fitness Archives - Page 20 of 30

From Primal to Bipedal: Why we need to get off the ground and walk more!

Dr. Emily Splichal/30 August 2017/ All MFN blog/

Before you start throwing stones at me assuming that I’m bashing or discrediting any of the primal movement programs out there – please hear me out. Anything I’m about to say does not mean I do not value the role primal movements and ground work has on restoring optimal movement patterns. However, where these programs fall short is that ultimately we need to GET UP and being able to navigate the world of ground and gravity. We need to be able to optimize the coordination required to load and unload impact forces, stabilize on a single leg and get from point A to point B.

When we look at the evolution of the human neuromuscular system, fascial lines and the skeleton we can see that the primary purpose behind human movement is WALKING.

From the medial rotation of the ilium creating the lateral fascial line and allowing single leg stance to the abduction of the foot’s 1st ray creating the spiral fascial line and lateral fascial line allowing the stability for a rigid lever – everything – I repeat everything favors locomotion – and we need to train the body as such.

When was the last time you walked? I mean REALLY walked?

I’ve been blessed with the opportunity to evaluate the gait of thousands of people from all over the world and there are a few key compensations that I see in too many people. So many people have lost the rotational element of gait. I’m talking locked up t-spines, restricted triplanar motion of the pelvis, tight ankles and even tighter subtalar joints.

Rotational loading and unloading of the fascial system is how we transfer impact forces and the potential energy of gait. If we lose this rotational element of gait the entire movement efficiency pattern breaks down and restrictions, compensations and connective tissue fatigue results.

So what’s causing this restriction in rotation?

Sitting, a sedentary lifestyle, driving, injury, compensation – there’s a lot of things that cause a restriction in rotation. However there is a KEY one that is missed so often and cannot be addressed through rolling, crawling and being on the ground.

This driver of restricted rotation is so important that it is what leads me to say GET OFF OF THE GROUND AND JUST WALK! What is it? Short strides!

The impact of shortened stride length!

Think of the type of walking you, your clients, your family does in a typical day. You walk around your home. You walk around the office. You walk around the store. This type of walking is not the walking EVOLUTION intended.

These small stacotic steps are insufficient to optimally 1) hydrate your fascia 2) load rotational forces in the body 3) stimulate the neuromuscular system.

To maintain an optimal gait you need to STIMULATE your gait. You need to tap into all the fascial systems with each step you take – a process that can only be achieved and a long enough stride length.

The Optimal Stride for Fascial Fitness

To better understand this let’s take a look at the point in gait in which the optimal stride is happening.

One foot is initiated heel contact with the ankle dorsiflexed, hip flexed, pelvis medially rotated and posteriorly tilted. With the foot, leg and pelvis in this position the posterior fascial line is tightened, locking the SI joint and preparing for ground contact.

Meanwhile the opposite leg is in 1st MPJ dorsiflexion ankle plantarflexion, hip extension, pelvis lateral rotation and anteriorly tilted. With the foot, leg and pelvis in this position the psoas, plantar fascia and functional fascial lines are primed to release elastic energy upon swing phase.

Now the SHORTER the stride you take you tighten your rotations of the t-spine, pelvis and foot eventually leading to fascial tightness and compensations.

Since walking is THE most functional movement we do every day with the average adult taking 5,000 – 8,000 steps per day – improper stride length is what’s f’ing up your body.

These small steps we take to our cars, around the office or at home are killing our fascial system. It is a cycle that can only be temporarily alleviated by rolling and crawling on the ground.

Imagine this. You take your client through all the rolling patterns, dynamic bodyweight movements, foam rolling – all which are so great for the body – and then they leave the session and go back to waking small steps and in insufficient stride length. They just REVERSED all the work you did.

The solution?

Walk. And I mean really walk. Put on your favorite shoes, grab your earbuds and walk. Do not go on the treadmill, I need you to walk outside. Find the pace that feeds into a momentous state. You will feel when your body has switched and is now flowing in your fascial. It is an effortless gait that is working WITH the ground and impact forces, not against it.

And then just walk.

Originally printed on the Barefoot Strong Blog. Reprinted with permission from Dr. Splichal.

Dr. Emily Splichal, Podiatrist and Human Movement Specialist, is the Founder of the Evidence Based Fitness Academy and Creator of the Barefoot Training Specialist®, Barefoot Rehab Specialist® and BARE® Workout Certifications for health and wellness professionals. With over 13 years in the fitness industry, Dr. Splichal has dedicated her medical career towards studying postural alignment and human movement as it relates to foot function and barefoot training.

The Skinny on Visceral Fat: Why Are Skinny People Dying from “Obese” Diseases, and What Can We Do About It?

Shane Caraway/24 August 2017/ All MFN blog/

Considering the near-consensus that adipose tissue is the culprit behind so many diseases, one must wonder the reason behind some obese people having no metabolic dysfunction.[1]

The real irony comes with the emergence of a new phenomenon that acknowledges and catalogues those within a healthy BMI range that find themselves at greater risk for diseases generally reserved for those considered obese.

People within the acceptable BMI range have found themselves saddled with heart disease, Type 2 Diabetes, and greater instances of certain cancers.[2] The inquisitive mind must ask why those that are considered low-risk by BMI standards exemplify the results of those considered at high-risk.

These individuals have a pattern of fat storage invisible to the naked eye and hidden deep around the organs and within the liver. Considered visceral fat, visceral adipose tissue (VAT) or intra-abdominal adipose tissue (IAAT), these skinny people are at an increased risk of metabolic diseases despite not being visibly overweight.[3] Also referred to as the thin-fat phenotype,[4] this particular population may be at increased danger of these potential diseases because the issue with visceral fat storage is not visible; it cannot be pinched, or jiggle, or seem unsightly, and so these individuals are not only unaware of the problem, but may even be resistant to the possibility since they do not manifest the outward appearances associated with these issues.

Understanding Visceral Fat

Visceral adipose tissue (VAT) is gaining increasing understanding and acceptance as an active hormone gland with dangerous, destructive potential on the endocrine system.[5] These functions allow it to partly control nutritional intake, hunger, and appetite through secretions of leptin and angiotensin, control insulin sensitivity and inflammation through tumor necrosis factor alpha (TNF-a), Interleukin-6 (IL-6), resistin, visfatin, adiponectin, and other hormones.[6] With such an impressive list, and such numerous and varied hormone functions, the vital importance of VAT’s endocrine functions becomes apparent. The ignorance or ignoring of this becomes dangerous.

What about normal adipose tissue? When examined and compared side-by-side, VAT proves itself far more dangerous. When compared to total body fat, VAT is significantly better correlated with triglycerides, systolic and diastolic blood pressure, HDL/total cholesterol ratio and its effects on glucose and insulin.[7]

Its intimate control over so many hormonal processes also places VAT in a potential death spiral. Since it acts as both a hunger controller and as a controller of insulin resistance and blood sugar through its release of leptin, resistan, visfatin, and acylation stimulating protein (ASP), visceral fat, in excess, exacerbates the very conditions that allowed it to expand. For example, a sedentary lifestyle and poor diet results in excess visceral fat accumulation. This excess visceral fat then produces excess hormones that signal the body to develop a diseased state such as Type 2 diabetes and insulin resistance. In turn, these disease states trigger their own lifestyle and dietary shifts that result in further visceral fat accumulation. And so spins the disease spiral.

VAT also plays a critical role in the secretion of endogenous growth hormone (GH). As levels of VAT increase, exogenous secretion of GH decreases.[8] As levels of GH drop, VAT increases due to a decrease in hormone-sensitive lipolysis.[9] This becomes more apparent when the use of a GH releasing hormone reverses these effects. A full series of articles is necessary to explain the myriad of potential dysfunctions caused by such endocrine disruption.

Fortunately, clinical treatment with a growth hormone releasing hormone is not necessary. VAT can be safely controlled long-term through intelligent lifestyle alterations and a properly designed training plan.

Fighting Fat With Fat

Unfortunately, there is very little information regarding effective dietary intervention to reduce VAT. However, understanding how integral VAT accumulation depends on endocrine disruption, especially that of hyperinsulinemia, one can intelligently extrapolate this outwards and hypothesize a sensible and logical dietary approach.

Since VAT accumulation depends on hyperinsulinemia and reduced exogenous GH secretion as two major components, we would want to incorporate a diet that controls blood sugar levels (and thus insulin secretion) as well overall improved endocrine function. Removing all sugar, with the notable exception of low-sugar fruits, is the first obvious step. A ketogenic diet has proven itself time and time again, clinically, to controlling hyperinsulinemia, even in those with congenital issues.[10] The ketogenic diet is also efficient at controlling blood sugar levels,[11]^,[12] and therefore insulin secretion, an excess of which similarly leads to hyperinsulinemia.

A diet that is the opposite of the Standard American Diet (appropriately abbreviated as SAD) is a good direction to go, regardless of the stance of a ketogenic approach.

Exercise Modalities to Combat Visceral Fat

When it comes to exercising with the sole intent of reducing VAT, there are a couple variables one must take into consideration to ensure maximal positive effect.

Per a meta-analysis in 2012 found that moderate or high intensity aerobic training has the highest potential to reduce VAT.[13] Note, too, that this was in the absence of caloric restriction. The type of diet otherwise pursued was not expanded on. One could wonder the potential improvement in outcomes if this same design was followed in combination with the ketogenic diet. Not surprisingly, similar results were found with strength training as well in this same meta-analysis. In this study, “moderate” was defined as >250 min.wk. Of similar importance is the studies analyzed that included greater volume defined as 45-60 minutes a day, six days a week, did not yield more positive results, suggesting a definite bell curve and potential for decrease in return for higher-volume work, an idea supported throughout this section.

This meta-analysis also implied a threshold for training intensity for VAT to be effected optimally. Unfortunately, no further evidence is described for this, other than mentioning the synergistic qualities of high-intensity training post-exercise.[14]

One must use caution with the word “aerobic”, however, as the effect of regular aerobic exercise, defined as walking and jogging at a moderate intensity on body fat is negligible.[15]^,[16] Perhaps this explains why so many people find themselves on treadmills and elliptical, performing steady-state aerobic exercise with little or no improvement.

High intensity training demands special mention here due to increased GH secretion.[17] In this same study, GH concentration was still ten times higher than baseline an hour after recovery. Harkening back to the relationship between VAT and reduced GH secretion, this method of training directly counteracts one of the most damning results of excess VAT and could single-handedly upset one of the mechanisms behind VAT accumulation.

Since Type 1 diabetics are prone to experiencing hypoglycemia after prolonged aerobic expenditure, a single 10-second sprint could help retain healthy sugar levels.[18] This opens a potential exercise prescription for a population group that otherwise would be at a higher risk. Obese women with metabolic disorder were studied under a high-intensity exercise training and low-intensity exercise training, with the HIET group showed significantly reduced abdominal fat, abdominal subcutaneous fat, and visceral fat, where no significant changes were found in either a control group or the low-intensity group.[19] The last thing a medical fitness expert wants to do is waste time with an ineffective approach.

Numerous studies also highlight the effectiveness of HIIE over steady-state aerobic exercise for reduction of adipose tissue and VAT. Tremblay et al. compared HIIE and aerobic exercise and found that the HIIE group lost more subcutaneous fat after 24 weeks than the aerobic group.[20]

Another study by Trapp et al. once again found that women in the HIIE group lost 2.5kg more subcutaneous fat than those in a steady-state aerobic program.[21]

The Slimmed-down Version

All this information implies that although VAT has numerous mechanisms to harm the body and exacerbate disease states, the appropriate modifications to training and lifestyle can help the body against it without the use of drugs. The optimal exercise prescription rests with a mixture of moderate and high-intensity training combined with intelligent diet. Thankfully, despite its horrible potential, managing visceral fat is not so difficult a task. As fitness professionals, we can utilize this information to ensure that we do not get stuck in an archaic steady-state paradigm and can better serve our clients.

Shane Caraway CHN, CPT, PTSP, uses his education, experience, and credentials as a certified personal trainer and nutritionist to help others recapture the primitive mystique, strength, and beauty that their body is capable of. His greatest pleasure comes from the successes of his clients, no matter how mundane or simple each small victory may be. Always in pursuit of various techniques, compounds, nutrients, herbs, and other means to help support the body against disease, Shane finds the challenge of combating chronic disease to be the pinnacle of his work, especially with diseases and conditions that otherwise cause clients to surrender.

References

Adipose tissue image: Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014″. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436

[1] https://www.ncbi.nlm.nih.gov/pubmed/?term=Exercise%2C+abdominal+obesity%2C+skeletal+muscle%2C+and+metabolic+risk%3A+evidence+for+a+dose+response.

[2] http://westminsterresearch.wmin.ac.uk/14274/

[3] http://westminsterresearch.wmin.ac.uk/14274/

[4] https://www.researchgate.net/publication/51618462_The_thin-fat_phenotype_and_global_metabolic_disease_risk

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3648822/

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3648822/

[7] https://www.ncbi.nlm.nih.gov/pubmed/?term=Exercise%2C+abdominal+obesity%2C+skeletal+muscle%2C+and+metabolic+risk%3A+evidence+for+a+dose+response.

[8] http://europepmc.org/articles/PMC4324360

[9] http://europepmc.org/articles/PMC4324360

[10] https://ojrd.biomedcentral.com/articles/10.1186/s13023-015-0342-6

[11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716748/

[12] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3506983/

[13] http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0056415

[14] http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0056415

[15] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2991639/?_escaped_fragment_=po=6.25000

[16] https://www.ncbi.nlm.nih.gov/pubmed/19175510

[17] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2991639/?_escaped_fragment_=po=6.25000#B1

[18] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2991639/?_escaped_fragment_=po=6.25000#B1

[19] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730190/

[20] https://www.ncbi.nlm.nih.gov/pubmed/8028502

[21] https://www.ncbi.nlm.nih.gov/pubmed/18197184

Postnatal Exercises

Zoey Miller/23 August 2017/ All MFN blog/

Exercise is recommended to keep the body strong and in proper working order. Exercise also builds and maintains healthy joints, bones and muscles. Postnatal exercises help a woman get back into shape after giving birth, and they also help combat postpartum depression. There are several basic exercises you can do within a few weeks after giving birth. However, if you’ve had a Caesarean section, you may want to wait at least six weeks before doing any abdominal exercises. If you experience pain while exercising, stop immediately and call your doctor for advice.

Walking

Walking is the most basic of exercises, and it’s a good way to begin a new workout regime. Begin by walking at a leisurely pace, and increase your pace and distance over time. Once you’re comfortable in your movements, take advantage of all those great baby registry gifts you’ve received. Put the baby in the baby carrier and push the child in front of you as you walk.

Some women enjoy walking with a friend, as it gives them time to socialize, an activity you may be neglecting while caring for your new baby. If you are a runner, avoid an intense running workout until you have spoken with your physician. Some women are discouraged from exercising strenuously in the first few weeks after giving birth, especially if they are waiting for the wound from a C-section to heal. A doctor can answer questions about your limitations.

Pelvic Tilt Exercise

The tummy is a major problem area for many women after giving birth. Thus, pelvic exercises are often helpful. The pelvic tilt exercise is easy to do and can tighten up your stomach and strengthen your back. Begin on your back on the floor with your knees bent and your feet flat against the floor. Then, flatten your back against the floor as you tighten your abs and lift your pelvis slightly off the floor. Hold this position for 10 seconds. Repeat the exercise by doing three sets of ten seconds each. Pelvic tilt exercises can be done anywhere. After you’ve finished breastfeeding and put the baby down for a nap, take a few minutes to do your exercises.

Kegel Exercises

Some people worry about finding the time to exercise. However, both pelvic tilts and Kegels can be done in a short time frame. The purpose of Kegel exercises is to strengthen the muscles in your pelvic floor. During pregnancy, the muscles of a woman’s pelvis are often weakened. This is why some women experience incontinence after childbirth. If you notice that coughing, sneezing or laughing causes you to leak small amounts of urine, then you could probably benefit from Kegel exercises.

Kegels are simple. First you must identify your pelvic floor muscles. These muscles are the ones you use when you stop yourself from urinating mid-stream. Practice stopping and starting urination while in the bathroom, but only do this once or twice to identify the proper muscles. Do not make a regular habit of contracting your muscles during urination, as this can cause bladder problems.

Once you’ve identified your pelvic floor muscles, you are prepared to do Kegels. Lie on your back and contract your muscles for five seconds, and then relax for five seconds. Do this until you can contract for ten seconds at a time. Do three sets of ten seconds 2-3 times each day. You can even do Kegels while standing up and walking around. Kegels can help those who leak a small amount of urine but probably won’t be helpful to women with a serious incontinence problem.

Forearm Planks

Planks are good exercises that target and tone your abs, thighs and butt. Planks are also a great way to strengthen your abs without straining your back and neck. Begin by lying on your stomach on the floor. Put your forearms on the floor beneath your shoulders and keep your back straight with your legs extended so that your toes touch the floor.

Then, lift your tummy from the floor so that it is parallel to the floor. Using your forearms and toes to hold your body weight, tighten your tummy and hold your abs off the floor for 30-60 seconds. Rest for 30 seconds, and then repeat the exercise 4-5 times. You can also do planks with your palms flat against the floor and your arms straight rather than placing your weight on your forearms.

Finding time to exercise after giving birth can be a challenge. Try to schedule a brisk walk several times weekly at a local park, or simply walk around your neighborhood. Any exercise is better than none at all. Kegels, pelvic tilts and planks can be done inside your home. Take a few minutes several times a day while your baby sleeps to do your exercises. It’s also a good idea to have your doctor recommend stretches and workout routines. Remember to start light, then increase your exercise intensity over time.

I’m the woman next door, with all of the problems and joys of everyday life. I know that the more I give, the more I’ll receive–so my blog is intended to help people, and hopefully, it will do good things for me too. As a working mother, I’m often faced with many practical, everyday situations that make life harder, but that shouldn’t be the case. Visit my website at thebabbleout.com

Sources
http://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/kegel-exercises/art-20045283
http://www.webmd.com/parenting/baby/6-exercises-for-new-moms#2
http://kemh.health.wa.gov.au/brochures/consumers/postnatal_exercise.pdf

Healthy Aging by the Decades: Your 50s

Nicholas Prukop/15 August 2017/ All MFN blog/

The primary question being asked in the majority of sessions for retirement planning is what you will need in terms of financial reserves to carry you through your later years. Unfortunately, this is the only model used in America and worldwide today. However, the question that you should really ponder is: “What will you do if your health fails, and how will your retirement life really be if you will no longer be able take care of myself?” An additional issue revolves around the date at which you start taking your social security benefits, but age is just a number! In reality, what if things don’t go according to plan and you don’t even make it to 70?

What healthy aging should be about

The concept of healthy aging is something that has appealed to me since I realised that at any point in time I was indeed training for the decades to come. When this dawned on me, I had to re-evaluate my own position on what aging healthfully encompasses. I am convinced that money is only part of the dilemma: if we reach our 50s and 60s with little of the health we desire, what are our realistic prospects? I have concluded that financial planning is not enough: it’s essential to be physically, emotionally, spiritually and professionally fit as well. Recently, I told a friend at the gym that I think that if people go by the common definition of retirement, namely “remaining in a state of leisure”, this will lead to an early death because people literally stop “living”.

The answer is to face the reality that we are all going to age and start preparing as carefully as we can NOW. It is much more appealing to get on with the business of training NOW rather than later when it may be too late. This thought reminds me of the oil filter ad that said: “Pay me now or pay me later” – meaning that you can replace your engine later (at a much higher cost) – or the oil filter today. Which choice would you prefer for your body? Train now or knee replacement later?

What I learned from my 50s

The decade of our 50s is when we start to “show our age”. This is the time when all our bad choices and lifestyle habits catch up with us. The truth is that playing catch up with our health is never a good option and if we prepare now rather than later we can be way ahead of the curve.

When I was in my early 50s, I realized my goal of running a combined 3000 plus miles (3675 to be exact in 1998 and 1999). That record stood until looking back on those two years I made the decision to break 4000 miles in a combined two year span so in 2011, at the age of almost 65, I started my “run” to a new two year record and finished 2011 with a total of 1955 miles. 2012 was in my sights now as a potential record breaker, so as I worked hard toward my new goal, I remained positive that I could make it past 2000 miles. I ended up with an all time record of 2145 miles and a grand total of 4150 miles. I was elated and found courage in setting a goal that had pushed me beyond previous boundaries and out of long held comfort zones.

This was possible because of my record keeping discipline over the years and the fact that I decided to break a record that had been set 12 years before. I share this example with you as a way of demonstrating that we are never old until we decide we are – and to illustrate how the succeeding decade can be influenced by something we did in the preceding one. I am planning for my 70s now based upon the foundation I laid in the previous decades of my life. I am approaching this new decade with the same thought and care that went into my 50s and 60s. Now, I feel a strong desire to maintain what I have achieved in terms of fitness, instead of going backwards and lose what I have gained.

Being driven to accomplish something meaningful is important to living a healthy and fit life. I found my work with my clients rewarding in my 50s. I believe I shared with them the best that was truly me. My 50s were a decade of growth for me. Some of my clients encouraged me to write about my training philosophy. They supported me because they believed in me and what I had been doing to serve and guide them to achieving their goals. They were responsive to my coaching and I in turn loved being with them and seeing them grow and evolve mentally and phsically. My view of life expanded greatly during my 50s. I found my stride – and witnessed becoming happier and more fulfilled than I had been in years.

In my 50s, my world was far from being perfect, but it was filled with love and support from those I cared about and served. My daughter and I grew closer during this decade while she was living a life of adventure and success. The foundation for who I wanted to be – and become – in my 50s had been laid in the previous two decades. I am grateful for my 50s because I fulfilled part of the promise I had shown as a child on Maui: I had become a good man with a kind heart and most importantly open minded. I loved learning and exploring again – just as I had done all those years before in Hawaii. This sense of progression and continuation at the same time, gave me a feeling I was being true to myself, which is the only key to happiness and wellbeing.

Some suggestions for your 50s

Continue to refine your plan for fitness activities and stick to it. Make changes sparingly and take one step at a time.
Be patient and loving toward yourself.
Eat well, sleep well, manage your stress levels and meditate (think consciously) every day.
Make choices that FEEL right to you. Don’t live for others, but find your own “center”.
Be attached to learning about yourself and accepting yourself just as you are – and as you are not.
Practice being grateful and have an attitude of acceptance and forgiveness. These two traits will carry you far.
Make an effort to reach out for help.
Don’t rely on the internet for your answers.
Stay current on issues that are of importance to you and be willing to say to yourself “I don’t know but I am willing to learn.” No one is an expert on everything – especially when it comes to life. Don’t hold yourself to that standard. Become an authority on yourself and the rest will take care of itself.
Be a student of your own life and an expert on becoming who you want to be – and let the rest go!

I will cover the 60’s and beyond in the final part of this series being fully aware that I have only “scratched the surface” of this examination and exploration of “training for the decades ahead”!

Originally printed on HealthyNewAge.com. 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.

Exercise for Osteoporosis

Jane Curth/14 August 2017/ All MFN blog/

There are many conditions for which exercise can help. Osteoporosis is one such condition, but due to its nature, there are some important factors to consider when putting together an exercise regimen.

Exercise to Decrease Inflammation and Risk of Basal Cell Carcinoma

Robyn Kade/11 August 2017/ All MFN blog/

Exercise is important in keeping the mind/body healthy for many reasons. Individuals, with Rosacea, however, must be careful not to cause permanent inflammation of the skin. Inflammation from this condition may be linked to Basal Cell Carcinoma.

Electronic bathroom scale and glucometer with result of measurem

Going Beyond Diabetes Treatment: Exercise!

Jeremy Kring/10 August 2017/ All MFN blog/

There are many treatments for Type II Diabetes (which will be referred to simply as diabetes in this article) but none come with the level of benefits seen by the implementation of a proper exercise program. This is a tall order but exercise is effective for the treatment of insulin resistance and diabetes in three areas. These areas are inflammation, the cell mitochondria (where the cell generates power), and hyperinsulinemia (high blood insulin).² Treating these areas with exercise goes beyond the benefits of treating just diabetes. In turn, you will be helping prevent other health issues associated with diabetes such as heart disease, stroke, and circulation issues. The questions is how does exercise do this and what kind of exercise is necessary?¹

To understand how exercise treats diabetes, it is important to understand that diabetes is the end result of insulin resistance. Insulin resistance can be illustrated in that: when we eat something with carbohydrates or sugar, our body breaks it down into blood sugar known as glucose. This glucose triggers a response from our pancreas to produce the hormone insulin. Insulin in turn shuttles the blood sugar into the cells to be used as energy. However, when someone becomes insulin resistant the cells do not respond to the insulin’s attempt to shuttle the blood sugar into the cell, so the pancreas produces more insulin to get the same job done. In essence, the cells are developing a tolerance to the insulin and in order to get the blood sugar absorbed the cells begin to require more and more insulin to do the same job. This leads to the blood retaining the blood sugar for prolonged periods of time as well as an elevated presence of insulin. When someone has prolonged high blood sugar, we call this hyperglycemia and the person is said to be diabetic. Having high blood sugar is dangerous due to the stress it places on cells. It can cause many problems up to and including death.

In the area of inflammation, it is known that not all inflammation is the same. Inflammation can be acute — meaning it is brought on for a short period of time — which happens with activities such as exercise or when tissue undergoes some sort of trauma. Inflammation can also be chronic, meaning it is persistent and recurrent.

Acute inflammation is necessary, and healthy, because it begins the healing and repair process by bringing in white blood cells, and ridding the tissue of damaged cells. Inflammation is required otherwise the body would be unable to heal.

Chronic inflammation can be found in many conditions, such as autoimmune diseases, prolonged injury/infection, obesity, diabetes and other chronic diseases. When inflammation remains present, even at a low level, it begins to damage the body’s cells. Science now knows that:²

Obesity creates a level of chronic inflammation.
Inflammation is the precursor to every chronic disease including heart disease, arthritis, and cancer.
Inflammation suppresses the insulin signaling pathway (how insulin and your cells communicate) which is believed to be related to a reduction of a heat shock protein, this protein however, can be increased through exercise.
- Increases of the protein begin after the first session of exercise.³

You may remember from science class the power generator of the cell is the mitochondria. This is where the energy is created from fatty acids and glucose. It is now believed that when the mitochondria of the cell becomes dysfunctional, less fatty acids are taken in, elevating fat (lipids) in the blood, and increasing fat storage. It is also believed that the cell becomes dysfunctional as a result of insulin resistance. This relationship may then further feed into the increased body fat and increased inflammation. Further scientific studies in this area have determined that:

Proper exercise increases mitochondrial efficiency, proper exercise being summarized as:
- No less than 150 minutes of moderate activity per week but ideally more than 250 (start light and increase intensity).
- Incorporate a combination of resistance exercise (i.e. calisthenics and weights) and cardiovascular exercise.
- Supervision by a registered clinical exercise physiologist if two or more chronic conditions are present is recommended.⁴
- Exercising following an interval training protocol ranging from 70-90% of maximal heart rate may provide superior results if tolerable by participant.⁵
It is well known that aerobic training increases the number of mitochondria in muscle fibers in order to increase the delivery of oxygen to the muscle. More mitochondria means more energy that can be generated within the cell.

Hyperinsulinemia is best described as an elevated level of insulin relative to the amount of glucose (blood sugar) present in the blood. This may be the truest indicator of someone who is insulin resistant and about to become diabetic.⁶ In the beginning, it was illustrated how insulin resistance develops, and it being characterized as requiring more insulin to do the same job. This additional insulin is the definition of hyperinsulinemia. When someone has hyperinsulinemia it can be expected that in a matter of time, even higher levels of insulin will be required as the cell increases its tolerance to the insulin. Eventually the pancreas will not be able to produce the level of insulin required to lower blood sugar and the person will be said to have hyperglycemia, and will be classified as diabetic. When someone is experiencing hyperinsulinemia, they are already experiencing inflammation, and a weakening of the insulin signaling pathway (ways the cells communication for glucose uptake), and likely a dysfunction of the mitochondria, which in turn may magnify the issue further.

What is known is:

Exercise lowers glucose in the presence of insulin, and thus exercise will lower both glucose and insulin levels.
If you’re currently diabetic and taking insulin, the amount may likely need reduced prior to exercise.
Consistent proper exercise may lead to the need to have a physician re-evaluate dosage or usage of insulin and/or pills (i.e. metformin). Never discontinue use of a medicine without consulting with your physician.

Proper exercise not only goes beyond the treatment of diabetes to the treatment of the cause (insulin resistance), it helps prevent other health issues that stem from diabetes. Health issues such as cardiovascular disease, stroke, and issues with circulation dramatically decrease with exercise. Also, remember diabetes aside exercise reduces risk of nearly every chronic disease.¹

Jeremy Kring holds a Master’s degree in Exercise Science from the California University of Pennsylvania, and a Bachelor’s degree from Duquesne University. He is a college instructor where he teaches the science of exercise and personal training. He is a certified and practicing personal/fitness trainer, and got his start in the field of fitness training in the United States Marine Corps in 1998. You can visit his website at jumping-jacs.com

References

Booth, F. W., Roberts, C. K., & Laye, M. J. (2012). Lack of exercise is a major cause of chronic diseases. Comprehensive Physiology, 2(2), 1143–1211. http://doi.org/10.1002/cphy.c110025
Ye, J. (2013). Mechanisms of insulin resistance in obesity. Frontiers of Medicine, 7(1), 14–24. http://doi.org/10.1007/s11684-013-0262-6
Matos, M. A. de, Ottone, V. de O., Duarte, T. C., Sampaio, P. F. da M., Costa, K. B., Fonseca, C. A., … Amorim, F. T. (2014). Exercise reduces cellular stress related to skeletal muscle insulin resistance. Cell Stress & Chaperones, 19(2), 263–270. http://doi.org/10.1007/s12192-013-0453-8
Moore, G. E., Durstine, J.L., & Painter, P. (2016). ACSM’s exercise management for personals with chronic diseases and disabilities. Champaign, IL: Human Kinetics.
Roberts, C. K., Hevener, A. L., & Barnard, R. J. (2013). Metabolic Syndrome and Insulin Resistance: Underlying Causes and Modification by Exercise Training. Comprehensive Physiology, 3(1), 1–58. http://doi.org/10.1002/cphy.c110062
Paniagua, J. A. (2016). Nutrition, insulin resistance and dysfunctional adipose tissue determine the different components of metabolic syndrome. World Journal of Diabetes, 7(19), 483–514. http://doi.org/10.4239/wjd.v7.i19.483

Pregnant woman using exercise bike at the gym

Benefits of Low Impact Exercise During and After Pregnancy

Richa Jauhari/9 August 2017/ All MFN blog/

Pregnancy can be a joyous time for women and it is also a period where the body experiences many significant changes. Since exercise can be beneficial to the mother in managing stress and staying healthy, it is important to for every pregnant woman to get clearance from their physician for both starting a new exercise program and/or maintaining her existing one.

Before becoming pregnant, I led a healthy and active lifestyle and continued to teach classes until I was ready to deliver. During the first trimester I had to change all strenuous workouts to low-impact workouts with lots of self-care such as taking frequent breaks to hydrate. This article can help women in all stages of pregnancy assess value of low-impact exercise during pregnancy and postpartum.

What is low impact exercise? Low impact (LI) basically means maintaining movement with one foot always on the floor. We do this when we are walking, doing yoga, dancing and strength training.¹ Low impact exercises have several benefits such as maintaining healthier joints, weight and heart.

Benefits of Exercise During Pregnancy

A combination of low impact dance classes, strength training and stretching during pregnancy helped me maintain my sense of self and self-esteem as my body changed drastically both anatomically and physiologically. There are several documented benefits of exercise during pregnancy including: improved circulation, sleep, digestion, as well as muscle tone to support joints, increased energy and endurance; improved body image and self-esteem.²

ACOG recommends that pregnant women get at least 150 minutes of moderate-intensity aerobic activity weekly. Moderate intensity means that you are moving enough to raise your heart rate and sweat and you can talk normally, but you cannot sing.³ If you are new to exercise it might seem daunting to get a 20 minute work out every day, but you can start out slowly and gradually increase your activity. For example, you can start with 5 minutes a day and add 5 minutes each week until you can stay active for 20-30 minutes a day. If you were very active before pregnancy, you can continue doing the same workouts until the third trimester, when a logical reduction in activity is recommended.²

Regardless of fitness level, one commonality between pregnant women is the release of Relaxin, the hormone that is responsible for softening the ligaments and joints during pregnancy and childbirth. Having relaxin in the joints can lead to wobbly, unstable joints and a loose pelvis so women should take extra precaution while choosing or continuing a fitness regimen.⁴

Examples of some exercises that you can do safely while you are pregnant are walking, water workouts, stationary bicycling, yoga and Pilates. Walking is a good option for many pregnant women because it is easy on the joints and muscles and it also gives a total body workout. If however you have low back pain you might consider wearing a pregnancy support belt and/or water workouts to reduce stress on the back. The water supports your weight so you avoid injury and muscle strain. For those who like bicycling and want to continue, stationary bicycling is a great alternative to avoid falls. Modified yoga and Pilates are great for reducing stress, improving flexibility, and focused breathing. Keep in mind that balance poses/exercises can be challenging due to a shift in the center of gravity caused by a growing belly, so it is okay to modify to accommodate this change. Pregnant women should also avoid poses that require them to be still or lie on their back for long periods.³

Benefits of Exercise After Pregnancy

The postpartum experience is different for every woman both emotionally and physically. My postpartum experience brought a mild-depression and weight-gain due to nursing (yes, many women gain weight during early nursing). Like many women, I waited 8 weeks before starting an exercise routine (most women are given a time period of 6-8 weeks for healing). Getting back to exercise helped me gain a sense of control over my body and helped cope with depressive episodes. According to ACOG, exercising after your baby is born may help improve mood and can help you lose the extra pounds that you may have gained during pregnancy.³ Additional benefits of exercise for postpartum women are that it helps strengthen abdominal muscles, can regulate energy level, can promote better sleep and relieve stress.³

Like the exercise guidelines during pregnancy, ACOG suggests that the duration of exercise for postpartum women, after physician approval, is at least 150 minutes of moderate-intensity. Working out after having a baby is different for every woman and it is a good idea to go at your own pace, listen to your body and gradually increase intensity. A key point to remember is that since relaxin can stay in the body for up to six months postpartum,⁴ it’s a good idea to choose a workout that is not too jerky in movement and stretching is controlled. Doing a good warm up prior to the workout and a good cool down after the workout are essential. ACOG suggests aiming to stay active for 20–30 minutes a day and trying simple postpartum exercises that help strengthen major muscle groups, including abdominal and back muscles. It is also a good idea to prepare for your workout by wearing clothing that will keep you cool and wear a high-support bra. Hydration is key, and it is okay to take water breaks as you need during your workout. For those mothers who are breastfeeding, it will be important for you to either nurse your baby or express your milk prior to working out to avoid the discomfort of engorged breasts.

Although the pregnancy and postpartum experience is different for every woman, and each stage of pregnancy brings unique challenges, maintaining a low-impact exercise program can be very helpful to the mother in managing stress and staying healthy.

Richa Jauhari is a fitness instructor, personal trainer and proud new mother based in Los Angeles. She has a passion for seeing individuals strive for their best and achieve their goals. Her personal weight loss experiences, pregnancy journey and working with senior populations have helped her understand the value of believing in oneself, balance, healthy eating and regular exercise. Visit her website at richajfit.wixsite.com/richaj

References

Schwecherl, Laura. “21 Low-Impact Workouts That Are More Effective Than You Think.” Greatist. Greatist, 27 Mar. 2017. Web. 15 June 2017. <https://greatist.com/fitness/take-it-easy-21-unexpected-low-impact-workouts>.
Yoke, Mary M., and Laura A. Gladwin. “Special Populations.” Personal Fitness Training: Theory & Practice. Sherman Oaks, CA: Aerobics and Fitness Association of America, 2010. 320. Print.
“Women’s Health Care Physicians.” Exercise During Pregnancy – ACOG. The American College of Obstetricians & Gynecologists, May 2016. Web. 2 July 2017. <https://www.acog.org/Patients/FAQs/Exercise-During-Pregnancy>.
Flashenberg, Debra. “8 Steps to Easing Back into a Fitness Routine After Birth.” Fit Pregnancy and Baby. Fit Pregnancy and Baby, 03 Apr. 2017. Web. 10 May 2017. <https://www.fitpregnancy.com/exercise/postnatal-workouts/8-steps-easing-back-fitness-routine-after-birth>.

Health-Related Fitness and Parkinson’s Disease

Carisa Campanella/7 August 2017/ All MFN blog/

When people hear the words “Parkinson’s disease”, they don’t often think of health-related fitness as a simultaneous condition. However, many people with Parkinson’s are in fact very physically fit! As a Care Advisor for Neuro Challenge Foundation for Parkinson’s, I have met Parkinson’s sufferers and Parkinson’s fighters. The fighters know very well the benefits of exercise and strive to maintain their health and fitness to the best of their ability despite the challenges they face.

Parkinson’s disease is a neurodegenerative disease that is marked by tremors, slowness of movement, stiffness of muscles, and unsteady balance. Dr. Dean Sutherland, Director of the Southeastern Center for Parkinson Disease states that “exercise is as important as anything you can do for Parkinson’s.” How can you become a Parkinson’s fighter? The first step is to understand the five components of health-related fitness and how they affect functionality.

The first component is maintaining a healthy body composition. What does this mean? Your weight should be appropriate to your height and you should strive to have more lean muscle mass than fat mass in your body. You can find out your body mass index by going to the Center for Disease Control’s website and accessing their BMI calculator. Excessive fat in the body can result in loss of muscle mass, and muscle is something people with Parkinson’s should strive to maintain.

The second aspect of health-related fitness is muscular strength. Having strong muscles improves posture, decreases the risk of musculoskeletal injuries, improves balance and decreases the risk of osteoporosis. Muscular strength helps people with Parkinson’s maintain independence.

The third component important for health-related fitness is muscular endurance; or the ability of a muscle or group of muscles to work repeatedly over a period of time. An example of muscular endurance would be the ability of the leg muscles to ride a stationary bike for 30 minutes. People with Parkinson’s will experience better posture and stability if they are able to sustain muscular endurance. They will also be able to have more fun doing recreational activities!

Fourth, health-related fitness is greatly enhanced by good cardiorespiratory functioning. This is the ability of the heart, blood vessels and the lungs to work effectively together to deliver oxygen to all the cells and muscles in the human body. Activities of daily living are more easily performed with strong cardiorespiratory fitness, and cognitive functioning is enhanced as well.

Finally, the fifth component of health related fitness is flexibility, or the ability of joints to move through a full range of motion. People with Parkinson’s who maintain good flexibility experience enhanced postural stability and balance, and are less like to fall. Being flexible also makes it much easier to perform simple tasks like bending over to tie your shoes, pull a shirt on over your head, or swing a golf club.

It’s never too late to begin a program towards improving your health-related fitness. Your body is designed to last a lifetime, and you can help influence how well it performs for you. Always get a physician’s clearance before beginning an exercise program and if you are new to exercise, enlist the supervision of a certified fitness professional.

Carisa Campanella, BA, AS, is an ACE Health Coach and ACSM Personal Trainer. She is the Program Manager at the Neuro Challenge Foundation for Parkinson’s. Neuro Challenge provides ongoing monthly support groups and educational programs, individualized care advising and community resource referrals to help empower people with Parkinson’s and their caregivers.