Cold weather aggravating your asthma while exercising outdoors?

If you have asthma, there is a 90% chance that you also have exercise induced asthma (EIA). There is also a good chance that exercising in cold dry weather makes your EIA worse. But there are some simple ways to overcome these barriers so that you can continue to exercise outdoors all winter long!

There are three things you can do to prevent EIA from creeping up on you during a workout, whether indoors or outdoors, hot or cold, dry or humid. These are scientifically proven to be helpful.

  1. Warm-up: For people with EIA a high intensity warm-up (60% of your max) 15 minutes before your workout is a proven way to reduce EIA symptoms during your workout. This is of course complicated as most people don’t sit around after they warm-up. You could warm-up, then do some strength training for 15 minutes, and then get back to your aerobic exercise. Or, you can…
  2. Take your rescue medication 15 minutes before your workout: This quick acting medication ensures that your airways stay nice and open during an exercise session and is a great way to prevent EIA from compromising your workout. Of course, if you exercise 5-7 days/week, you may not want to take all that medication. So, number 1 may be the better option. Alternatively, you can reduce the frequency and severity of EIA by doing number 3.
  3. Increase your aerobic fitness: This is a bit of a catch 22. How do you increase your aerobic fitness if you’re constantly having EIA symptoms? Well, you can warm-up or take your medication when you first begin an exercise routine and then once your fitness levels improve, the frequency and severity of EIA should decrease quite significantly, therefore eliminating the need for a high intensity warm-up or medication 15 minutes prior.

These sure fire ways of preventing EIA of course are further complicated when you’re exercising outdoors on a cold-dry day. So, here are some things that I do to prevent EIA from creeping up on me when I run outdoors in the winter. I hope they work for you. FYI: these are not scientifically proven to be effective, but 9/10times, they work for me!

  1. Breathe through a face mask or scarf: I’m a scary looking person when I go for a run in the winter. I wrap a scarf around my nose and mouth nice and tight so that I am breathing through the scarf during my run. This allows for the air to warm up before entering the airways…which helps prevent EIA. It also moistens the air a bit since you are breathing in through a damp scarf (it naturally dampens after the first couple of minutes of running).
  2. Breathe through your nose: If you have asthma, you’ve likely heard this before. Breathe in through your nose and out through your mouth. In the winter, this technique ensures that you are not breathing cold dry air directly into your airway, but are forcing it to go through the nasal passage (to warm up and get moist) before entering your airways. It also helps keep that scarf around your face nice and damp (I know, gross!).
  3. Chew gum or suck on candy: I find that having gum in my mouth or sucking on a hard candy forces me to continuously swallow saliva…this keeps the throat somewhat moist and helps prevent EIA symptoms; particularly if a sore throat is one that bothers you. This technique also helps with breathing in through your nose since your mouth is busy.

I am sure there are many other techniques to prevent the cold from ruining your workout. Please feel free to share them here as I am always looking for additional ways to overcome this annoying little barrier!

I hope these tips help you maintain your Healthy Active Lifestyle Forever!

 

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Finally Some Research on Crossfit!

High intensity, short duration exercise programs are growing in popularity. Evidence shows that such exercise programs lead to significant improvements in cardiorespiratory fitness (aka  aerobic fitness), body composition, muscular strength, and of course, health. Crossfit is a company that believes in this fitness principle and emphasizes programming focused on functional fitness. It has had much success and is continuing to grow in popularity. Unfortunately, there is no peer-reviewed research available on the effectiveness of Crossfit training. I am certain that anyone involved with Crossfit would happily provide anecdotal evidence that it has led to significant improvements in their fitness, health and quality of life. But for a program to be endorsed by professionals in the field, evidence is required.

As such, I was delighted to see a paper recently published in the Journal of Strength and Conditioning Research entitled “Crossfit-based high intensity power training improves maximal aerobic fitness and body composition” (doi: 10.1519/JSC.0b013e318289e59f); In Press).  I was particularly delighted to see that they used cardiorespiratory fitness as an outcome since the program consists primarily of strength and power based exercises. The study was a 10 week intervention with a total of 23 males and 20 females. The average age of this sample was approximately 32 years. Participants completed a maximal treadmill exercise test to determine VO2max; a measure of cardiorespiratory fitness that is considered to be the gold standard. The second main outcome assessed in the study was body composition as measured by the Bod Pod (air-displacement plethysmography). Unfortunately, this is not considered to be a highly reliable or valid method for assessing changes in body composition. The researchers would have been better off taking measures such as waist circumference, flexed bicep circumference or skinfolds at specific sites. These would have been more accurate in describing changes over the 10 week training period. Nonetheless, significant improvements in VO2max, body fat% and lean mass (i.e. muscle mass) were found. Another significant shortcoming of the present study is the lack of a control or comparison group. We know that exercise leads to improvements in fitness and body composition, but does Crossfit training provide additional benefit over other forms of exercise? We can’t answer that question with this data. More importantly, given the unreliable measure of body composition, the only take away from this study is that Crossfit training may lead to significant improvements in VO2max. Just in case I’m starting to sound cynical, I would like to emphasize that cardiorespiratory fitness or VO2max is the strongest predictor of health and mortality, so this is a very important finding.

TAKE HOME MESSAGE: There is no doubt that exercise is good for you and that high intensity exercise is better. For those of you interested in improving your health and cardiorespiratory fitness, Crossfit may be a great option. It provides a social support system, motivating coaches and a positive environment for exercise; all things that will really help you adhere to a Healthy, Active Lifestyle Forever!

NOTE: High intensity requires that you have a certain baseline level of fitness, so be sure to ease yourself into such a program; this will minimize your risk for injury and make for a much more enjoyable experience.

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My Optimistic Journey with Barefoot Science Insoles

I have flat feet but I didn’t realize it until I started running 8 years ago. I was told to invest in custom orthotics and I trusted the experts, so I had a pair made. The orthotics helped at first, but 2 years in I ended up with a stress fracture. Perhaps other factors were to blame, but since I started wearing my orthotics I’ve had one injury after the other. This past year I was recommended by a physiotherapist to get a new pair since my old ones were clearly inadequate. So, a new plaster was made, another $500 paid, and I started running with new orthotics. Less than 5 months in a new debilitating injury appeared. It felt like I was going to be stuck in a vicious cycle of injuries, rehab, new orthotics and new running shoes. Lots of money spent, but no long-term solution on the horizon. If this story is starting to sound familiar, you might be interested to hear what I have to say.
I decided to go minimalist; not barefoot, just minimalist. I have an arch in my foot but it collapses when I’m standing or weight bearing. This means that strengthening/stretching the associated muscles and tendons could rectify the problem, at least partially. Yet, in all the years of going to rehab specialists, not one recommended exercises for my feet or ankles. Not one!
I did some research and found some appropriate exercises. I also got rid of my painful orthotics and started wearing running shoes with no arch support. I stopped running for a couple of weeks and through a friend of a friend I learned about Barefoot Science Insoles (http://www.barefoot-science.com). As a scientist I rarely buy something without seeing the evidence first but with no research trials available on the product and two extremely positive anecdotal reports, I decided to give them a try anyway.

WEEK 1: Last week, with a sample size of just one (n=1, literally) I began my research on the Barefoot Science Insoles. I put them in my running shoes and decided to pound the pavement. I mapped out a 5K, but it was a gorgeous day, so I ran just over 8K. It felt great. With the exception of a little IT band pain while running up the final hill and the smallest start of a blister, it went well. For the first time in months I was able to run more than 6K without ankle pain, knee pain or complete discomfort in my feet. Now obviously, it was day one, and I might have been a bit euphoric on hope.
Over the course of the week I have used the insoles in all of my shoes for workouts and work. My calves were easily fatigued and occasionally I experienced discomfort in my foot (primarily when on the elliptical), but all in all, things have been good. My ankle is feeling better; likely a combination of a decrease in running over the past couple of weeks and hopefully because of the new insoles.
Stay tuned for weekly updates on the insoles (it is a 7 week program). I will be sharing the good, the bad and the ugly. I also hope to hear from others that have used them or products similar to them.

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Is being flexible really all that important?

There are three main components of health related fitness: aerobic fitness, musculoskeletal strength and endurance, and flexibility. While the link between aerobic and musculoskeletal fitness with health and independence is clear and consistent, there is limited evidence to show any relationship between flexibility and long term functional health outcomes.

So, is flexibility important? It is important to note that I am not asking if stretching is important. Of course, at the end of a long run or strenuous workout, one should stretch as there is evidence to suggest that this prevents injury and maintains flexibility. But does it matter if I am a flexible person? Do measures of flexibility actually determine whether I will be healthy and remain independent when I am older? A recent review published in the Journal of Aging Research attempted to answer just this question. In a paper entitled “Flexibility Training and Functional Ability in Older Adults: A Systematic Review” Dr. Stathokostas and her colleagues reviewed 22 research studies and found that flexibility training (i.e. stretching of the appropriate intensity, frequency and duration) leads to an increase in range of motion of a joint, but does not necessarily lead to an increase in functional abilities. The average age of participants in the papers reviewed was 74 years. The main outcomes assessed were range of motion about a joint (flexibility), assessments of gait and walking speed as well as a variety of functional tests such as how long one takes to stand from a chair and walk 8 meters. According to the results of the review, gait and walking speed were positively affected by flexibility training, but this was not consistent. Further, many studies did not demonstrated a significant improvement in functionality with flexibility training. In a subgroup of older old participants (aged 80 and older) results were a bit more promising, but still not consistent.

The flexibility training used in the studies ranged in intensity, type, duration and frequency. Some studies used whole body training i.e. joints all over the body were trained while others only used lower body/lower back stretches. The studies ranged in duration from 4 weeks to one year and the frequency was approximately 4 sessions per week. Stretches were held anywhere from 30-85 seconds. Despite scientifically devised flexibility training sessions, the review showed that there is not much benefit on overall functional ability. So, why is there such an emphasis on stretching? Well, as I mentioned above, for those of us who are active we need to stretch to ensure we prevent injury and to ensure we are able to maximize our athletic performance. Also, for those who have sedentary jobs, stretching can help ease muscle tension. Of course, an inflexible lower back leads to significant problems as well. It seems then that maintaining “normal” flexibility is important, but increasing flexibility may offer no additional health benefit.

Take Home Message: Maintaining “normal” flexibility is important for general health however, it is apparent from this review that flexibility training is not strongly associated with functional ability, particularly among older adults. Thus, while we should spend some time stretching after a workout or a long day at the office, there may be no point in spending additional time stretching. I would suggest that you use that extra stretching time to do some aerobic activity (eg. walking) as aerobic fitness is STRONGLY associated with health and wellness. Whatever you do, stay active so that you can maintain your HALF!

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Reasons we should be cautious of the new finding that being overweight reduces the risk of death

A recent article published in the Journal of the American Medical Association entitled “Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index Categories concluded that “Grade 1 obesity overall was not associated with higher mortality, and overweight was associated with significantly lower all-cause mortality.” In other words, based on body mass index, these authors found that being overweight was a good thing and that being obese is not a problem.

Well, here is the problem: the authors used body mass index (BMI). This is a ratio of one’s height and weight. It can be calculated by dividing your weight in kilograms by your height in meters-squared. A BMI of 18.5-24.9kg/m2 is considered to be normal where as a BMI of 25-29.9 is considered overweight and a BMI of 30-34.9 is considered grade 1 obese. The problem with this measure is that it does not take into account the distribution of fat. For example, let’s say I had a BMI of 28, but the majority of my fat was located in my thighs and arms. This may not be desirable, but it isn’t necessarily a health risk. It is when fat is located in the mid-section that we should be concerned. Specifically, fat located in the mid-section underneath the muscle i.e. visceral fat is of great concern. Waist circumference is therefore a better predictor of disease and mortality risk than BMI as it tells a more complete story. Let’s go back to my original example. If my BMI were 28 and I had a waist circumference of more than 88cm (102cm for males) then I would be at HIGH risk for death and diseases.

So, my quick take on this paper is that it should be ignored by the media and the general population. There is unequivocal data to show that being over-fat is a health risk. Granted, having a BMI that categorizes one as overweight or obese doesn’t necessarily mean the person is over-fat. It is because of these limitations that the Edmonton Obesity Staging System was created. Please read my previous post on this comprehensive approach here: http://sdogra.com/2012/06/18/healthy-obese/ and please stay committed to your Healthy Active Lifestyle Forever!

 

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Five Tips to Stay Healthy this Holiday Season

Christmas is a special time of year.

It’s filled with presents, food, family and lots of holiday cheer.

But when it’s all over and there is nothing left to do,

We are often left unhealthier and feeling somewhat blue.

So here is a list of 5 things that you can do,

To make sure this season doesn’t leave too many New Year’s Resolutions for you!

  1. Get lots of sleep: If you want to ensure you don’t munch on goodies all day, stay cheery, have lots of energy and stick with an active lifestyle, it is ESSENTIAL that you get all the zzzz’s you can. There is a strong and growing field of research to indicate a significant relationship between lack of sleep and obesity. So schedule in your 8 hours for every night this holiday!!!
  2. Liquid Calories and Portion Size: ‘Tis the season of food and drink. And we shouldn’t deprive ourselves of our favourites, but remember, one or two bites should be good enough to satisfy your cravings! Keep portion sizes in mind and be aware of how many snacks you’re eating while waiting for the big turkey or ham. Try to avoid loading up on mashed potatoes, dinner rolls and gravy. More importantly, keep track of how many glasses of wine, beer and hot chocolate you’re drinking. Those liquid calories add up fast!!!
  3. 30 minutes to move:  Time is a big barrier to maintaining physical activity levels over the break, but all you need is 30 minutes, and  no one said they had to be a solitary 30 minutes! Go for a walk with your siblings or parents or cousins or in-laws or nieces and nephews. It’s a great way to keep moving and a great way to have meaningful conversations with your loved ones! Here is a little inspiration for those 30 minutes a day: https://www.youtube.com/watch?v=aUaInS6HIGo
  4. Laugh Lots!: Laughter really is the best medicine. It’s a great stress reliever, and boy do we ever need one at this time of year. So either rent a good comedy or bring up old embarrassing stories of one another and get laughing. You might even get a good ab workout from it J
  5. Relax and Enjoy: Many of us work our buns off so that we can enjoy time off with the families this time of year. Some of us have worked really hard to ensure that our families have a great holiday meal, presents and the like. Overall, we lead stressful lives, and this time of year is no exception. Be kind to your mind and body by taking some time to rest, relax and enjoy the season. Do some yoga, take a nap or listen to soothing music. Whatever works for you!

If you’re happy, rested and relaxed, you’ll be able to stick with your healthy, active lifestyle forever!

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These are a few of my fave fitness gifts to give…

Have a health conscience person on your Christmas list this year? Not to worry, there are some wonderful gifts you can purchase for your loved ones that range from inexpensive to pricey. Each one shows that you understand their commitment to their health and are happy to support it!

Here are some that I have given in the past and HIGHLY recommend:

  1. Resistance Bands: You can buy these bands in most fitness/sport stores but also in stores such as Walmart or Canadian tire. The bands can be used for in home strength training and provide an excellent workout if done correctly. You can buy a little book with exercise descriptions to go along with it, or search online for some good exercises and print a few pages off to create a customized booklet.
  2. Sarah Powers Yoga: I love my yoga, especially after a long, hard day. But I use yoga to relax and revitalize, whereas some use it as they’re primary workout. The Sarah Powers DVD (http://www.sarahpowers.com/) gives you two easy and two hard yoga workouts that focus on functional fitness and mind-body wellness. She is amazing, and I highly recommend her DVD to people of all fitness levels.
  3. Nordic Walking Poles: Nordic poles are a great way to increase the intensity of your regular walk. If you know someone who is trying to lose weight, has diabetes, arthritis, high blood pressure or is at a high risk for any of these conditions, a pair of Nordic Poles could really change their life. The poles incorporate upper body muscles and when done properly, Nordic pole walking can increase the number of calories burned during a walk and increase your aerobic fitness levels quite dramatically! Here is a website for an inexpensive but high quality pair of poles: www.nordixx.com
  4. Lifestyle and Fitness Consultation: If you know someone who needs to start exercising but is at a loss of where and how to begin, consider purchasing them a couple of sessions with a qualified exercise professional such as myself.  Sessions can involve fitness assessments, lifestyle consultations and one-on-one exercise sessions. Be sure to look for someone with the right certifications and qualifications for the job!  (Certified Personal Trainer or Certified Exercise Physiologist in Canada).
  5. Gym Membership: Depending on your budget, purchase a gym membership for a loved one for a few months or the whole year. This is particularly a great idea if you are already a member at the gym so that two of you can provide each other with the support and motivation required to maintain a healthy active lifestyle forever!

 

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How many times per week should older adults lift weights?

There is no doubt in the exercise science and health world that strength training (a.k.a. weight training or resistance training) is beneficial for older adults. In addition to increasing overall strength, it prevents bone and muscle wasting as you age. This is particularly important for older women. Women are at a higher risk of developing conditions such as sarcopenia (low muscle mass that increases risk of becoming dependent) and osteoporosis (low bone mineral density that increases risk of fractures) than men. In other words, they are more likely to require assistance to conduct activities of daily living such as cleaning, cooking and washing themselves, than are men. This is one of the reasons we see more women living in assisted living facilities (nursing homes) than men. Luckily, women can prevent this loss of independence if they routinely participate in strength training. While there are guidelines available on what you should do, there is some debate over “how much” you need to do to reap these health and fitness gains.

A recent study conducted by Farinatti et al. in the Journal of Strength and Conditioning Research set out to determine the difference in benefits from training once a week compared to training twice or even three times per week. Women over the age of 60 participated in 16 weeks of strength training and completed fitness assessments both before and after this training program. The training program consisted of 8-12 repetitions of 10 exercises conducted at an intensity of 60-80% of maximum measured strength. Only one set of these exercises was conducted at each session and weight (loads) was increased by 5% when the participant was able to perform more than 12 repetitions. Thus overall, participants who were in the group that exercised once per week conducted 8-12 repetitions of each of the 10 exercises at a weight that caused their muscles to fatigue completely.  Those in twice weekly and three times weekly groups did this same exercise routine on one or two other days of the week. The authors found that generally, more was better. When looking at gains in strength, those who exercised three times per week had the greatest gains. Furthermore, those in the group who exercised three times per week also had the greatest gains in functional fitness. However, it should be noted that ALL GROUPS had significant improvements in strength and functional fitness i.e. just one set of high intensity strength training per week led to significant gains in strength and thus health!

TAKE HOME MESSAGE: As we age we lose muscle mass and increase our risk of becoming dependent on others. In order to maintain our independence it is essential to include strength training in our weekly exercise program. Research indicates that one set of 8-12 repetitions of high intensity strength training is sufficient to improve strength and functional fitness, but that doing this on 2 or even 3 days of the week will lead to greater benefit. So, if you are crunched for time be sure to include at least one set of high intensity strength training to your weekly routine. If muscle loss is of concern to you, do your strength training exercises 3 days/week. Remember, strength training is essential in ensuring your HALF!

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Pole Dancing…I mean Pole Walking is good for your health!

Well, pole dancing is probably good for your health too, but in this article I will be focusing on the health benefits of pole walking a.k.a Nordic walking or Nordic pole walking. If you’ve ever seen someone out for a walk with ski poles in their hands, you’ve witnessed Nordic walking. You might wonder why they have these poles in their hands. The short answer is that Nordic walking is a much more effective way to improve health than standard walking. Adding poles to a standard walk allows you to walk faster and also allows you to engage the muscles of the upper body; muscles often neglected in a standard walk. This form of walking has been shown to be especially beneficial to those with type 2 diabetes, people who have arthritis and of course to those hoping to lose weight.

A recently published intervention among overweight adults with varying levels of blood glucose control (normal, impaired and type 2 diabetes) assessed the benefit of unsupervised Nordic Walking among middle-aged and older adults. The researchers randomly assigned participants to either a control group (i.e. no exercise changes) or a Nordic walking group. The Nordic walking group was instructed to increase their weekly physical activity levels by 5 hours per week for 4 months using the Nordic poles. They attended an instructional class and were explained what intensity range they should walk within. At the end of the 4 months the Nordic walking had differing effects in the three groups. In the group with normal blood glucose levels body weight and waist size (waist circumference) both improved significantly. In the groups with impaired blood glucose levels, exercise capacity and physical fitness levels improved significantly. Finally, in the diabetes group, blood glucose levels and exercise capacity improved significantly. Another noteworthy finding was that those in the Nordic walking groups increased their weekly physical activity levels by 4-5 hours per week in each of the three groups. This is great news as it seems that Nordic walking is an activity that overweight individuals enjoyed and therefore were able to stick with!

It appears that one simple addition or change to your walking routine can have a fairly significant influence on your health and fitness levels. While it wasn’t assessed in the study described above, and research certainly is limited in this area, I can say from personal experience that Nordic walking can lead to improvements in muscular endurance of the upper and lower body as well as increase the speed with which you can walk. All in all, it is a great way to increase the intensity of your walking and a great way to derive greater health benefits while spending the same amount of time being active. If you are interested in learning how to walk with Nordic poles please check the following website for instructors and groups in your area: http://nordixx.com/find-a-walking-group/

TAKE HOME MESSAGE: Adding some Nordic poles to your walk can lead to significant improvements in your health and fitness levels. Be sure to give it a try, but make sure you learn the proper form before purchasing a pair of poles. This will ensure you prevent injuries and that you maximize the benefits derived from the activity. This activity is particularly beneficial if you are trying to lose weight, have diabetes or cardiovascular disease or arthritis. So be sure to give it a try and see if a simple pair of poles can help you get closer to your HALF!

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