H E A L T H Y F O R L I F E N E W S L E T T E R J U L Y / A U G U S T V O L. 1 6, N O. 4 P A R T 2 -- H E A L T H Y L I F E S T Y L E S

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1 H E A L T H Y F O R L I F E N E W S L E T T E R J U L Y / A U G U S T V O L. 1 6, N O. 4 P A R T 2 -- H E A L T H Y L I F E S T Y L E S EXERCISE I believe everyone is aware of the fact that moderate, consistent exercise is essential to a healthy lifestyle. The Surgeon General of the United States issued a statement in the early 1980 s listing all the major health benefits that are the result of having a modest exercise program. The highlights of those benefits are: Weight loss Lower blood pressure Stronger bones and decreased risk of osteoporosis Lower cholesterol levels Elevated levels of "good" HDL cholesterol Decreased levels of "bad" LDL cholesterol Decreased levels of triglycerides--the other fat in the blood Increased strength and coordination, which leads to decreased risk of falls Improved sensitivity to insulin Enhanced immune system Overall increase in the sense of wellbeing The type and kind of exercise that is best for you is always a continual debate among the exercise gurus of today. However, as a physician, I have a different attitude about how my patients should approach developing an exercise program. I personally feel that it is more important that my patients exercise consistently than worry about exactly how they exercise. Any exercise program is better than none. I always encourage my patients to choose an exercise program with which they will be more consistent. They need to enjoy, as much as possible, their exercise program, because they will have a better 1

2 chance of developing a good, consistent program. They need to schedule their workouts instead of trying to work their exercise program into their schedule. I can testify that this does not work--my schedule always wins out. It is very important to me that my patients do not hurt themselves when they start to exercise. Most of us have not been in good shape for years--if ever. Start slowly and gradually increase the length and intensity of your workouts. It is not a race. Your strength and endurance will increase. Why push yourself so hard that you hurt yourself and have to quit for a while? If they have any joint or musculoskeletal problems, I have them see a physical therapist who can guide their exercise program and help protect them from injury. If they have any risk factors for coronary artery disease, they need an exercise stress test by a cardiologist before they begin an exercise program. As I mentioned earlier, any exercise program is better than none. There are health benefits to a simple walking program. If my patients want to swim, ride a bike, play racquetball, basketball, or even walk while they are playing golf, it does not matter to me. However, I do feel that a nice combination of aerobics with strength training is the ideal workout program. I am going to detail some principles of this program in order to give you a clear understanding of this program. It combines the benefits of aerobic exercise, resistance training, and stretching. You can take some of these principles and hopefully incorporate them into your exercise program. BENEFITS OF STRENGTH/RESISTANCE TRAINING The benefits of aerobic exercise have been well publicized over the last years. However, when many people think of strength or resistance training, often they have a negative reaction. They may think of body building or feel that this form of training is just for athletes. What is not so widely known are the positive fitness and health benefits of strength or resistance training. Following are a few of these benefits: If a program is designed well, resistance training can provide increased stress to the long bones of the upper extremities, the spine, pelvis and ribs. This can produce positive results on those who may have, or who are prone to osteoporosis. Generally an aerobics program will only stress the lower extremities. When losing weight many are not concerned whether they lose muscle mass along with the fat mass. They just want to "lose weight." Resistance training can prevent the loss of muscle mass and can actually aid in your fat loss effort. Since muscle is the furnace that burns the fuel (glucose), the more muscle mass that you have the easier that it is to maintain your optimal body weight (mass). Exercise, including strength training, helps to make us more sensitive to insulin not only during but also following exercise sessions. This is a great benefit to those who have 2

3 Diabetes Mellitus or are at increased risk to develop Diabetes. It was once thought that the loss of muscle mass, especially in the upper body, was a normal part of the aging process. This is far from the truth. Strength training not only helps prevent the loss of muscle mass associated with aging but can actually increase muscle mass in those even in their 80 s and 90 s. It is a known fact that we begin losing muscle mass after age 35 unless we are involved in strength training. It has also been shown that otherwise healthy elderly individuals that are stronger are less likely to have frequent falls. An appropriately designed resistance program can also help maintain flexibility and balance. The benefits of such a program can be enhanced adding specific stretching exercises into the program. A well-designed program can also have significant cardiovascular benefits. Resistance training may play a role in preventing heart attacks by conditioning the cardiovascular system to cope more efficiently with sudden changes in blood pressure and heart rate. STRENGTH TRAINING PROGRAM Basic Principles Never exercise through pain. You might feel a mild strain in the muscles being used but you should not experience pain. Pain is the body s warning system and should not be ignored. If you are having pain or an exercise is too difficult, the exercise may be modified or another exercise can be substituted for the one that is causing you problems. Never hold your breath while you are doing any of the exercises. Holding your breath causes excessive stress on your heart. It may also cause you to become lightheaded or dizzy. Proper technique when performing the exercises is critical. This helps prevent injury and helps you achieve maximum benefit from each exercise. The amount of resistance used is not as important as the quality of each exercise. The resistance should be selected so that the last 2-3 repetitions in each set are difficult but proper technique is not compromised. If pain is felt with a specific amount of resistance, then reduce the resistance so that pain is not experienced. A program that is designed to stress movement patterns (groups of muscles) rather than specific muscles is better in my mind. This will allow you to work more muscles with fewer exercises. In general, this also allows you to elevate your heart rate higher than you would if you worked one muscle at a time. Whenever possible, exercises should be done which challenge your balance, also. This provides a dual benefit from the same exercise. This type of program should be done three days per week. A day off between each workout session is recommended. On the off 3

4 days you may walk or perform any other moderate level activity that you wish. A gentle warm-up should be carried out for 3-5 minutes prior to starting the strengthening exercise. This activity should help increase your heart rate somewhat. An appropriate warm-up could involve walking, walking on a treadmill, using a bicycle or stationary cycle, walking in place or any other type of exercises that would ready you for the resistance exercises. Any stretching should be done following the exercise session. Stretching is usually easier and in general more productive when done at this time. Exercise variables and definitions: reps, sets, tempo, and rest interval. Repetitions This is the number of times that the exercise is done. Doing the exercise 1 time equals 1 repetition. Repetitions are commonly called reps. Sets A set is a group of repetitions (reps). If an exercise were done 10 times before resting this would be 1 set. It is common to do several sets (groupings) of an exercise. Commonly an exercise will be prescribed by writing the number of sets times (x) the number of repetitions (e.g. 3 sets x 15 reps). The number of sets and repetitions recommended in a program will help you to gain muscular strength and endurance. Adding more sets of the same exercise will help you primarily gain muscular endurance. Tempo This is the speed or cadence of each repetition. The tempo can be changed in order to create varied effects or outcomes. For most strength training programs the raising and lower phase of each repetition (rep) should be 2-3 seconds. Doing the exercises in this manner allows the muscles to remain under tension for a greater period of time yielding greater benefit from each repetition. Rest interval - This represents the amount of time between each set and/or exercise. The rest interval is best if it is 60 to 90 seconds. This means that you should not rest any less than 60 seconds and no more than 90 seconds. If you are significantly deconditioned (not in good shape) the rest interval can be increased to 120 seconds (2 minutes). The rest interval (period) between each set should be monitored fairly closely. Keeping the rest interval in the recommended range also allows for greater health benefits. Whenever doing an exercise that works only one side at a time, move immediately to the other side before resting. FREE WEIGHTS VS. MACHINES Strength training can come in many forms. However, for simplicity, the discussion can be broken down into the way the resistance is delivered. When it comes to using machines vs. using free weights (no machines), there are advantages and disadvantages to both; but in general there are far greater advantages to the use of free weights than to the use of machines. Following is a list of reasons for the advantages of the use of free weights: When you only use weight machines your balance and coordination are rarely challenged. The use of free weights allows you to follow varied patterns of movement rather than just one pattern. This 4

5 provides an opportunity to make changes to the original exercise in order to create a new or modified exercise. Although machines have some ability to make adjustments to an individual s size, they still make the general assumption that one size fits all. The use of free weights overcomes the fit problem all together. The adaptability when using free weights allows someone designing a program for you to make changes according to your personal problems and needs. If you follow a set program, it allows you to vary the program to fit your personal needs and skills. Free weight training or using resistant bands permits your program to be more portable you can take it with you if you go out of town or you can do it at home if you choose. Training with free weights or body weights can require more of a demand on the core (abdominal, back, hips, and trunk) muscles. This allows you to then work muscle groups and movement patterns rather than work individual muscles. The more muscles that you work simultaneously the greater will be the cardiovascular demand. The use of free weights, especially when using dumbbells, gives you the opportunity to load one side of your body at a time. This creates more of a demand on your core muscles. Since you are only working one side at a time this allows your overall "work time" to be longer. Both of these create a greater cardiovascular (aerobic) stimulus. NUTRITIONAL SUPPLEMENTATION The final aspect of a healthy lifestyle is that we need to be taking nutritional supplements. For years I told my patients that they could get everything they need from their diet. However, after researching the medical literature for years on this subject, I am convinced that every man, women, and child needs to be taking nutritional supplements to help protect their health. Oxidative stress (the "dark-side" of oxygen) has been shown in medical research to be the underlying cause of over 70 chronic degenerative diseases. These are diseases like heart disease, cancer, stroke, macular degeneration, arthritis, and Alzheimer s dementia. In fact, the leading cause of the aging process itself is now felt to be oxidative stress. I explain this process in detail on my web page. However, it is important to note that it is not a natural process of aging. We have very complicated and sophisticated antioxidant defense systems to protect ourselves from the devastating damage of oxidative stress. Because this generation is under greater attack from the toxins in our environment, our stressful lifestyles, and poorer eating habits than any other previous generation, we need to optimize these defense systems. Eating a healthy diet (addressed in Part 1 of this Healthy for Life Newsletter) is a good start. However, there is no way we can obtain the optimal levels of these nutrients we need from our diet. Therefore, we must supplement our diet with optimal levels of antioxidants and the supporting minerals and B vitamins to best protect our health. 5

6 Bionutrition is supplementing these nutrients at optimal levels, which have been shown to provide a health benefit in the medical literature. My book, "What Your Doctor Doesn t Know about Nutritional Medicine May be Killing You, details these studies and the actual levels of nutritional supplements we need to be consuming each day. Please refer to my book if you would like more details on this subject. I recommend that my patients take antioxidants and minerals daily. It is best to take these with food because they are absorbed better and tolerated better when taken with food. Since nutritional supplements are an unregulated market, you need to research the manufacturing company to truly understand what you are getting. Reading labels means nothing if the nutritionals are not pharmaceutical-grade and follow Good Manufacturing Practices (GMP). It is important that they are also manufactured in a FDA-registered facility. Otherwise, you have no true assurance that what is on the label is even really in the tablet or capsule. I am presently only recommending nutritional supplements that are manufactured in a facility that is also licensed and approved to manufacture over-the-counter medication (OTC). It is also important that the tablet or capsule follow the US Pharmacopeia guidelines (USP) for dissolution of the tablet or capsule. In other words, you want to be sure that the supplements you are taking actually dissolve or it doesn t matter what is in them--you won t get anything. The overwhelming majority of supplements on the market today do not follow these guidelines. Essential Fatty Acids---Omega-3 Fatty Acids Over eighty percent of Americans are deficient in Omega-3 fatty acids. This is an essential fat that our bodies need. We cannot make this fat and need to get it from our diet. It is important in counterbalancing the increased inflammation that is in our bodies. Even though eating a healthier diet by consuming more "good" fats is a start, it is hard to regain the balance we need in our essential fats without supplementing with more Omega-3 fatty acids. Fiber In Part 1 of this Healthy for Life Newsletter, I explained the importance of fiber in our diet. I recommended that we need a minimum of 35 grams of fiber each day. However, the average American only consumes 8 to 10 grams of fiber in their diet each day. Therefore, I believe that it is important that everyone should supplement their diet with more fiber. Calcium and Magnesium Over eighty percent of Americans are also deficient in magnesium. Osteoporosis is an epidemic in the Western World. Therefore, I like to see all my patients taking highly absorbable calcium and magnesium in a 1:1 ratio. Vitamin D in the form of vitamin D3 in a range from 2,000 t0 4,000 IU daily is also an important addition. However, we are now learning that your calcium/magnesium supplement should also contain vitamin K2. Vitamin K2 acts like a traffic cop. It attracts the calcium to be deposited you re your bones where it is needed and actually blocks calcium from being deposited you re your arteries where it can increase your risk of 6

7 having a heart attack or stroke. Magnesium and calcium may also improve our blood pressure and the rhythm of our heart. It is just a very good idea to include these supplements to protect your health. There are more detailed descriptions of the supplements I recommend on the website under the title of Supplements found under the Healthy Lifestyles link. CONCLUSION Part 1 and Part 2 of this series on Healthy Lifestyles presents the optimal program I believe is needed to protect your health and the health of your loved ones. It is based on the scientific medical literature. Our own bodies are the best defense against the ravages of chronic degenerative diseases. When I have applied these principles in my patients, the results have been amazing. It is much easier to maintain your health than it is to try to regain your health, once you have lost it. Eating a healthy diet, modest exercise, and nutritional supplementation offers you the best chance to protect and maintain your health. Adding any one of these three to your lifestyle will be beneficial. 7