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Continuing Education

Sitting less and moving more or deliberate exercise: which is the more effective strategy

Posted on May 12, 2017 at 9:15 AM Comments comments (1)


Sitting less and moving more

May be more important than deliberate exercise.


What do we know?

New research reveals that individuals at high risk of developing overweight/obesity related diseases such as type ²diabetes would benefit from being told to sit less and move around more often rather than simply exercising regularly. The experts suggest that reducing sitting time by 90 minutes in total per day could lead to important health benefits. The idea that exercise is good for us is drilled into our brains by the medical community and what I call “those media experts on Good Morning America”. While certain types of exercise can certainly be beneficial, placing too much emphasis on formal exercise may be highlighting the wrong issue and contributing to long term health problems. Research is now telling us that movement rather than exercise has the most positive impact on our weight and overall health.

What do you think the definition of the term Sedentary is?

You may be surprised how the usual, conventional thinking is not supported by what physiology science supports. I can’t tell you how many people I have seen in my practice that begins our initial conversation with “I have no idea of why I am overweight/obese since I exercise!” Typically it goes like this: I go to the gym nearly every day. I work with a personal trainer a couple of days a week. I do “beach boot camp” a couple of times a year. I go Zumba class 3 X per week.

Who is more sedentary: the person who exercises for one hour several times per week or the one who never exercises at all? Conventional wisdom tells you that the second person is sedentary. This, however, is an incomplete picture and may in fact be completely wrong if other factors are considered.

More important than how often you participate in structured exercise is how much you move during your everyday life. Why? Because how much time you spend sitting adversely affects your health far more than how much time you spend doing formal exercise. If you spend hours a day sitting (at a computer, in front of a television, reading, playing video games, etc.), it can negatively impact your health even if you exercise regularly. Basically, regular exercise is not enough to counteract an otherwise sedentary lifestyle.

Given this new understanding of inactivity physiology and the health impacts of sedentary behavior, I would argue that there is now sufficient evidence for health practitioners to expand their thinking beyond “purposeful exercise”. In my opinion, it would be very helpful if PCP’s would feel comfortable engaging their patient’s in this “health” conversation. Especially; this new perspective on the negative health consequences of too much sitting should be seen as a sensible first start for those who are inactive due to motivation and/or limited mobility. Adding in consistent movement along with participation in any purposeful, physical activity the patient is already engaging in is certainly an advantageous partner.

Communicating this new perspective to the public and to policy-makers will require some ingenuity and clear messages that it is neither one nor the other but both. I suggest that too much sitting around need equal emphasis with exercise recommendations. Many people have a poor or limited understanding of what is meant by “sedentary time.” Perhaps the most practical definition of sedentary time for the public could be based on postures such as sitting and lying down. People do not know their minute-by-minute energy expenditure or personal metabolic profile throughout the day, but they do know their posture. When people are sedentary and awake, they sometimes lie down but they usually sit. People sit at work. People sit to eat. People sit in social settings. Thus, public health recommendations about physical inactivity may be best communicated if they use terminology related to posture: “Be aware of your posture throughout the day: sit less, stand more!”

The best solution to being sedentary is to sprinkle “good posture” into our everyday lives with activity. This can be done in a variety of ways:

1. Take phone calls standing up or walking.

2. Use a standing desk if possible or sit on an exercise ball at your desk.

3. Take frequent breaks during your day by getting up and walking around for about 5 minutes every hour

4. Try yoga or Tai Chi stretching movements 2-3 times per day for 2-5 minutes

5. Get up during commercial breaks while you`re watching television.

6. Use the stairs instead of the elevator whenever you have the choice.

7. Park on the far side of the parking lot when you can.

8. Get up and go window shopping rather than browsing online.

9. When you meet with friends, clients or colleagues try to do something that includes more movement and stop making eating the center of these fellowship based activities. I always say: “Time with others should always be about the fellowship not the food!”

  

This information is solely provided to assist you in a conversation with your physician. Consult your physician regarding the applicability of any information provided to your symptoms or medical condition. Only your physician is qualified to determine what is right for you and your specific health concerns


These are the resources that provided the information that I used in this article and shaped my opinion                                                                                                                                                                                                           

Haskell WL, Lee IM, Pate RR, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116:1081–1093.

 

 

Peri Menopause or Menopause?

Posted on February 28, 2016 at 11:10 AM Comments comments (0)

This information is solely provided to assist you in a conversation with your physician. Consult your physician regarding the applicability of any information provided to your symptoms or medical condition. Only your physician is qualified to determine what is right for you and your specific health concerns

 

Perimenopause, also called the menopausal transition, is the interval in which a woman's body makes a natural shift from more-or-less regular cycles of ovulation and menstruation toward permanent infertility, or menopause. Women start perimenopause at different ages. In your 40s, or even as early as your 30s, you may start noticing the signs. Your periods may become irregular, longer, shorter, heavier or lighter, sometimes more and sometimes less than 28 days apart. You may also experience menopause-like symptoms, such as hot flashes, sleep problems and vaginal dryness. Discuss any treatments available to help ease these symptoms with your physician. Once you've gone through 12 consecutive months without a menstrual period, you've officially reached menopause, and the perimenopause period is over.

Perimenopause or Menopause? Menopause is the time during a woman's life when she stops menstruating. You have not yet reached menopause if you're still having periods, even though they might be irregular or occur only once every few months, according to the Mayo Clinic. After one year of no periods, you can assume you've reached menopause. Symptoms such as night sweats, depression, moodiness, and anxiety and heart palpitations occur during perimenopause. Common changes that occur include sleep disorders, hair loss and the one most women complain of is weight gain. This can also be accompanied by pain and discomfort in various parts of the body. During pre-menopause, more commonly known as perimenopause, weight gain is a universal occurrence among women experiencing natural changes in hormone levels, according to the Mayo Clinic. Perimenopause is the stage leading up to menopause and is accompanied by symptoms and changes most people usually associate with menopause, including weight gain. However, women can take steps to minimize these symptoms and changes, such as following a healthier diet and exercising regularly.

Can how you eat make a difference? Diet plays a crucial role in helping women to maintain a healthy weight during perimenopause. According to the Mayo Clinic, women who gain weight often gain the most weight during perimenopause. Many complain that they make no changes in their diet and exercise regime that had served them quite well until they were visited by the perimenopause/menopause “friend’. So let’s look at what might be the underlying culprits for this Phenomenon. 1. When we feel a little off we are more likely to lean a little heavier on starches. This is the carbohydrate group that connects to our feel good senses in two ways: starches give us a sustained high and often starches are imprinted as a remedy from childhood. Remember when you skinned your knee and got a cookie or felt sad and you got an ice cream cone. Think back about these childhood imprints- Did your parent every offer you vegetables when you were feeling off? Starches are the carbohydrate sub-group more likely to make us fatter. 2. Estrogen and progesterone are hormones. All hormones have been shown to be synergistic with other hormones and the optimal functionality of the human body. Changes in estrogen and progesterone can alter the efficacy of other important hormones such as thyroid and insulin. Even if these hormones remain in the “normal area” on your labs, they may be just off enough to invite a little weight gain. 3. When we are not feeling our best, we can talk ourselves out of being as active as we should be. The older we are the more we need to sit up straight and move our tush! Think of it this way, the more miles you have on your chassis the more effort we need to put into our vehicle to keep it on the road. We need to think sports car not a beat up 2 ton truck! Weight gain at any age is risky and can lead to health problems, but it can especially be problematic for older women. Some women believe that by taking herbs they can thwart the symptoms of perimenopause, including weight gain. Although these dietary additions tout that they may help to reduce symptoms, I am suspect of these claims. Discuss any of these with your physician. All supplements should be considered in the realm of medications with possible risks. The safe and sensible strategy to address any weight gain during perimenopause/menopause is to follow a well-balanced and healthy diet that includes plenty of fresh vegetables and fruits along with moderate exercise and stress management. Importance of Exercise At any age, exercise is important for maintaining overall health. However, people tend to lose more muscle mass as they age. More than ever, it's critical for older women to maintain a regular workout routine that includes aerobic activity, stretching exercises and strength training, according to the Mayo Clinic. Not only does regular exercise help with maintaining a healthier weight, but it also helps to lift your mood and can help women deal with the naturally occurring changes in the body during perimenopause. Hormone Therapy Some women take synthetic or natural hormones, or bioidentical hormones, to help relieve perimenopausal symptoms. However, since every woman is different, it is important to talk to your physician to understand your options and what is best for you and your specific health needs.

References: DS00554 Sept. 16, 2010 © 1998-2012. Mayo Foundation for Medical Education and Research (MFMER).