5 Practical Ideas to Improve Health and Fitness by Michael Wood, CSCS

“Mens sana in corpore sano” (Latin)  – a healthy mind in a healthy body.

There were almost 82 million Americans who were completely inactive in 2015. We know that exercise on a regular basis can be a very difficult task since most people do not even like to exercise. More than 30% of the population will not workout at all this year and only 5% will exercise at a level that is considered vigorous. Compounding the problem, the average American sits more than 9 hours a day; sitting is now considered the new smoking. We have become a society where inactivity is fast becoming the new norm. If this resonates at all with you then you may want to try to incorporate the following practical tips into your lifestyle.

There have been many things that I have learned and continue to learn during my three decades in the fitness industry and I can honestly tell you, in addition to some nutritional advice, these five particular items should be on your radar. It would be prudent for you to make sure these five components (5M’s) find their way and get ingrained into your lifestyle.

  • Measurement

Athletes at the collegiate and professional level continue to improve because they work with the best strength and conditioning coaches and nutritionist. They have a well thought out plan and get tested periodically. This is the one component that offers the most bang for the buck yet most individuals find reason to neglect it. Find the time to take some type of measurement(s) and periodically test yourself in order to (1) hold yourself more accountable, (2) determine if your exercise plan is actually working and (3) to help keep you motivated. This applies to not just exercise and your workouts but also on the nutritional side of things. Are you eating, for example, too much added sugar? Checking your body weight is OK but go beyond just checking your weight. What percentage of muscle and body fat make up that overall weight of yours? What is your waist measurement? Can you run a mile? Can you run up a flight of stairs without feeling winded? These types of measurements offer more value than jumping on a bathroom scale.

Credit: http://www.azquotes.com

A few (measurement) ideas for you:

  • Determine your Waist-to-hip ratio
  • Monitor your % body fat and/or lean muscle mass
  • Record your daily grams of added sugar (<35 grams/day/men and <25 grams/day/women). Use the MyFitnessPal app.
  • Determine your best 500 or 2000 meter row time
  • Vertical jump measurement
  • Plank challenge (can you hold position for 2:00 or 3:00?)
  • Are you getting 8,500-10,000 steps/day

Finally, remember another great quote from Peter Drucker, “what’s measured improves.”

Suggested Reading

Koning L et al., Waist circumference and waist-to-hip ratio as predictors of cardiovascular events: meta-regression analysis of prospective studies. European Heart Journal (2008). 28, 850–856 doi:10.1093/eurheartj/ehm026

  • Mindfulness

Once your measurements are taken and documented you’ll then have a baseline and you’re ready to begin. A good first step, is to work towards becoming more mindful, this will help you not only with exercise and diet but in all aspects of your life. The net result will be a significant improvement in the “quality” of your exercise and the way  you fuel your body. As we become more in tune with mindfulness, we become more aware of the relationship between a stimulus and response. You can think of mindfulness as a tool that can help you develop that gap between the stimulus and the response to that stimulus.

Mindfulness is “the ability to stay focused, while being aware of your thoughts and surroundings and being able to recognize and move past distractions as they arise.” Harvard Business Review

Researchers looked at subjects who had the opportunity to choose from 22 general activities, such as walking, eating, shopping, and watching television. Their study showed that respondents, on average, reported their minds were wandering 47% of time, and no less than 30% of the time during every activity except making love. Becoming more mindful in regard to exercise and diet is extremely important. Learn to become truly present when you’re involved in these activities otherwise your mind and body are not taking in 100% of the benefit.

One way to help you get moving down this road of mindfulness is with daily meditation. A typical session involving meditation could range from two minutes up to sixty minutes. I have used the popular Headspace app to help me get started which is excellent and I highly recommend you start with this free, simple to use, app. More than 4 million people have used the app to date. According to a Tim Ferris, podcast, author of the 4-Hour Work Week, more than 80% of the world-class performers who he interviews use some form of daily meditation and he’s a big proponent of the free Headspace Take 10 program.

There is a great deal of research that demonstrates mediation creates positive changes in our brains. Harvard University neuroscientist Sara Lazar told the Washington Post, “long-term meditators have an increased amount of grey matter in the insula and sensory regions, the auditory and sensory cortex.”

In a 2014 study in the Journal of Economic Behavior and Organization, Australian researchers looked at the relationship between various personality traits and exercise and other health-related habits. The researchers found that people who thought they had control over their lives were more likely to exercise and adopt other healthy steps than those who felt that luck or fate largely dictated their lives. Daily meditation offers that sense of control.

With everything we have going on in our daily lives like raising children, marriage issues, social media, political upheaval, and all the demands at work, we need to find more time to focus on ourselves. The goal should be to work on eliminating all the distractions and “noise” that surrounds us. Becoming more mindful will enable us to have better control in all aspects of our lives especially with what we’re focusing on here, improving your lifestyle especially with regard to diet and exercise.

You can take this assessment to see where you currently rate when it comes to mindfulness. Try taking the assessment before and then after completing ten sessions using the Headspace app.

  • Mobility

Mobility, or joint mobility, in general, is one of the most misunderstood terms. The first thing you need to understand about mobility is that it does not start this week and then end in a day or two. If you want to improve mobility then it needs to be part of your every day life and one of the components of each workout you do. You will receive the most benefit when regular mobility work becomes part of your lifestyle.

Let’s first look at a good definition of mobility. According to physical therapist Joe Vega, M.S.P.T., CSCS,. “a person with great mobility is able to perform functional movement patterns with no restrictions in the range of motion of those movements.”

A more in-depth look at what happens when you perform specific mobility exercises is given here by fitness expert, Steven Maxwell. “Joint mobility exercise stimulates and circulates the synovial fluid in the bursa, which ‘washes’ the joint. The joints have no direct blood supply and are nourished by this synovial fluid, which simultaneously removes waste products. Joint salts, or calcium deposits, are dissolved and dispersed with the same gentle, high-repetition movement patterns. Properly learned, joint mobility can restore complete freedom of motion to the ankles, knees, hips, spine, shoulders, neck and hands.”

Remember, you should take a proactive approach when it comes to mobility, not a reactive one. In other words, don’t wait for problems to arise before you address them.

A great tool to help you get started is a foam roller (see below) which can be used for self-myofascial release. It has been shown to help increase joint range of motion and with delayed-onset muscle soreness, commonly known as DOMS. For more information check out MWOD.

Suggested Reading

Supple Leopard, Dr. Kelly Starrett, Victory Belt Publishing, 2013.

Foam rolling and self-myofascial release, Strength & Conditioning Research.

Mobility Training May Be the Most Important Factor in Musculoskeletal Health, Steve Maxwell.

Training Principles for Fascial Connective Tissue, Schleip R., Muller DG., J. Bodywork & Movement Therapies, 2012.

  • Movement

Hippocrates once said, “walking is a man’s best medicine.” To find out if his 2,400 year-old remark was actually valid, two scientists from University College London performed a meta-analysis of research published between 1970 and 2007 in peer-reviewed journals. After studying more than 4,000 research papers, they identified 18 studies that met their high standards for quality. The studies evaluated 459,833 test-subjects who were absent of cardiovascular disease at the start of the investigation. The subjects were followed for an average of 11.3 years, during which cardiovascular events (i.e. heart attacks and deaths) were recorded. Their meta-analysis makes a strong case for the benefits of good old walking. The group of studies showed that walking reduced the risk of cardiovascular events by 31 percent, and decreased the risk of dying during the time of the study by 32 percent.

More movement of any kind is obviously a good thing. One tool you can use to monitor your exercise and especially walking is a pedometer. It can be valuable because it (1) can hold you more accountable, (2) it can help to build up to a desired step total for a daily/weekly/monthly total and (3) it can be a useful motivational tool along the way. Research out of Stanford University has shown that individuals who use a pedometer take an additional 2,000 steps each day, compared to nonusers, and their overall physical activity level increases by 27%. Another study showed participants who increased their steps to average more than 9,500 a day for 32 weeks lost 5 pounds, 1.9% body fat and 1.9 centimeters from their hips. They also increased their HDL cholesterol by 3 mg/dl and lowered their BMI by nearly 2 points. The participants in the study increased their steps by an average of 4,000 steps a day from the start of the study.

The goal with trying to add in more daily movement is consistency. If you have a crazy week at work and can’t get to the gym as much during the week then be sure you check it off during the weekend. The key is to do something. Research by Krogh-Madsen and colleagues showed the dramatic changes that can take place after just two weeks of decreasing your activity. The subjects were young, lean, healthy men who decreased their daily steps from 10,000 steps a day to 1,300 steps a day. They experienced an increase in body weight, 7% decline in VO2 max, a 2.8% loss of lean muscle in their legs, and a 17% drop in insulin sensitivity after just two weeks of decreasing their activity by 8,700 steps a day.

A few thoughts to keep in mind when it comes to movement. More movement, like walking, and other forms of exercise (like strength training), translates into an elevated metabolism. There are many external as well as internal forces that can have an effect on your metabolism and exercise is the most variable. Sedentary individuals may add only 10-30% to their total daily energy expenditure (TDEE) while very active individuals can increase that number above 50-75%. TDEE is the total amount of calories the human body burns (or expends) in one day. When you’re more active throughout the day you get the added bonus of what scientist refer to as NEAT or non-exercise activity thermogenesis. NEAT is the energy expenditure of all physical activities other than exercise. NEAT can vary by up to 2000 kcal per day between people of similar size in part because of the substantial variation in the amount of activity that they perform. Obesity is associated with low NEAT; obese individuals “appear to exhibit an innate tendency to be seated for 2.5 hours per day more than sedentary lean counterparts.” When you exercise at higher intensity levels you increase your body’s ability to burn calories post exercise, known as exercise post oxygen consumption (EPOC). EPOC is one of the by-products of high-intensity interval training.

TDEE = BMR + TEF + NEAT + EPOC + Exercise

Finally, according to research published in the journal Medicine & Science in Sports & Exercise, subjects who were least active during this particular study were five times more likely to die than the most active people and three times more likely than those in the middle range in terms of daily activity. The data was taken from approximately 3,000 people aged 50 to 79 that were part of the University of Pennsylvania Population Study. When in doubt, always remember the old saying “use it or lose it.”

Suggested Reading

Movement: Functional Movement Systems, Gray Cook, Lotus, 2011.

The One-Minute Exercise, Martin Gibala, PhD, Avery, 2017.

The Inner Runner, Jason Karp, PhD, Skyhorse Publishing, 2016.

How to Think About Exercise, Damon Young, The School of Life, 2015.

Better Movement, Todd Hargrove, Amazon Digital, 2014.

Born to Walk, James Earle, Lotus Publishing, 2014.

  • Muscle

The ability to maintain muscle mass as you age is considered by many as the closest thing to the fountain of youth. There is still hope for you even if you’ve been inconsistent or unable to exercise at all. That hope comes in the form of regular strength training. Research has shown that approximately three decades of age-related strength loss and two decades of age-related muscle mass loss can be recovered or reversed within the first couple of months of starting a strength training program. Research from a 2016 meta-analysis published in Medicine & Science in Sports & Exercise reviewed 49 studies of men ages 50 to 83 who did regular strength training and found that subjects averaged a 2.4-pound increase in lean muscle mass.

There are a few additional items you need to focus on consistently beyond your strength training. When it comes to maintaining or building muscle, sleep and recovery are critical and good nutrition is a must. When I say nutrition I’m talking a surplus of good calories especially in the form of high quality protein. If your body is not continually in an anabolic state you will not be building any new muscle.

A recent study in the journal Nutrients suggests a daily intake of 1 to 1.3 grams of protein per kilogram of body weight is needed for older adults who do resistance training. For example, a 175-pound man would need about 79 to 103 grams a day. If possible, divide your protein equally among your daily meals to maximize muscle protein synthesis.

There is a strong association between strength training and muscle mass but as you continue to age the key is working smarter. You can do that by making sure you include these primary lifts or movements as part of your strength program: squat, dead lift, pulling and pushing movements, and some type of loaded carry.

In a recent comprehensive research review, Donnelly and colleagues note that the majority of peer-reviewed resistance training studies (lasting 8–52 weeks) show increases of 2.2–4.5 pounds of muscle mass. These researchers suggest that an increase of 4.5 pounds of muscle mass would probably increase resting metabolic rate by about 50 kcal per day. Although this small change is not nearly as much as some advertisers may suggest, it does help close the gap between energy intake and energy expenditure.

There you have it – my five practical tips that will help take your health and fitness to the next level. The choice is now yours.

Suggested Reading

Biochemical Adaptations in Muscle. J. Biol. Chemistry 424(9): 2278-2282, 1967.

Dynamic exercise performance in Masters athletes: insight into the effects of primary human aging on physiological functional capacity. J Applied Physiol 95: 2152-2162, 2003.

Core Performance, Mark Verstegen, Rodale Books, 2005

Athletic Body in Balance, Gray Cook, Human Kinetics, 2003

Functional Training for Sport, M. Boyle, Human Kinetics, 2003

Never Let Go, Dan John, On Target, 2011

References

Schneider PL, Bassett DR, Thompson DL, Pronl NP, and Bielak KM (2006). Effects of a 10,000 Steps per Day Goal in Overweight Adults. Am J Health Promotion 21(2): 85-89.

Donnelly, J.E., et al. Is resistance training effective for weight management? Evidence-Based Preventive Medicine, 1(1): 21–29, 2003.

Krogh-Madsen R, Thyfault JP, Broholm C, Mortensen OH, Olsen RH, Mounier R, Plomgaard P, van Hall G, Booth FW, and Pedersen, BK (2010). A 2-wk reduction of ambulatory activity attenuates peripheral insulin sensitivity. J. Applied Physiology, 108(5):1034-1040.

Wu BH, Lin J, (2006). Effects of exercise intensity on excess post-exercise oxygen consumption and substrate use after resistance exercise. J Exerc Sci Fit, 4(2).

Abboud GJ, Greer BK, Campbell SC, Panton LB, (2012). Effects of Load-Volume on EPOC after Acute Bouts of Resistance Training in Resistance Trained Males. October.

Levine JA, et al. (2006). Non-Exercise Activity Thermogenesis. Arteriosclerosis, Thrombosis, and Vascular Biology. 26: 729-736.

Ivey, FM et al., (2000). The Effects of Age, Gender and Myostatin Genotype on the Hypertrophic Response to Heavy Resistance Strength Training. J. Gerontol: Med Sci 55A: M641-M848.

Ezra I. Fishman, Jeremy A. Steeves, Vadim Zipunnikov, Annemarie Koster, David Berrigan, Tamara A. Harris, Rachel Murphy. Association between Objectively Measured Physical Activity and Mortality in NHANES. Medicine & Science in Sports & Exercise, 2016; 1 DOI: 10.1249/MSS.0000000000000885

The New Lexicon of Healthcare: Terms for the 21st Century of Wellness

Weekend warriors dedicated to fitness for play and performance are beginning to see the signs of aging wear and tear. Osteoarthritis can cause pain to crucial areas like elbows, hips, knees and back. Advances in healthcare are giving new options and alternatives to surgery.  This next generation of medicine is integrative bringing all medical modalities to patient care.

At the helm of this new direction is Dr. Chris Renna. This holistic, alternative approach merges complementary and functional medicine bringing pharmaceutical, behavioral and nutritional aspects together to address the root cause of health issues.  The result is allowing athletes to continue to do what they love longer without the long recovery time and a plethora of preventative measures.

With these new advancements come a new language of medical health terminology. Dr. Chris Renna breaks it down and explains the new trends.

MEDICAL LEXICON

Integrative medicine:

Integrative medicine brings together 4 principles in creating a unique medical approach:

  1. “Holistic”/ Comprehensive: everything in the body affects everything else. Nothing is separate or isolated.
  2. “Inclusive” /Integrative: invites the best medical practices worldwide with an emphasis on cultural norms or how each person was conditional.  For example acupuncture might be a second choice treatment for an American individual but a first choice treatment for a Korean individual.
  3. Functional:  looking for the origin of problems, treating causes not symptoms
  4. Complimentary/synergistic:  Using treatments or techniques that are beneficial when used individually but are more beneficial used together.  For example:  Healthy diet + exercise + sleep produces better health than one or two of these alone.

Prolotherapy: A treatment technique used for chronic myofascial pain, back pain, osteoarthritis, or sports injury. It involves repeated injections of dextrose solution or other irritating substances into or around ligaments, tendon, or painful tissue in order to provoke a regenerative tissue response.

Translational medicine: Incorporates conventional medical recommendations, alternative remedies and new, research-based treatments to improve health and prevent disease. Employ practices of translational medicine to close the gap between discovery of new treatments and methodologies and their implementation in clinical practice.

Regenerative: Believe the body’s natural ability to heal coupled with the world’s best technologies is where non-surgical orthopedics really makes a difference in the health and lives of those in pain.

Regenokine Program:  A breakthrough treatment for osteoarthritis, chronic back and joint pain. Prior to its introduction in the US, Regenokine was used by thousands of individuals in Europe including Pope John Paul II, pro athletes, celebrities, politicians and business magnates. Regenokine uses a small volume of the patient’s own blood to create a serum that reduces inflammation, was met initially with fierce resistance by the medical establishment. Ultimately, the remarkable results achieved for patients, some of whom had given up all hope of treatment for their chronic back and joint pain, turned the tide of opinion.

Bone Marrow Concentrate Therapy (BMAC): BMC therapy is a promising non-surgical regenerative treatment used to treat various orthopedic injuries, including moderate to severe osteoarthritis and tendon injures. BMC is a concentrate of regenerative stem cells obtained from a patient’s own bone marrow. The physician removes a small amount of the patient’s bone marrow and spins it in a centrifuge in order to generate a powerful concentrate that is injected into the injured area.

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Platelet Rich Plasma Therapy (PRP): Begins with collection of patient’s blood and the sample is placed in a centrifuge to separate the platelets from the other components of whole blood.  Doctors then inject the concentrated platelets into the site of the injury. Platelets function as a natural reservoir for growth factors that are essential to repair injured tissues.  The growth factors that the platelets secrete stimulate tissue recovery by increasing collagen production, enhancing tendon stem cell proliferation, and tenocyte-related gene and protein expression. These growth factors also stimulate blood flow and cause cartilage to become more firm and resilient.

A2M Therapy: A2M stands for Alpha 2 Macroglobulin, a naturally occurring protein found in blood plasma. It acts as an inhibitor of a wide variety of proteinases, which are enzymes that break down proteins. In particular, it’s A2M’s ability to inhibit the action of Matrix Metalloproteinases (MMPs) that may make it useful as a possible treatment for arthritis. One type of MMP breaks down the collagen that makes up cartilage and is believed responsible for how arthritis can destroy cartilage in a joint. Hence a naturally occurring protein that blocks the action of this and other MMPs would be potentially a good thing.

Radio Frequency Ablation: A procedure used to reduce pain. An electrical current produced by a radio wave is used to heat up a small area of nerve tissue, thereby decreasing pain signals from that specific area. RFA can be used to help patients with chronic (long-lasting) low-back and neck pain and pain related to the degeneration of joints from arthritis. Pain relief from RFA can last from six to 12 months and in some cases, relief can last for years.

Nutritional IV Therapy: Delivers targeted, bioavailable nutrients in super concentrations directly to cells and parts of the body where they are needed most.  LifeSpan offers a variety of IVs to support athletic performance, surgical prep/recovery, healthy aging, disease conditions and immune function.  Benefits include improvements with energy, hormone function and balance, overall health, chronic conditions and risk factors, immune health, detoxification, antioxidant protection, stress protection and improved athletic performance.

Biologic Medicine: Biological therapy is treatment designed to stimulate or restore the ability of the body’s immune (natural internal defense) system to fight infection and disease. Biological therapy often involves the use of substances called biological response modifiers (BRMs). The body normally produces these substances in small amounts in response to infection and disease. Using modern laboratory techniques, scientists can produce BRMs in large amounts for use in the treatment of cancer and other diseases, such as rheumatoid arthritis and Crohn’s disease. Biologics have been shown to help slow progression of rheumatoid arthritis when all other treatments have failed to do so.

Concierge Medicine: The LifeSpan approach to concierge medicine encompasses health-based, preventive medical care when and where you need it.  Whereas most concierge programs only include access to a physician or provider, our LifeSpan approach couples comprehensive, preventative health based medicine with 24/7 access to your healthcare team along world-class care-coordination support.

Dr. Chris Renna,  is a board certified primary care specialist in practice for more than 30 years.  He has pioneered the field of integrative and preventive medicine at his busy Dallas and Los Angeles LifeSpan medicine clinics that count among their patients NBA and NFL players, Olympic athletes, movie stars and Fortune 500 executives.  Dr. Renna has co-authored two books, The End of Pain and Balance Your Brain, Balance Your Life.  He is a former clinical faculty member at several medical schools and has discussed his work internationally and on the Dr. Oz radio show.

ABOUT LIFESPAN MEDICINE

LifeSpan Medicine is an integrative, functional medical practice with a team of doctors that offer the most advanced technology for non-invasive medicine. The practice has two locations in Santa Monica and Dallas. Clients range from the average person looking to be healthier to NFL, NBA, and Olympic athletes to movie stars and Fortune 500 executives.