Exercise: A Healthy Addiction?

Exercise should be part of a healthy lifestyle, but it should not take over your life. 

This is a guest blog post.

Is there such a thing as too much exercise? You will often hear concerns regarding Americans’ sedentary lifestyles and the need for people to “get moving” in the media. While this is most definitely a present concern, there are also individuals on the opposite spectrum that need to tone their exercise behaviors down. I work as an instructor at a gym and have experienced compulsive exercise behaviors first hand. Some people habitually visit the gym three to four hours a day and become extremely troubled if something gets in the way of completing their rigorous workout routine.



Terms such as “obligatory (or compulsive) exercising”, “negative addiction”, and “exercise dependence” are all used in literature and all encompass obsessive exercise behaviors (1-4). Compulsive exercise can be defined as “an intense drive to be active, often in a rigid, routine-like fashion that is predominantly performed to manage weight and shape, as well as alleviating negative emotions.” (1). Up to 10% of high-performance runners have an addiction to exercise (3). Compulsive exercise is often discussed within the family of eating disorders (i.e. Bulimia Nervosa and Anorexia Nervosa), as they often occur simultaneously (1,2). Exercise, along with purging or restricted eating, is often used as another method for weight control.


Predictors of compulsive exercise:

One study investigated the risk factors for compulsive exercise. The three strongest predictors were:

1) A drive for thinness
2) Perfectionism
3) Obsessive-compulsiveness (1)

It is by no surprise that perfectionism and a drive for thinness were on the top three predictors of compulsive exercise, as society today endorses both of these behaviors.

According to Diane A. Klein, MD, of Columbia University’s College of Physicians and Surgeons, “So for people driven to achieve, to be perfectionists, and to be in optimal health, it’s kind of understandable that they become excessive.” (3) The demands from society to have a perfectly sculpted physique are simply unattainable and harmful.


How much is too much?

How do you know that exercise is becoming a problem? Symptoms of exercise dependence may include the following withdrawal symptoms in the absence of exercise: disturbed psychological functioning (i.e. severe distress, guilt, anxiety) and an interference with personal relationships. In addition, some individuals continue to run despite serious injury (2,4).

Acknowledging that there is in fact a problem is the first step to treat exercise addiction. Getting to the route of the obsession - whether it is a low sense of self-esteem or previous family history of addiction - is key. In very serious cases, psychotherapy may be a treatment (3).


Exercise for your health

In moderation, exercise is a wonderful thing. Benefits of exercise include a lower risk for chronic diseases, prevention of weight gain, better cognitive function, reduced depression, and the list goes on. It is currently recommended that Americans get at least 2 hours and 30 minutes of moderate level activities per week, and at least 2 days of strength training. How will you get your exercise this week?


Jenny, a 46-year-old secondary compulsive-exerciser (i.e. secondary to an eating disorder), was interviewed about her exercise attitudes and behaviors. Jenny stated, “My life tends to fit around the exercise, not the exercise fits into my life.” (2) Healthy living requires a careful balance of both diet and exercise. Make it a priority to fit exercise into your life for health!



References

1) Goodwin H, Haycraft E, Willis A, Meyer C. Compulsive Exercise: The Role of Personality, Psychological Morbidity, and Disordered Eating. Int J Eat Disord. 2011 Nov; 44(7):655-60.

2) Bamber D, Cockerill I M, Rodgers S, Carroll D. “It’s exercise or nothing”: a qualitative analysis of exercise dependence. Br J Sports Med. 2000;34:423–430.

3) Allen A. Exercise addiction in men: When exercise becomes too much. Retrieved June 21, 2012 from WebMD:

http://men.webmd.com/guide/exercise-addiction

4) Shipway R, Holloway I. Running free: Embracing a healthy lifestyle through distance running. Perspectives in Public Health. 2010 Nov; Vol 130 No 6.

5) U.S. Department of Health & Human Services. Physical Activity Guidelines for Americans. Retrieved June 21, 2012. http://health.gov/paguidelines/adultguide/part2.aspx


About the Author:

Amy Krug is a senior Nutrition and Dietetics major at Messiah College, located right outside of Harrisburg.  She plans to apply for Dietetic internships next spring and to continue on to become a Registered Dietitian. Amy has a passion for people, and desires to empower others to lead a fit and healthy lifestyle.  She enjoys the outdoors, gardening, running, jamming out on the piano, singing, and laughing!

Women Need More Muscles

Women must weight train their whole life to support their muscles and bones

Bad news for us ladies, a recent study showed that body mass index (BMI) underestimates obesity in 48% of women. The study which was released this week determined that when body fat was measured by duel-energy x-ray absorptiometry (DXA), almost half of the women who were not considered obese using BMI measurements actually were (25% of men were mis-classified as non-obese). This study highlights the problems that women face as they age in losing a greater amount of muscle and bone mass then men.

Being considered the weaker sex for thousands of years, women were discouraged from engaging in physical activity, exercise and sports as recently as the mid-twentieth century. Consequently, even women considered engaging in physical activity unfeminine. Many of us were sedentary throughout most of our lives and dieted to stay thin when we were younger. We know that muscle loss accompanies dieting. As we approached forty, fifty, sixty and beyond, we accumulated more fat at the expense of muscle and bone (you have to use it or you lose it).

Both men and women need to engage in weight training, but women need it more. More attention should be placed on getting women of all ages to pump some iron to prevent the loss of muscle and bone that occurs with age. Today young women seem to embrace this idea, but older women should too (even 90 year olds). Weight training at any age promotes an increase in muscle and bone mass. In turn, stronger muscles and bones promotes improved health. Exercising your muscles is one way to decrease insulin resistance and increase coordination to prevent falls.

So ladies, don't lament the bum hand that we've been dealt in having more body fat then men. Get to the gym now and start cutting up (lose body fat and gain muscle). You will need to watch your diet too to get rid of that extra body fat, but no more dieting at the expense of your muscles. If you want to do it right, consult a personal trainer and a dietitian to get you on track. A personal trainer will teach you the correct form for lifting weights and a dietitian will tailor your diet to maximize fat loss and minimize muscle loss.

To your health!

Facebook Moratorium

The social network connection

I often wonder why I spend so much time creating my online presence using social media tools such as Facebook. There are a few reasons that I use Facebook professionally. It is a great tool for staying connected with my colleagues and keeping on top of cutting edge news in my field. It also serves as a valuable resource for getting my message out to my clients, although I question if I'm really reaching my ideal client. It's difficult to tell the impact that I'm having without getting feedback in the form of comments. I carefully look for information to post to help others make positive diet and fitness changes and have only once been made aware of the value of this work to my audience. It is important to me to stay connected with my audience but difficult to to so when I wonder if I even have an audience.

Social media is a time sink. Facebook and Twitter eat up time that I should spend doing other things to grow my business. There already is enough to keep us tethered to our computers without the addition of Facebook and Twitter. In the back of my mind I think that I should spend more time in endeavors that will make money rather than posting free information for an invisible audience.

To make matters worse, I have been gaining weight lately despite exercising regularly. I can't help but think that all this sitting behind a computer is a bad thing for humans in general. My recent weight gain has spurred me into action. I have decided to impose a moratorium on Facebook and Twitter for the next week. Every time that I think about checking my social media accounts I will do ten jumping jacks and ten push-ups instead. One of the purposes of my social media existence is to inspire others to improve their lifestyle. I can think of no better place to start doing this than with myself. The calories we burn when we exercise are a small fraction of what we burn in a whole day. Our goal should be to pursue activity all day long. So whenever I have the urge to post an article, picture of food, recipe or any other tidbit that I find interesting, I will be active instead. I wonder how many jumping jacks and push-ups I will complete in a week. I'm sure that I will be doing quite a few of them. Social media has become a big part of my professional life in the past couple of years.

I will return to sharing information on Facebook and Twitter after a week, but I will incorporate my new habit of activity before every interaction. I encourage everyone else to attach some form of physical activity to your more sedentary pursuits.

To Health!

What are some of your impressions about social media?

The Cost of Inactivity

To stay healthy throughout life, you've got to move it! 

Very few things in life are static, especially the human body. From birth through old age, the body is continually changing. It is important to realize that when we put off regular exercise, our bodies are not just frozen in time, they’re fading. Physical activity stimulates most organs to work at their best. We are made to move, and if we don’t, all body systems are affected, right down to the cellular level, where our ability to transfer oxygen for energy can be diminished. This is evident in a person's inability to run between airline gates to catch a connecting flight, or carry laundry baskets up and down the stairs. Inactivity impacts the brain, muscles, heart, blood vessels, bones, liver, gut, sleep, anxiety, depression, self-esteem, and the ability to use glucose (to name a few).




Diabetes

Insulin sensitivity deteriorates with inactivity. Type 2 diabetes is characterized by the body’s inability to utilize the insulin it produces. The cells of the body become insulin resistant. Insulin carries sugar from the blood into the cells of the body. Without the ability to do this, blood sugar levels rise and diabetes develops.



Type 2 diabetes is a sedentary disease, in that regular exercise reverses the damage. Insulin sensitivity increases with exercise and the cells of the body become better at taking in and processing glucose. The impact of activity on diabetes is striking. Every two hours of weekly TV watching is linked to a 14% increase in the risk of diabetes. Conversely, every hour of brisk walking per week confers a 34% lower risk of developing diabetes. That’s something to think about the next time you are too tired or busy to put on your athletic shoes.



The Heart

Exercise affects the heart in several ways. Not only does it strengthen the pump, but it also impacts the pipes. In recent years, researchers have discovered that physical activity makes the lining of blood vessels more flexible, from the largest artery to the smallest capillaries. This allows blood vessels to relax, permitting more blood to be sent to the heart. Think of it in terms of pumping blood through a rubber hose instead of a concrete pipe. This is particularly important if a vessel is partially blocked.



Regular exercise also increases HDL (good) cholesterol. This is the type of cholesterol that leaves the arteries instead of sticking to them. For those who already have heart disease, exercise can lower your risk of dying from it. Take that to heart!



Stroke

Active people are 25% less likely to have a stroke than sedentary folks.

Exercise affects the arteries to the brain in the same way as the heart. Most strokes occur when a blood clot gets stuck in a partially blocked artery leading to the brain. Hemorrhagic stroke occurs when a blood vessel in the brain bursts. High blood pressure is a risk factor for any type of stroke, and regular aerobic exercise lowers blood pressure in 75% of people.



Muscles

If you don’t use it, you lose it. The metabolic cost of maintaining muscle is high. Muscles require a lot of energy, so if you don’t use them, they become a luxury for the body to maintain. As we age, we become increasingly inactive and lose muscle mass. Anyone can rebuild muscle with strength training. The earlier you start, the better, but even those of advanced age can benefit from carefully pumping a little iron. Strong muscles can help to prevent the frailty that makes older people lose their independence. Regular exercise is one way to stay out of a nursing home.



Weight

Inactivity and weight gain go hand in hand. When you lose your muscle mass because of inactivity, you need less energy (calories) to maintain what is left. Due to inactivity, it becomes possible to gain weight with a modest calorie intake, and nearly impossible to lose weight. The rate of weight gain is slow, perhaps 1-5 pounds a year, but over 10 years the pounds add up and the loss of physical fitness is significant.



In order to avoid becoming overweight or obese, 45-60 minutes a day of physical activity is needed. If you’re already overweight or have lost a lot of weight, you need more – between 60-90 minutes of physical activity a day to avoid regaining weight. If this seems daunting, just 30 minutes of exercise a day is enough to reduce the risk of many chronic diseases without significant weight loss.



Bones

Bones are living tissue. Every day, minerals move in and out of our bones in response to the demands of daily living. If you stress bone, it responds. If you don’t, the balance between bone gain and loss shifts toward bone loss. Research shows that strength training preserves bone better that walking or running, and can increase bone density. The amount that a bone is stressed, or overloaded, determines whether bone formation is stimulated. A small number of repetitions (8-15) with a heavy load can do the trick.



Regular physical activity has also been shown to prevent certain types of cancer, depression, dementia, and improve immunity. If exercise were a pill, it would be called a wonder drug.



To reduce health risks associated with inactivity, at least 30 minutes of moderate-intensity aerobic exercise five days a week or 20 minutes of vigorous aerobic exercise three days a week are required. To maintain lost weight, 60-90 minutes a day of exercise is needed. To build muscle and prevent bone loss, strength train at least twice a week with a weight heavy enough to lift eight to fifteen times.



The good news is that it is never too late to start moving. People well into their 90s can benefit from regular exercise. And if you’ve been moving all along, you can reach your 90s with vitality and independence. The only “magic bullet” out there that I know of is physical activity. So commit yourself to exercise. Schedule it in your date book. As a well known athletic company says, “Just do it!”

Small Changes for a Healthy New Year

Start with small achievable goals

Another year has begun. It’s a good time to start a diet and exercise program, many of us think. We have to be ready to do more than think. Like getting married or starting a family, there is no perfect time to begin a health regimen. What’s most important is to have the resolve to make small changes in your lifestyle that will be far-reaching over the long run, and to stay the course. Change too many undesirable habits at once, and you could end up abandoning your efforts altogether.


The changes that you make must have significant value to you. It is not enough to just want to lose weight, exercise more or eat healthier. There needs to be some type of internal motivation that drives you to achieve these goals. Take the time and explore why it is important for you to make these changes, and then start making (and mastering) one small change at a time.  The following is a list of lifestyle changes that current research has shown will benefit your health, from promoting weight loss to decreasing the risk of cancer. Some you may already do; others you may need to work on. Take it one small step at a time.

Eat Breakfast. It’s the best way to control your weight. Start the morning with whole grain cereal. Breakfast is a great place to get fiber in your diet. Look for cereals where the first ingredient listed on the label is a whole grain, like oatmeal or whole wheat. Add berries or other fruit and a full cup of low fat milk.

Exercise. Give up the excuses; you have to do it to stay healthy. Sixty to ninety minutes of daily exercise is recommended to promote weight loss and maintenance. If you can’t meet these recommendations don’t be discouraged, any movement helps.

Eat Low Fat Dairy. The jury is still out on whether low fat dairy can promote weight loss, but dairy is important for other reasons. The calcium that it provides can stave off osteoporosis and has been linked to improving blood pressure. Recent studies have shown that men who consume low fat dairy regularly have a reduced risk for developing type 2 diabetes and gout. Women that get plenty of calcium and vitamin D may have a reduced likelihood of developing PMS. Get 2 to 3 servings daily of milk, yogurt or low fat cheese.

Add Vitamin D. It promotes the absorption of calcium and is very important for bone health. It may also improve muscle strength, reducing the risk of crippling falls in the elderly. Vitamin D has also been shown to reduce the risk of developing the most aggressive form of prostate cancer. It may be difficult to get enough vitamin D from your diet. If you live in the northern half of the country, your skin isn’t making any vitamin D from October through March. Vitamin D supplementation is recommended for most people, but the amount of supplementation is still being debated. Supplementing with 1,000 to 2,000 IUs of vitamin D daily is considered safe, however some people may require more. The rest of the year, expose some skin (arms and legs) without sunscreen to the sun for 20 to 30 minutes. People with darker skin may require up to six times more sun exposure.

Eat More Fruits and Vegetables. The evidence is mounting, if you don’t eat enough of it, you’re at a health disadvantage. From arthritis to weight loss, fruits and vegetables have been shown to improve health. No wonder the dietary guidelines increased the daily servings. Eat the rainbow. Five to thirteen daily servings are recommended.

Eat More Dark Leafy Greens. Some vegetables are better than others. This is where Popeye was right. Spinach and other colorful greens may help prevent cataracts, stroke, and the cognitive decline associated with aging (and possibly even Alzheimer’s disease). This is one of the biggest changes that most people need to make in their diets.

Choose Healthy Fats. Switch from saturated animal fats and trans fats to monounsaturated and polyunsaturated vegetable oils. All fats have about 120 calories per tablespoon, so don’t add vegetable oil, but replace unhealthy fats with it. Olive oil is good, but so is canola oil. Minimize fats from dairy and meats by choosing lower fat varieties.

Eat More Fish. It’s the easiest way to get those omega-3 fats that are so good for us. Plan a fish meal twice a week (yes, tuna fish sandwiches count, but fried fish is a no-no). Omega-3 fats are good for your heart, immune function, and your brain (those who eat fish twice a week show less mental impairment with age). They have also been shown to fight inflammation, which benefits your joints too.

Hydrate. The first thing you should do in the morning and the last thing you should do before bed are to drink 1-2 cups of water. Sip water all day long and eat foods with high water content such as cucumbers, lettuce, tomatoes, soup, apples, and oranges (you get the picture). Being well hydrated will also help you look your best.

Get An Extra Hour of Sleep Each Night. Sleep is when your body repairs the physiological damage done each day. Most of us burn the candle at both ends and then trudge through the day feeling like a zombie, going from one cup of coffee to the next. A good night’s rest will help us look and feel our best and can help our weight loss efforts too.

During the next few weeks, I will discuss each of these recommendations in more detail. I will provide more practical tips and recipes that can help you make 2011 an incredibly healthy year!

The Enigma of Blood Sugar Control

My son has type 1 diabetes. I've blogged about our struggles with this disease before. My son would love for me avoid sharing our personal experiences with respect to him, but I'm on a mission to better understand how diabetes is controlled and to help other diabetics in the process.

To me, the expression "blood sugar control" seems like an oxymoron. It is elusive at times and often we are left scratching our heads as to why our son's blood sugar becomes high or low (even though I'm a dietitian and my husband is a physician). Diabetics, especially teenagers, can take these values personally and may feel like they have failed in managing their health. There are so many factors that affect blood sugar. Understanding why blood sugar becomes high or low is very complicated. Lately, I feel like we've been chasing our tails and I need to know more about diabetes to help my son understand more and manage his disease without excessive emotion.

As I educate myself, the nuiances of blood sugar control are becoming more apparent. I have decided to post a "pearl of wisdom" on my Facebook page daily to reinforce the concepts that I am learning and to share that knowledge with other diabetics or those responsible for caring for a person with diabetes. I invite your comments, experiences, and knowledge on this topic here on my blog as well as on Facebook and Twitter. I'm hoping to impact hundreds of people and create an online comminuty of diabetics sharing their experiences and wisdom. Please pass this on to your diabetic family, friends, and coworkers. To your Health!

5 Healthy Tips for Your Best Holiday Season Yet!

Keep your healthy habits through the holidays

'Tis the season for overeating and inactivity, but it doesn't have to be. You've worked hard all year to change unhealthy habits and now it's time to run the gauntlet of holiday parties and coworkers bringing cookies and treats to work. If you can make it through the holidays unscathed while practicing your healthy habits, you are truly a new person. Here are five tips to keep you focused on having a happy and healthy holiday season.

1. Be positive. Positive emotion is necessary for behavior change. To flourish, we should exhibit three positive emotions for every negative emotion. Flourishing is like navigating a sail boat. Negative emotion is your rudder and positive emotion is the sail that soars high into the air. Your sail should be three times as high as your rudder to keep you on course. Of course, you need both a sail and a rudder to navigate. The trick is to have enough positive emotion to balance the negative. We typically focus too much on negative feelings, so lighten up and be positive. You can track your emotions at positivityratio.com. Emotions change daily, so track yours often. It might help you focus a little more on the positive aspects of your life.

2. Catch up on your ZZZ's. During the holidays, most people overstuff their days and weekends with activity and short change sleep. Adequate sleep is vital for health. Lack of sleep is a risk factor for diabetes, heart disease, obesity, accidents and it lowers your immunity. You may have to resist the urge to be a party animal, but getting enough sleep will ensure that you enjoy your celebrations to the fullest. Allow at least one day a week to catch up on your sleep. You might have to delegate some holiday shopping or cooking, leave a party early once in a while, and resist the urge to stay up late watching TV, playing video games, etc.

3. Keep moving. The best way to avoid weight gain over the holidays is to move daily. Face it, we are made to move and without movement we couldn't survive. Preserve your regular exercise routines as much as possible. If you notice that you can't exercise as much as you used to, wear a pedometer and track your activity as daily steps. The goal is to log at least 10,000 steps a day which is equivalent to walking about five miles. I did this last year between Thanksgiving and New Year's. It was a great way to keep moving. When I noticed that I was short of my goal, I would take the dogs for another walk (god for the dogs as well as me) or take an extra lap in the mall while shopping. Taking a walk after a larger meal is also helpful. The artery clogging effects of one high fat meal can literally be visualized. Fortunately, so can the health promoting effects of one bout of activity. So get up after your meal and take a walk!

4. Maintain your weight. Most people only gain about one pound over the holidays, but that one pound hangs around long after the holidays are over and is often joined by more pounds the next year, and the next, and the next... Setting your sights on weight loss may be too difficult at this time. The goal should be to maintain what you've already lost. You have to measure this somehow. I encourage my clients to weigh themselves daily. You will notice small changes in your weight that you can equate to your eating and exercise habits. If you notice a weight increase in one day, examine what you ate earlier. If you ate a meal in a restaurant, chances are the meal was excessive in calories, fat, and sodium. You can make corrections in your eating and activity and work to bring your weight back to where it was. If you don't measure, you won't know to correct. Before you know it that one pound will be sitting on your hips or mid-section and will be hard to lose.

5. Be thankful.  There is so much flurry around the holidays that is is easy to forget what they are about. Enjoy the time that you are allowed to be with your family, friends, colleagues and coworkers. Humans are social beings and having a supportive community around us is one of the best ways that I can think of to be happy and healthy. We bring the burden of the season upon ourselves. It is within our power to lighten that burden with humor, love, kindness, thoughtfulness, friendship and thankfulness.

I wish you the best holiday season yet!