat over 30 chronic conditions, mostly in primary prevention but also in secondary and tertiary, making it the number one intervention against chronic disease.
Due to the growing incidence of obesity and chronic disease, leveraging the skills of various providers who can collaborate to deliver the best possible care, based on clinical needs, is necessary to manage the complex health care demands of a population with an increasing incidence of comorbidities. Due to a worldwide shortage of health workers, in 2010, the World Health Organization (WHO) recognized interprofessional collaboration as means to mitigate the global clinician shortage, strengthen health systems and improve outcomes. Interprofessional collaboration refers to health care teams, made up of trained professionals with various backgrounds, who work alongside patients and their families to provide high-quality care, based on the needs of the patient. Consequently, as medical providers begin to recognize the need to prescribe evidence-based exercise as an intervention in the management of chronic disease, MFSs, who are on the front line of health care, are trained and educated to be part of a clinical team that complements and leverages the strengths of each team member to improve population health. As health science and technology advance, it is imperative for fitness professionals who work with clients who have one or more chronic diseases to remain up-to-date on emerging fitness protocols. An MFS is required to participate in continuing education in areas including cardiopulmonary disease, metabolic disorders, and orthopedic dysfunction.
Although the scope of practice of many allied healthcare fields overlaps, the role of the MFS is to work with the client’s team of other healthcare providers, while staying within the scope of practice, based on KSAs. Regardless of the collaborative health team, the client’s physician is always the center, and as such should be provided regular updates as to the client’s progress.
An MFS is uniquely qualified to work with individuals within the healthcare continuum. Some KSAs associated with MFSs are:
- Knowledge of basic chronic disease pathophysiology
- The use and side effects of common medications taken by someone suffering from a chronic disease
- The knowledge to perform and analyze basic assessments related to movement and anthropometry
- The knowledge to design a safe and effective workout based on information received via assessment results, and the clinical recommendations from other healthcare providers
- FITT protocols, exercise progressions, and regressions
- The implications of exercise and activity for individuals with chronic disease
- Contraindications of chronic disease, and signs and symptoms of distress related to chronic disease
- Knowledge of signs and symptoms that require expertise outside of the scope of practice for medical exercise
- The ability to recognize a medical emergency
- Current CPR and adult AED are required
Personal Trainers & Fitness Professionals: Prevent & Manage Chronic Disease and Collaborate with Clinicians
Check out MedFit Classroom’s 20-hour online course, Medical Fitness Specialist. This course is designed for fitness and health professionals who want to learn more about using exercise as medicine with clients who suffer from one or more chronic diseases. As a Medical Fitness Specialist, you will be able to prevent and/or manage numerous chronic diseases and collaborate with clinicians.
Dan Mikeska has a doctorate degree in Health Science and a master’s degree in Human Movement, as well as certifications from NASM, ACE, the Cancer Exercise Training Institute and the Exercise Is Medicine credential from ACSM. He currently owns NOVA Medical Exercise and Medical Exercise Academy and is adjunct faculty for A.T. Still University’s Master of Kinesiology program.
This article was featured in MedFit Professional Magazine. Access past issues or subscribe to read more great content like this!
Every person longing to be slim has heard the same advice forever: Eat less and exercise more. So simple, so logical, so what happened? America is the land of the overweight and the frustrated. For millions of people, every road has led to the same locked door. Until now. I’m going to give you the secret to helping you help your clients reach their weight loss goals in a healthy, lasting and fulfilling way.
For reasons ranging from stress to the influence of advertising, the majority of Americans find it difficult to lose the weight and keep it off. In addition, they are famously sedentary. According to the Centers For Disease Control & Prevention, 70% of adults are overweight or obese, contributing to health risks including heart disease, high cholesterol, high blood pressure, diabetes, stroke, and more (1). Either for health or vanity reasons, many of these overweight men and women try to slim down and usually gain back at least as many pounds as they lost. The secret to effectively losing weight and transforming patterns of behavior happens with breath.
How Breath Influences Fat Burning
The way we breathe, fast or slow, mouth open or closed, shallow or deep affects our biochemical, physiological, biomechanical and psychological states of being. Nasal diaphragmatic breathing signals our parasympathetic branch of the autonomic nervous system while mouth breathing signals our sympathetic branch. The difference determines whether you’re fat-burning or sugar-burning. Can you guess which turns you into a fat-burning machine? You guessed, nasal breathing.
Most of our clients are living in a stressed state (or the sympathetic branch of our nervous system). Not only is this the sugar-burning system, it also leads to abnormally high levels of cortisol. High cortisol levels promote weight gain (2).
In addition, nasal breathing increases oxygenation while mouth breathing decreases oxygenation. The speed at which your body burns oxygen or fuel for fat-burning benefits depends on how well your body utilizes oxygen. As we diaphragmatically nasal breathe, we stimulate the vagus nerve. “The vagus nerve regulates metabolic homeostasis by controlling heart rate, gastrointestinal motility and secretion, pancreatic endocrine and exocrine secretion, hepatic glucose production, and other visceral functions.” (4)
How The Fat Leaves On The Exhale
Fats are large molecules made up of oxygen, carbon, and hydrogen. When the oxygen we breathe reaches these fat molecules, it breaks them down into carbon dioxide and water. The blood then picks up the carbon dioxide – a waste product of our bodies – and returns it to the lungs to be exhaled. Therefore, the more oxygen our bodies use, the more fat we will burn.
Nasal breathing is more efficient than mouth breathing in terms of supplying oxygen to the body as well as the transfer of oxygen and carbon dioxide between the lungs and red blood cells. When performing cardiovascular exercise, it is therefore preferable to inhale and exhale through the nose. (3)
Have you ever wondered where the fat goes? If you’re like most of us, you probably think the majority of fat is excreted through bodily fluids. Surprisingly, it’s not. Based on the research from the British Medical Journal, the majority of fat turns into carbon dioxide which is exhaled when we breathe. (5)
Transforming Patterns of Behavior
The person who’s been sedentary for years won’t suddenly be persuaded to run a marathon. Core changes must come first in order to make everything else possible. Using “breath as medicine” to improve health and the training experience, we cultivate the “choosing mind,” where we can alter lifelong patterns.
People become sedentary and develop poor lifestyle patterns based on habit, boredom or emotional triggers. So, there’s more involved than just losing the physical weight. Our issues are in our tissues. We’ve got to transform the emotional and physiological weight which is embedded in our unconscious and subconscious minds.
Mindful breathing while exercising is being “neurofit” meaning we’re influencing physiological changes in the brain related to behavior. Life is a sensory experience and the body keeps score. Focusing on the breath allows a person to slow down, unwind and look inward. This is crucial for people whose lives are chronically hectic and stressful, who eat without thought, regardless of hunger. With deep, powerful breathing, they can break old patterns while cleansing internal systems. How does this happen? By stimulating the vagus nerve (which only happens through nasal diaphragmatic breathing), we strengthen the areas of the brain responsible for emotional self-regulation. (6)
The body always lives in the present. It will never crave a Twinkie because of unrequited love, an upcoming review with a cranky boss, or an unhappy childhood. It cares only about what it needs from moment to moment to maintain homeostasis. The typical brain calls for millions of automatic acts in a day – from adjusting endocrine levels to blinking to deploying white cells for battle. As the connection between body and mind is fortified with breath, the choosing mind emerges reconnecting with our body to hear its’ objective voice which discriminates between emotional reactivity and true desire.
All that from a simple breath.
Continuing Education: Breath as Medicine
Ed Harrold’s Breath AS Medicine breath coach training focuses on breath regulation concepts & strategies by applying the principles and philosophy of yoga breathing (or pranayama) to improve breathing rates and patterns. Breath AS Medicine is a highly effective modality for both the prevention of illness as well as therapy for managing and/or reversing existing chronic illness.
Click here to learn more about Ed Harrold’s Breath AS Medicine e-learning courses. Use coupon MedFit20 for 20% off either the 15 or 25-hour trainings.
A shorter 6-hour course is also available on MedFit Classroom. Click here for details.
Ed Harrold is an author, inspirational leader, public speaker, coach and educator. Ed’s mastery in the science of mindful breathing has guided him to apply conscious breathing practices in corporate performance coaching, fitness & athletic training, healthcare trainings, stress reduction and overall health and well-being.
Today, Ed blends the fields of neuroscience and the wisdom of contemplative traditions into effective strategies to improve well-being in Corporate America, Healthcare, athletic performance and individual health. Ed’s fluency in mindfulness-based strategies combined with the belief in the human potential gives him the depth and understanding to meet individuals and group needs across industries and platforms.
Ed is the author of “Life With Breath” and “BodyMindBusiness”; he is a contributing health & wellness editor for Huffingtpost, Thrive Global, MindBodyGreen & PTOnTheNet. Ed’s Breath AS Medicine Training offers CE in the healthcare, wellness coaching, fitness & athletic training sectors. Ed is a Faculty Member of the Medical Wellness Association. Learn more about Ed at www.edharrold.com
- National Center For Health Statistics, Health, United States, 2015. Table 53. https://www.cdc.gov/nchs/fastats/obesity-overweight.htm
- Sominsky, L. & Spencer, S. (May 2014). Eating behavior and stress: a pathway to obesity, School of Health Sciences and Health Innovations Research Institute, Retrieved from http://journal.frontiersin.org
- Novotny, S. (2007, February 1). The science of breathing. Ideafit.com. Retrieved from http://www.ideafit.com/
- Harada, S., Yamazaki, Y., Koda, S., Tokuyama, S. (April 23, 2014). Hepatic Branch Vagus Nerve Plays a Critical Role in the Recovery of Post-Ischemic Glucose Intolerance and Mediates a Neuroprotective Effect by Hypothalamic Orexin-A, Retrieved from http://journals.plos.org/
- Meerman, A. Brown (December 19, 2014). When Somebody Loses Weight, Where Does The Fat Go? The BMJ. Retrieved from http://www.bmj.com/content/349/bmj.g7257
- Porges SW, Doussard-Roosevelt JA, Maiti AK (1994). Vagal Tone And The Physiological Regulation of Emotion. PubMed. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/7984159
Over the past 18 months, I have seen my primary M.D. three times, enjoyed the services of my favorite massage therapist six times, visited my chiropractor nine times, chatted with a local R.D. twice and seen my personal trainer regularly. And not one of them even asked if I was seeing any of the others, much less inquiring what their treatments or approaches to treatments might be. To me, that is like trying to achieve success with a baseball team where the 1st base coach, 2nd base coach, 3rd base coach and pitching coach never communicate with each other.
Success cannot occur in a vacuum, neither can trueindividual health & wellness, yet for decades these medical, fitness & wellness providers have proffered their services in distinct and distinctly separate spaces.
Even as the internet has made access to information easier and facilitated the sharing of knowledge, including private, HIPAA compliant information, these providers continue to operate in “informational silos.”
It is true that in the past some of these providers may have held less than favorable opinions of some of the other providers, but that is, and certainly should be, a thing of the past. No longer will M.D.’s consider Chiropractors “quacks”, R.D.’s claim nutritionists “just don’t know enough”, and Physical Therapists think of Personal Trainers as ”wanna-be P.T.’s who couldn’t hack the education.” Science, knowledge and time have evolved all these disciplines into valuable, useful and incredibly beneficial specialties, each offering specific training and specific methods to apply to their patients/clients. And all those patients/clients typically can benefit from their combined expertise and knowledge.
No longer is it sufficient to simply treat the symptoms. Real wellness needs to encompass the patient/client holistically… address the symptoms, understand the cause, strengthen the mind, examine the diet, resolve the issue and prevent future occurrences. And isn’t that best accomplished by viewing patient/client wellness as a Team Sport?
Over the years I have had the pleasure of knowing and speaking at length with many of these medical, fitness & wellness providers, and not one of them indicated there is anything in their training that says “Thou Shalt Not Collaborate.”
We are not talking about “asking for help.” Rather we are simply saying to include those other practitioners in the conversation. Instead of the M.D. telling the patient to “walk more to improve cardio health”, why not conference call with the Personal Trainer and discuss the walking program that is most appropriate. Let the Physical Therapist inform the Personal Trainer of any specific issues to address or avoid. Allow the Massage Therapist to work with the Chiropractor to ensure optimum results from both. In other words, (and the simplicity of all this may surprise you), just TALK TO EACH OTHER.
So, let’s start to make that happen. For more than 20 years my company has helped health clubs and fitness centers create mutually beneficial relationships with Physical Therapy practices, Chiropractic offices, Registered Dietitians, Nutritionists and Massage Therapists. Now is the time to extend the conversation, and, to return to my baseball metaphor, get ALL the coaches working together to create truly Championship results.
Cosmo Wollan is the Senior Executive at Synergy Cubed, a premiere consulting firm providing customized solutions to the health & fitness, parks & recreation, medical fitness and corporate wellness industries since 1994. His Fitness Industry clients have engaged him as an expert problem-solver in profit center development, retention strategies, customer engagement, sales training, programming design, operational streamlining and health club management.
This article is meant to be a wake-up call to the fitness industry. The health of our population and country are at stake. While advancements have extended our country’s overall lifespan, it has occurred primarily through the use of medications and life-saving procedures rather than through lifestyle changes. The stark reality is that the overall health of Americans is declining as evidenced by the $3.5 trillion spent every year on health care expenditures.
Another alarming statistic is that between 1997 and 2016, there were approximately 4.5 billion prescriptions written per year. 70% of Americans take at least one and 20% take five or more prescription medications (Preidt 2017). The majority of these medications were taken to address lifestyle-related diseases and the subsequent impacts of poor nutrition choices and lack of physical activity. Additionally, many prescription and over-the-counter medications are used to treat osteoarthritis, the most common cause of physical disability in the world. While genetics, weight, and age have been considered as underlying factors, the decrease in quantity, as well as quality, of physical activity have been shown to be much greater factors to the onset and prevalence of osteoarthritis in modern society (Wallace 2017, Osar 2018).
While often attributed to causes outside one’s control (i.e. genetics), the fact is that the diseases contributing to the greatest number of deaths (heart disease, cancer, and Type 2 diabetes) and disability (osteoarthritis) are directly related to controllable factors. While each has a genetic component, lifestyle has a much greater impact on the incidence and prevalence of these diseases. One of most important and underappreciated components in the overall decline in one’s physical, physiological, and cognitive health, is the lack of physical activity. Less than 20% of the population meet the daily physical activity guidelines and less than 5% of the adult population participates in 30 minutes of physical activity. Even more disturbing is that more than 78 million U.S. adults and 12 million children are obese.
Dr. Caldwell Esselstyn has been attributed with the quote, “Genetics loads the gun, lifestyle pulls the trigger.” This suggests that lifestyle is as important as genetics in the expression of many chronic diseases. This sentiment is reiterated in a recent study from Bodai et. al (2018). “Epidemiological, ecologic, and interventional studies have repeatedly indicated that most chronic illness, including cardiovascular disease, cancer, and type 2 diabetes, are the results of lifestyles fueled by poor nutrition and physical inactivity.”
The health of our population and country is at stake. This is a call for fitness professionals to step up and recognize that you are the first line of defense against the deleterious impacts of lifestyle diseases. It is your responsibility to educate your communities that lifestyle changes, incorporating proper nutrition as well as increased physical and cognitive exercise, should be the first step in addressing chronic lifestyle diseases. You can continue to change the health of our nation by implementing evidence-based nutrition, exercise, and cognitive training programs. Be the solution your clients, your community, and our country needs by investing in advanced education in nutrition, exercise, movement, and cognitive training. Create relationships with allied health professionals so that we can collectively educate, collaborate, and coordinate the changing of our nation’s health care system.
This article was featured in MedFit Professional Magazine Winter 2020 issue. Subscribe to MedFit Professional Magazine to read more great content like this!
Dr. Evan Osar, an internationally recognized speaker, author, and expert on assessment, corrective exercise, and functional movement. Dr. Osar is committed to educating and empowering fitness professionals while helping them develop relationships with allied health professionals. He is author of the Corrective Exercise Solutions to Common Hip and Shoulder Dysfunction and has developed the industry’s most complete training certification, the Integrative Movement Specialist™. With his wife Jenice Mattek, he created the online educational resource. For more info, visit IIHFE.com.
Bodai, B. I., Nakata, T. E., Wong, W. T., Clark, D. R., Lawenda, S., Tsou, C., … Campbell, T. M. (2018). Lifestyle Medicine: A Brief Review of Its Dramatic Impact on Health and Survival. The Permanente journal, 22, 17–025. doi:10.7812/TPP/17-025
Centers for Disease Control and Prevention. Osteoarthritis. Retrieved from https://www.cdc.gov/arthritis/basics/osteoarthritis.htm
Centers for Disease Control and Prevention. Leading Causes of Death. Retrieved from https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
Centers for Medicare & Medicaid Services. National Health Expenditure Data. Retrieved from https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html
Osar, E. (2018). The Fundamentals for Training the Older Client with Osteoarthritis. Retrieved from https://www.ptonthenet.com/remote-learning
Preidt, R. (2017). Americans Taking More Prescription Drugs Than Ever. https://www.webmd.com/drug-medication/news/20170803/americans-taking-more-prescription-drugs-than-ever-survey
U.S. Department of Health & Human Services. Facts and Statistics. Retrieved from https://www.hhs.gov/fitness/resource-center/facts-and-statistics/index.html
Wallace, IJ., Worthington, S., Felson, DT., Jurmain, RD., Wren, KT., Maijanen, H. Woods, RJ., Lieberman, DE. (2017). PNAS. 114(35): 9332-9336.
Is there such a thing as an anti-inflammatory diet? While there is no specific “diet” that people with arthritis or rheumatoid arthritis (RA) should follow, researchers have identified certain foods that can help control inflammation. Many of them are found in the so-called Mediterranean diet, which emphasizes fish, vegetables, olive oil, whole grains, nuts and seeds, among other staples.
A discussion of medical fitness is rooted in an understanding of the health benefits of fitness and exercise. The documented benefits are endless and include management of chronic disease, management and prevention of osteoporosis, improved mood and sleep disorders, stress relief, management and prevention of obesity.
Health agencies across the spectrum of public health and disease-specific organizations recognize and promote exercise and fitness as an integral part of the management of chronic disease; diseases that include diabetes, cardiovascular disease, Parkinson’s, depression, multiple sclerosis, and arthritis, among others.
If fitness and exercise are well accepted as part of the management strategy for multiple diseases, why is it that access to organized exercise plans, and fitness professionals who can help implement those plans, are not a standard part of the medical treatment paradigm? Why is it not a standard benefit covered by common medical insurance policies?
The reasons are multifactorial and a reflection of the overall healthcare conundrum in our country today. Let’s focus, however, on how to make a change. We need to focus on how to integrate fitness professionals into the medical paradigm. A perfect model for this is an integrative medical fitness center.
What is a medical fitness center? It is a fitness facility with a multidisciplinary staffing approach and has the following characteristics:
- Regular medical oversight by a medical director
- Practitioners with nationally-recognized certifications and training in the care of chronic disease
- Comprehensive health assessments and exercise prescription
- Exercise classes geared toward specific medical conditions
These centers bring together credentialed staff in a collaborative way to provide exercise prescription plans specific to the needs of an individual with chronic disease.
The concept of the medical fitness center is not new; many currently exist in communities throughout the United States. However, an understanding of their importance in the context of the current healthcare environment has grown. The idea of creating “medical homes” that are collaborative across disciplines and provide a comprehensive healthcare approach is now being recognized to provide a high standard of care while simultaneously decreasing overall healthcare costs. This is true specifically for high-risk individuals who suffer from chronic disease.
Further integration of medical fitness centers, and broad access to exercise and fitness resources, will hopefully become standard of care and widely accessible to all individuals, especially those with chronic disease. This integration will inherently bring fitness professionals into the paradigm of healthcare and promote healthcare through fitness.
This article was featured in MedFit Professional Magazine. Visit medfitpromag.com to read past issues or subscribe for future issues.
Dr. David Kruse attended medical school at UC San Diego, after graduating from UC Berkeley. He holds board certifications in family and sports medicine. He practices sports medicine with the Orthopaedic Specialty Institute, in Orange, CA. Dr. Kruse is the Chief Medical Officer for the MedFit Network and on the Medical Advisory Board for the MedFit Education Foundation. He is currently a Team Physician for USA Gymnastics, Orange County Soccer Club, and Biola University. Visit his website, krusesportsmd.com