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holidays-xmas

Surviving the Holiday Season

The hardest time of year for weight management is from Halloween until Valentine’s Day – temptations are everywhere from home to the workplace and everywhere else you go, people wear more clothes and are more covered up because of the weather, and people tend to exercise less because they are stressed, exhausted, it is cold, and they have very little time. Here are some tips to manage weight during the holiday season:

Plan ahead

  • Eat something before you go out so that you are not inclined to eat everything or anything in sight.
  • Stock your home, office, and/or car with healthy snacks such as fruit in your home, almonds in your office, and a nutrition bar in your car.
  • Plan on making healthy choices for your meals such as mustard instead of mayonnaise or light Italian rather than ranch dressing.

Manage stress

  • Make a list of stress relieving activities that do not include food or eating such as getting a massage, exercising, listening to music, or talking on the phone.

Party responsibly

  • If you are attending a pot-luck party, bring something healthy so you know there will be at least one healthy choice at the party.
  • Eat small portions of your favorite sweets at parties.
  • Try to fill your plate with mostly fruits and veggies at parties.
  • If you want to try new dishes, only take a taster size portion so that you are not tempted to eat more than you should. Then go back and get more of what you like if you are still hungry.
  • Drink a glass of water after each glass of soda or alcoholic beverage in order to cut beverage calories in half.
  • Focus on socializing with other guests rather than eating the food available.

Keep moving

  • If you know you will not have time to exercise, try to fit other small activities into your day such as parking farther away, taking the stairs, and putting the shopping cart away instead of putting it to the side.
  • If you have a stationary bicycle or a treadmill that you haven’t used for a while, take it out and put it in front of the TV, so you can watch TV when you work out.
  • Take a walk alone or with your spouse, kids, or other family and friends after dinner.

Kristy Richardson is a dietitian and exercise physiologist, specializing in sports nutrition and weight management, She is the founder of OC Nutrition and also works as a nutrition professor at Fullerton College.

References

Cleveland Clinic. (2009). 8 Steps to Surviving the Holiday Weight Gain. Retrieved December 22, 2009 from: http://my.clevelandclinic.org/heart/prevention/nutrition/holidayeating12_01.aspx

Zamora, Dulce. (2007). Holiday weight management; Surviving the Feasting Season. Retrieved December 22, 2009 from: http://www.medicinenet.com/holiday_weight_management/article.html

DNA-puzzle

The Evolution of Truly Personalized Medicine: Epigenetics, Food, and Fitness

Most would not argue that there is ongoing transition in how our healthcare is being delivered. This article will examine some of these transitions as a result of breakthroughs in technology, as well as how genetic information, exercise, and diet will play an increasingly greater role.

When medical science was first getting its start, a more holistic philosophy was taken on how to treat illness and maintain health. Hippocrates is often deemed the father of modern medicine, and even today the allopathic physicians (M.D.s) take the Hippocratic Oath – to do no harm to their patients. Hippocrates knew, even in 400 B.C., that the best healer of the body is the body itself. For the most part, the best treatment is to create a strong body and get out of the way. Five guiding principles used in his philosophy for treatment include:

  1. Walking is man’s best medicine.
  2. Know what person the disease has, rather than what disease the person has.
  3. Let food be thy medicine.
  4. Everything in moderation.
  5. To do nothing is also a good remedy.

The second and fifth principles emphasize the power of knowing the individual and getting out of the way! The first and third principles show the power of exercise and food for healthy living. Even the genius, Thomas Edison, realized that a health maintenance organization (HMO) approach was the best method of healthcare both practically and financially. His quote, “The doctor of the future will give no medicine but will interest his patient in the care of the human frame, in diet and in the cause and prevention of disease,” is evidence that a holistic, preventative approach is what he advocated. He is also quoted, “…you can’t improve on nature.”

One size does not fit all

Personalized medicine is now on the forefront and it utilizes the genetic and epigenetic data of a person to guide medicines and treatment plans. Cancer drugs have probably harnessed this advantage to the greatest extent, thus far. Former President Jimmy Carter received Keytruda (pembrolizumab) for his brain cancer and it boosted his immune system and beat the cancer. While most of America (71%), still doesn’t even know about personalized medicine, those who were familiar with it did not know it would yield better results with fewer side effects. The different directions of personalized medicine are still being realized, but the field of pharmacogenetics is the first to really jump on the bandwagon of highly effective, precision-based treatment.

The reasons some drugs work for some people and not for others, or why side effects occur in some individuals and not others, is due to individual variability in metabolism. Why are some people lactose tolerant, or some can drink alcohol with no problem, and others have severe issues? It is usually because of enzyme differences, which are under the control of our genes. Interestingly, our enzyme genes can often be turned on or off by “inducible sequences” known as promoters or suppressors of operons, respectively. These “switches” can be repressed or induced depending on our environmental stimuli. Thus, we actually have some control over our gene expression, and this field is known as epigenetics.

Knowing what gene variants someone possess or not will guide the personalized medicine physician on which drug to use or not. By knowing allergic reactions in advance or which medicines may have side effects will help physicians to not make a bad situation worse. Unfortunately, the cost of personalized medicine drugs is much higher than alternative treatments. There is still a lot of exploration to be done on all the various applications of this technology, but the bottom line is that understanding individual variations and enabling the body to do what it is designed to do is a very good thing! Companies like Toolbox Genomics is one of many companies that use your genetic information to then tell you what foods and supplements to eat or avoid, and which exercises may help you the most, and ones that you may not respond to so well. The reason physicians do an intake on family history, or run various tests is to collect information that will guide their treatment. A genetic test on certain gene variants is simply taking this a step further.

How does exercise and diet apply to our epigenetics?

Did you know that exercise is highly beneficial to not only help with fighting cancer once it is already present, but also to never getting it? Physical exercise or movement in general will shift the epigenetics so that genes that suppress tumors are increased, and genes that cause cancer (oncogenes) are decreased. It does this by changing the amount of certain reactions called methylations. Things go wrong when there is too much or too few methylation reactions. Exercise has been shown to reduce or even reverse the epigenetic mutations that often result in tumorigenesis or tumor production. Exercise has also been shown to reduce genetic factors associated with aging like telomere length.

The fields of proteomics and metabolomics as well as pharmacogenomics, are all emerging because of the knowledge on how our genetics affects proteins, metabolism, and reactions to drugs, respectively. The field of nutrigenomics is rapidly expanding, and several companies are capitalizing on studying the relationship of how our genes affect how we process and utilize foods, as well as how food can affect our genes. Vitamins A and D, certain fatty acids, especially medium and short chain, some sterols (derived from cholesterol) and zinc have been shown to directly influence gene transcription. In direct effects include how diet affects gut bacteria, which in turn influences gene expression. Soon when nutritional recommendations are given, it will likely be “for this individual.”

The future of medicine will be taking our genetic information to a whole new level. Soon “smart” watches, clothes, hats, and other common devices will collect information that can benefit our health in many ways as the way healthcare is delivered continually evolves.

This article was featured in MedFit Professional Magazine summer 2019 issue.

Subscribe to MedFit Professional Magazine to read more great content like this!


Dr. Mark P. Kelly has been involved with the health and fitness field for more than 30 years. He has been a research scientist for universities and many infomercial projects. He has spoken nationally and internationally on a wide variety of topics and currently speaks on the use of exercise for clinical purposes and exercise’s impact on the brain. Mark is a teacher in colleges and universities in Orange County, CA., where Principle-Centered Health- Corporate Wellness & Safety operates.

mid age man exercising at the beach

Exercise and Prostate Cancer

The rising rate of prostate cancer necessitates developing better methods to prevent and treat prostate cancer. Prostate cancer is the third leading cause of cancer death among U.S. men, according to the American Cancer Society. The country’s 3.3 million prostate cancer survivors account for 21 percent of all cancer survivors.

There are many reasons why a cancer patient should stay as active as possible through cancer treatment and recovery. I will begin by pointing out a few studies that show how exercise can benefit cancer patients.  These studies demonstrate how exercise can reduce certain side effects from treatment, increase energy, decrease stress, and improve quality of life. In the last article of this series, I will suggest ways to develop an exercise program that is based on an individual’s needs and is safe and effective.

There is evidence to support the use of exercise in prostate treatment. Exercise plays a role in the all-around improved physical and mental health and therefore should be considered in the treatment plan. We know that exercise can decrease recurrence for some cancers and the role it plays in weight control, which is correlated with some cancers. For prostate cancer specifically, data indicates that obesity increases the aggressiveness of prostate cancer, and thus mortality. Men receiving androgen deprivation therapy are at higher risk for depression. Exercise reduces depression.

Studies do have their limitations.  Some use self-reported data about lifestyle and exercise. Moreover, there may be a low number of minority participants who may often have higher cancer rates. The following are a few of the published studies, which confirm that exercise should be included in the treatment plan for prostate cancer patients.

Studies have suggested that patients with high levels of physical activity had a lower rate of disease progression and also reduced mortality from prostate cancer. Ying Wang, PhD, a senior epidemiologist in the Epidemiology Research Program at the American Cancer Society in Atlanta, and colleagues analyzed data on 10,067 men diagnosed with non-metastatic prostate cancer between 1992 and 2011.  Men with prostate cancer, which hasn’t spread may have longer survival the more they exercise.  A study demonstrated that men who were the most physically active had a 34% lower risk of dying from prostate cancer when compared with men who were the least physically active. Men who either maintained or increased their exercise level also benefited. Prostate cancer patients who kept up a moderate to high level of physical activity also had better survival prognoses compared with their more sedentary counterparts. Those men who were more active before diagnosis were more likely to have lower-risk cancer tumors and a history of prostate screenings. They were also leaner, more likely to be nonsmokers and vitamin users and they ate more fish. Wang concludes, “Our results support evidence that prostate cancer survivors should adhere to physical activity guidelines, and suggest that physicians should consider promoting a physically active lifestyle to their prostate cancer patients.”

Androgen Deprivation Therapy leads to numerous side effects, which can be decreased through exercise. Side effects of ADT include loss of muscle, increase in fat mass and osteoporosis. Risk for diabetes and heart disease also increases.  Brian Focht, reported at the November AICR convention, that functional ability increased dramatically as did quality of life for those that exercise, and side effects of ADT were reversed.

Exercise can decrease blood sugar levels, which lower insulin levels and also helps to lower inflammation. There does appear to be a positive association between insulin levels, inflammation and prostate cancer risk.

The evidence for physical activity in reducing anxiety and depression, while increasing general-well being is fairly substantial.  Improving well-being can have a dramatic beneficial effect on sexual function.  Consistent exercise will also help to lower insulin, blood sugar, and improve overall cardiovascular health, all of which have positive impact on erectile dysfunction and libido.

In 2016, Rider and Wilson studied the connection between ejaculation and prostate cancer, which was published in European Urology. Men that reported higher ejaculatory frequency were less likely to be diagnosed with prostate cancer. This study showed a beneficial role of frequent ejaculation particularly for low-risk disease.

Some doctors have traditionally told patients to rest during this time but Favil Singh’s research confirms the importance of getting fit prior to surgery. Singh’s research published in the journal Integrative Cancer Therapies has shown that a regular dose of physical activity prior to surgery helps the recovery process. This reduces time in the hospital.

Singh stated “This is the first time we’ve been able to demonstrate the benefits of ‘pre-habilitation’ for prostate cancer patients. It is safe, side effect-free and can be done while undergoing chemo or radiotherapy. Just two sessions a week of resistance and exercise training for six weeks can make a difference to recovery.”

Often, there is a waiting period in between diagnosis and surgery. If fitness level can be improved before surgery the patient, then the patient goes into the surgery stronger and may have a better recovery.

The American Cancer Society and American College of Sports Medicine recommends at least 150 minutes of moderate physical activity or 75 minutes of vigorous exercise each week. This advice is a good goal for those who have been inactive. Unfortunately, in my view this is insufficient for a significant number of cancer patients. Having worked with cancer patients for over 20 years, I believe that this recommendation needs to be changed. It is impossible to include aerobic exercise, strength training, and other exercise methods in the current recommended time frame. 


Carol J. Michaels is the founder and creator of Recovery Fitness® LLC, located in Short Hills, New Jersey. Her programs are designed to help cancer survivors in recovery through exercise programs. Carol, an award winning fitness and exercise specialist, has over 17 years of experience as a fitness professional and as a cancer exercise specialist. Visit her website, carolmichaelsfitness.com

 

References

Steven C. Moore PhD, et al, Association of Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults. JAMA Intern Med. 2016; 176(6): 816-825.

Lynch B.M., Dunstan D.W., Vallance J.K., Owen N. Don’t take cancer sitting down: A new survivorship research agenda. Cancer. 2013, Jun 1; 119(11): 1928-35 Medicine

Kristina H. Karvinen, Kerry S. Courneya, Scott North and Peter Venner, Associations between Exercise and Quality of Life in Bladder Cancer Survivors: A Population-Based Study, Cancer Epidemiology and Biomarkers Prevention May 2007, 10.1158/1055-9965

Gopalakrishna et al, Lifestyle factors and health-related quality of life in bladder cancer survivors: a systematic review. Journal of Cancer Survivorship, 2016 (5): 874-82

Vallance, J., Spark, L., & Eakin, E.. Exercise behavior, motivation, and maintenance among cancer survivors. In Exercise, Energy Balance, and Cancer (2013) (pp. 215-231). Springer

Cannioto et al., The association of lifetime physical inactivity with bladder and renal cancer risk: A hospital-based case-control analysis, Cancer Epidemiology, Volume 49 August 2017

Cramp F, Byron-Daniel J. Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev. 2012; 14(11): CD006145.

Booth FW, et al., Lack of exercise is a major cause of chronic diseases. Compr Physiol. 2012 Apr; 2(2): 1143-211.

Stephanie Cash et al, Recreational physical activity and risk of papillary thyroid cancer among women in the California Teachers Study. Cancer Epidemiology, Feb 2013,37(1): 46-53

Hwang, Yunji MS; Lee, Kyu Eun MD, PhD; Park, Young Joo MD, PhD; et al, Annual Average Changes in Adult Obesity as a Risk Factor for Papillary Thyroid Cancer: A Large-Scale Case-Control Study, Medicine, March 2016, Mar; 95(9): e2893

Cao Y, Ma J. Body mass index, prostate cancer-specific mortality, and biochemical recurrence: a systematic review and meta-analysis. Cancer Prev Res (Phila). 2011; 4: 486-501.

Galvao, et al. Combined resistance and aerobic exercise program reverses muscle loss in men undergoing androgen suppression therapy for prostate cancer without bone metastases: a randomized controlled trial. J Clin Oncol. 2010 Jan 10; 28(2): 340-7.

Galvao, et al. Exercise can prevent and even reverse adverse effects of androgen suppression treatment in men with prostate cancer. Prostate Cancer Prostatic Dis. 2007; 10(4):340-6.

Winters-Stone KM, et al. Resistance training reduces disability in prostate cancer survivors on androgen deprivation therapy: evidence from a randomized controlled trial. Arch Phys Med Rehabil. 2015 Jan; 96(1): 7-14.

Giovannucci EL, Liu Y, Leitzmann MF, Stampfer MJ, Willett WC. A prospective study of physical activity and incident and fatal prostate cancer. Arch Intern Med. 2005; 165: 1005-1010.

Storer TW, Miciek R, Travison TG. Muscle function, physical performance and body composition changes in men with prostate cancer undergoing androgen deprivation therapy. Asian J Androl. 2012, Mar; 14(2): 204-21.

Focht, Brian C.; Lucas, Alexander R.; Grainger, Elizabeth; Simpson, Christina; Fairman, Ciaran M.; Thomas-Ahner, Jennifer; Clinton, Steven K., Effects of a Combined Exercise and Dietary Intervention on Mobility Performance in Prostate Cancer, Medicine & Science in Sports & Exercise. May 2016:48(5S): 515.

Rider J, Wilson K.et al. Ejaculation Frequency and Risk of Prostate Cancer: Updated Results with an Additional Decade of Follow up, European Urology. December 2016, volume 70, issue 6

Singh F. et al. Feasibility of Presurgical Exercise in Men With Prostate Cancer Undergoing Prostatectomy, Integrative Cancer Therapies (2016). DOI: 10.1177/1534735416666373

Wang et al, Recreational Physical Activity in Relation to Prostate Cancer–specific Mortality Among Men with Nonmetastatic Prostate Cancer. European Urology July 2017 online bit.ly/2tXMK6Y

Instructor Showing Health Results On Clipboard To Senior Couple

Respiratory Disease and Exercise: How to help your clients not suck at exercise!

According to the World Health Organization (WHO), hundreds of millions of people suffer every day from chronic respiratory diseases (CRD).  Currently in the United States, 24.6 million people have asthma1, 15.7 million people have chronic obstructive pulmonary disease (COPD)2 while greater than 50 million people have allergic rhinitis3 and other often-underdiagnosed chronic respiratory diseases.  Respiratory diseases do not discriminate and affect people of every race, sex, and age.  While most chronic respiratory diseases are manageable and some even preventable, this is what is known about the nature of chronic respiratory diseases4:

  • Chronic disease epidemics take decades to become fully established.
  • Chronic diseases often begin in childhood.
  • Because of their slow evolution and chronic nature, chronic diseases present opportunities for prevention.
  • Many different chronic diseases may occur in the same patient (e.g. chronic respiratory diseases, cardiovascular disease and cancer).
  • The treatment of chronic diseases demands a long-term and systematic approach.
  • Care for patients with chronic diseases should be an integral part of the activities of health services, alongside care for patients with acute and infectious diseases.

Exercise and CRD

If you are a health and fitness professional, some of your clients may be suffering from a chronic respiratory disease and you may be an important source for relief.  Moderate exercise is known to improve use of oxygen, energy levels, anxiety, stress and depression, sleep, self-esteem, cardiovascular fitness, muscle strength, and shortness of breath. While it might seem odd that exercise improves breathing when one is short of breath, exercising really does help one with respiratory disease.  Exercise helps the blood circulate and helps the heart send oxygen to the rest of the body.  Exercise also strengthens the respiratory muscles which can make it easier to breathe.

Beneficial Types of Exercise

There are several challenges to exercise prescription and physical activity participation in this population, but a large body of evidence demonstrates important health benefits from aerobic exercise.  Resistance training has also been shown to increase muscle mass and strength, enhancing individuals’ ability to perform tasks of daily living and improving health-related quality of life.5

Aerobic exercise is good for the heart and lungs and allows one to use oxygen more efficiently. Walking, biking, and swimming are great examples of aerobic exercise. The guidelines are approximately the same as generally healthy individuals.  One should attempt to train the cardiorespiratory system 3-5 days a week for 30 minutes per session.  One should exercise at an intensity level of 3-4 on the Rating of Perceived Exertion Scale (Scale Rating from 0 Nothing at All-10 Very, Very, Heavy).

Resistance exercise increases muscular strength including the respiratory muscles that assist in breathing.  Resistance training usually involves weights or resistance bands but using one’s own body weight works just as well depending on the severity of the symptoms.  It is recommended that one should perform high repetitions with low weight to fatigue the muscles.  This type of resistance training also improves muscular endurance important for those with CRD.  Resistance training should be performed 2-3 days a week working all major muscle groups.

Stretching exercises relax and improve one’s flexibility.  When stretching, one should practice slow and controlled breathing.  Not only does proper breathing help to deepen the stretch, but it also helps one to increase lung capacity.  One should gently stretch all major muscles to the point of mild discomfort while holding the stretch for 15 to 30 seconds, slowly breathing in and out. Repeat each stretch 2-3 times.  Stretching is an effective method to warming up and cooling down before and after workout sessions.

When exercising, it is important to remember to inhale in preparation of the movement and exhale on the exertion phase of the movement.  An individual should take slow deep breaths and pace him/herself.  It is recommended to purse the lips while exhaling.

Use of Medication

If an individual uses medication for the treatment of respiratory disease, he/she should continue to take the medication based on his/her doctor’s advice.  His/her doctor may adjust the dosage according to the physical activity demands.  For example, the doctor may adjust the flow rate of oxygen during exercise if one is using an oxygen tank.  In addition, one should have his/her inhaler on hand in case of a need due to the increase of oxygen demand during exercise.

Fitness professionals can effectively work with those who have a chronic respiratory disease providing them with a better quality of life through movement.  You as their health and fitness coach can provide a positive experience to facilitate an effective path to better health and wellness.

Expand your Education to Work More Effectively with these Clients!

Check out CarolAnn’s 4 hour course with PTontheNet, Respiratory Disease and ExerciseThe goal of this course is to educate health and fitness professionals on how to effectively implement exercise training techniques and work with clients that suffer from various respiratory diseases to help develop strength, flexibility, balance, breathing, and improve their quality of life.  Click here to learn more about the course.


Known as the trainers’ trainer, CarolAnn has become one of the country’s leading fitness educators, authors, and national presenters. Combining a Master’s degree in Exercise Science/Health Promotion with several fitness certifications/memberships such as FiTOUR, ACSM, ACE, AFAA, and LMI, she has been actively involved in the fitness industry for over 25 years. She is currently the Founder and Director of Education for Chiseled Faith, a Faith Based Health and Fitness Program for churches. Visit her website, www.CarolAnn.Fitness

References

  1. 2015. NHIS Data; Table 3-1. www.cdc.gov/asthma/nhis/2015/table3-1.htm
  2. Mannino DM, Gagnon RC, Petty TL, Lydick E. Obstructive lung disease and low lung function in adults in the United States: data from the National Health and Nutrition Examination Survey 1988-1994. Arch Intern Med. 2000;160:1683–1689.
  3. CDC, Gateway to Health Communication and Social Marketing Practice. Allergies. https://www.cdc.gov/healthcommunication/toolstemplates/entertainmented/tips/Allergies.html
  4. World Health Organization http://www.who.int/gard/publications/chronic_respiratory_diseases.pdf
  5. Eves ND, Davidson WJ. Evidence-based risk assessment and recommendations for physical activity clearance: respiratory disease. Applied Physiology Nutrition and Metabolism. 2011;36(Suppl 1):S80–100. [PubMed]