Keeping Active during the Festive Season

As the holiday season approaches, it is important not to lose all the physical fitness you have worked so hard to improve throughout the year. Having said this, it is important to take a break from the everyday routine that you find yourself in, so that you are motivated to start afresh in the New Year. So, here are some suggestions on how you and your family can keep active during the festive season.

If you are staying home this holiday season, try to do different physical activities, such as walking in the park with your family or friends, taking a trip to the zoo, going ice skating, playing with your children in the garden, and swimming. Go to the gym and attend different classes that you normally wouldn’t be able to get to.

If you are going on holiday, enjoy a walk on the beach, swim, play with the kids, walk instead of taking the car or bus whenever possible, and take the stairs instead of the lift. Or, simply choose 3 simple exercises that you can do each morning to start your day.

Remember: you feel better when you keep active! Exercise also helps you relax. So, look for ways to stay active this holiday, rather than loafing around. Do enjoyable and different activities with your families. Most importantly, relax and have fun!

Merry Christmas and best wishes for a happy and healthy 2012!!!

HIV/AIDS and Exercise

December 1^st was World AIDS Day, thus I thought it appropriate to provide some insight into the role of exercise in managing HIV/AIDS.

Human immunodeficiency virus (HIV) is a virus that attacks certain cells in the immune system, resulting in a decrease in immune function. An HIV positive individual is thus at an increased risk for infectious diseases. HIV is progressive and is classified into 3 stages, the final stage being acquired immune deficiency syndrome (AIDS).

There is currently no vaccine or cure for HIV. Therefore, management of the condition is crucial to maintain a good quality of life for as long as possible. According to ACSM, exercise has been scientifically proven to be effective in the management of HIV, especially in the early stages when an individual is still asymptomatic and healthy.

Common symptoms of HIV include fatigue, diarrhoea and weight loss. These symptoms must be carefully considered when designing an exercise programme so that the symptoms are not exacerbated by exercise. The main goal of the exercise programme is to keep the individual as physically healthy as possible. An HIV positive individual will reap the same benefits in terms of cardiovascular fitness, muscular strength and flexibility as any other person engaging in a regular exercise programme. However, special considerations need to be taken with regards to intensity and duration of exercise.

Immune function drops immediately after high intensity exercise or exercise that is performed for a long duration (more than 90 minutes). Because these individuals already have a low immune function, it is important not to compound this. Therefore, ACSM recommends that exercise be kept to a shorter duration – no more than 60 minutes per session, 3 to 5 days per week. Intensity should also be moderate, ranging between 60 and 75% of the maximum heart rate.

ACSM also recommends that aerobic exercise using the major muscle groups is performed as part of any exercise regimen. Therefore, exercises such as walking, swimming and cycling should be included. This will enable the HIV positive person to maintain a high level of cardiovascular fitness, which is important in reducing the risk for cardiovascular disease. Due to the increased weight loss associated with HIV, it is important that these individuals also perform resistance exercise on a regular basis to maintain high levels of muscle mass. Stretching should be part of the exercise regimen to maintain flexibility and joint range of motion. Functional exercises should also be included in the exercise programme to maintain functional ability.

Other special precautions that should be taken include exercising in an appropriate temperature to avoid getting sick and exercising away from others to avoid picking up their infections. The general health of the individual, including blood pressure and heart rate, should be assessed before each session. If the individual is not feeling well, then exercise should be postponed, so that the individual’s immune system can fight off any potential infection.

HIV is often seen as a death sentence from the minute of diagnosis; however, an individual can live a healthy, asymptomatic life for many years. It is, therefore, important to maintain good health and physical function, thereby improving quality of life.

The Benefits of Aqua Therapy

Exercise performed in water does not only refer to swimming lengths using the four traditional strokes. Various forms of exercise and therapy techniques can be performed in water for injury rehabilitation, chronic disease management or the improvement of cardiovascular fitness.

Water provides resistance without putting stress on the joints. Individuals who have experienced an acute orthopaedic injury, such as a torn ligament or strained muscle, need to strengthen the surrounding muscles to support the joint, without putting too much stress on the joint. Due to buoyancy, this is possible in water. The water supports the body, while providing resistance to movement which can be controlled by the individual – the faster you move a limb through the water, the greater the resistance will be. This individual, who is likely to be apprehensive to exercise after the injury, feels in control of the resistance and thus more comfortable with performing the exercise. Water also assists movement, thus contributing to greater joint mobility, which is important following injury. The hydrostatic pressure created by the water assists in reducing swelling around the injured area and promoting increased circulation, thus assisting in the healing process.

Aqua therapy is particularly effective in individuals with arthritis, as the reduced impact on the joints means less inflammation of the joints and therefore less pain. These individuals are thus able to perform a greater range of exercises without suffering pain or causing further degeneration in the joints.

Individuals who have chronic neurological conditions, such as Parkinson’s Disease or Multiple Sclerosis, benefit from the relaxation associated with being in the water. Fluid movements are more easily performed in water. The risk of injury due to falls is eliminated, although balance is constantly challenged due to the water constantly moving around the individual. Often, in these cases and with acute back injuries, the therapist will manually move an individual through the water, while s/he is completely relaxed, using flotation devices to assist the therapist. In this way, range of motion of the spine and other areas is improved while the individual is completely relaxed.

In more agile people, water can be used to improve cardiovascular fitness and increase muscle strength. Here, individuals actively perform exercise in the water. Additional resistance can be added using various pieces of aquatic equipment, such as pool noodles and special weights. Aerobics is performed in the water, where individuals feel safe and the risk of injury is reduced. Water aerobics can be very intense; therefore individuals with cardiovascular disease or similar risks must be cleared by the doctor before starting exercise.

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Traditional swimming strokes are also hugely beneficial. Again, the water provides resistance, thereby increasing muscular strength and endurance. Heart rate increases with the intensity, contributing to improved cardiovascular fitness.

The temperature of the water needs to be carefully monitored. The water must be warmer when doing manual therapy in which the individual is completely relaxed. If the water is too cold, the individual will be unable to relax. Cooler temperatures are appropriate when doing water aerobics or traditional swimming strokes.

An aquatic exercise programme is hugely beneficial for those individuals who cannot perform land-based exercises and the same benefits are achieved. There is reduced stress on the body, often making the exercises more enjoyable and more appropriate for those who struggle with impact exercises.

So, if you think you have an excuse not to exercise, think again! There is always some form of exercise that can be adapted to suit your specific needs.

World Diabetes Day - 14 November

Diabetes is a fairly dreaded word, as many people just think of pricking and injecting oneself numerous times a day. However, this is not always the case. Being World Diabetes Day today, as well as Diabetes Awareness Week this week, I thought I would provide some insight into this common, yet often misunderstood, condition.

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What is Diabetes?

Diabetes is defined by ACSM as: “a chronic metabolic disease characterized by an absolute or relative deficiency of insulin that results in hyperglycaemia”. More simply put, diabetes is a condition resulting in prolonged high blood glucose (sugar) levels, as a result of little or no insulin production.

Various types of diabetes exist. I will discuss the two most common types – type 1 and type 2 diabetes. The first distinction to make is the difference between Type 1 and Type 2 diabetes mellitus. Type 1, or insulin-dependent, diabetes is usually present from a young age, although late onset type 1 diabetes may also occur later in life. Type 1 diabetes is an autoimmune disease, in which there is destruction of the beta cells in the pancreas – the cells responsible for producing insulin. The result of this is a complete insulin deficiency; therefore, these people immediately start insulin injections.

Type 2, or non-insulin dependent, diabetes usually presents itself later in life and occurs as a result of a combination of insulin resistance and decreased insulin secretion by the pancreas. Various factors increase the risk for developing type 2 diabetes. These include obesity (especially a large waist circumference), physical inactivity, family history, smoking, high blood pressure, high cholesterol, and stress. Individuals with type 2 diabetes usually start with oral medication to improve insulin sensitivity and will possibly start insulin injections later on if necessary, to accommodate for the decreased insulin secretion. Thus, it is possible to have type 2 diabetes and be insulin-dependent; this does not mean you have type 1 diabetes.

Why is exercise so important in managing diabetes?

There are many complications associated with diabetes, including cardiovascular (heart), renal (kidney), and neuropathies (nerve system damage). Physical activity is essential in managing these complications. Both type 1 and type 2 diabetes put individuals at increased risk for heart disease. Therefore, exercise is important to reduce the risk of heart disease, as has been discussed in previous blogs. Exercise also improves insulin sensitivity and glucose tolerance, thereby decreasing insulin requirements. Individuals with type 2 diabetes also often have high blood pressure and high cholesterol and are often overweight. Exercise is particularly important for these individuals to manage these conditions, as well as to reduce body fat percent.

Individuals who are on insulin therapy (injections) must be carefully monitored, especially when starting an exercise programme, as they tend to respond very quickly to exercise. During exercise, the body uses glucose as an energy source. Different types of insulin have different peak onset times. If the insulin peaks at the same time as the individual is exercising, then too much glucose may be used up, resulting in the individual experiencing a hypoglycaemic incident – the glucose dropping too low to keep the body functioning. The individual may faint and lose consciousness. Usually, one will have other symptoms first, such as sweating, shaking and nausea. Individuals will generally start to learn how their bodies react to hypoglycaemia.

On the other hand, individuals with type 1 diabetes are at risk of developing ketoacidosis if they exercise with very high sugar levels. If the blood glucose levels are not controlled and are too high, then there is no glucose in the cells, which means that fat must be broken down and used as an energy source. During this process, ketones, which are acids, are produced. This causes the body to become acidic and a coma may result if this state is prolonged.

An individual with diabetes will benefit from any exercise regimen. It is recommended that these individuals do at least 150 minutes of aerobic activity per week, to reap the cardiovascular benefits of exercise. They must also do light resistance training at least 2 to 3 times per week to improve muscle strength, decrease body fat percent and increase glucose metabolism. Stretching is also important to maintain flexibility and joint mobility and to reduce stress.

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So, if you have diabetes, don’t pretend it is not there and that it can’t cause any harm because you don’t have any visible symptoms. It is crucial to check your blood glucose levels regularly, follow a healthy diet and exercise on a regular basis. When exercising, be aware of how you are feeling and check your blood glucose levels whenever necessary if you are not feeling quite right. Always have a snack or some fruit juice nearby in case your glucose levels drop too low.

Diabetes is not something to be afraid of. If it is carefully monitored and correctly managed, one can live a reasonably hassle-free, long and healthy life. Educate yourself on how it works, so that you can be proactive and look after your body.

Neck Pain and Stiffness

I recently did some corporate wellness testing and one of the most common complaints was that of neck and mid back pain and stiffness. The main complaint was a dull ache in the neck and mid back region with a sharp pain at the base of the skull, often resulting in headaches. One of my earlier blogs spoke of correct ergonomics when sitting at your desk, as poor seated posture is very closely related to back and neck pain. Besides correct seated posture, remember to get up from your desk and walk around the room at least every hour.

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Other factors also contribute to this very debilitating neck and mid back pain. An x-ray should be done to rule out the possibility of any disc disorder. Then one must look at muscle spasm and tightness. Weakness of the deep neck stabilizing muscles, mid back muscles, shoulder and arm muscles, and tightness of the chest and superficial neck muscles may contribute to neck and mid back pain. In other words, a muscle imbalance exists, which causes certain muscles to go into spasm, resulting in pain and stiffness in the neck and mid back region.

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Numerous deep muscles stabilize the neck, as can be seen in the image below. If these muscles are weak, the superficial muscles, predominantly the trapezius muscles, compensate, often causing them to be tight and possibly to go into spasm because they are permanently working.

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The muscles in the mid back region help to stabilize the scapulae (shoulder blades). If these muscles are weak, it creates a pulling sensation on the neck muscles, as the scapulae pull downwards with gravity and the muscles are not strong enough to hold them in place. This constant pulling puts enormous strain on the neck, resulting in pain.

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If the shoulder and arm muscles are weak, the neck muscles, predominantly the trapezius muscle (shown above) tends to take over, especially when lifting heavy objects, such as shopping bags in and out of the boot of your car. Again, this overworked portion of the trapezius muscle results in pain and stiffness of the neck and mid back region.

Tightness in a muscle results in limited range of motion (ROM) of the joint it surrounds. When the trapezius muscle is overworked, it becomes very tight and may even go into spasm, resulting in pain. The chest muscles are often tight because of sitting in front of a computer all day with a poor seated posture – shoulders forward and rounded back. Add a phone tucked in between your ear and shoulder and you’re headed for disaster! These tight muscles must be stretched regularly before any strengthening can begin, because full (ROM) needs to be achieved and then the muscles strengthened throughout that range. Stretching also generally provides immediate relief of symptoms. If the neck is in spasm, see a Physiotherapist to break down the spasm before starting a specialized stretching and strengthening programme with a Biokineticist.

Arthritis

Two common forms of arthritis exist, namely osteoarthritis and rheumatoid arthritis. Osteoarthritis is a degenerative joint disease in which the cartilage of a specific joint degenerates, resulting in localized pain and inflammation within that joint. The most common joints affected by osteoarthritis are the hands, spine, hips and knees. Rheumatoid arthritis is an inflammatory, multi-joint disease in which numerous joints and organ systems may be affected as a result of an autoimmune response. The most commonly affected joints include the wrists, hands, knees, feet and neck.

When exercising a person with osteoarthritis, one needs to consider the degree of articular cartilage degeneration in the specific joint, the level of pain and discomfort in that joint, the range of motion of the joint, the strength of the surrounding muscles of the affected joint, and finally, whether or not the individual is having a flare up. Osteoarthritis will periodically flare up and then may almost go into remission. During a flare up, pain will be much more severe. Common features associated with exercise include joint pain and stiffness, osteophytes (small bony formations) and cartilage destruction. It is important to strengthen the muscles surrounding the affected joints so that they can support those joints. However, these exercises must be performed carefully, placing minimal stress and impact on those joints. It is also essential to stretch the muscles surrounding the affected joints in order to maintain their range of motion and reduce joint stiffness.

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When selecting exercises for individuals with rheumatoid arthritis, you need to know if the individual is having a flare up – increased pain will be the primary symptom. Common features associated with rheumatoid arthritis include morning stiffness that lasts longer than 30 minutes, acute and chronic inflammation, chronic pain and reduced joint integrity. Low-intensity and low-impact exercises, with lots of stretching, are recommended for these individuals.

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For any form of arthritis, it is important that individuals do regular low-impact, aerobic exercise, such as swimming or cycling, and lots of stretching. Any exercises that place heavy stress on the affected joints should be avoided. During flare ups, vigorous exercise must be avoided. Water therapy and water aerobics are highly recommended for individuals who suffer from arthritis.

Arthritis is a common condition, which often leaves people afraid to do any form of physical activity. However, exercise is important in managing the condition and maintaining mobility. So, if you suffer from arthritis, see a biokineticist to have a comprehensive assessment and be given an appropriate exercise programme. This will allow you to function more normally and improve your quality of life.

Osteoporosis

Tomorrow, October 20, is World Osteoporosis Day, so I decided that this would be an appropriate time to provide you with some insight into osteoporosis and the importance of exercise in managing and preventing this condition.

Osteoporosis refers to a decrease in bone mass and bone quality, mainly due to increasing age. After the age of 35 years, there is a reduction in the activity of the cells that contribute to bone formation. This results in reduced bone mass. This is a concern because it puts these weaker bones at an increased risk for fracture. A bone density scan is the most accurate way to diagnose osteoporosis.

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The American College of Sports Medicine (ACSM) found that every 1 in 2 women and 1 in 8 men over the age of 50 are likely to experience an osteoporotic fracture at some stage in their lives. Women are at a much higher risk for osteoporosis due to the reduction in estrogen levels following menopause, while men generally experience bone loss much later on in life (after age 70) and to a much lesser extent, as a result of reduced testosterone production.

ACSM identifies the following risk factors for osteoporosis:

·         Females are at a higher risk than males

·         Increasing age

·         Race – Caucasian/Asian

·         Family history of osteoporosis

·         Low body weight for height (individuals with small frames)

·         Early menopause

·         Prolonged premenopausal amenorrhea (missed periods over a long duration)

·         Low testosterone levels in men

·         Lack of physical activity

·         Smoking

·         Excessive alcohol consumption

·         Low dietary calcium intake

·         Chronic use of medications causing bone loss (e.g. steroids)

It is essential that adequate calcium is ingested as part of one’s diet, particularly during a child’s growth years, as this is when the bones are forming and developing. The Good Life Dietitians can provide more insight into dietary requirements for osteoporosis.

In terms of exercise, it is essential that individuals keep physically active throughout their lives in order to prevent osteoporosis. This means performing aerobic, weight-bearing activity at least 3 times per week for 30 to 45 minutes. If you already have osteoporosis, then the types of exercises you can perform depend on the degree of severity of osteoporosis, as one does not want to increase the risk for injury or fracture. Weight-bearing exercises are particularly important in building bone strength. These exercises include walking, squats and lunges. ACSM recommends aerobic, weight-bearing activities 4 days per week and resistance exercises 2 to 3 days per week. By strengthening the muscles around the bones, bone mass is conserved and the muscles can support the weaker bones. It is essential that balance exercises are performed on a regular basis in order to reduce the risk of falling and thus injury or fracture. Functional exercises that will assist an individual to perform the activities of daily living are also recommended.

The Science of Stiffness

Anyone who has done any form of strenuous activity will have felt that painful ache in the muscles for a few days after exercise. A lot of you may have decided that this pain couldn’t possibly be good for you and, therefore, have avoided any exercise since. Some of you might have decided you quite like that achy feeling, reminding you of what a good workout you had the day before. Basically, this mild discomfort is not bad for you and the good news is it won’t last forever.

Various myths regarding muscle soreness as a result of exercise exist. The most common is the idea that a build up of lactic acid in the muscle causes muscle soreness the next day. It is true that there is a build up of lactic acid in the muscle tissue with strenuous exercise; however, this lactic acid is removed within an hour of finishing exercise. Thus, it is not the cause for pain and stiffness that materializes the following day.

Muscle stiffness or pain after exercise is termed delayed onset muscle soreness (DOMS). There are two key models to explain this exercise effect. The first is known as the Local Ischemic Model. This model suggests that following either strenuous exercise, or even moderate, non-traumatic exercise, there is swelling in the soft tissue. This causes an increase in tissue pressure and a local reduction in blood and oxygen supply to the muscle (ischemia). This in turn causes muscle spasm and the pain known as DOMS.

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The second model is known as the Mechanical Trauma Model. Here, it is suggested that there is structural damage (microtears) to the muscle tissue as a result of increased mechanical forces during muscle contraction. This again leads to swelling and inflammation in the muscle tissue, resulting in pain.

Neither of these models suggests that there is permanent damage to the muscle tissue. In fact, it is recommended that one repeats the same exercise on a regular basis so that the muscle tissue can adapt to the increased force placed on it. This is called the “repeated-bout effect”. The more the exercise is performed, the quicker the muscle tissue adapts, reducing muscle soreness.

So, next time you wake up the morning after exercise, cursing your trainer, the gym, exercise and life in general because you can’t walk up stairs or stand up from the toilet, think of the positive changes taking place to the muscle. Take yourself off to the gym and do a light exercise session with a good cardiovascular warm-up and lots of stretching – even if it hurts a little. This will increase blood flow to the sore muscle tissue, improve flexibility and thus reduce pain and stiffness.

Simply Stretched

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You have no doubt been told by someone at some stage that you should always stretch before doing any exercise. But why, you may ask. You don’t sweat or lose weight or build muscle from stretching, so why do it? Well, stretching is actually a crucial element in physical fitness and performance.

The first important point is that stretching should be done before and after exercise, as part of a warm up and cool down. Stretching before exercise assists in reducing the risk of injury. Stretching after exercise helps maintain increased flexibility of muscles and helps to reduce muscular pain and stiffness following exercise. Remember: never stretch a cold muscle, so do a gentle warm up such as a walk or light jog and then stretch before starting any strenuous exercise.

Secondly, people of all ages should stretch on a regular basis. With age, we lose flexibility, resulting in muscular pain and joint stiffness. This can affect one’s ability to perform various activities, from regular daily activities like reaching into high cupboards to specific sporting activities like moving across a tennis court.

When stretching, one should feel slight discomfort, not pain. Overstretching a muscle beyond its limits can cause damage to the tissue. The range of movement at a joint, or this point of slight discomfort, will increase as flexibility improves with regular stretching. Every joint is unique and flexibility will vary depending on the joint, activity levels and types of activities performed on a regular basis.

Muscle tightness is often associated with numerous orthopaedic conditions, such as lower back pain, neck pain or knee pain, amongst others. By carefully stretching tight structures and strengthening weak ones surrounding a joint, symptoms can be alleviated, often with immediate, but temporary relief. By performing appropriate stretching and strengthening exercise on a regular basis, more permanent relief can be achieved.

There are various types of stretching techniques that can be used to improve flexibility. The most common is static stretching. Here, a muscles is taken to the end of its range (slight discomfort) and held for about 15 seconds while the muscle is completely relaxed. Static stretching is most effective after exercise to reduce muscle pain and stiffness.

Dynamic stretching involves the individual moving his/her own leg through its range. As the muscle warms up, the individual can swing the limb further and further through its range, never taking it more than the point of slight discomfort. Dynamic stretching is most commonly used prior to strenuous exercise.

Ballistic stretching is a slightly more risky technique, as it involves taking the muscle to its end range and gently bouncing the limb at this range. This technique is generally not advised, unless done under careful supervision of a Biokineticist.

Proprioceptive neuromuscular facilitation (PNF) is a highly effective form of

stretching, performed with the assistance of a therapist. It involves a contraction of the muscle to be stretched, which is held for about three seconds against the resistance of the therapist. The contraction is then released and the therapist pushes the limb slightly further.

Active-isolated stretching is another highly effective technique to improve flexibility while reducing the risk of injury. This technique must also be performed by a trained therapist. The individual contracts the opposite muscle those being stretched, thus assisting the therapist in moving the limb through its full range. By contracting the opposite muscle, one ensures that the muscle to be stretched is completely relaxed, thus reducing the risk of injury. This technique is particularly effective in more apprehensive patients who find it difficult to relax when being stretched.

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Finally, stretching provides a great form of relaxation and stress relief. So, whether you are young or old, active or sedentary, you need to stretch to reduce the risk of injury, maintain joint mobility and keep the body moving with ease and minimal pain.

Exercise Basics 101

Many of you may not be familiar with some of the terminology used when talking about exercise and some basic exercise principles. Exercise, like any other topic, has jargon, which is meaningless to someone who does not engage with such information on a regular basis. Seeing as you are all about to get started, if you haven’t already, I thought I’d provide some insight into the basics of exercise.

Three main types of exercise exist, namely cardiovascular, resistance and range of motion exercise. Cardiovascular fitness refers to the ability of your heart and circulatory system to efficiently and effectively supply the body with sufficient oxygen and energy when it is placed under physical stress, that is, when you are exercising. Types of cardiovascular exercise include walking, running, swimming, cycling and rowing. Cardiovascular exercise is essential in reducing the risk for heart disease and for weight loss/management. Resistance exercise is when the muscles are required to perform an action against some sort of resistance. In the gym, these are usually weights, toning circuits and body-weight exercises. Resistance exercise builds muscle, which in turn decreases fat percent. With age, one loses muscle mass. Therefore, it is important to do light weight exercises in order to maintain muscle mass and keep the fat percent at a healthy level. A high fat percent increase the risk for cardiovascular disease. Finally, range of motion exercises refer to stretching, an important but often forgotten part of the exercise regimen. Stretching is essential in maintaining mobility around the joint and flexibility of the muscles, thus reducing the risk for injury.

Ideally, one should include all of these three components during an exercise session. Depending on your exercise goals, you will spend more or less time on each component in a session and the structure of the session will vary accordingly.

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Heart rate refers to the number of times your heart beats in a minute. The average resting heart rate for adults is 72 beats per minute (bpm). To calculate your estimated maximum heart rate, the following simple formula is used:

                                    Maximum Heart Rate = 220 – Age

Fitter individuals will have a lower resting heart rate and will be able to elevate their heart rate to near-maximum levels during exercise. Less fit individuals will struggle to get the heart rate to the maximum, as the cardiovascular system will be unable to cope with the stress. Unfit individuals will have a quicker increase in heart rate during exercise than fitter individuals, as they are unable to cope as efficiently with the increase in exercise intensity. It is, therefore, important that you slowly increase your exercise intensity so that your body systems are able to adapt to the increased stress placed on them.

Aerobic activity is exercise of long duration and low intensity. Your heart rate is elevated to between 60 and 80 percent of your maximum. At this level, you should still be able to breathe comfortably, although you will feel that your heart rate is increased. Aerobic activity is important to improve cardiovascular fitness, which helps reduce the risk of heart disease, and for weight management.

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Anaerobic activity is maximal effort performed for short bursts, for example sprinting. Your heart rate is increased to between 80 and 100 percent of your maximum. You will be very short of breath immediately after the exertion. This type of training also improves cardiovascular fitness, but is often used more in sport-specific training.

So, as you begin your exercise regimen, first decide what your training goals are and then plan your exercise sessions accordingly. Remember: never exercise when you are sick and always have at least 1 rest day per week!

Exercising For Your Health

Many of you may believe that going to the gym means lifting heavy weights and sweating it out on the treadmill for an hour to make sure that you look good for the beach. What you may not realise is that, besides the physical changes that take place in terms of the appearance of your body, there are many more physiological changes taking place inside your body, improving your state of health.

Last week, I encouraged you to keep active on a daily basis and gave you tips on how to do that. Here, I will reiterate the importance of keeping active in order to improve your physical and mental health.

I have already explained that exercise is important in lowering blood pressure in individuals with high blood pressure, or maintaining a healthy blood pressure in individuals with a normal blood pressure. High blood pressure increases your risk for a heart attack and stroke. Also, high cholesterol increases your risk for heart disease. As I have mentioned previously, exercise also plays an important role in lowering cholesterol levels. Thus, by controlling your blood pressure and cholesterol by exercising regularly, you will reduce your risk for heart disease and stroke.

Exercise also plays a vital role in the musculoskeletal system. With age, you lose muscle mass, which means that your fat percentage increases, putting you at a higher risk for heart disease. By performing light resistance exercises 2-3 times per week, you can maintain your muscle mass and thus keep your body fat percentage at a healthy level. These exercises will also help to maintain the strength of your muscles, allowing you to perform your daily activities with more ease for longer. By performing gentle stretching exercises, you maintain flexibility of the muscles and mobility around your joints, thereby reducing your risk for injury. Weight-bearing exercises (exercises performed using your own body weight) assist in maintaining bone strength and are thus essential in patients with osteopenia or osteoporosis. Moderate-intensity, low-impact exercises are recommended for individuals with arthritis and assist in maintaining mobility and reducing pain in arthritic joints.

Exercise is an essential component in the management of various chronic diseases, such as diabetes, Parkinson’s Disease and Multiple Sclerosis. For diabetic patients, exercise is, in fact, one of the primary treatments for the management of this condition. By keeping the diabetic patient active, you assist in maintaining reasonable glucose levels, reduce their risk for heart disease, and assist in weight management. Exercise is also important in reducing the risk for developing diabetes. In neurological conditions, exercise can assist in managing the progression of these diseases.

Exercise provides a wonderful means to manage stress levels and enhance mood. When you exercise, endorphins – ‘happy hormones’ – are released, which improve your mood, making you feel better about yourself. Cardiovascular exercise and aerobics result in greater release of endorphins. Exercise also enables you to relieve the stresses of daily life, as you make time for yourself to focus on you and your body. Yoga and stretching exercises are wonderful for relieving stress and tension.

So, next time you think about starting an exercise regimen, think about the health benefits you will gain, rather than the physical changes you expect to see. Although it may often feel like a struggle to exercise, you will quickly miss it when you can no longer do it or have to stop temporarily.

Remember: don’t exercise if you are sick or on an antibiotic! The additional physical strain of exercise may be too much for your body to cope with if you are already trying to fight off an infection. Also, your immunity drops immediately after exercise, which means that you are likely to get sicker if you continue to exercise when you are not well. Listen to your body and take a break!  

 

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Exercise or Illness?

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One of the most common excuses I hear from people who don’t exercise is that they don’t have time to exercise. I realise that it is hard to dedicate an hour a day to formal exercise; however, it is essential to keep active on a daily basis in order to maintain a healthy body and mind, especially if you are stuck behind a desk all day.

It is recommended that you do at least 150 minutes of aerobic exercise per week, or about 30 minutes per day. This does not necessarily have to be spent sweating it out at the gym, but rather, it can be accumulated throughout the day. It is important to remember that the benefits of exercise are cumulative. This means that whether you do three 10-minute bouts of exercise throughout the day, or one 30-minute bout of exercise, the benefits are the same. But, in order to benefit from the exercise bout, your heart rate does need to increase, which means that a concerted effort does need to be made. Ideally, you want to exercise at least 3-5 times per week, for a minimum of 45-60 minutes. This does, however, depend on what your exercise goals are.

Having said that, a little bit is better than nothing. So, on the really hectic days when you simply cannot get to the gym to do an hour of formal exercise, here are some suggestions to get you active at work:

·         Go for a walk around the building as many times as possible during your lunch break – take a colleague to keep you company.

·         Always take the stairs instead of the lift.

·         Make sure you get up from your desk every hour and walk around a bit.

·         Fetch your own glass of water from the kitchen every hour; don’t have it brought to you.

·         Design your office so that you are forced to get up every now and then, for example, put your printer where you can’t reach it.

·         Walk to your colleagues offices instead of phoning them.

·         Choose simple exercises that you can do in your office, for example, stand up and sit down 10 times each hour.

At the practice where I work, we have a saying: “He who has no time for exercise must create time for illness!” I hope that you will think about this carefully and change now before it’s too late. Exercise is the best form of preventative medicine and it’s freely available to everyone! But, if you have not been active on a regular basis, please get medical clearance from your doctor before starting an exercise programme and consider starting under the supervision of a biokineticist.

Good luck and remember to keep moving! J

Cholesterol

Many of you have probably been told at some stage that you have high cholesterol and that you either need to start medication immediately or you need to adjust your diet and lifestyle to try and manage your cholesterol levels conservatively. Some of you may decide to take medication so that you can eat whatever you want; others may decide to eat whatever they want anyway and start medication when it becomes necessary. What you don’t realise is how detrimental to your health high cholesterol levels are.

It is important to mention that cholesterol is a vital component in cell structure, playing an important role in the functioning of the cells. Therefore, it is necessary in the body. However, high cholesterol levels put individuals at a much higher risk for cardiovascular disease than individuals with lower cholesterol levels. Ideally, total cholesterol levels should be below 5mmol/L. When testing cholesterol levels, it is essential that a total cholesterol profile is done using a vile of blood, as opposed to a simple finger-prick test, as there are various levels that need to be considered for diagnosis. Two important levels to consider are high-density lipoprotein (HDL), the ‘good’ cholesterol, and low-density lipoprotein (LDL), the ‘bad’ cholesterol.

So why are high cholesterol levels so bad? Cholesterol is a thick, waxy substance that sticks to the inner surface of the blood vessels when there is too much of it. This causes a build up in the vessels, which results in a thickening and hardening of the vessel walls, which in turn results in narrowing of these vessels. This means that there is reduced blood flow through the vessels, putting an unnecessary strain on the cardiovascular system. Because the vessels become hardened, they lose their elasticity, which results in an increase in blood pressure through the vessels. As I mentioned last week, increased blood pressure also puts undue strain on the cardiovascular system.

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There are numerous factors that increase a person’s risk for high cholesterol, including:

·         Gender (men > women)

·         Age

·         Genetics

·         Obesity

·         Body fat distribution (fat carried mainly in the waist is a greater risk)

·         High blood pressure

·         Diabetes

·         Diet

·         Smoking

·         Stress

·         Lack of physical activity

Exercise plays an important role in lowering total cholesterol levels, as it increases the level of HDL (‘good’ cholesterol), which assists in lowering LDL levels. It is recommended to do at least 30 minutes of aerobic cardiovascular activity 5 times per week. This means that you must be able to breathe reasonably comfortably, but your heart rate must be elevated for the entire 30 minutes. This will help to keep the blood flow through the blood vessels strong, thereby lowering the risk for heart disease.

Resistance exercises (light weights) and stretching are also recommended for an overall improvement in body condition. Remember: you want to increase your calorie expenditure, so that excess calories are not stored as fat in the body, contributing to high cholesterol levels.

For those of you who think you are too young to worry about your cholesterol, remember – it runs in the family. So, start exercising regularly now to avoid high cholesterol levels later. Do as much as you can as often as you can and be careful of what you eat!

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Please visit the Good Life Dieticians blog for more information on how to maintain a healthy diet while still enjoying the good life!

http://goodlifedietitians.blogspot.com/

The Silent Killer

Hypertension, more commonly known as high blood pressure, has been nicknamed ‘the silent killer’ because there are no noticeable symptoms, but its presence can be fatal. An individual with hypertension is at an increased risk for renal (kidney) disease, cardiovascular disease and stroke. The table below classifies blood pressure for adults aged 18 years and older.

Category	Systolic BP (mmHg)	Diastolic BP (mmHg)
Optimal	< 120	< 80
Normal	< 130	< 85
High-normal	130-139	85-89
Hypertension      Stage 1      Stage 2      Stage 3	140-159 160-179 180	90-99 100-109 110

Adapted from ACSM’s Exercise Management for Persons with Chronic Diseases and Disabilities, Second Edition, 2003.

Systolic blood pressure refers to the pressure in the blood vessels when the heart is contracting. Diastolic blood pressure refers to the pressure in the blood vessels when the heart is relaxed. Hence, high blood pressure puts undue strain on the heart. ACSM identifies the following risk factors for hypertension: obesity, high sodium intake, smoking and inactivity. All efforts should be made to modify lifestyle first, but medication may be administered immediately when necessary. It is important to note that hypertension generally does not occur in isolation; often other pathologies exist, such as high cholesterol and insulin resistance.

Exercise plays an important role in managing cardiovascular disease and hypertension by improving cardiovascular fitness, increasing circulation and relieving stress. The following exercise guidelines can be used for persons with hypertension:

·         Increase aerobic activity (walking, jogging, cycling, rowing, etc.) – try to do at least 30-45 minutes 3-5 times per week

·         Avoid heavy weights

·         Avoid movements that involve lifting weights above your head

·         Remember to breathe throughout exercises – don’t hold your breath!

Remember: check your blood pressure on a regular basis so that preventative measures can be taken before the silent killer strikes!