Want To Live Longer? Doing This Amount of Exercise Will Probably Prolong Your Life, But More Doesn’t Seem to Help.

4 Jun

The idea that exercise can help you live longer isn’t a new one. Experts have touted the benefits of exercise for decades. What is new is that researchers may have found the optimal amount of exercise needed to extend your longevity…

In a study published April 6, 2015 in JAMA Internal Medicine, researchers analyzed information from more than 660,000 people ages 21 to 98 in the United States and Sweden who answered questions about how much time they spent doing physical activity, including walking, running, swimming, and bicycling.

The most interesting findings were that doing just a little exercise showed quite a bit of benefit and doing a lot more exercise provided only marginal returns. People who exercised a little, but not enough to meet current physical activity recommendations (150 minutes of moderate activity per week or 75 minutes of vigorous activity per week), were still 20 percent less likely to die during the 14-year study than those who did not perform any physical activity.

People who engaged in the recommended level of physical activity saw even more benefit. According to the data, they were 31 percent less likely to die during the study than those who did not engage in any amount of physical activity. The maximum benefit was seen by people engaging in three-to-five times the recommended levels.  They were 39% less likely to die over the study period than people who did not exercise.

Here is something interesting:  Many believe if some exercise is good, then more is better.  But there appears to be a ceiling on the amount of exercise that has a beneficial effect on your health.

According to the study, exercising more than three-to-five times the recommended levels did not show any significant additional health benefits. (In fact, previous research indicates that excessive exercise can even be harmful to the heart.) The authors of the study write, “In regard to mortality, healthcare professionals should encourage inactive adults to perform leisure time physical activity and do not need to discourage adults who already participate in high-activity levels.”

Here’s the Biggest Take-Home Message from This Study:

While many people shy away from exercise because they do not feel like they have enough time to exercise enough, this study shows that the people most likely to benefit from increasing the amount of exercise they do are those who do not currently exercise at all.  In other words, if you are not doing any exercise, you can see quite a big potential benefit from just doing a little. You do not have to go crazy and start running marathons.  You just have to get moving and do something.

And the best part is: if you do a little exercise, then you will start to feel better and be able to do more.  Who knows, soon you may find yourself exercising the recommended levels and then one day you’ll look at your journal and realize you are actually exercising the maximum beneficial amount, as uncovered during this study. But reaching the maximum level is not the important thing, and if you are not doing any exercise right now, then you should not even think about that much physical activity.

Probably the biggest reason for failure is setting goals too high.  (I know goal-setting experts often say to set high goals and REACH FOR THE SKY!) If that is working for you, awesome.  But if you are like most people and do not reach a majority of the goals you set, let’s try something a little different.

Let’s set a very small goal, one that you can reach relatively easily and in a short time.  When you do, you will not only feel great, you will gain a little momentum. Once that first little goal is reached, set another small goal and so on… For many people, this is the best way to actually reach their big goals.

So, if you are not exercising now, then make a small goal.  Write down some small thing you are going to do TODAY just to get started. Make it easy.  Make it quick.  Then, just do it.  Tomorrow write down another one.  One of the best techniques is to write down your exercise goal the night before so when you wake up you know exactly what you are going to do that day. But let’s make this very clear:  make your goal very easy so you can get the ball rolling.  Remember, you are going to get quite a bit of benefit from just a small amount of exercise.

While We Are on the Topic of Exercise, Here’s Something You Should Think About:

Do you know how much television you watch every day?  According to recent research, the average American watches five hours per day!  And get this, the number increases with age.  By 65, the average American watches an average of seven hours of television per day. That kind of blows the whole, “I don’t have enough time to exercise” excuse right out of the water, doesn’t it?  But here is something else you should know: a study published in Diabetologia (the Journal of the European Association for the Study of Diabetes) found that each hour spent watching TV daily increases an individual’s risk of developing diabetes by 3.4%.

It’s no wonder why the Centers for Disease Control (CDC) reported in 2014 that 29.1 million Americans, or 9.3% of the population of the United States, have diabetes.  What’s incredible is 8.9 million of that 29.1 million (27.8%) are undiagnosed.  That means almost 9 million people are pretty much ticking time bombs for all kinds of serious health problems and do not even know it. The good news is that many type 2 diabetics can benefit from diet and exercise.  (There is that “exercise” thing again!)

Advice for this month:  Take 20 minutes out of the five-to-seven hours you may spend watching  television and instead do a little exercise and watch what happens!

Fibromyalgia and the Importance of Sleep

28 May

One of the most frustrating symptoms of fibromyalgia (FM) is the inability to get a good night’s sleep! Recently, at an Harvard-sponsored conference on the subject of pain, it was stated that “…no one should have to live in constant pain with what is known about pain management in this day and age (paraphrased).” Many attendees agreed that improving sleep quality may be the #1 way to improve the quality of life for patients with widespread pain. So the question is, what can be done to improve the sleep cycle for all of us, not only the fibromyalgia patient? Let’s take a look!

The importance of sleep has long been discussed as being not only key in managing the FM patient, but some experts even suspect it’s the probable cause of the disorder itself. It has been found that we must get at least four hours of continuous sleep in order to reach a deep sleep stage, and only at this level of sleep can we fully relax. If we can’t get to that deep sleep stage, our muscles (and mind) can’t fully relax and over time, the gradually increasing tightness may result in pain and the vicious cycle continues to chip away at the quality of life of the FM patient.

Exciting new research from the United Kingdom reports that for those over age 50, non-restorative sleep – the type where you wake up tired, foggy, and listless – is STRONGLY tied to widespread pain, the “hallmark” of FM. The researchers also report that anxiety, memory loss, and poor physical health are linked to widespread pain in older adults. In the journal Arthritis & Rheumatology, author Dr. John McBeth wrote that musculoskeletal pain becomes more common with aging and affects four out of five seniors on a daily basis! Widespread pain is a KEY FEATURE of FM, which also includes fatigue and tenderness in muscles, joints, tendons, and other soft tissues. It is estimated that about 5 million American adults are affected by FM with women being affected four times more often than men (for reasons unknown). FM can occur insidiously (for no known reason) or secondary to an injury or illness.

After studying a group of 4,300 adults (> age 50) of which 2,700 had some pain but not widespread pain, Dr. McBeth and his colleagues found several factors that can increase an older individual’s risk of developing widespread pain. At the start of the study, participants completed questionnaires about pain, mental and physical health, lifestyle and health behaviors, medical conditions, and more. After three years, they were reassessed in a similar manner and 19% reported NEW widespread pain. This included 25% of participants who initially reported some pain and 8% who reported no pain at the study’s start. The most important link for the development of widespread pain was non-restorative sleep. Other links included pain status, anxiety, physical health-related quality of life, and some form of cognitive complaint (such as memory loss). They also note that brainwave studies of FM sufferers often show the inability to reach deep sleep. Moreover, in an experiment where healthy volunteers were woken during each period of deep sleep, a number of them soon developed typical signs and symptoms of FM!

Chiropractic care includes treatment methods that reduces pain and muscle spasm and as a result, frequently improves an interrupted sleep pattern. Doctors of chiropractic are also STRONG ADVOCATES of home exercise and typically offer in-office training. Before attempting drugs with significant side effects, you owe it to yourself to include chiropractic care in your FM management “team!”

If you, a friend or family member requires care for Fibromyalgia, we sincerely appreciate the trust and confidence shown by choosing our services!

Neck Pain – Management Strategies

27 May

As discussed last month, when you make an appointment for a chiropractic evaluation for your neck pain, your doctor of chiropractic will provide both in-office procedures as well as teach you many self-help approaches so that as a “team”, together WE can manage your neck pain or headache complaint to a satisfying end-point. So, what are some of these procedures? Let’s take a look!

In the office, you can expect to receive a thorough history, examination, x-ray (if warranted), and a discussion about what chiropractic care can be done for you and your condition. Your doctor will map out a treatment plan and discuss commonly shared goals of 1) Pain reduction, 2) Posture/alignment restoration, and 3) Prevention of future episodes. Pain reduction approaches include (but are not limited to) joint mobilization and/or manipulation, muscle/ligament stretching techniques, inflammation control by the use of physical therapy modalities (such as electrical stimulation), ice, and possibly anti-inflammatory vitamin / herbal therapies. Your chiropractor will also teach you proper body mechanics for bending/lifting/pulling/pushing, and help you avoid positions or situations where you might re-injure the area. Posture/alignment restoration can include methods such as spinal manipulation / mobilization and leg length correction strategies (heel and/or sole lifts, special orthotic shoes, and/or foot orthotic inserts). These are often GREAT recommendations as they “work” all the time they are in your shoes and you don’t have to do anything (except wear them)! The third goal of future episode prevention is often a combination ongoing treatments in the office and strategies you can employ at home. This includes (but is not limited to): 1) whether you should use ice, heat, or both at times of acute exacerbation; 2) avoiding positions or movements that create sharp/lancinating pain; 3) DOING THE EXERCISES that you’ve been taught ON A REGULAR BASIS; and 4) eating and an “anti-inflammatory” diet (lean meats, lots of fruits/veggies, and avoid gluten – wheat, oats, barley, rye).

 

Let’s talk exercise! Your doctor of chiropractic will teach you exercises that are designed to increase range of motion (ROM), re-educate a flat or reversed curve in the neck, and strengthen / stabilize the muscles in the neck. Studies show that the deep neck flexor muscles – those that are located deep, next to the spine in the front of the neck – are frequently weak in patients with neck pain. These muscles are NOT voluntary so you have to “trick” them into contracting with very specific exercises. Your doctor will also teach you exercises that you can do EVERY HOUR of your work day (for 10-15 seconds) that are designed to prevent neck pain from gradually worsening so you aren’t miserable by the end of work. Along these lines, he/she will discuss the set-up of your work station and how you might improve it – whether it’s a chair, desk, computer position, a table/work station height issue, or a reaching problem; using proper “ergonomics” can REALLY HELP! Your doctor will also advise you not to talk on the phone pinching the receiver between your head and shoulder, to face the person you are talking to (avoiding prolonged head rotation), to tuck in your chin as a posture training exercise, and more. Cervical traction can be a GREAT home-applied, self-help strategy, and these come in many varieties. Proper positions for the head when sleeping and a properly fitted contoured pillow is also important since we spend about 1/3 of our lives asleep!

 

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for neck pain or headaches, we would be honored to render our services.

 

A Quick Way to Lose 50 Pounds?

26 May

Our basic premise is that your body is amazing.  You get a do over. It doesn’t take that long, and it isn’t that hard if you know what to do.  In these notes, we give you a short course in what to do so it becomes easy for you, and for you to teach others. We want you to know how much control you have over both the quality and length of your life.

Q: I need to lose 50 pounds. I’ve tried everything! Nothing seems to work well enough (or fast enough) to keep me on the right path. Can you help? — Kelly G., San Francisco

A: We feel your frustration. To get on the path to a lifelong healthy weight, you’ll need to learn how to change your eating habits while you’re losing weight and how to keep them up afterwards in order to keep the weight off. So to help you reach your goal, we’ve developed a jump-start program for weight loss, and we had it road-tested by more than 2.5 million folks.

  • Every morning, drink a cup of hot water with lemon. It’ll kick start your digestive process and help detoxify your system (lemon activates bile flow).
  • For breakfast, try a smoothie or tasty quinoa egg muffins (search for the recipe on Google).
  • The rest of the day, focus on protein-rich foods. Go for 12 ounces of lean protein daily from fish and skinless chicken.
    Don’t go hungry! Enjoy as much veggie broth as you want. Still hungry? Try two snacks daily consisting of quinoa with non-starchy veggies, unsalted nuts (try 12 walnut halves), 2 percent Greek yogurt, or an apple with nut butter.
    Enjoy 1 cup of coffee daily (decaf is okay, depending on the process used to decaffeinate it); use unsweetened vanilla almond milk or coconut milk instead of milk or creamer.
  • Ditch these foods: wheat; refined sugar; artificial sweeteners; dairy; alcohol; and processed foods.
  • Add these bonus boosters: Take 1,000 IUs of vitamin D daily and enjoy a nightly soak in a warm tub with 2 cups of Epsom salts and 1 cup of baking soda.

Thanks for reading. And feel free to send questions—to youdocs@gmail.com, and some of them we may know enough to answer (we’ll try to get answers for you if we do not know).

-Young Dr. Mike Roizen
(aka, The Enforcer)

 NOTE: You should NOT take this as medical advice. This article is of the opinion of its author. Before you do anything, please consult with your doctor.  You can follow Dr Roizen on twitter @YoungDrMike (and get updates on the latest and most important medical stories of the week).  The YOU docs have tow newly revised books: The patron saint “book” of this column YOU Staying Young—revised and YOU: The Owner’s Manual…revised —yes a revision of the book that started Dr Oz to being Dr Oz.  These makes great gifts—so do YOU: ON a Diet and YOU: The Owner’s Manual for teens.  And, the new book by Dr Mike Roizen: This is YOUR Do-Over Michael F. Roizen, M.D., is chief wellness officer and chair of the Wellness Institute at the Cleveland Clinic. His radio show streams live on http://www.radioMD.com Saturdays from 5-7 p.m. He is the co-author of 4 #1 NY Times Best Sellers including: YOU Staying Young.

The Challenges of Carpal Tunnel Syndrome

25 May

Carpal Tunnel Syndrome (CTS) is one of the most common “peripheral neuropathies” patients have when they visit a chiropractor for the first time. Peripheral neuropathy (PN) is defined as “…damage or disease affecting nerves, which may impair sensation, movement, gland or organ function, or other aspects of health, depending on the type of nerve affected.” Let’s take a closer look!

Common causes of PN include systemic conditions such as diabetes, vitamin deficiency, medication side effects (such as chemotherapy meds), traumatic injury, after radiation therapy, excessive alcohol intake, an autoimmune disease such as rheumatoid arthritis, and/or viral infection. PN can be linked to an individual’s genetics that are present from birth. For others, it can be unknown which is then referred to as “idiopathic.”

PN can affect one nerve (mononeuropathy) or multiple nerves (polyneuropathy) and can be acute (which means it comes on quickly) or chronic (which means it comes on gradually over time and progresses slowly). PN symptoms can include cramp/charley horse-like pain, muscle twitching, muscle atrophy or shrinkage, numbness, tingling, pins and needles, burning or cold feeling, and can also affect other tissues such as bone causing degeneration, skin changes, and hair and nail changes. PN can also affect a patient’s balance and coordination which can increase an individual’s chances of falling. If organs or glands are also impacted, PN can lead to poor bladder control, heart rate or blood pressure changes, and/or affect the sweat glands.

Getting back to CTS specifically, one of the challenges of this condition is determining the cause/s. Here’s what we know about CTS: 1) it is more common in women than men; 2) it is more common in those who are overweight; 3) it is more common in those who work in highly repetitive environments; 4) it is more common over age 50; 5) it is often accompanied by other upper extremity “over-use” conditions like tendonitis in the hand, wrist, elbow, and/or shoulder and can also involve the neck (as CTS cases improve faster when treatment is also applied to the cervical spine); and 6) it commonly includes one or more of the conditions previously mentioned that can cause neuropathy such as diabetes and rheumatoid arthritis. Other conditions such as hypothyroid can also cause or worsen an existing case of CTS, in part due to “myxedema,” a type of swelling that occurs with this condition. Here, the additional swelling can add to the compression or pressure pushing on the median nerve in the carpal tunnel and either cause CTS or worsen an existing case.

Because CTS can have more than one underlying cause, it’s important that your doctor determine as many as possible in order to achieve the best treatment results. We’ve all heard of the cases that fail to respond to surgical intervention, which in many cases is because there were MULTIPLE CAUSES and only one was addressed with the surgical approach. Surgery has always been described as “the last resort” and indeed it’s appropriate in some cases. However, MANY CTS patients respond well to chiropractic management, which often includes (but is not limited to): 1) joint manipulation and mobilization of the hand, wrist, forearm, elbow, shoulder, and neck; 2) use of a night-time splint; 3) home/work exercises; 4) physical therapy modalities; 5) nutritional considerations; and 6) ergonomic modifications (work station assessment). If these approaches fail to achieve satisfying results, your doctor will refer you to a hand surgeon to determine which procedure might be best for you.

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for Carpal Tunnel Syndrome, we would be honored to render our services.

Low Back Pain? Should You Take an NSAID?

21 May

Statistics suggest that low back pain (LBP) will plague most of us at some point in our lives, if it hasn’t already. Most healthcare professions that manage patients with low back pain focus on pain management. In fact, studies have reported that 67% of patient satisfaction is driven by pain elimination. One of the most common strategies for reducing pain is managing inflammation. The “easiest” way to do this (according to the many TV commercials and magazine advertisements) is to take one of the many non-steroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen (Advil, Nuprin), Piroxicam Flurbiprofen, and Indomethacin. Let’s take a closer look to see if this is a good or bad idea!

In a recent March 2015 article, researchers investigated the use of NSAIDs between 1993 and 2012 in patients who had fractures that failed to heal, technically called “non-union fractures.” They found that non-union fractures increased during years when NSAID use was increasingly recommended for patients with fractures and dropped in years when NSAID use declined. This isn’t the first study to report poor fracture healing results from NSAIDs when they’re used as the primary form of pain relief and in fact, studies on this subject date back to the early 1990s. So how does this equate to LBP? Most directly, fractures are one of the many causes of LBP, so for that population, the answer is clear. However, LBP is much more commonly caused by sprains (ligament injuries) and strains (muscle/tendon injuries), as well as cartilage injury. Here too, studies show that the healing rate of sprains, strains, and cartilage is also delayed when NSAIDs are used as the primary pain relief approach. This healing delay is reportedly due to NSAIDs’ inhibition of “proteoglycan synthesis,” a component of ligament and cartilage tissue regeneration and repair. NSAIDs also inhibit release of prostaglandins (especially prostaglandin E2), which is needed for tissue repair. These effects are ESPECIALLY observed with long-term use, but recent studies show injured athletes are best off NOT taking NSAIDs AT ALL as these drugs delay the healing process and thus the athlete’s ability to return to their sport.

In a January 2015 study, researchers criticized the common use of NSAIDs in elderly patients for the treatment of non-cancerous pain. They found 75% of the elderly population studied was prescribed NSAIDs which, in retrospect, the researchers determined to be inappropriate!  Because NSAIDs interfere with healing, the net effect is an ACCELERATION of osteoarthritis and joint deterioration! In 1995, a North Carolina School of Medicine study compared four groups of patients with soft tissue injuries (tendon strains): Group 1 received NO treatment (control group); Group 2 received exercise only; Group 3 received exercise AND Indomethacin; and Group 4 received Indomethacin only. At 72 hours post-injury, ONLY the exercise group had an INCREASE in prostaglandins (E2 particularly – necessary for healing). This effect was even more profound at 108 hours after injury. The research team also found DNA synthesis in the fibroblasts (an important part of the repair mechanism) was greatest in the exercise group and was completely lacking in the NSAID-only group.

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for back pain, we would be honored to render our services.

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