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Senior-Fall-Prevention

After a fall, would you make it back up? Moves for Functional Fitness

/8 July 2021/ All MFN blog/

The primary reason we move to a long-term care facility is not an illness but dependence on others due to physical weakness. Deconditioned seniors have the greatest potential to improve functional strength. With practice, you can develop muscles to recover from a fall. Fear only increases our risk.

A Recovery

Imagine you fell. Take deep breaths. Do toes and fingers move? Where is the phone? If it’s not close, you roll, drag, crab walk or crawl. Once near a chair or low table:

  1. Roll onto your belly. Rest.
  2. Raise onto forearms and knees. Rest.
  3. Aim your buttocks toward the chair. Rest.
  4. Press up to hands and feet. Rest.
  5. Go backwards to the chair. 
  6. Back your hips onto the chair. Rest.

The 10 Moves

Hopefully, you never fall, but practiced weekly, these exercises can improve strength and stamina for moving in bed, sitting up and life. Do these on your bed. Have a friend nearby. Start with one exercise 1-3 days a week for 1-3 weeks. Then add on. To gain more, try them under the weight of your covers. Listed in progression: 

  1. Practice rolling. Lie sideways across the bed; feet hanging off. Exhale away from the bed. The exhale stabilizes your low back and releases pressure on the heart. Face up, roll to each side. Rest. Repeat 10 times. Roll from face down to your sides. Rest. Repeat. Roll from the foot of the bed to head of the bed. Rest. Repeat 10 times. Avoid rolling from edge to edge on the bed. 
  2. Lie on your side; place your upper hand on the bed. Exhale- push on your lower elbow and top hand to lift shoulders and head up. Rest. Repeat 10 times. Switch sides.
  3. With no pillow, lie on your back to lift your hips. Exhale before and during the lift. Rest. Repeat, but stay up for a count of 5. Do not hold your breath! For low back issues, try it with one leg straight. Rest. Alternate. Repeat.
  4. Lie on your side with a head pillow. Keep head, shoulders and knees down; lift your hips with an exhale. Rest. Repeat. Stay up for a count of 3. Switch sides. Try it up, on one elbow. Rise out of the shoulder. Press into your upper hand too.
  5. Practice scooting: Lie face up. Exhale- lift your hips, shift them to one side, lower hips. Then lift to return to center. Repeat, alternating sides. Try scooting twice to each side, adding your upper body to travel. Stay on the bed!
  6. Crawl onto the bed on all fours. Engage your abdominals for support. Practice staying on forearms and knees. Rest. Repeat, adding a few seconds. Practice on hands if your wrists allow. Rest. Repeat.
  7. Crawl onto your bed from the foot of the bed. Crawl to the headboard. Crawl backward. To practice crawling sideways, enter the bed from the side. No slippery bedspreads!
  8. Drag your hips or crab walk on forearms or hands. Use deep breathing to move. Rest often. Use your glutes. Stay aware of your location on the bed.
  9. Standing with back of legs touching a chair, walk hands down the legs and back up to standing. Sit to rest. Repeat. Stop if dizzy. From a fall, standing is not a goal, but prepares us for the next move.
  10. When you feel ready to walk on all fours on the floor, stay near a couch or low table. Look behind to go backward. Sit to rest. Repeat. 

Please Note

Do whatever you can. Many of us feel dizzy or have joint limitations that affect performance. The biggest mistake is to quit, because of temporary discomfort or lack of confidence. With consistent practice, discomfort typically lessens.

Another way to recover from a fall involves kneeling to a lunge position next to a chair. This works for able-bodied seniors. Find what is best for you. Every week, practice your weakest steps until you gain confidence.

As an ACE-certified Medical Exercise Specialist with decades of experience training fragile to fit seniors, Emma Spanda Johnson designs adaptive exercise programs, for clients of all abilities. She is a nationally certified personal trainer with an Orthopedic Specialty. Emma offers virtual training sessions, visit her MedFit Network profile for details.

 

References and Resources

Smiling elderly woman training in a group

It’s time to play!

/7 July 2021/ All MFN blog/

I had just returned home from an amazing educational conference in Arizona. Some of the most educated and credentialed humans in the fitness world had come together to share and learn the most up-to-date and evidenced-based systems in the fitness world. My thoughts felt like a bag of ping pong balls had been dropped, bouncing in many directions at once.

I was getting out of my car on the way to get groceries. All the lessons, lectures, and workouts swirling in my mind. I was looking for a common thread. What was the connection to all that I have learned?  Then, I hear this clippity clack clippity clack! I look over my shoulder in the parking lot of a Publix. There was this young girl holding her mother’s hand. She had her princess outfit on, crooked crown, fake jewels and plastic shoes. The shoes skipping on the pavement was the clippity clack sound that made me look. I giggled at the difference between mom’s face, stress, deep thought and worry, and the young girl’s free and happy smile. Then I see them in the store. The young princess was leaping from colored tile to colored tile. I could see the imaginary moat she might be trying to cross while being chased by the creatures below.

I flashback to a seminar and one of the drills I just experienced with Master Instructor, Andy Hainey. Bounding in multiple planes of motion to challenge the athlete’s ability to accelerate and decelerate force efficiently. This beautiful happy princess was naturally doing some of the most advanced programming I flew thousands of miles to study.

BOOM! It hit me. PLAY…. she was PLAYING! The sessions and lessons that shone brightest and stayed with me from the workshops, were those that felt like play. They were technical and evidence-based, and they were fun! No one used jargon or spoke of the sagittal plane or the eccentric phase.  They made it fun.

Benefits of Incorporating “Play” into Your Programming for All Ages

The are many studies of the benefits of play and physical relation between activity in youth populations. The evidence shows a positive relation between physically active youth, and seven areas of cognitive performance (perceptual skills, intelligence quotient, achievement, verbal tests, mathematics tests, developmental level/ academic readiness, and other). Sibley et al., 2003

Playing increases enjoyment and adherence at all ages. It creates a positive reaffirming cycle of success. The more you enjoy something, the more time spent doing it. The more time spent doing an activity, the more skilled you become. The greater the skill level you achieve or the higher the achievement, the more you will enjoy doing the activity. 

We forget what it was like to play as we age with all the responsibilities and stresses we have We are told to put childish things aside. As a “fitness professional” we are blessed to keep playing in many senses of the word. I have spent many hours of my life educating myself and gaining certifications. While I believe that time has been well spent, my clients continually tell me their favorite aspect of our time together is the fun factor.  

Many feel as though they haven’t repeated a workout ever. This is not the case. I do follow the NASM OPT model. It is a progressive system that can be applied to every aspect of fitness training. Our body has a miraculous ability to adapt to specific demands placed on it. That is my primary guide to programming for my clients. Once we establish their baseline abilities through comprehensive assessments, and what goals they want. Then we create the program based on the S.A.I.D. principle (Specific Adaptation to Imposed Demands). The assessments many times feel intimidating and clinical and set that as the tone for you and your client.  If we as trainers and coaches make the assessments fun and non-intimidating games (I use the term drills in place of games for my adults many times) or play, we can start creating a positive nurturing environment for our clients.  Don’t just show them where they are deficient. Let them show and celebrate what they are capable of.

Bottom line is, have fun and play! You will enjoy every session. Your clients will look forward to each session. They will give their all and get better results.  Keeping clients training is one of the most challenging parts of what we do.  Embrace your inner child, and theirs. Get them to hop from stone to stone in monster infested waters or bring out the agility ladder. Either way just play!

Coach Pete Guzman is a NASM Master Trainer with CES, PES, YES, CNC, SGPT MMACS and 4th degree Black Belt. Look for his upcoming seminar in June to find out more about youth programming and adding fun to your clients’ journeys.

Dont-panic

Pandemic of Panic Is Worse than COVID-19

/29 June 2021/ All MFN blog/

While the threat of the COVID-19 needs to be taken with great concern, it is as important to understand the useless and counterproductive effects of panicking. Whether you take the vaccine or not, prevention is the best approach to any viral challenge. Panic is an extreme fear response triggering stress hormones that suppress immune function increasing susceptibility to any pathogen, including viruses.

plant-protein

Eat Plant Protein to Live Longer

/28 June 2021/ All MFN blog/

Scientific research continues to show consuming red and processed meats or a high-animal protein diet has a profoundly damaging effect on overall health and longevity. It is vitally important that red meat in our diet should be replaced (or at least greatly limited) in favor of foods that are proven to offer protection against cancer – such as green vegetables, berries, beans, nuts and seeds. This should not be seen as controversial and is supported by an overwhelming amount of data. 

Long-term studies

Large, long-term studies investigating intakes of animal and plant protein with regard to mortality have consistently concluded that more plant protein and less animal protein is linked to a longer life. (1-4) Studies consistently link greater red meat consumption to a greater risk of premature death. (5-7)

Here’s an example:

A 2016 study published in JAMA Internal Medicine investigated the relationship between animal vs. plant protein sources and mortality risk from almost 30 years of follow-up from the Nurses’ Health Study and Health Professionals Follow-up Study. Together, these two studies included over 170,000 participants.

Interesting findings came out of one particular question the researchers asked: What would happen if the participants replaced some of their animal protein with plant protein?

They analyzed the data to estimate how participants’ risk of death from all causes over the follow-up period would change if some of the animal protein sources (equivalent to 3 percent of total daily calories) were replaced with plant protein sources:

  • Replace processed red meat: 34 percent decrease in risk
  • Replace unprocessed red meat: 12 percent decrease in risk
  • Replace poultry: 6 percent decrease in risk
  • Replace fish: 6 percent decrease in risk
  • Replace eggs: 19 percent decrease in risk
  • Replace dairy: 8 percent decrease in risk3

Higher intake of plant protein sources is associated with better health: for example, seeds and nuts reduce the risk of cardiovascular disease and are linked to longevity, and micronutrient and fiber-rich beans are linked to improved blood pressure, LDL cholesterol, body weight, insulin sensitivity and enhanced lifespan. (4, 8-13)

Prospective cohort studies are observational and cannot prove causality, but these studies are crucial to our understanding of health and longevity, because heart disease and cancer – our two biggest killers – develop over the course of multiple decades, not just a few months. Studies that follow tens of thousands of people for 10 or 20 years or more, and evaluate hard endpoints (death, heart attack, stroke, cancer, etc.) provide valuable insights into the habits that may promote or prevent these diseases. The significance of findings from observational studies is supported by laboratory studies showing there are plausible mechanisms for the association – good reasons why it’s not just a random correlation, but likely a causal relationship.

Many meat-centered diet proponents dismiss these important studies out of hand, ignoring the careful collection of data and complex mathematical analysis by skilled epidemiologists that control for potential confounding factors and detect potentially significant associations. 

The correlations between animal protein intake and all-cause mortality in long-term prospective studies are consistent with other observational studies on specific diseases, and are backed up by laboratory studies that have uncovered the plausible cellular and molecular mechanisms behind the correlations:

  • High animal protein intake excessively elevates insulin-like growth factor 1 (IGF-1), which promotes cancer development. (14-18) 
  • Research on nutrient-sensing pathways that respond to protein intake suggests reducing essential amino acid intake (i.e. reducing animal protein) promotes longevity. (19) (Note that the elderly require more protein than younger adults. (20, 21))
  • The pro-inflammatory effects of dietary saturated animal fats. (22-25)
  • The pro-oxidant and pro-inflammatory properties of excess heme iron. (26, 27)
  • Cooking-produced carcinogens in meats, such as heterocyclic amines and polycyclic aromatic hydrocarbons. (28-31)
  • Genotoxic N-nitroso compounds produced from processed meats. (30-33)
  • Detrimental effects of carnitine and choline on the gut microbiome that promote inflammation. (34-37)

Although eating a keto or carnivores’ diet can lower blood sugar and promote weight loss in the short term, the long-term effects of a diet so high in animal products (according to the preponderance of evidence) is damaging over the long term. That is why I reiterated that it is important to see the long-term studies with hard endpoints. Looking at short-term weight loss studies will lead you on a path to damage your potential for optimal longevity.

Although the disease-promoting effects take many years to build up, several short-term studies point to the beginnings of the damage of a high-animal product diet:

  • Measured after a single meal, butter impaired vascular function compared to nuts and other predominantly unsaturated plant fats. (38)
  • A study comparing Atkins, South Beach, and Ornish weight maintenance diets (all with the same calorie counts) assigned participants to each diet for four weeks each. At the end of the Atkins diet phase, LDL cholesterol was higher and vascular function lower compared to the other diets. (39) 
  • Participants (who lived at the study site during the study) were fed 420 g red meat or a vegetarian meal daily for 15 days, with the rest of their diets kept exactly the same. Stool samples and colon cells collected after 10 days on each diet showed an increase in production of carcinogenic N-nitroso compounds during the red meat diet compared to the vegetarian diet, and an increase in N-nitroso compounds binding to DNA in colon cells (which leads to DNA damage and colon cancer). (40)
  • A study comparing about two servings daily of fiber-rich whole grains to red meat for three weeks each suggested the whole grain diet improved gut microbiome diversity compared to the red meat diet. Body fat mass was also lower after the whole grain intervention. (41)
  • After four weeks, a diet containing red meat increased production of the pro-inflammatory compound TMAO, compared to white meat and vegetarian diets. (36)

Meat-heavy diets get one important thing right: They cut out weight gain-promoting, disease-promoting high-glycemic refined carbohydrates. But large amounts of animal products are unquestionably disease-promoting, too.  The Nutritarian diet does more than just restrict one type of harmful food. It limits or completely avoids all other disease-promoting foods and focuses heavily on foods that are richest in protective nutrients and are linked in scientific studies most consistently to a lower risk of cardiovascular disease, cancer, and other chronic diseases.

 

Joel Fuhrman, MD is a board-certified family physician specializing in nutritional medicine. He is President of the Nutritional Research Foundation and the author of 7 New York Times bestselling books, including his most recent book, “Eat to Live”. Visit his website, DrFuhrman.com.

👉👉Get $10 off $150 or more on Dr. Fuhrman’s website. Use coupon LS10OFF150.

Originally posted on DrFuhrman.com. Reprinted with permission.

References

  1. Budhathoki S, Sawada N, Iwasaki M, et al. Association of Animal and Plant Protein Intake With All-Cause and Cause-Specific Mortality. JAMA Intern Med 2019. doi: 10.1001/jamainternmed.2019.2806
  2. Huang J, Liao LM, Weinstein SJ, et al. Association Between Plant and Animal Protein Intake and Overall and Cause-Specific Mortality. JAMA Intern Med 2020. doi: 10.1001/jamainternmed.2020.2790
  3. Song M, Fung TT, Hu FB, et al. Association of Animal and Plant Protein Intake With All-Cause and Cause-Specific Mortality. JAMA Intern Med 2016, 176:1453-1463. doi: 10.1001/jamainternmed.2016.4182
  4. Tharrey M, Mariotti F, Mashchak A, et al. Patterns of plant and animal protein intake are strongly associated with cardiovascular mortality: the Adventist Health Study-2 cohort. Int J Epidemiol 2018. doi: 10.1093/ije/dyy030
  5. Wang X, Lin X, Ouyang YY, et al. Red and processed meat consumption and mortality: dose-response meta-analysis of prospective cohort studies. Public Health Nutr 2016, 19:893-905. doi: 10.1017/S1368980015002062
  6. Pan A, Sun Q, Bernstein AM, et al. Red Meat Consumption and Mortality: Results From 2 Prospective Cohort Studies. Arch Intern Med 2012. doi: 10.1001/archinternmed.2011.2287
  7. Sinha R, Cross AJ, Graubard BI, et al. Meat intake and mortality: a prospective study of over half a million people. Arch Intern Med 2009, 169:562-571. doi: 169/6/562 [pii] 10.1001/archinternmed.2009.6
  8. Grosso G, Yang J, Marventano S, et al. Nut consumption on all-cause, cardiovascular, and cancer mortality risk: a systematic review and meta-analysis of epidemiologic studies. Am J Clin Nutr 2015, 101:783-793. doi: 10.3945/ajcn.114.099515
  9. Jenkins DJ, Kendall CW, Augustin LS, et al. Effect of legumes as part of a low glycemic index diet on glycemic control and cardiovascular risk factors in type 2 diabetes mellitus: a randomized controlled trial. Arch Intern Med 2012, 172:1653-1660. doi: 10.1001/2013.jamainternmed.70
  10. Bazzano LA, Thompson AM, Tees MT, et al. Non-soy legume consumption lowers cholesterol levels: a meta-analysis of randomized controlled trials. Nutrition, metabolism, and cardiovascular diseases : NMCD 2011, 21:94-103. doi: 10.1016/j.numecd.2009.08.012
  11. Papanikolaou Y, Fulgoni VL, 3rd. Bean consumption is associated with greater nutrient intake, reduced systolic blood pressure, lower body weight, and a smaller waist circumference in adults: results from the National Health and Nutrition Examination Survey 1999-2002. J Am Coll Nutr 2008, 27:569-576. doi:
  12. Darmadi-Blackberry I, Wahlqvist ML, Kouris-Blazos A, et al. Legumes: the most important dietary predictor of survival in older people of different ethnicities. Asia Pac J Clin Nutr 2004, 13:217-220. doi:
  13. Li SS, Blanco Mejia S, Lytvyn L, et al. Effect of Plant Protein on Blood Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc 2017, 6. doi: 10.1161/JAHA.117.006659
  14. Travis RC, Appleby PN, Martin RM, et al. A Meta-analysis of Individual Participant Data Reveals an Association between Circulating Levels of IGF-I and Prostate Cancer Risk. Cancer Res 2016, 76:2288-2300. doi: 10.1158/0008-5472.CAN-15-1551
  15. Vigneri PG, Tirro E, Pennisi MS, et al. The Insulin/IGF System in Colorectal Cancer Development and Resistance to Therapy. Front Oncol 2015, 5:230. doi: 10.3389/fonc.2015.00230
  16. Anisimov VN, Bartke A. The key role of growth hormone-insulin-IGF-1 signaling in aging and cancer. Crit Rev Oncol Hematol 2013, 87:201-223. doi: 10.1016/j.critrevonc.2013.01.005
  17. Key TJ, Appleby PN, Reeves GK, Roddam AW. Insulin-like growth factor 1 (IGF1), IGF binding protein 3 (IGFBP3), and breast cancer risk: pooled individual data analysis of 17 prospective studies. Lancet Oncol 2010, 11:530-542. doi: 10.1016/S1470-2045(10)70095-4
  18. Kaaks R. Nutrition, insulin, IGF-1 metabolism and cancer risk: a summary of epidemiological evidence. Novartis Found Symp 2004, 262:247-260; discussion 260-268. doi:
  19. Mirzaei H, Raynes R, Longo VD. The conserved role of protein restriction in aging and disease. Curr Opin Clin Nutr Metab Care 2016, 19:74-79. doi: 10.1097/MCO.0000000000000239
  20. Bauer J, Biolo G, Cederholm T, et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc 2013, 14:542-559. doi: 10.1016/j.jamda.2013.05.021
  21. Volpi E, Campbell WW, Dwyer JT, et al. Is the optimal level of protein intake for older adults greater than the recommended dietary allowance? J Gerontol A Biol Sci Med Sci 2013, 68:677-681. doi: 10.1093/gerona/gls229
  22. Erridge C. The capacity of foodstuffs to induce innate immune activation of human monocytes in vitro is dependent on food content of stimulants of Toll-like receptors 2 and 4. Br J Nutr 2011, 105:15-23. doi: 10.1017/S0007114510003004
  23. Erridge C, Attina T, Spickett CM, Webb DJ. A high-fat meal induces low-grade endotoxemia: evidence of a novel mechanism of postprandial inflammation. Am J Clin Nutr 2007, 86:1286-1292. doi: 10.1093/ajcn/86.5.1286
  24. Masson CJ, Mensink RP. Exchanging saturated fatty acids for (n-6) polyunsaturated fatty acids in a mixed meal may decrease postprandial lipemia and markers of inflammation and endothelial activity in overweight men. J Nutr 2011, 141:816-821. doi: 10.3945/jn.110.136432
  25. Fritsche KL. The science of fatty acids and inflammation. Adv Nutr 2015, 6:293S-301S. doi: 10.3945/an.114.006940
  26. Cornelissen A, Guo L, Sakamoto A, et al. New insights into the role of iron in inflammation and atherosclerosis. EBioMedicine 2019, 47:598-606. doi: 10.1016/j.ebiom.2019.08.014
  27. Brewer GJ. Risks of copper and iron toxicity during aging in humans. Chemical research in toxicology 2010, 23:319-326. doi: 10.1021/tx900338d
  28. Zheng W, Lee S-A. Well-Done Meat Intake, Heterocyclic Amine Exposure, and Cancer Risk. Nutrition and Cancer 2009, 61:437-446. doi: 10.1080/01635580802710741
  29. National Cancer Institute. Chemicals in Meat Cooked at High Temperatures and Cancer Risk.
  30. International Agency for Research on Cancer, World Health Organization. Press Relsease No. 240. IARC Monographs evaluate consumption of red meat and processed meat. 2015.
  31. Turesky RJ. Mechanistic Evidence for Red Meat and Processed Meat Intake and Cancer Risk: A Follow-up on the International Agency for Research on Cancer Evaluation of 2015. Chimia (Aarau) 2018, 72:718-724. doi: 10.2533/chimia.2018.718
  32. Lunn JC, Kuhnle G, Mai V, et al. The effect of haem in red and processed meat on the endogenous formation of N-nitroso compounds in the upper gastrointestinal tract. Carcinogenesis 2007, 28:685-690. doi: 10.1093/carcin/bgl192
  33. Herrmann SS, Granby K, Duedahl-Olesen L. Formation and mitigation of N-nitrosamines in nitrite preserved cooked sausages. Food Chem 2015, 174:516-526. doi: 10.1016/j.foodchem.2014.11.101
  34. Koeth RA, Wang Z, Levison BS, et al. Intestinal microbiota metabolism of L-carnitine, a nutrient in red meat, promotes atherosclerosis. Nat Med 2013, 19:576-585. doi: 10.1038/nm.3145
  35. Tang WH, Wang Z, Levison BS, et al. Intestinal microbial metabolism of phosphatidylcholine and cardiovascular risk. N Engl J Med 2013, 368:1575-1584. doi: 10.1056/NEJMoa1109400
  36. Wang Z, Bergeron N, Levison BS, et al. Impact of chronic dietary red meat, white meat, or non-meat protein on trimethylamine N-oxide metabolism and renal excretion in healthy men and women. Eur Heart J 2019, 40:583-594. doi: 10.1093/eurheartj/ehy799
  37. Wang Z, Klipfell E, Bennett BJ, et al. Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease. Nature 2011, 472:57-63. doi: 10.1038/nature09922
  38. Keogh JB, Grieger JA, Noakes M, Clifton PM. Flow-mediated dilatation is impaired by a high-saturated fat diet but not by a high-carbohydrate diet. Arterioscler Thromb Vasc Biol 2005, 25:1274-1279. doi: 10.1161/01.ATV.0000163185.28245.a1
  39. Miller M, Beach V, Sorkin JD, et al. Comparative effects of three popular diets on lipids, endothelial function, and C-reactive protein during weight maintenance. J Am Diet Assoc 2009, 109:713-717. doi: 10.1016/j.jada.2008.12.023
  40. Lewin MH, Bailey N, Bandaletova T, et al. Red meat enhances the colonic formation of the DNA adduct O6-carboxymethyl guanine: implications for colorectal cancer risk. Cancer Res 2006, 66:1859-1865. doi: 10.1158/0008-5472.CAN-05-2237
  41. Foerster J, Maskarinec G, Reichardt N, et al. The influence of whole grain products and red meat on intestinal microbiota composition in normal weight adults: a randomized crossover intervention trial. PLoS One 2014, 9:e109606. doi: 10.1371/journal.pone.0109606
Fitness parners in sportswear doing exercises at gym. Fitness sp

The Perils of Taking the Easy Way Out When It Comes to Fitness

/24 June 2021/ All MFN blog/

We are by nature lazy creatures. We try to get by with as little effort as possible; we love to minimize work but maximize enjoyment. Sadly, this concept applied to exercise can have severe consequences to our bodies. 

Weak links, in essence, are parts of our bodies that are not as strong as the others. Logically, it would make sense for us to strengthen these weak links in order to build our bodies as a whole. 

However, our bodies usually choose to perform a movement with the least amount of effort and resistance. If one of our muscles is weak, instead of activating it, our body will compensate or cheat by making the other muscles around it work harder to complete the movement. 

This results in strong muscles growing stronger, and weak links growing weaker. The only way to overcome our cheating tendency is to consciously activate our weak links and establish proper movements. 

Once fundamental movements are established, only then can you add in other factors such as strength, endurance, speed, agility and athletic skills, which will help play a big role in improving performance and injury prevention.

A chain is only as strong as its weakest link

There’s no point building big muscles if your joints, tendons, and bones can’t stand the strain. Instead, it is wiser to first build your foundation — and for many people, that means revisiting the weakest parts of your body. 

Perhaps it came from a previous injury, or maybe it’s just a muscle you didn’t pay attention to previously. Whatever the case, tending to your weakest link will lay the necessary groundwork for true fitness. Skip this step, and you may end up doing yourself more harm than good. 

It’s not just limited to gym-goers who overload their muscles by lifting too much weight. In fact, women who are supposedly “flexible” and great at yoga can get into trouble too. On one hand, the gym-goers are building strength without flexibility; on the other hand, yoga enthusiasts are pushing the limits of their stretches without increasing their strength. This can result in joint laxity (looseness of joints) that makes them vulnerable to injury. 

Weak links due to injuries

Some of you reading this right now may have suffered injuries before, whether major or minor. And most of you would be able to relate to the fact that you never feel the same after an injury. The weak links caused by injury are often hard to repair and can lie dormant for a long time before resurfacing to cause discomfort and pain. 

That’s why it is important to identify your weak links. Even if you’ve never been injured, there are other factors that may cause weak links: 

  • old injuries that you were unaware of
  • surgery
  • poor movement
  • incomplete rehabilitation
  • alignment issues
  • muscle imbalances
  • aging
  • mindset
  • genetics 

As you may realize, weak links are not always caused by outward injuries, but may also develop due to intangible factors like age, mentality and physical habits. 

Nevertheless, many people suffer because they do not rehabilitate completely from an injury. A lot of people go through physio and recovery program, but stop once they reach 80% wellness. However, it’s at this stage where it’s the easiest to experience re-injury. Instead, it’s always better to achieve 110% fitness before you go back to your usual workout or sports routine. This ensures your weak link has been strengthened and prevents injury from occurring easily. 

Getting fit the right way

Ultimately, your body is unique. Although most of us want to go straight to training like Arnold, or run like Usain Bolt, our body has its own sets of strengths and weak links that need to be addressed individually first. And the best way to do that is through a personally tailored corrective exercise program, measured out specifically for you. 

The shortcut to fitness is doing it right in the first place.

Ke Wynn Lee, author and an international award-winning corrective exercise specialist, currently owns and operates a private Medical Fitness Center in Malaysia. Apart from coaching, he also conducts workshops and actively contributes articles related to corrective exercise, fitness & health to online media and local magazines.

seniors-biking-in-gym-group

Be Physically Active to Boost Your Immune Response

/16 June 2021/ All MFN blog/

In these challenging times, if we only could get a medication that would boost our immune system and response to viruses, lower all stress associated with still being in a pandemic, and treat most of the pre-existing health conditions that are associated with a higher risk of dying from COVID-19, we would all be lined up for it! Guess what? We already have something that does all these things already—and that is physical activity.

Let’s consider its impact on how well your immune system works. While physical activity can boost your immune function, here’s what else we know about the immune system and all the lifestyles factors we can manage:

Exercise: A single workout may temporarily suppress your immune system, but chronic training (assuming it is not excessive) boosts immunity to the common cold, other viruses, and a whole host of pathogens (1). Being regularly active generally makes you less likely to get sick.

Stress: Any type of stressor, be it physical or mental, can weaken your immune system, most commonly through increases in levels of the hormone cortisol and other factors (2). Exercise overtraining raises cortisol levels and can make you more likely to catch a cold or the flu.

Sleep: Lack of sleep—particularly deep REM sleep—and short sleep duration cause a rise in cortisol levels that can dampen immune function (3). Many people with type 2 diabetes and overweight/obesity also have sleep apnea that interferes with getting quality sleep, making them more susceptible to getting sick. Better management of all of these conditions helps.

Nutrition: Chronic malnutrition lowers the ability of the immune system to function optimally. Low levels of vitamin D (which acts as a prohormone) in the bloodstream has also been tied with lower immunity, and many people with diabetes and older adults have low vitamin D status. Getting adequate vitamins, minerals, and calories in your diet can boost your immunity.

Alcohol: While a moderate intake of alcohol may give you some health benefits, abuse of alcohol suppresses your immune system (4). “Moderate” is one drink per day for females, two for males—and there is no rollover from one day to the next if you miss one!

Smoking: Tobacco smoking increases inflammation and lowers immune function, and it may also lower your immune response to certain vaccines. Quitting smoking can help restore immune function.

We also need to discuss how our bodies react to vaccinations. All of us are facing possible vaccination for COVID-19 once we all can get access to the many safe and effective vaccines that are now slowly being distributed around the US and the world. You may be, like I was previously, assuming that vaccines work the same for everyone. In reality, there is no guarantee of a universal and equally protective response, and a whole host of factors (inside your body and out) can impact how well a vaccine actually works for you (5). Not surprisingly, all of the lifestyle factors listed above can impact the strength of your immunity post-vaccination, and making improvements in any/all of them can help. But your age can also have a negative effect.

COVID-19 is unlikely to be the last threat to our collective health, so it is worth discussing why we are more vulnerable to threats to our immune system as we get older. For starters, older adults have a less robust immune response to everything, including strains of influenza, and they suffer from a more rapid waning of antibodies. Basically, our immune systems are getting less robust and effective as we age—and that potentially impacts our response to vaccines. 

Generally, older adults have a lesser immunity to any virus that they have been vaccinated against, and that will likely include the current global coronavirus once a vaccine is available. However, engaging in regular aerobic training improved flu vaccine responses in a group of older adults who had been previously sedentary (6): participants who did a regular moderate-intensity physical activity like brisk walking were 30 to 100 percent more likely to have an antibody response sufficient to keep them from getting the flu. Although research on this topic remains limited, exercise is likely to help boost the immune systems in people who are currently sedentary and start being active.

Other confounding health issues may make immune responses weaker when you are exposed to a virus or vaccinated. For instance, many seniors with diabetes develop kidney disease requiring dialysis. In these individuals, many fail to have an adequate immune response when given a vaccine for hepatitis B; how well it works depends on their age, how long they have been on dialysis, their diet, and other factors (7). In children (and adults) with type 1 diabetes, certain vaccines have been shown to be less effective, particularly when they also have celiac disease and consume gluten (8).

So, what can you do? Fight back by adopting the healthiest lifestyle that you can—one that includes being regularly moderately active—and stay as healthy as you can for when the next virus comes along. Protect yourself with a daily dose of exercise!

Sheri R. Colberg, PhD, is the author of The Athlete’s Guide to Diabetes: Expert Advice for 165 Sports and Activities (the newest edition of Diabetic Athlete’s Handbook). She is also the author of Diabetes & Keeping Fit for Dummies, co-published by Wiley and the ADA. A professor emerita of exercise science from Old Dominion University and an internationally recognized diabetes motion expert, she is the author of 12 books, 30 book chapters, and over 420 articles. She was honored with the 2016 American Diabetes Association Outstanding Educator in Diabetes Award. Contact her via her websites (SheriColberg.com and DiabetesMotion.com).

 

References

  1. Cerqueira É, Marinho DA, Neiva HP, Lourenço O. Inflammatory Effects of High and Moderate Intensity Exercise-A Systematic Review. Front Physiol. 2020 Jan 9;10:1550. doi: 10.3389/fphys.2019.01550. PMID: 31992987.
  2. McEwen BS. Central effects of stress hormones in health and disease: Understanding the protective and damaging effects of stress and stress mediators. Eur J Pharmacol. 2008 Apr 7;583(2-3):174-85. doi: 10.1016/j.ejphar.2007.11.071. PMID: 18282566.
  3. Vgontzas AN, Zoumakis M, Bixler EO, et al. Impaired nighttime sleep in healthy old versus young adults is associated with elevated plasma interleukin-6 and cortisol levels: physiologic and therapeutic implications. J Clin Endocrinol Metab. 2003 May;88(5):2087-95. doi: 10.1210/jc.2002-021176. PMID: 12727959.
  4. Rodríguez-Rabassa M, López P, Sánchez R, et al. Inflammatory Biomarkers, Microbiome, Depression, and Executive Dysfunction in Alcohol Users. Int J Environ Res Public Health. 2020 Jan 21;17(3):689. doi: 10.3390/ijerph17030689. PMID: 31973090.
  5. Zimmermann P, Curtis N. Factors That Influence the Immune Response to Vaccination. Clin Microbiol Rev. 2019 Mar 13;32(2):e00084-18. doi: 10.1128/CMR.00084-18. PMID: 30867162.
  6. Woods JA, Keylock KT, Lowder T, et al. Cardiovascular exercise training extends influenza vaccine seroprotection in sedentary older adults: the immune function intervention trial. J Am Geriatr Soc. 2009 Dec;57(12):2183-91. doi: 10.1111/j.1532-5415.2009.02563.x. PMID: 20121985.
  7. Udomkarnjananun S, Takkavatakarn K, Praditpornsilpa K, et al. Hepatitis B virus vaccine immune response and mortality in dialysis patients: a meta-analysis. J Nephrol. 2020 Apr;33(2):343-354. doi: 10.1007/s40620-019-00668-1. Epub 2019 Nov 7. PMID: 31701375.
  8. Opri R, Veneri D, Mengoli C, Zanoni G. Immune response to Hepatitis B vaccine in patients with celiac disease: A systematic review and meta-analysis. Hum Vaccin Immunother. 2015;11(12):2800-5. doi: 10.1080/21645515.2015.1069448. Epub 2015 Sep 17. PMID: 26378476.
Stressed Man Working At Desk In Busy Creative Office

Stress: An Easy Exercise To Help You Deal With It!

/4 June 2021/ All MFN blog/

Stress. It’s everywhere. If you live and work on this planet it’s almost impossible to avoid. In normal times are stressful enough but this past year we have had to share our lives with Covid 19.

Feeling stressed? Me too!

Today I’m writing about how to reduce stress and suggest some easy ways to get that burden off your back.

Stress has been around since the beginning of time. It started as the fight-or-flight response when early humans confronted a life-threatening situation. In that situation, stress hormones- adrenaline and cortisol- are produced. Your blood vessels constrict, blood pressure goes up, pupils dilate, heart rate quickens, and breathing becomes more rapid. The body is preparing itself to do battle or run. This response is essential in times of acute danger. But problems at work, crying kids, traffic, you name it can trigger the same response.

Given the pressures of daily life, chronic stress itself has become a life-threatening situation. It can cause a host of health problems including headaches, gastrointestinal issues, insomnia, trouble concentrating, anxiety, depression, increased body weight, high blood pressure and heart disease.

We can’t eliminate the stress. But we can relieve the fight-or-flight response that sends our bodies into danger mode. And we can cultivate a relaxation response over time that will reduce our physiological stress reaction.

So what do we do about chronic stress? How do we get rid of it?

How? Relax. That’s what my first yoga teacher used to say when I was all bent up in the pretzel pose with a grimace on my face. Once I was able to relax, I was stress-free even in the pretzel pose.

Seriously, daily conscious relaxation exercises can make a real difference in the way your body responds to stress. Dr. Herbert Benson coined the phrase “relaxation response” in his book by the same name in 1975.

Since then, he and others have conducted numerous studies, including a recent one at the Benson-Henry Institute for Mind/Body Medicine, that have detailed the body’s intricate positive response to conscious relaxation exercises. In a nutshell, the relaxation response has the opposite effect of fight-or-flight. It engages the parasympathetic nervous system to counteract the effects of stress. You experience a feeling of deep relaxation and well-being. And if you practice relaxation regularly, you’ll feel better and help yourself avoid those stress-related health issues. That’s how we get rid of chronic stress.

Meditation is just one of an almost infinite number of ways to consciously relax. Virtually anything that takes your attention away from your daily grind and makes you concentrate on just one thing can work. Doing the dishes, aerobic exercise, yoga, stretching, golf, playing a musical instrument, casting a fishing rod, playing with a cat — almost anything can work if you pay attention to only that and clear your mind. I’m partial to exercise because I get the benefits of a workout as well as the relaxation. It’s my mantra. It’s what I do to get rid of chronic stress.

Dr. Benson suggests you practice some form of conscious relaxation for 10 to 20 minutes every day to get rid of chronic stress in the long term.

But what if you’re pressed for time? (Pressed rhymes with stressed.)

Reduce Chronic Stress with this little exercise. 

Sometimes you only need a few seconds and you feel a lot better.

  • Sit down and close your eyes. (If you’re on the street, duck into a doorway, stand and keep your eyes open and one hand on your purse.)
  • Let your muscles relax. Concentrate on your breathing.
  • Breathe in and hold your breath for one second, count “one, one-hundred-thousand”, and breathe out.
  • Breathe in again a little deeper and hold for two seconds – “one, one-hundred-thousand; two, one-hundred-thousand” — breathe out.
  • Breathe in deeper and hold for three, then four, then five seconds.
  • When you get to around three seconds of breath-holding, your stress level should start to drop and your mind should start to clear itself of thoughts.
  • After five, you should feel pretty good. This works well for me particularly in moments of acute stress.

That one worked too, didn’t it? I hope concentrating on reading this helped you reduce your stress and I hope you’ll make conscious relaxation a part of your life.

It’s a lifestyle change that’s easy to make because it feels so good when you do it.

Check out Mirabai’s video below, guiding you through a short Meditation and Stretch to reduce stress that can be done at work or home.

Mirabai Holland MFA, EP-C, CHC is one of the foremost authorities in the health and fitness industry. Her customer top-rated exercise videos for Health issues like Osteoporosis, Arthritis, Heart Disease, Diabetes & more are available on her website, mirabaiholland.com. Join her NEW Online Workout Club. Mirabai offers one-on-on Health Coaching on Skype or Phone. Contact her at askmirabai@movingfree.com

team hands

Collaborative Thinking in Health & Wellness

/21 May 2021/ All MFN blog/

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.

med-fit-client-doctor-exercise

Healthcare Through Fitness

/10 May 2021/ All MFN blog/

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. 

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