Great Ways to Fit in Physical Activity

Don’t like to “exercise” or “work out”? No worries. Here are some great tips on how to fit physical activity into your daily routine:

• While golfing and using the golf cart, try to park farther from your ball and walk more. Or, if you have more energy that day, try walking the entire course.
• Try parking farther from your destination to get in a few extra steps or hop off of the subway or bus one stop sooner to get in some personal mileage.
• Get off of the elevator a few floors from where you are going and walk up or down the rest.
• Try playing a new activity with friends, family or with a club such as: tennis (try singles), golf, badminton, walking/hiking clubs or tours, cycling, swimming, dancing (ballroom, country line dancing, etc.), community center activities, or volunteer activities like Habitat for Humanity (you end up being active and proactive at the same time!).
• Do your own housework (it burns more calories than you might think) and your own gardening.
• Stand up and sit down while talking on the phone or march in place.
• Take walks on the beach, boardwalk, along trails on vacations or day trips.
• Walk around your house each time you use the bathroom to get in extra steps or if you are at work, try using a bathroom on a different floor.
• Do balance training throughout the day:
  *Stand on one leg while waiting in line at the bank, grocery store or theater lines.
  *Rock back and forth lifting your heels and toes as you stand in line or while brushing your teeth.
  *Try to stand up and sit down without using your hands/arms-but have them ready to steady you if necessary.
  *While going to get your mail or walking in your home, pretend you are walking on a balance beam-one foot in front on the way up (but always 1 at a time on the way down).

As long as you keep moving, you’ll keep moving in the right direction!

Kristin Sprows, BS, CPT

"Using Video Games as Exercise-for Mind and Body"

Video game-based exercise is becoming increasingly popular with not only children and families, but with senior centers, rehabilitation and fitness centers, and school systems. Although video games should never replace traditional physical activity or exercise routines, there are health benefits to them that are gaining attention and respect from physical therapists, doctors and researchers alike for activity and rehabilitation supplementation.

“Exergaming,” the term used to describe video game-based exercise, has been shown to improve cardiovascular endurance, muscle tone/strength, balance and cognitive function. It can also create a level of socialization that other sedentary and solitary games and activities do not offer. Exergaming allows grandparents to bowl or play golf or tennis with their grandchildren without the associated physical risk involved with the actual activity. It can bring groups of people together, offer a fun option for families rather than sitting and watching television and reintroduces physical activity as an enjoyable time rather than a chore. The convenience and affordability is unbeatable. For those who are not comfortable in a fitness center setting, this is a viable option as a supplement to traditional exercise or to use when the weather is bad, work to improve balance, post-rehabilitation for an injury, or to prevent workout boredom. The level of play can also be adjusted to accommodate the players’ abilities.

In the December issue of Psychology and Aging, a study suggests that the cognitive functions of older people may be retained or improved by playing complex video games. The Silverado Senior Living Center in San Juan Capistrano in California, an assisted living facility for those with Alzheimer’s and other forms of dementia, uses the Nintendo Wii Sports as a form of moderate physical activity and socialization for the residents. Not only does it help bring people together each day, but it also gives them a sense of purpose which, in turn, increases their sense of value according to a spokesperson for the U.K. Alzheimer’s Society.

The University of Aberdeen in Scotland and the UK’s National Health Service have begun a four month study on people over 70 years of age to see if there are any changes in balance after using the Wii Fit regularly. Wii Fit includes a balance board (which sits about 1 inch off of the floor) that provides feedback to you on your performance. The fitness training involves aerobics, yoga, strength training and balance games. The results seem positive; however, the study conclusions have not been reported as of yet.

The initial results from a pilot study done at Southern Cross University in Australia are also positive and promising for those with Parkinson’s. The Wii Fit helps to develop muscle strength and coordination that will help to reduce the risk of falls. It aids in building confidence, overall fitness levels and body awareness (knowing where your body is in space) which are necessary for maintaining balance.

The Wii Sports game includes tennis and boxing as options for more cardiovascular physical activity, although traditional exercise will provide an increased benefit. The baseball, bowling and golf games within the Wii Sports do not burn as many calories but may aid in training to return to the actual game. The Wii Fit monitors your progress and exercise frequency, which increases accountability and provides positive feedback and encouragement.

There are some risks involved, as with any physical activity, with Exergaming. Be sure to discuss your planned activity with your doctor prior to attempting to play, make sure you warm up and take stretch breaks during the activity and then cool down afterwards. Some overuse injuries have been reported in those who try to do too much, too often and at too high a level. As with any activity, start at a lower level and slowly increase the difficulty and playing time. The exercise benefit does outweigh the risk of injury, according to Professor Darren Rivett, the spokesperson of the Australian Physiotherapy Association. The games have also been used as “Wiihabilitation” of stroke and accident victims in many facilities.

Dance Dance Revolution, created by Playstation, is another example of Exergaming that features dance challenges with great music. There is a mat that you stand on and follow the arrows on the screen to know where you place your feet along with the music. It is popular with all ages, although Dancetown might be more appropriate for the older crowd. Dancetown has more songs that would be more enjoyable and is toned down from the original Dance Dance Revolution game. Playstation also has a game called Dancing with the Stars that is based on the hit television show. The dance pads are also compatible with the Wii-but be sure that the product you purchase states that since older models may not be compatible.

Video games are obviously not “just for kids” anymore. They are a fun way to be active without thinking about being active and an effective way to improve your balance—a skill that can always be improved regardless of age. Exergaming benefits not only your physical being, but also your social self since it is a wonderful way to connect with friends and family. And if traditional exercise is not possible as frequently as it is prescribed, than supplementing with video games is one of the next best options.

Sources:
American Council on Exercise
Bloomberg.com
Fisher Center for Alzheimer's Research Foundation
CNN.com
Medline Plus
Best Health Magazine
The Courier-Mail
Newsweek
Associated Content

Add Zip to Your Day to Help Zap Stress!

In times of increased stress, many feel as though exercise or any physical activity is a luxury and not a necessity. However, even a few moments each day can make a remarkable difference in your resiliency and your sense of well-being.

Some theorize that exercise affects the neurotransmitters in our brains which mediate our moods and emotions so it makes us feel better and less stressed. Although there is no scientific evidence to support the neurotransmitter theory, there is enough to show that there are significant stress-relieving benefits.

Here are some ways that exercise helps to control stress:
· Exercise can decrease anxiety. Following exercise sessions in a clinical setting to treat nervous tension, clinicians have measured a decrease in electrical activity of tensed muscles, a decrease in jittery feelings and less hyperactivity.
· Exercise can promote relaxation. One exercise session can generate 90-120 minutes of relaxation response according to the American Council on Exercise.
· Exercise can make you feel better about you. Feeling an increase in self-worth and self-confidence also aids in stress relief and will positively affect other areas in your life. It has also been reported to decrease the symptoms associated with mild depression and anxiety.
· Exercise can help improve your nutrition. Those who exercise regularly have healthier eating tendencies and take in more nutritional foods. Improved nutrition also contributes to your body in managing stress.

How do you get started?
· Consult your physician before beginning any exercise program, especially if there is a history of, or risk factors for, heart disease.
· Build your fitness level gradually—essentially walk before you run. Slow and steady will win the race—no need to rush and risk injury.
· Find something you love to do. Play tennis, take some hikes and enjoy the scenery, try Yoga in the park, dance the night away…
· Find a friend to share the time and benefit with you. It is great to have someone keeping you company as well as holding you accountable to the activity. Not only is it physically beneficial, but it is also social which can add to your stress relief.

Resources: MayoClinic.com, American Council on Exercise, Medline Plus

Over-the-Counter Nutrition--Facts About Supplements

There are many misconceptions about vitamin and mineral supplements and the benefits they claim. Many believe that if something is good, then more must be better. However, too much of a ‘good thing’ can easily turn into a harmful thing.

Healthy people can get all of the vitamins and minerals they need from eating a variety of foods including fruits, vegetables, whole grains, legumes, lean meats and fish. Deficiencies are rare unless a person’s diet is limited, lacks variety or if there are allergies and/or intolerance(s).

Supplements should be recommended by your physician or registered dietitian and all medications should be taken into consideration to avoid potentially dangerous interactions.

Colorado State University has compiled some myths and facts regarding supplements:

Myth: You need to take a vitamin and mineral supplement for good health.
Fact: Supplements supply only a fraction of the 42 nutrients that we need each day or provide the components of food necessary for good health. They should not be used as a quick fix or as a replacement for food.

Myth: Time-released supplements help absorption.
Fact: They are actually absorbed less efficiently than tablets, chewables or solutions.

Myth: Taking supplements that contain antioxidants such as Vitamins A and C, beta carotene, vitamin E or selenium will prevent cancer.
Fact: Recent research has found that taking antioxidant pills does not offer protection against cancer; however, eating lots of foods rich in antioxidants has shown to be protective. Foods such as leafy, green vegetables, citrus fruits, deep-orange colored produce as well as other fruits and vegetables are protective.

Myth: Antioxidants prevent heart disease.
Fact: There has been little to no evidence supporting this statement. Some supplements may even increase the risk of heart failure.

Myth: Osteoporosis can be prevented by taking calcium supplements.
Fact: The most effective treatment in postmenopausal women may be a combination of extra calcium, vitamin D, exercise and estrogen. Calcium is only one of many factors involved with osteoporosis.

Myth: Zinc shortens the amount of time that you have a cold.
Fact: Zinc has shown mixed results in studies, especially in the form of lozenges. And too much zinc actually depresses the body’s immune system. Experts recommend no more than 40 mg of zinc per day.

Myth: Supplements would not be on the market if they weren’t safe.
Fact: Currently, there is not pre-market approval of vitamin-mineral supplements. The FDA cannot limit the quantity or concentration of nutrients a single pill can contain.

Myth: There is no harm in taking supplements; after all, they contain the same nutrients as foods.
Fact: Very high doses of many vitamins such as A, C, D and B-6, as well as several minerals, can cause serious health problems if taken regularly. Too much of one nutrient may cause nutritional imbalances or increase the need for other nutrients. Some supplements interfere with the action of medications, creating a variety of ill effects.

Mega-vitamins contain mega-doses of nutrients, meaning they contain 10 to over 100 times the Dietary Reference Intake (DRI) for a vitamin or mineral and can act like drugs with serious side effects. Some of the side effects may include: fatigue, diarrhea, hair loss, kidney stones, liver or nerve damage, birth defects or even death. At high levels, single-nutrient supplements function as a drug in the body and not as a nutrient.

Fat-soluble vitamins such as vitamins A and D are dangerous because the excess vitamin is stored within your fat cells and can increase your risk of toxicity and side effects. Water-soluble vitamins have commonly been though to be harmless, but have been found to be just as risky in high doses. Large amounts of vitamin C can cause diarrhea and nausea. High doses of vitamin B-6 can cause nerve damage.

Who Needs Dietary Supplements?

Talk with your doctor or registered dietitian about the necessity of supplementation and what doses would be appropriate and safe for you. Be sure to list all medications to ensure there will not be any interactions.

Dietary supplements may be appropriate if you:
· Don’t eat well or consume less than 1,600 calories per day
· Are a vegetarian and do not substitute or complement your diet properly
· Are pregnant, trying to get pregnant or breastfeeding
· Are a woman who experiences heavy bleeding during your menstrual period
· Are a postmenopausal woman
· Have a medical condition that affects how your body absorbs, uses or excretes nutrients, such as chronic diarrhea, food allergies, food intolerance(s) or a disease of the liver, gallbladder, intestines or pancreas
· Have had surgery on your digestive tract and are not able to digest food and absorb nutrients properly

Choosing Dietary Supplements:

· Check the supplement label. Read them carefully and look for the active ingredient(s), serving size, and the amount of nutrient per serving.
· Avoid supplements with ‘mega-doses.’ Try to choose a supplement that provides about 100 percent of the Daily Value (DV) of all the vitamins and minerals. The exception is calcium—if the supplement would be too large to swallow if it provided 100 percent of the DV. Calcium should be divided and taken throughout the day for the best absorption anyway.
· Look for ‘USP’ on the label. This ensures that the supplement meets the standards for strength, purity, disintegration and dissolution established by the testing organization U.S. Pharmacopeia (USP).
· Look for expiration dates. Dietary supplements lose potency over time, especially in hot and humid climates. If there is not expiration date printed on the bottle, do not buy it.
· Store all vitamin and mineral supplements safely. Store them in a dry, cool place. Avoid hot, humid areas such as the bathroom cabinet.



Sources:
MayoClinic.com
Colorado State University

Great resource:
Office of Dietary Supplements
http://ods.od.nih.gov/index.aspx

"Thirsty? Got Water?"

How much water should you drink each day? Unfortunately, thirst isn't a reliable gauge of the body's need for water, especially in children and older adults. There is no easy answer and no single formula fits everyone; however, knowing more about your body's need for fluids will help you estimate how much water to drink each day.

Water is your body's principal chemical component, comprising, on average, 60 percent of your weight. Every system in your body depends on water. For example, water flushes toxins out of vital organs, carries nutrients to your cells, regulates body temperature, lubricates joints and provides moist environment for ear, nose and throat tissues.

If you're an average adult, you lose close to 2.5 liters (more than 10 cups) of water simply by sweating, breathing and eliminating waste. You also lose electrolytes--minerals such as sodium, potassium and calcium -- maintain the balance of fluids in your body. All this may occur before you even think about mowing the lawn on a sticky afternoon, working out at the gym or cleaning your house.

You can normally replenish what you've lost by consuming food and liquids, but sometimes you eliminate more water and salts than you can replace. The result is dehydration--your system literally dries out. This can cause changes within your body that may affect your health, even if you don't have noticeable signs or symptoms. As little as a 1 -- 2 percent loss of your body weight can sap your energy and make you tired. Even a 2 percent loss of body weight can affect athletic performance, and a 3 percent to 5 percent loss adversely affects reaction time, concentration and judgment. The problem is that these effects often occur before you're aware of them.

SIGNS AND SYMPTOMS:
Mild to moderate dehydration:
*Excessive thirst
*Sleepiness or tiredness
*Dry mouth
*Decreased urine output (eight hours or more without urination)
*Muscle weakness
*Headache
*Dizziness or lightheadedness

Severe dehydration:
*Extreme thirst
*Irritability and confusion
*Little or no urination
*Shriveled and dry skin
*Low blood pressure
*Rapid heart beat
*Fever

CAUSES:
Sometimes dehydration occurs for simple reasons: sickness, being busy or just not thirsty, or because you lack access to potable water when you're traveling, hiking or camping. Other causes could be from exercise, fever, diarrhea, increased urination (uncontrolled diabetes or certain medications such as diuretics), long airplane flights (drier air), hot and sunny climates and burns (such as severe sunburn or worse burns).

RISK FACTORS:
*Older adults -- as you age, you become more susceptible to dehydration for several reasons: your body's ability to conserve water is reduced, your thirst sense becomes less acute and you're less able to respond to changes in temperature. Also, older adults tend to eat less than younger people do and sometimes may forget to eat or drink altogether. These problems are compounded by chronic illnesses such as diabetes, hormonal changes associated with menopause and by the use of certain medications.
*Infants and children -- usually due to diarrhea, low sweating capacity and high turnover of electrolytes
*Endurance athletes -- the longer you exercise, the more difficult it is to stay hydrated. During exercise, your body can absorb about 24 -- 32 ounces of water per hour, but you may lose twice that amount in hot weather.
*People with chronic illnesses -- having uncontrolled or untreated diabetes, kidney disease, cystic fibrosis, alcoholism and adrenal gland disorders.

HOW MUCH IS ENOUGH?
There are no magic numbers that will apply to everyone. Determining the appropriate water intake is not an exact science and it all depends on your age, physical condition, activity level, locale and your unique physiology.

The average urine output for adults is 1.5 liters a day. You lose close to an additional liter of water a day through breathing, sweating and bowel movements. Food usually accounts for 20 percent of your total fluid intake, so if you consume 2 liters of water or other beverages a day (a little more than 8 cups) along with your normal diet, you will typically replace the lost fluids.
The Institute of Medicine recommends that men consume roughly 13 cups of total beverages per day and women roughly 9 cups of beverages per day. A general and easy to follow guideline would be to drink enough fluids so you rarely feel thirsty and produce colorless or slightly yellow urine. The darker color your urine output, the more dehydrated you are.

It is generally not a good idea to use thirst as a guide for when to drink because by the time you become thirsty, it is likely that you are already slightly dehydrated. To help avoid dehydration and the associated risks and effects, drink a glass of water with each meal and between each meal, or take water breaks instead of coffee or tea breaks. Also, make sure you hydrate before, during and after exercise. If you are concerned about your fluid intake, check with your doctor or a registered dietician. He or she can help you determine the amount of water that is best for you.

Resources: www.mayoclinic.com, www.osha.gov