New Years Resolutions -Pt 2
Why didn’t it work?
Never started
Goal were unrealistic/short
Economics
Another stressor took priority
Started but injured
Started but flared up medical prob
-Never started
Kristen Dieffenbach, PhD :“We avoid exercise because we’ve robbed it of any joy”
-I can’t deal with one more thing… Healthy living for the Healers
-I’m always tired….. Give yourself 10 minutes
-I know I’ll get bored and quit….. Personal trainer for first few weeks
April O magazine
-Unrealistic goals
1 Preventing weight gain in adults, POP study Low intensity educational approach not enough to prevent gain
2 Systematic review of the use of financial incentives
in treatments for obesity and overweight meta-analysis of 9 studies using incentives=no significant effect 12 18 mnth
3 Obesity, Weight-Loss Failure Linked to Personality Traits
small study showing personality traits may be responsible
International Journal of Obestiy, April 2007
bibliography
1. Am J Public Health. 1999 May;89(5):747-51
2. Obes Rev. 2008 Jul;9(4):355-67. Epub 2007 Oct 23
3. Psychiatr News May 18, 2007,Volume 42, Number 10, page 28
…Unrealistic goals
Too much too soon becomes a stressor (failure)
POP (pound of prevention) study Increase exercise (82%),
Decrease fat (79%),
Reduce volume (78%),
Eliminate sweets/junk (73%),
Reduce calories (73%),
Increase fruits and veggies (67%)
Am J Public Health. 1999 May; 89(5): 747–751
-Economics
Still need to stay healthy while looking
Networking while exercising
Low cost to freeAfter the trauma, inspiration is difficult to maintain when unhealthy. (exercise will make you recognize opportunity in places won’t notice when stressed)
Dr Saguil’s 3 stars
La Fitness Naperville (630) 303 9341-(Demir) 49/m +149 enrollment
Lifetime Fitness Winfield (630) 393 2600 -59/m +(179+85) initiation fee
Parks Plus Fitness
(630) 871 6713 -37m with varying plans for age and number people
Dr Saguil’s 4 stars
Planet Fitness Naperville (630) 416 7200 -21/m for a year
Cardinal Fitness Glen Ellyn (630) 790 0306 -20/m monthly
Wheaton College (630) 752 5146 -125/quarter + 30 initiation fee
College of DuPage (630) 942 2364 -80/ 3month or 40/3month >60y/o
Dr Saguil’s 5 stars
Dick Ponds Lisle or Carol Stream (630) 357-6884 or (630) 665 3316 -Walk to Run Groups
Spokes (630) 690 2050 – 4x a week non elite riding group
Dr Saguil’s Honorable Mentions
Tai Chi/Qi Gong (world tai chi day 4/25) The Lightheart Center Winfield 630 260-1084
Dahn Yoga Naperville 630 505-0809
Bikram Yoga Naperville 630 428-9644
Aikido College of DuPage 630 942 2364
-Another stressor took priority
Stress Response* - “fight-or-flight” prepares us to fight or run away from a stressor with
an array of physiologic changes; increase heart rate, increased blood pressure, fast breathing,
heightened awareness, more blood flow/oxygen to skeletal muscle and less to smooth muscle
- 60-90% of visits to physicians are related to stress and other mind body interaction (adapted from Clinical Training Mind-Body Medicine Harvard) *
(driving, deadlines, bills, relationships, jobs, hunger, pain, news)
Bibliography
*Adapted from Clinical Training in Mind-Body Medicine Henry Benson Institute/ Cummings, VandenBos, 1981; Kroenke, Mangelsdorff,1989
-Another stressor took priority
Relaxation response* -”A state of relaxed, passive attention to a repetitive or absorbing
stimulus that turns off the “inner dialogue” thereby decreasing arousal of the sympathetic nervous system.” *
-Our results suggest consistent and constitutive changes in gene expression resulting from RR may relate to long term physiological effects. **
Bibliography
* Denninger, J, Clinic training in mind body medicine, Relaxation response research, Harvard 2009
**Marie G. Joseph, Towia A. Libermann, Manoj Bhasin, Jeffery A. Dusek, Herbert Benson, Hasan H. Otu, Ann L. Wohlhueter, Luiz F. Zerbini Genomic Counter-Stress Changes Induced by the Relaxation Response Published 02 Jul 2008
KOBE BEEF!
Drink beer, sake
Massage daily
Eat the best available
Brushing daily
Walk through nature
Low stress!
What relaxation can do:
-Started but injured
Stretching important (yoga)
Shoe-ware important (sports specific)
Surface important (soft / supportive)
Equipment important (eliptical/incline)
Education important (research)
Instruction important (atc/pt/instructor
Typical start up injuries
Plantar fascitis
Shin splints
Patello femoral syndrome
Iliotibial band syndrome
Rotator cuff tendinitis
Lateral epicondylitis
Wii-itis
Common remedies
Back off activityTea treeMassageChiropracticAcupunctureNsaids (otc or script)NarcoticsSteroids/prolotherapyPhysical therapy
-Started but flared up medical
Asthma
Diabetes
Arthritis
Hypertension
Sleep disturbance
Headache
Trigger points
MD Treatment
Narcotics/steroids/prolotherapyPhysical therapyChiropractic manipulationOsteopathic manipulationCraniosacral therapy (ND)Medical acupunctureOrthopedic second opinionSports medicine specialist
How it can work this time!
Understand the previous points
Watch your intake
Calculate you output
-Intake
Calories
Carbohydrates
Glycemic index
Calories (a cave man can do it)
Calculate daily calories daily
Diet diary
Dietician (American Dietetic Assoc) www.eatright.org
Project and cut back-500 a week but not less than 1200/day
www.mypyramidtracker.gov/
“The Box”
Carbohydrates
Whole grain, beans, fruits, veggiesWhite bread, rice, pastries, sugared sodas, “processed foods”
Glycemic index/glycemic load 20 year study showed women with low carb high in vegetable sources had a 30% lower
risk of heart disease and modestly lower risk of type II dm compared to high carb/low fat*
Two trials showed low carb worked better than low fat but point is diet maintenance more so than diet**
Bibliography
*Halton TL, Liu S, Manson JE, Hu FB. Low-carbohydrate-diet score and risk of type 2 diabetes
in women. Am J Clin Nutr. 2008;87:339-46. ** Foster GD, Wyatt HR, Hill JO, et al. A randomized trial
of a low-carbohydrate diet for obesity. New England Journal of Medicine. 2003; 348:2082–90.
** Samaha FF, Iqbal N, Seshadri P, et al. A low-carbohydrate as compared with a low-fat diet in severe obesity. New England Journal of Medicine. 2003; 348:2074–81
Fruits and veggies
Color and variety
Based on a 2000 cal/day diet:
9 servings= 4.5 cups/day
(2 cups fruits/2.5 cups veggies)
Harvard school of public health
Supplements
Omega 3 fish oil (1500gm/day
Multivitamin (pharmceutical grade)
Antioxidants (in theory)
Problem specific supplement
-Output
Basal metabolic rate
www.runnersweb.com/running/bmr.html
ACSM / AHA
30 min moderate intensity 5x wk
20 min vigorous intensity 3x wk
The talk test:
moderate=sweat + chat
vigorous=faster heart, inc breath,
short sentences
http://www.cdc.gov/physicalactivity/downloads/PA_Intensity_table_2_1.pdf
METs (metabolic equivalents)
1 MET = 1 cal/kg/hr
Goal to burn 500 MET / week
http://prevention.sph.sc.edu/tools/compendium.htm
Moderate activity (3-6 METs)
walk brisk (3-4 mph)
bike (10-12 mph)
swimming
house cleaning
walk lawn power mower
Vigorous activity (>6 METs)
hiking jogging (5mph) running (7mph) bike (12-14 mph) tennis singles swimming shoveling
Dr Saguil Approach:
Review why it didn’t work
Know your calories and cut 500 a week
Know your BMR
Know METs and increase 500 week
Know your resources and project long term (12 -24 months)
See your healthcare profesional