Walk This Way!

walk-this-wayI like smart people.  Folks that spend years and years becoming expert in their chosen field.  It’s especially appealing if they are, what I call, Switzerland, i.e. neutral. If they don’t have a book to sell, a product to push, or an axe to grind then I find it all the more impressive.

Catrine Tudor-Locke is Switzerland.

Dr. Tudor-Locke is a researcher at the Pennington Biomedical Research Center in Baton-Rouge.  She is recognized internationally as an exercise expert….specifically walking.  Dr. Tudor-Locke has published over 180 scientific papers in her career (that’s a ton!) but what I like most is her practical approach to physical activity.  She clearly understands how our environment influences our behavior and offers simple, targeted solutions for overcoming the challenges of today’s sedentary world.

Let’s start with the facts.  The average American takes 5,117 steps per day. Obviously the odds are you are not average.  If you don’t know how many steps you take in a day I highly recommend you get a pedometer or accelerometer and start getting a feel for what your average is.  There are approximately 2,000 steps per mile so most of us are covering just over 2.5 miles per day.  Of interest, folks in Colorado average 6,500 steps a day and residents of Tennessee and Arkansas average 4,500.  By comparison, a 2004 study of 98 Amish in Ottawa, Canada found that the women in their community averaged about 14,000 steps per day and the men over 18,000.  Of note, their rates of overweight and obesity were a fraction of what we see in America.

So how many steps do we need to get a return on our investment?  Often you hear the magic number of 10,000 steps per day.  That’s almost double what most Americans are currently getting.

Dr. Tudor-Locke has a different take.  Her total steps recommendation is less but she also addresses intensity since walking briskly confers more benefit than just a “window shopping” pace.

Here’s Dr. Tudor-Locke’s Walking Recipe:

  • Avoid less than 5,000 steps/day
  • Strive for at least 7,500 steps/day
  • At least 3,000 of those steps (representing at least 30 minutes) should be taken at a cadence of >100 steps/minute.

Dr. Tudor-Locke also recommends we sit less.  Many Americans spend the majority of their waking hours sitting in front of a screen, at both work and home, and there is a growing body of evidence indicating that’s a significant problem.  A study last year in the Archives of Internal Medicine indicated that 10 hours of sitting is as harmful as 30 minutes of exercise is beneficial. If your job requires you so sit for most of the day try setting the alarm on your phone to prompt you every hour to get up and take a short little walk break.  There are many benefits to this, not the least of which is it will help clear your head and improve what’s known as “attention to task.”

Bottom line is we need to sit less and move more….and now, thanks to smart people like Dr. Tudor-Locke, we know exactly how much more.

Vitamin D… From Sun or Supplements?

Today’s Healthy Living Section of the Dallas Morning News featured a story on healthy ways to make your face more beautiful, which included protecting your skin from the sun’s UV rays. As a guy that works at Cooper and oversees our vitamin and nutritional supplement line, I spend a great deal of time following the literature on this topic.

I obviously agree that the sun can do tremendous damage (aging and increased risk of skin cancer).   But I also I think it’s always important to remind folks that when it comes to sun screen you should be careful “not to throw the baby out with the bathwater.” That same UVB light that accelerates aging and increases cancer risk is also the same light that generates vitamin D.

We have a vitamin D deficiency epidemic in this country.  An article published in the 2009 Archives of Internal Medicine found that 77 percent of U.S. adults and adolescents were insufficient in vitamin D (90 percent of Mexican-Americans and 97 percent of all non-Hispanic blacks). At Cooper Clinic we have been measuring vitamin D levels in our patients since 2006, and we find approximately 80 percent of our first time patients have levels lower than we like to see (<40 ng/ml).

Dr. Ed Giovannucci, a highly respected researcher from Harvard, wrote in the Journal of the National Cancer Institute in 2006 that “sunlight might prevent 30 deaths for each one caused by skin cancer. I would challenge anyone to find an area or nutrient or any factor that has such consistent anti-cancer benefits as vitamin D.  The data are really quite remarkable.”

Of course, then the question comes up of whether physicians prefer that their patients get vitamin D through supplementation, as opposed to directly from the sun.  That really depends on whom, and what type of doctor, you ask.  Most of the research indicates that there is really very little difference between the two.

Most physicians feel supplements are the most logical choice because of ease, cost, accuracy of dosing, etc. Dermatologists clearly like to steer folks away from the sun.  However a few, including Dr. John Cannell, Founder of the Vitamin D Council, feel that the sun is the preferred method since that’s the way we were “designed” to get vitamin D.

Obviously no one, including Dr. Cannell, recommends getting a sun burn, but for most folks 10-15 minutes of unprotected sun exposure seems to be a logical, and safe, dose. The problem is how often do most people go out in a bathing suit, or shorts and a tank top, between 10 a.m. and 2 p.m. when the UVB light is most available? Clearly if the weather is gloomy and overcast that wouldn’t be practical.

Something else to keep in mind is that there is a huge variability in how much vitamin D we synthesize from the sun, or absorb from supplements. There clearly is no such thing as “one size fits all.” Cooper Clinic physicians recommend starting with 2000 international units (IU) of vitamin D-3 per day and go up in dose as needed. The ideal method to determine how much vitamin D you need is to get a blood test. But from a practical standpoint, most people aren’t going to take the time or spend the money to do that. 2000 IU per day may not get them to an “optimal” blood level, but for most individuals it will at least help them avoid “deficiency” (less than 20 ng/ml).

Even though I run and ride my bike outside quite a bit, I have found that I need to take 5000 IU of Vitamin D-3 per day for me to maintain a blood level of 60 ng/ml (my ideal target).  But remember, everyone is different.  The main takeaway is to make sure to get your vitamin D.  Whether it’s from the sun or supplements….just get it.

Is it True that Birds of a Feather Flock Together?

There was a recent article in the Wall Street Journal  (1-21-2013) I found very interesting.  It was about “mixed-weight couples” where one partner is overweight and the other isn’t.  Researchers from the University of Puget Sound and the University of Arizona studied 43 heterosexual couples and found those in the “mixed-weight” category experienced more relationship conflict, including resentfulness and anger, than so-called “same-weight” couples.  The results were published in the December, 2012 issue of the Journal of Social and Personal Relationships.

Results also indicated that those couples with the most conflict involved a healthy-weight man and an overweight woman.  When just the man was overweight it wasn’t much of an issue.

Hmmmm!

It’s not news that men and women are different.  John Gray made that very clear in his famous book, Men Are From Mars, Women Are From Venus: The Classic Guide to Understanding the Opposite Sex.   Weight is a very touchy subject and when it comes to relationships, one should always tread lightly.  However, while they certainly exist, “mixed-weight” couples are not the norm.  We know that those in our “warm circle,” which obviously includes spouses, have a huge influence on our behaviors and habits, and ultimately our weight.  A study in the July, 2007 issue of the New England Journal of Medicine found that if your spouse is obese then you are 37% more likely to be obese.  It might be surprising to learn that if your friends are obese you are 171% more likely to be obese!  As I often say, when if comes to your health, which includes your weight, you are NOT the Lone Ranger!

In the Cooper Wellness Program we don’t often see “mixed-weight” couples.  Usually those that come with their spouse have similar BMI’s and their overall health is fairly comparable.  What we do see quite often though is a spouse motivated to improve his or her health that comes through the program solo.  Then, after they spend six days getting “Cooperized” they leave campus completely convinced they will return home and “motivate” their spouse to hop on the wellness bus and embrace a healthy lifestyle.  “Whoa, slow down!”  In cases like this you need to be careful.

The last lecture of the Wellness Week is called “Managing Expectations” and its placement is intentional.  We know that if you are willing to invest a reasonable chunk of change and six days of your life to come through the Wellness Program you are most likely in a “stage of change” that vastly improves your odds of success.  More simply, you are ready to change.  Remember, “When the student is ready, the teacher will appear.”  But ONLY when the student is ready.

It’s human nature that once you participate in a positive experience you want to share it with those you love.  The problem however is if your loved one isn’t ready to change then your unbridled enthusiasm will most likely not be received as you intend it.  In fact, it might completely backfire which could then potentially extinguish your flame.  I’m not saying this always happens…. just don’t be surprised if it does.

Change is difficult and when a spouse or close friend decides to change, even if it’s a positive change, then it often is viewed as a threat to the one being “left behind.”  “What’s wrong with the way we’ve been ____________(fill in the blank….living, eating, exercising, etc.) for all these years?  Am I suddenly not good enough for you?”  It can lead to some very difficult, but necessary, conversations.

Stanford’s Dr. BJ Fogg teaches that as humans we are lazy, social, and creatures of habit.  Overcoming the status quo is often very hard but relying on the experience of experts can dramatically improve your odds of success.  Human “energy” can be phenomenally helpful but remember that we are all unique and when it comes to change, those we love don’t always move at the same speed.

Take a Seat

From a guy that normally recommends to “walk the dog even if you don’t have one” the suggestion to “take a seat” seems somewhat contradictory.  Don’t worry though, there’s a very logical explanation and it’s based on science.

A study done by researchers in Brazil concluded that testing a person’s ability to sit down on the floor and then rise up can predict how long they will live.  That’s right, the less support you need to sit down on the floor and then stand back up is an outstanding predictor of your future.  The researchers tested over 2,000 men and women between the ages of 51 and 80.  Those that needed the most support for sitting and standing, including bracing with a knee or hand or both, had a 6.5 times greater risk of dying within the next six years.  Speed was not a factor in the assessment.  The study was published in the European Journal of Cardiovascular Prevention.

When I speak to groups I often ask them to stand up from their chairs without using their arms.  This is one of the many “activities of daily living” that experts use to assess frailty and disability.  Other activities include dressing yourself, feeding yourself, using the bathroom without assistance, and walking down a hall and back in a prescribed time.  Rising from a chair with only your legs helps to assess lower body and core strength, flexibility, and balance.  These outcomes are obviously related to the risk of falls and fractures which are major concerns for older adults.  They’re also directly related to your quality of life.  If you can’t stand up without using your arms then your lifestyle is clearly compromised.  You are by definition “limited.”  Years of research indicates we can push back the onset of disability by between 13 and 20 years by maintaining our fitness levels.  That’s huge!

By now I wouldn’t be surprised if you have already tested yourself on the Brazilian sit/stand test.  Getting a perfect score of 10 is the goal….five for sitting and five for standing.  Points and half points are deducted for things like touching a hand or knee to the ground while sitting or pushing off with a hand on one knee on the way up.  If you wobble on the way up or down that will cost you half a point each.  In the Brazilian study, more than half of the subjects between 76 and 80 failed the tests, scoring three points or less.  70% of those under 60 earned perfect or near perfect scores of eight, nine or 10.  The higher your score the higher your ratio of muscle power to body weight….and the longer you will live.  No matter how you score today remember you can improve that ratio, and your overall quality of life, with activities such as weight training, yoga, Pilates, Zumba, kettle bells, and swimming.

It doesn’t matter where you are.  What matters is the direction you are headed.

Clearly the goal is to live and not just be alive.  By maintaining your fitness you can be assured you will never have to shout, “Help, I’ve fallen and can’t get up.”

Stay well!

 

Run Proud

I ran a 5K this morning.  Actually “jogged” is a much more accurate description than “ran.”  It was the Run Proud race to help raise money for ALS/MDA.  The race started and finished on the campus of the Cooper Aerobics Center and is named after our former running pro, Diane Proud, who passed away last year from ALS (Lou Gehrig’s Disease).  She was 59.  Diane was one of the nicest, most sincere individuals I ever met.  She loved helping all runners and triathletes but she had a special fondness for beginners.  Sharing her passion for fitness allowed Diane to impact the lives of hundreds of people in a very positive way.

Today was a perfect day for running….temps in the low 70s with a cool, steady drizzle. Wet, but not enough to get in the way. Just enough to let you feel “connected.”

Before the race I saw Bob Proud, Diane’s husband. He was actually the reason I got up early today. During Diane’s extended three-year illness I often crossed paths with Bob and I was always awed by his unwavering, upbeat spirit. He knew, as did Diane, that a diagnosis of ALS is always, not sometimes, not usually, but ALWAYS fatal. That didn’t deter Bob. He knew that maintaining a high-energy, optimistic attitude was exactly what Diane needed most.

I had not seen or talked to Bob since Diane’s funeral last year and I wanted to shake his hand. I did that about 15 minutes before the race and we talked briefly. I would have liked to talk more but just about everyone involved in the race had known Diane and Bob and like me, they wanted to say hello. I didn’t want to monopolize his time.

At the starting line I saw friend who is a longtime member of the Cooper Fitness Center. We decided to run together although he warned me he was having issues with his I.T. band and wasn’t sure how he would hold up. Normally he wouldn’t have even considered running but, like many of us, he was there because of his love and appreciation of Diane. Sure enough, after less than a quarter of a mile into the run my buddy had to pull out. Doing that is never fun but clearly it was a smart move.

I continued on at a very comfortable (read slow) pace. Soon, as the course extended down a long stretch through a beautiful neighborhood, I looked up and saw Bob running by himself. His pace was right in sync with mine so I gradually began to narrow the gap and after a minute or two we were side by side. We started talking and it wasn’t long before Bob encouraged me to, “Feel free to run ahead. Don’t let me slow you down.” Little did he know I was delighted to be running at such a moderate pace. Even though I’ve been lifting consistently and cycling on a pretty regular basis my running mileage has been down so I was not in a great position to take Bob up on his offer. Besides, for me the opportunity to run with Bob and talk about life far exceeded the need to foolishly push myself to meet some arbitrary 5K time. From a very selfish standpoint, this was a great chance to spend about 30 minutes one on one with a guy that I had really come to respect but had not taken the time to let him know that.

As often is the case when running, we talked about all sorts of things; the radio business, The Rangers pennant race, why for some reason a relatively flat neighborhood suddenly felt like the Newton Hills in Boston! More than once Bob apologized for his slow pace. “My 5K time is now beginning to approach my 10K PR.” I assured him not to worry about it, “No need to apologize.” I reminded him that just the fact we were out running early on a Saturday morning, regardless of the speed, probably put us in the top half of one percent of most Americans as it relates to physical activity! All the research shows that the vast majority of benefit from exercise comes from just getting off the couch. A little bit, on a consistent basis, goes a long way in improving health and quality of life.

As we neared the end of the course and came back onto the Cooper campus there were all sorts of folks cheering us on; friends, family, volunteers, and many runners who had finished before us. Most recognized Bob and were very supportive and enthusiastic. Last year, less than a week before she died, Diane despite the fact she could no longer talk and was so weak she was confined to a golf cart, was at the finish line passing out cupcakes to every single runner that crossed the finish line. This year there was no Diane. I was glad it was raining hard enough to mask the fact I was tearing up a bit. Bob quickly was surrounded by a crowd of well-wishers so I gave him a high-five and began my post race recovery, which included all sorts of wonderful fare provided by the sponsors. That’s always one of the great treats of finishing an endurance event….all the great treats!

Afterwards I felt great. I had gone on a nice run, seen a lot of friends and co-workers, and it was still early enough so that most of my Saturday was before me. Most importantly though I appreciated the wonderful time I had spent with Bob and I promised myself I would reach out to him soon to schedule a dinner or a workout.

And guess what? This afternoon I got an email from Bob THANKING ME for running WITH HIM this morning! How great is that? I told him the pleasure was all mine…..and I meant it!

Eat more fruits and vegetables.

Strive to add at least one serving of a fruit or vegetable per meal.  Notice I said at least one…  One half of a cup is considered a “serving”. A piece of fruit (i.e. small banana, apple, pear, etc.) is also considered a serving. Fried does NOT count, nor do corn, peas, or potatoes (except sweet potatoes). Think colorful and leafy green vegetables like broccoli, carrots, spinach, cabbage, kale, tomatoes, green beans, bell peppers, etc.