Tag Archives: health

The exercise mindset shift of a new mom

Inspired by Dr. Gitkind’s story last week, about how he used his fitness to help others, I decided to do a blog series about the real life exercise challenges and successes of UMass Memorial Weight Center Staff. This week I interviewed Anna Grotevant, one of our dietitians.  As many of you know, she had a baby last year.  I asked her about how being a new mom has shifted her mindset about exercise.


What was your mindset about exercise before pregnancy?

Before starting a family I exercised to stay fit and as a social activity. I wasn’t very consistent. I had more time to myself and tended to procrastinate. I didn’t really use exercise as a form of self-care because I had other forms of self-care that were more relaxing. Exercise felt more like something I had to check off on my to-do list. I would go weeks or months without exercising even though it is important to me.

What do you do now for exercise as a new mom?

After giving birth to my daughter a year ago, I spent time anna blog picrecuperating. I stopped exercising completely as I didn’t have the physical or mental energy to think about it. I also felt like I was so “out of shape” that my typical forms of exercise (running /yoga) were out of the question. Once I hit six months postpartum, I started with some walking. I built up from there, and now I’m walking, running, strength training and doing some yoga – usually something every day. I exercise on my own in the evening and with my sister on the weekends (we have “run dates”, which I really enjoy). I also walk on my lunch at work when it’s nice out.

How has your mindset about exercise shifted since having a baby?

My mindset about exercise has shifted. Since I have less time to myself, I tend not to procrastinate. If I’m going to do anything it has to be while my daughter is sleeping, so I get right on it as soon as my daughter goes down. I also have to multitask – I look at exercise not only as a way to stay fit but as a form of self-care and relaxation. I appreciate the time I have to myself a lot more. I’m a lot more gentle and forgiving in my workouts because it’s not about burning calories or running faster, but just about being able to move my body and have some time alone.

What is the biggest challenge about exercising as a new mom?

The biggest challenge about exercising as a new mom is the time that it takes. There’s always something I “should” be doing. Exercising during my daughter’s nap time means I’m not doing any of my household tasks. Having exercise dates with my sister on weekends means I’m not spending time with my daughter and husband.  That can actually make my life feel more stressful, especially if I’m falling behind in my responsibilities or it’s a particularly busy time of life. I try to manage this by prioritizing. I say no to some activities and requests from others so that I can preserve time for the people who are most important to me. I try to incorporate exercise into family activities on the weekends. Most importantly, I try to remember that no one is perfect. I can’t be the perfect mom, wife, sister, daughter, employee or exerciser. I can just do my best with what I’ve got and keep moving forward.

 

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by | September 30, 2019 · 8:17 pm

Is it your body or your mind holding you back?

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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

The weight loss you don’t want

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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

Exercise and Osteoarthritis

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What is Osteoarthritis?

In normal joints, a firm, rubbery material called cartilage covers the end of each bone. Cartilage provides a smooth, gliding surface for joint motion and acts as a cushion between the bones. In osteoarthritis or OA, the cartilage breaks down, causing pain, swelling and problems moving the joint. As OA worsens over time, bones may break down and develop growths called spurs. Bits of bone or cartilage may chip off and float around in the joint. In the body, an inflammatory process occurs and cytokines (proteins) and enzymes develop that further damage the cartilage. In the final stages of OA, the cartilage wears away and bone rubs against bone leading to joint damage and more pain.  Arthritis Foundation Website

How does exercise help?

Exercise is considered the most effective non-drug treatment for reducing pain and improving movement in osteoarthritis. Arthrtis.org

Movement in general can reduce inflammation, the cause of pain in arthritis.   Your lymph system relies on movement to keep this fluid part of your blood moving so your body can lower inflammation.  All three types of exercise work well for osteoarthritis:

  • Stretching reduces stiffness that makes movement more difficult.  Simply moving a joint through its full range of motion a few times several times a day can be very beneficial in reducing stiffness and movement limitations from OA
  • Strength training helps your muscles, ligaments and tendons support arthritic joints. Strength training has been shown to reduce arthritis pain.  The key is knowing how to do strength training with proper alignment so your joints work there best and you minimize strain.  In your exercise visit, we practice this to ensure strength training is not painful so your body can gain strength without strain.
  • Cardio can reduce pain, but there are several factors to consider.  If the activity is weight bearing (such as walking), your joints probably won’t tolerate it for as long. However, since walking is a type of activity needed for daily life, it is important to incorporate if at all possible.  Use a cane or walker if it helps you walk with less pain.   Walk in several short bouts for the duration that does not increase pain.  Supplement with a form of cardio that is non-weight bearing and allows you to move for a longer period of time,  such as an exercise bike or seated aerobics. The key is doing the amount and type that decreases, not increases pain and then repeat that more frequently to make up for the lower duration.

The key to each of these  is listening to your body.   When movement decreases pain, it is lowering inflammation.  When pain increases, so does inflammation.  So doing small bouts throughout the day, doing the types of exercise that reduce pain and stiffness is the way to use exercise as the most effective non-drug treatment for reducing pain and improving movement in OA.

One last thing to consider is stress.  If exercise or physical activity is stressful, it will increase inflammation.  Choose types of movement you enjoy, that leaves you feeling good about yourself, and do it in a way that it does not increase your pain, and you will be using exercise in the way that it can make it easier to live with osteoarthritis.

In the next blog, I will address why exercise is important if you are having  joint replacement surgery.

Keep moving, be well,

Janet

Sources:
Exercise in the management of knee and hip osteoarthritis. Elizabeth Wellsandt and Yvonne Golightly. Current Opinion in Rheumatology. 30(2):151–159, MAR 2018
Educating patients about the benefits of physical activity and exercise for their hip and knee osteoarthritis. Systematic literature review. C.Gay, A.Chabaud, E.Guille, E.Coudeyre.  Annals of Physical and Rehabilitation Medicine.  June 2016, Pages 174-183

 


Please share these posts with anyone you know interested in losing weight with or without weight loss surgery.  Click here to learn more about the UMass Memorial Weight Center

These weekly blogs are general guidelines. These guidelines apply to patients who are cleared by a physician for the type of exercise described. Please contact your physician with any concerns or questions. Always report any symptoms associated with exercise, such as pain, irregular heartbeats, and dizziness or fainting, to your physician.

 

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by | July 9, 2019 · 7:30 pm

Exercise and diabetes

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If you have been told your blood sugar (glucose) is too high, you probably have also been told to exercise.  But why?  Knowing how exercise helps lower blood sugar levels is a key for staying motivated to exercise regularly.  Let’s take a look at the inside story of exercise and blood sugars. 

Sticky Blood: When sugar gets wet, it gets sticky.  One of the biggest problems with having high blood sugars is that sugar makes blood “sticky”.   When sugar is at higher levels in your blood for too long, it is concerning because that “sticky” blood is now traveling to every part of your body.   This is why diabetes puts you at risk for so many different medical issues.  Nearly every part of the body is strained when blood sugars are high; your kidneys, your nerves, your eyes, etc.

Natural blood sugar management: Two of the most important ways your body is designed to move sugar out of your blood after you eat is (1) the movement system (2) the insulin system.  The movement system is meant to be the main system for keeping blood sugar from getting too high. The insulin system is designed to be your back up system, for use when you are not moving.

When you move:

  • your body uses the sugar in your blood to help fuel moving muscles
  • your body is able to use its own insulin more efficiently.  After exercise, your body is more sensitive to its own insulin, making this back up system work better for hours after exercise.

When you don’t move often:

  • your main (movement) system for managing blood sugars is not available
  • your body needs to use the back up (insulin) system to bring sugar into cells to be stored as fat
  • over time your back up (insulin) system gets overused and can ‘wear out’

When you have type II diabetes, your body is resistant to insulin, causing sugar and insulin build up in your blood.   When you move your body, you activate the main natural system for lowing your blood sugar.   Exercise then, temporarily reverses the cause of type II diabetes.

Not all movement is created equal.  However, if you move all day for your job or for child care, your movement system could be counteracted by another system – the stress system.  When you are moving but stressed, your body releases more sugar into your blood.  That means the movement system cannot do its job as effectively.  This is what sets exercise apart from your every day physical activities.  Exercise is when you are moving for the purpose of self-care. When movement reduces, rather than increases stress, it is able to do its job of lower blood sugars. 

Plus, exercise has GREAT side effects. The bonus is, exercise also helps you manage diabetes in other ways too:

  • Think clearly:  Moving your body can help your brain function better, giving you a better mood, focus and ability to make healthy choices
  • Health protection:  Regular exercisers have a lower risk of heart disease, cancer and stroke.  When you have diabetes you are at greater risk for health concerns, so the extra protection from exercise comes in very handy.
  • Weight managementExercise (specifically strength training) counteracts the metabolism lowering effect of dieting by keeping your muscles strong and functioning well while losing weight.
  • Improved sleep: When sleep deprived, the stress response in the body is triggered, raising blood sugar and making weight loss more difficult.  Using exercise to improve sleep has a ripple effect to many other parts of your life.
  • Reduce Arthritis pain: stronger muscles around joints can decrease arthritis pain and make moving easier.  Less pain means you can move more and moving more helps keep blood sugar in check.
  • Reduce Back Pain:  The job of the core is to protect the spine from wear and tear. Exercises that teach the core muscles to do their job in a functional way can reduce back pain.  Plus, stretching in a way that helps to improve tolerance of things like bending and lifting and helps the body recover from strains of daily life can reduce back pain flare ups. Again, less pain, more movement, better blood sugar control.
  • Counteracts depression, anxiety, and improves mood and focus:  Exercise, when used properly, has been shown to be very effective as part of a treatment plan for depression, anxiety, ADHD, and other areas of mental health.  Living with a disease like diabetes can be overwhelming at times and can affect mood.  Exercise can help boost your ability to cope with the stress and pressures of having diabetes

Bottom line:  Moving your body, in a way that reduces stress, activates the natural blood sugar management system in your body.  Keep moving to keep this system working for you and your health.

Keep Moving, Be Well,

Janet

 

 

 

 

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by | May 28, 2019 · 8:55 pm

Who can you inspire to move?

Who can you inspire to move_

My whole team is doing the stretches as part of our morning huddle.  We don’t have pain during the day and have more energy at the end of the day!

This week a patient shared with me an inspiring story.

She is a dental hygienist and she would always get pain her her neck and shoulders from being in that position all day long. That pain drained her energy too.  In her first visit, we did some stretches that she could incorporate into her day to see if they help with this energy draining discomfort.

They really worked for her.  So she showed the stretches to her co-workers one day at morning huddle.   Now they all don’t have that pain any more and they have more energy at the end of the day too.  They decided to make it part of their morning routine.

Kudos to you for inspiring others to move and feel better!

Who could you inspire today to keep moving and be well?

Share your story!

Janet

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by | May 22, 2019 · 4:44 pm

Exercise and high blood pressure

Exercise in the age of distraction(1)

High blood pressure has been called a silent disease because there are often no symptoms. This medical condition could be undetected for years if you don’t have your blood pressure measured regularly.  But what is the big deal about high blood pressure and why is exercise an important part of the treatment?

What is it?  Blood pressure is the pressure of blood on your blood vessel walls.  Two parts of your cardiovascular system effect blood pressure:

1. Your Heart:  The force with which blood is pumped from your heart puts pressure on blood vessel walls.  This varies depending on the strength of your heart as well as if you are moving or still. When you are moving, your heart not only pumps faster, it pumps stronger.     Think of an untied balloon filled with air.  The more air you put in the balloon, the more forcefully it will fly around the room when you let it go.   The more of your body that is moving, the more blood that is circulated back to the heart and pumped out again.  The more blood that fills the heart with each beat,  the more forcefully it contracts, the more pressure that blood puts on the blood vessel walls.

2. Your blood vessels:  Blood vessels can tighten and relax to help control where blood is sent in your body.   When you move,  blood vessels relax, especially in moving muscles to allow for more blood flow to bring  oxygen and fuel to moving muscles. In fact, when you exercise your body releases Nitric Oxide. This chemical helps blood vessels relax to compensate for the higher pressure from the stronger heart beat (described above).  This way your blood pressure does not go as high when you exercise.

Your blood pressure goes up during times of stress because the blood vessels are more stiff than elastic when you are stressed.  This causes higher pressure on the walls of your blood vessels. Over time this pressure on the walls can wear down the smooth, slippery lining in your blood vessels, increasing the chances plaque with stick to the walls.  This process is called atherosclerosis and is what can lead to heart attack or stroke.

When you exercise  your blood pressure goes up, but it is because your heart is pumping stronger (and getting stronger in the process), while your blood vessels are relaxing.  This raise in your blood pressure does not cause the wear and tear on your vessel walls because at the same time the walls are more elastic, not stiff like when you are under stress.  This combination helps prevent, rather than lead to the build up of ‘stuff’ on the walls of your blood vessels.

That’s in part because the effects of the Nitric Oxide lasts for up to 22 hours after one single bout of exercise!  Long after you stop exercising, your blood vessels stay a bit more relaxed. This helps to reduce the wearing down of your artery walls because your blood vessels are more relaxed, helping you manage high blood pressure for a whole day after one single bout of exercise.

Bonus: Exercise also helps to reduce the fats and sugars that are in your blood that could stick to vessel walls.  More on that in another blog.

When it comes to your blood pressure though, exercise is one of the great ways to keep your blood pressure lower and reduce the effects of high blood pressure, naturally.

Keep Moving, Be Well,
Janet

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by | May 15, 2019 · 7:14 pm