Author Archives: keepitmovingweekly2

Stepping out to help others

Many of our patients find it rewarding to be able to do a fundraising walk for a cause that is close to their heart.  The ability to participate in these is an added bonus of ‘getting your life back’ after weight loss surgery.

Gitkind

If you are a UMass Memorial Weight Center patient, you know about the diversity and dedication of our team.  What you may not know is how each member of our team makes exercise a part of their lives as well.  Like our patients, many members enjoy using their fitness to benefit others too.

Dr. Mitch Gitkind is one of them.  This past weekend he and his wife completed the Boston Marathon Jimmy Fund Walk. Together they raised $1000 in memory of a young woman in their town who passed away a few weeks ago at the age of 18.

Gitkind steps

To be able to do 50,000 steps at age 60, raise money to help others, and come in to work with a smile the next day is the reward of someone who is a regular exerciser.  His daily routine keeps him healthy and young.  The ability to enjoy being part of this and other incredible fundraising events during the year is an added bonus to the many ways exercise adds to his enjoyment of life.

Studies show that our health improves when we help others.  We know exercising regularly improves to health too. When you add this kind of meaning to your every day exercise routine, your  health benefits from exercise are multiplied.  You don’t need to walk 50,000 steps to do it either.  The amount of steps you do, nor the money raised don’t matter. It is the fact that you are adding a broader level of purpose to your exercise time.

Has your regular exercise routine enabled you to complete a fundraising event lately?  Share your story in the comments below.

Keep moving,  Be Well,

Janet

 

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by | September 23, 2019 · 5:51 pm

Is it your body or your mind holding you back?

Why exercise for diabetes_(12)

The header at the top of this page is a collection of pictures of people who are on a weight loss journey. They are all at various stages on that journey, most are not at their goal weight yet.  However, each of them are now doing things they could not do before losing weight.  It is quite inspiring to see these smiling faces enjoying life while on the journey. How did they overcome their body and get so fit?  It took changing their mind so their body didn’t get in the way.

 The brain is a reality simulator.  What you imagine can seem very real.  Just think of how you feel when waking up from a dream.  The feelings can stay with you for a while, even though it was all in your head.

When your body is carrying extra weight, it can hold you back from exercising and doing many other activities you once easily enjoyed.  It can seem like you cannot exericse and it would be better to wait until you lost some weight to get started.  What you are feeling in your body is very real.  Just like a dream however, what your brain believes about how much is enough exercise may not be the reality.  Your expectations could be based on your memories of what you used to be able to do and what you want to be able to do now.  They could also be based on recommended amounts, which are really general guidelines.    Just like your dream, your mind can hold beliefs about what your body should be able to do, even when your body is telling you that it cannot do it.

This can feel like your body is getting in the way, holding you back from exercising.  However it is really your ideas about what it means to exercise that is holding you back.  Your body does not know the recommendations.  It only knows what it can do now, in this moment.  Your body does not know how many calories you want it to burn, it only knows what it will burn based upon what will be keep you healthy and well.  Your body does not know the numbers displayed on the weight machine or the treadmill or your activity monitor.  It only knows if it can tolerate what you are asking it to do.

If it cannot tolerate it, your body will let you know through pain and fatigue. Pain and fatigue are a sign of too  much too soon. Contrary to popular beliefs, pain is not a sign of progress (nope, not even muscle soreness). If you body has what it needs to do what you are asking it to do, it will let you know instantly through more energy, greater freedom of movement, more focus and a better mood.  Basically, your body is smarter than your brain when it comes to exercise. Your body and brain work best when they work together, that means your brain observes your body rather than dictates what it should be able to do.

So the next time you start thinking your body is working against you, ask what it is trying to tell you.  The answers may not be clear right away, and usually it is not telling you to stop exercise completely.  It is usually telling you it needs less for a while until it has time to adapt. You will know you have found the just right level and type of exercise by how you feel during and after exercise.  Your body  will tell you if and when it is ready for more. Until then, keep the peace between your brain and your body, by trusting you body to tell your brain how much is enough exercise right now.

Keep Moving Be Well,

Janet

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by | September 18, 2019 · 6:44 pm

Depression and Exercise

Why exercise for diabetes_(11)

Some solutions sound so great on paper, but putting them into practice is another story. It could not be more true when it comes to exercise, especially when using exercise to help treat depression.

There are plenty of studies backing up the recommendation for people with depression to exercise as part of their treatment for depression.  But, when you are feeling low, getting up and moving is just not that easy, no matter how much you know you should.  Let’s look at how to find your way to use movement to feel better.

This article is the conclusion from 25 studies, 1487 adults with depression.  Importantly, they included only studies that were actual exercise studies, not information from self report surveys about general physical activity.  Why is this important?

First because people tend to overestimate the amount of physical activity they do. Second, physical activity is not exercise. Physical activity is any movement.  Surveys that ask folks about their levels of physical activity ask about thinks like housecleaning, and yard work. This type of movement are the things you need to do.  They are tasks and can be stress producing.   When you exercise, your attention is on your body, moving for the purpose of taking care of yourself, which is stress reducing.  This has a very different effect on your brain and your body.

So what did they conclude? “exercise has a large and significant antidepressant effect”

This is great! On paper anyway.  But if you are feeling depressed you know there are two big problems with taking that great news and putting it into action:

First, depression is not a stand alone disease.  The disease itself, plus the medications that treat it leads to many other health concerns, like weight gain, which can lead to diabetes, joint pain, and cancers.  When you feel depressed, getting up and moving is the furthest thing from your mind. Add to that extra weight, elevated blood sugars, joint pain and the side effects of other diseases and their treatments, and putting this amazing tool into practice is far from easy.

Second, our brain is set up to avoid things that make us feel worse.  With the ‘no pain no gain’ mentality of so many exercise programs, why would a brain, that is not feeling great, tell a body that is not feeling great to get up and exercise, just to make it feel worse?  Motivation to exercise comes when it makes you feel better. When it makes you feel worse, your brain will come up with some pretty creative excuses why you cannot exercise.

What is the answer to this conundrum? Part of the answer is right in the research. Moderate intensity exercise for as little as ten minutes is enough. You don’t need to run a marathon, you don’t even need to run. You don’t need to be at the gym for an hour, you don’t even need to be at a gym.  You don’t need to be sore, because that is just a sign you did too much too soon anyway (yes soreness does not mean progress). You don’t need to do high intensity training, just moderate, comfortable level for your body.

When you choose what you do, where you exercise, who you exercise with (or without), and how you exercise so you feel better right away, you are getting the antidepressant effects and your brain will help you stay motivated.

The thing is, only you can tell what type, where and how much is enough to make you feel better.  The trick is, not doing too much on that first time out, so your body and brain both actually feel better right away.   Then your brain will tell you to do it again, because it felt good.

Bottom Line:  The only one who knows the right amount and type of exercise that makes your brain function better is you.  The only one who can administer this medication is you.  Just like any new medication, start with the smallest dose and see how your body and brain respond. Exercise works best for depression when it is used with the just right type and dosage for you right now.

Keep Moving Be Well,

Janet

 

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by | September 10, 2019 · 1:54 pm

Stress and exercise

Why exercise for diabetes_(10)

All you have to do is watch the news, and stress level begins to rise.  Then there are the usual stressors of work and family, plus the bigger stressors that pop up and you have a mind and body that are working overtime.   These mental stressors are part of life, but they can also lead to weight struggles.

Within seconds of a stress response, chemicals (catecholamines) change every system in your body;  Your heart rate increases, blood vessels constrict in your digestive system and your skin, your liver pumps glucose into your blood, your brain narrows its attention to deal with the ‘problem’.

The catecholamines also signal your body to release cortisol.  This chemical suppresses appetite immediately but after some time it then stimulates appetite and the preference for food that is rich in fat and sugar (ie: comfort food).  Cortisol is also known to cause fat to be deposited around the abdomen. Cortisol also increases your body’s insulin resistance, making it more likely those sugars will stay in your blood system.  This chemical also also changes cells in organs in a way that can lead to asthma and eczema as well as pain, gastrointestinal symptoms and panic attacks.

When the stress response is prolonged, it can lead to conditions like: anxiety, depression, type 2 diabetes, fibromyalgia, loss of muscle mass, osteoporosis, high cholesterol, hypertension, and heart disease.

When you are carrying extra body weight there are additional factors that can lead to chronic stress too.  Experiencing weight discrimination, having more health concerns and symptoms such as pain and sleep apnea all keep cortisol levels high.

Add to that other factors such as smoking, excessive alcohol use, and some medications like antidepressants and steroids also increase cortisol levels.

This can create a spiral where higher cortisol increases weight and weight gain increases cortisol.  When we think of weight loss as simply moving more and eating less, we miss this major hidden factor that is contributing to weight – stress.   Then, when going on a diet and exercising are stressful, it can speed up this cycle rather than reversing it.

While all of this may seem overwhelming, the way out is closer than we think.   It is found in understanding why your body does all of those changes in response to stress.

When you are in a stress response your body is preparing to protect you by preparing you to move; to run away from or fight a stressor.  We all have heard the stress response called the ‘fight or flight’, and that the problem is that our modern day stressors are not solved by fighting or fleeing the ‘danger’.  The bigger problem is that we have made exercise stressful, reducing the chances it will be able to take you from the stress response back to the state your body can heal and repair.

The answer is found not in more exercise, but instead carefully designing movement time so it is stress reducing by:

  • Focusing on what you are doing, not multitasking to just get it done
  • Moving the way your body was designed (hint: it was not designed to do sit ups)
  • Doing just the right amount for your body now,  not exercising to a point of pain or exhaustion

The fact is, only you know if exercise is stress producing or stress reducing.    It starts with knowing how your body is designed to move, staying away from marketing based exercise programs.   Then listening to your body so you know how it moves well now, at your current shape and size.

It’s not only possible for exercise to reduce stress, it is essential if exercise is going to lead to weight loss and improved health and well-being.

The bottom line is that exercise is the antidote to stress. It is what your body needs when you are stressed in this modern society.  Take time to move in ways that help your body lower your cortisol levels now, and it will thank you by getting back to its job to keep you healthy and well.

Keep Moving, Be Well,

Janet

Source:

Stress and Obesity: Are There More Susceptible Individuals? Eline S. van der Valk et al. Current Obesity Reports(2018)

 

 

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by | September 4, 2019 · 7:11 pm

The weight loss you don’t want

Why exercise for diabetes_(9)

When you are trying to lose weight, every pound down on the scale is exciting.  It’s an affirmation that what you are doing is working.

Or is it?

If the goal is just to lose weight, regardless of your health or how your body feels or functions at the lower weight, then yes, it is working.

But if your reasons for losing weight are to feel and function better, be healthier, live longer and look better, research is affirming the scale is not the best tool.

Weight loss can be up to 30% muscle loss. This the weight loss you don’t want! It turns out, muscle is more about our health and longevity then we ever thought. Here is some of the recent research backed connections between muscle loss and health:

  • Joint Replacement:  Patients who had less muscle mass had more complications, slower wound healing, increased risk of infections and longer recuperation after  total knee replacement surgery.
  • Cancer: Patients who had lower levels of muscle mass had reduced ability tolerance of treatment. Patients with less muscle mass having surgery for colon cancer had a higher incidence of both blood transfusion and complications after surgery.
  • Gastric Sleeve:  Patients with lower muscle mass were at greater risk of a leak after having a sleeve procedure for weight loss.
  • Osteoporosis:  The loss of bone and muscle have a huge impact on how a person ages.  Researchers now know that there is a strong connection between loss of muscle and loss of bone.  Researchers are asking we think of muscle loss and bone loss one disease because they know that increasing muscle mass has a direct effect on improving bone mass.
  • Others:  Reduced muscle mass has been connected to increased risk of falling, bone fractures, reduced longevity, fatigue, arthritis, as well as emotional health including depression, anxiety, and social isolation.

The medical name for muscle loss is Sarcopenia and it is now considered a disease.  However, this is not the kind of disease a medication can fix.  Muscle, like the rest of your body is a use it to keep it commodity.  The way to keep it, or get it back if you lost it is through strength training exercise.

sarcopenia

How do you know if you are losing muscle?  Well, that is part of the problem.  Measuring muscle mass has not been quite as convenient as getting on the scale.  Fortunately, researchers have found there is an easier way to test muscle loss. Its called a hand grip test.  It is strongly connected with how much muscle mass you have.  No tool is perfect, but this is one of our best ways to know if you are holding on to your muscle mass as you age and as you lose weight.

Soon, we will be incorporating this test as part of our measurements before and after weight loss surgery to give you another number to see how you are doing.  Since the connection between muscle mass and health has the potential for being a reliable measurement of true progress with weight loss for health, these numbers are ones to pay attention to as you lose weight.

Keep Moving, Be Well

Janet

 

Sources:

  1. The impact of sarcopenic obesity on kneeand hip osteoarthritis: a scoping review Godziuket al. BMC Musculoskeletal Disorders (2018)
  2. Preoperative grip strength measurement and duration of hospital stay in patients undergoing total hip and knee arthroplasty A. J. Shyam Kumar. European journal of orthopedic surgery, July 2013
  3. Is sarcopenia a better predictor of complications than body mass index? Sarcopenia and surgical outcomes in patients with rectal cancer Colorectal Disease  SB Jochum, 2019, 
  4. Preoperative Detection of Sarcopenic Obesity Helps to Predict the Occurrence of Gastric Leak After Sleeve Gastrectomy, Martin Gaillard, Obesity Surgery August 2018
  5. Osteoporosis and sarcopenia: two diseases or one?, Jean-Yves Reginster, Current Opinion in Clinical Nutrition and Metabolic Care, Jan. 2016
  6. Interaction of nutrition and and exercise on bone and muscle, Endocrinology 2019
  7. Sarcopenia FDA report, April 2017
  8. Sarcopenia is a disease –  why are we looking for a medication.? The Conversaion

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by | August 27, 2019 · 7:30 pm

Peace is not just a state of mind

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This is a simple reminder that to be calm in your heart, your body first needs to release built up tension.

Your body releases tension when you move it with present moment attention, with the intention of taking care of it.

Doing more tasks, getting more done, only builds up more tension.

Watching TV or scrolling through social media only distracts from that tension. It does not release it.

Dance.  Stretch.  Walk. Play.  Move in some way that helps your body release that tension.

When your body has released that tension and restored calm, your mind and heart will follow.

Keep Moving, Be Well,

Janet

 

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by | August 21, 2019 · 6:59 pm

Exercise and dementia

Why exercise for diabetes_(8).png

Dementia is a medical condition that hits close to home for more and more people.  According to the World Health Organization, around 50 million people have dementia, and there are nearly 10 million new cases every year.  Chances are, it is affecting your life through those you know and care about.

In 1999 a group of scientists discovered that running caused new brain cells to form in mice (3).  Before this, it was believed we had a set number of brain cells at birth and it was not changeable.  This and other studies on exercise and the brain shifted our thinking about exercise beyond just the health of the body.    This started a cascade of studies that are providing more and more information about how exercise helps the brain in humans. The brain is now is know to respond to exercise much like a muscle -getting weaker with less exercise and stronger with regular exercise.

It has been shown through research that 35 percent of risk factors for developing dementia can be attributed to modifiable lifestyle choices, with exercise being a large portion of what we can control in our chances of getting dementia (4).

Although maintaining a healthy weight is part of that healthy lifestyle that helps prevent dementia, how you lose weight matters. In one study between three sets of people—individuals who lost weight through restrictive eating, people who lost weight through exercise, and a group that used a combination of the two—only the groups who had exercise as part of their weight loss regimen noted an improvement in brain function (2).

How exercise makes the difference in your brain is still not fully understood but it seems to improve brain function by:

  • Increasing the size of the hippocampus (the part of your brain responsible for memory and learning)
  • Increased BDNF (brain-derived neurotrophic factor), called fertilizer for the brain by John Ratey, MD because it is an important brain chemical in boosting memory and learning
  • Increased blood flow to the brain

However, one factor that cannot be ignored when we talk about these brain benefits of exercise; the role stress plays in helping or limiting these brain benefits. Prolonged and unpredictable stress can interfere with brain cell growth, whereas mild stress (what we might call a “good challenge”), improves brain cell growth (3).  We need to then carefully plan exercise so it is not stress producing, but rather to be a good challenge for the body and brain. 

That means that the type, level and frequency of your exercise plan needs to be something you look forward to, not something that is boring or that is overwhelming. The place you choose to exercise in needs to help you feel confident, not self-conscious  Exercise needs to fit into your life rather than make your life fit around your exercise plan.  Finding that sweet spot takes careful planning, mindful awareness, and a good understanding about how much is enough exercise to get what you want from it.    This balance is not only possible, it is essential if you are going to use exercise to help your brain function at its best for your whole life. 

Keep Moving, Be Well,

Janet

 
 

1. Exercise and hippocampal neurogenesis: a dogma re-examined and lessons learned.  Patrick Z. Liu, BA and Robin Nusslock.  2018

2. Why Exercise Is Good for Your Brain. Mylea Charvat, Ph.D. January 2019

3. Adult neurogenesis and physical activity. José R. Alonso. January 2018

4. .Dementia prevention, intervention, and care. Commission in Lancet. July 2017

 

 

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by | August 13, 2019 · 7:46 pm