I Can't Exercise - Just Do It!

 

I am not here to convince you to exercise; you already know the reasons why you should. Yet, more than 60% of Americans under-exercise, and of these, more than 25% are simply sedentary. The remainder of this writing is taken from my previously published  EzineArticles and other articles.

Common reasons given for failure to exercise include: I don't have the time...I'm too tired...I don't know what type of exercise to do...I have a medical condition (usually a "bad heart," back pain or knee pain)...I'm too heavy... I become short of breath...I can't afford the gym...It's boring...I'm too old.

And there are more innovative excuses: my uncle lived to 106 and he never exercised (we should all be blessed with such good genes)...It's too cold outdoors in the winter...I'm always away... I do enough at work...

You get the idea.

Almost any form of physical activity is helpful, but a good exercise program should include at least 30 minutes of moderate, aerobic physical exercise most days of the week. Examples of aerobic exercise are brisk walking, jogging, bicycling, swimming and aerobic dance. An effective exercise program should include:

• Warm-up, 3 to 5 minutes. A warm-up gradually increases your heart rate and the blood flow to the heart and muscles preparing them for exercise. To warm-up, do the activity you have chosen to do (for example walking or biking), but at a slower pace during the warm-up period.
• Aerobic activity, at least 30 minutes (build up gradually from 15 minutes over several weeks). With aerobic exercise you use more oxygen to burn calories for the extra energy you spend. Exercise within your target heart rate zone (target charts are available in gyms, on the net, and at your doctor's office).
• Cool-down 3 to 5 minutes. Cooling down allows your heart rate, breathing and blood pressure to return to normal, and allows you to stretch better.
• Stretching, 5 to 10 minutes. Stretching will improve your flexibility, decrease muscle soreness and help you relax. It's important to stretch those muscles you were using during exercise. Hold each stretch for 15-20 seconds, but don't stretch to the point of pain.
• Strength training, which is a very important component of a good exercise program.

Before you start an exercise program, check with your doctor if you are over 40 or have a history of medical problems. If you truly have special needs, a reasonable exercise program can usually still be designed for you.

Start before it's time for New Year's resolutions

Are you interested in checking your degree of conditioning and your general exercise capacity? We have a unique testing facility where we measure your maximum oxygen capacity (known as vO2max) and tell you how fit you are. The test is done as part of a cardiopulmonary exercise evaluation, under medical supervision. We are the only free standing medical facility in our area performing this type of evaluation.

Watch those new HMO premiums

Beginning in January 2011, it is expected that most group and individual health insurance premiums will increase significantly. Most health insurers are seeking increases of more than 20%. It remains to be seen how much of it will be approved (I bet most of the requested increases will be approved). The biggest offenders appear to be Anthem Blue Cross and Aetna. In our experience, Anthem is also been shown to reduce benefits more than others.

This may be the right time for you to look at your health insurance plan, and, assuming you are in a position to do so, choose the policy that best fits your needs.

You may want to take a few points into consideration:

1. A high-deductible, lower premium policy, may save you money if you're generally healthy and able to take a limited monetary chance. Most of these policies still pay for yearly preventive care. Our practice does its part of cost control by keeping fees as low as possible for uninsured visits.

2. Our practice is not an Anthem provider (we're in litigation, we've filed suit).

3. We have special programs for the uninsured, which take into account your economic situation, and help you take advantage of cost saving programs outside our practice (e.g., lab tests and imaging studies).

Don't forget that, in the end, much of your future health is up to you. US health care is still reasonable, but the main reason we rank only number 37 in the world in longevity, is our faulty lifestyles.

So, make sure you don't smoke, limit sugars, starches and saturated fats, and please exercise!

Have a great holiday season.

Weight loss 101 - a beginner's primer

Weight loss should be taken seriously. It's a contract between you and your body. Guidance can come from many sources: your nutritionist, your doctor, or a recognized weight loss organization; but if you don't work at it, you'll be disappointed with your results.

Generally, you'll be given a diet and/or sensible eating guidelines. Our many years of experience have demonstrated beyond any doubt that "sticking to it" pays off handsomely in the end.

Your daily caloric consumption (your metabolic rate) can be estimated by measuring your REE (Resting Metabolic Expenditure), and adjusting this measurement for daily activity. The test is available at our facility.

If you decrease your calorie intake by 500 calories a day, you should lose approximately one pound a week. You'll lose more in the first week because of excess water loss.

If you increase your physical activity you'll lose more, depending on your type of activity. Walking a mile on flat ground burns 100 calories on average. Doing intense activity on a regular basis will also increase your metabolic rate, and further enhance the rate of your weight loss. Do not take on intense physical activity without consulting your physician.

Stick to your assigned daily caloric intake.

Weigh yourself frequently (daily is OK) on a reliable scale, same scale each time, preferably when you first wake up in the morning, before breakfast and before getting dressed. Record your weight on a single sheet (preferably on your computer, use Excel or a similar program if you have it), and bring it with you at your next visit with your health care provider.

Food calories
Fat: 1 gram has 9 calories
Protein: 1 gram has 4 calories
Carbohydrates: 1 gram has 4 calories
Alcohol: 1 gram of alcohol has approximately 7 calories

Fat is "calorie dense," it's packed with calories. Some fat is essential, and it helps keep appetite in check.

Most vegetables are "volume foods" with few calories and a lot of nutritional value; and they help fill your stomach.

Sugars of any kind (watch out for high fructose corn syrup, cane powder, "organic brown sugar" and others) are unhealthy carbohydrates. The same is true for white flour products and starch. Whole wheat products are a much better choice.

Take a close look at food labels, and make sure you look at the line that tells you how much sugar is in each portion; the less the better. There are acceptable sugar substitutes such as blue agave nectar (a liquid) and erythritol (sugar-like crystals).

Organic foods. Organic food is great. It's grown without chemical pesticides, hormones or antibiotics. But organic food may still contain unacceptable amounts of fat and sugar. So, again, don't forget to look at the food labels.

Snacks. It's OK to have snacks, but don't forget to take them into account when you calculate your calorie intake for the day.

Eating out. Eating out is not a sin. It's sometimes hard to keep a calorie count when you eat out. If you feel you over-ate, cut down the next day. Better yet, "bank" your calories by cutting down a little a day earlier.

Don't be embarrassed to ask the waiter to make sure that sauces are not too heavy, or to express other weight concerns you have. Don't rely on "iffy" answers: it's OK to ask to talk to the chef.

Use of special medications. Occasionally, medication may be prescribed to help you lose weight. These are usually meant to decrease you're appetite or the desire for food. Many of our patients have benefitted from the temporary use of appetite suppressants. But these medications are not meant to be a substitute for portion control, and their use has to be prescribed by a physician and monitored periodically.

Good luck in pursuing your weight loss goals.

A visit to Israel and a treatment for psoriasis and dermatitis

My wife and I returned today from a 12 day trip to Israel (which we have done many times before), and were back at work before noon.

This was a dual purpose trip: visit family, friends and new sites; and re-visit the developers of the new EdenSkin line of products designed to treat common skin conditions such as psoriasis, atopic dermatitis and seborrheic dermatitis.

Some of the exciting sites included the impressive IDF air force outdoor museum in the Negev; the Tel Aviv museum which exhibited the unusual and unique photos of David LaChapelle (born in Fairfield, CT); the Palmach museum in Tel Aviv commemorating the importance of this organization in the creation of the state of Israel, and the Druze village of Dalyiat el Carmel on the slopes of Mount Carmel overlooking the breathtaking Izrael Valley.

And on the medical front, we learned a lot more than what we already knew about the Israeli health delivery system, how effective it is, and how much simpler it is than what we have here. More about it in the future.

We also completed our review of the EdenSkin family of products, developed by a small company in Kfar Saba.

We have been watching the development of QoolSkin for several years. I've been using it successfully in the office for a while. It's herbal, and it contains no steroids, parabens, colors or fragrances. Most importantly, its side effect profile is extremely low, and it works where conventional therapy doesn't. We now keep the product at our office.

Other EdenSkin products include TopicSkin, also an herbal preparation, which I have used for the treatment of allergic dermatitis, and SeboSkin, which I intend to use for the treatment of seborrheic dermatitis.

Looking at the whole picture, this was a great trip, which also carries a potential benefit to our patients.

Avoid those extra winter pounds

Winter is approaching, and the natural tendency for many of us was to stay indoors. For many of us, lack of activity and overeating follows, and the result is those frustrating extra winter pounds.

Weight gain is not only a medical issue. Sure, there is an increase chance of diabetes, high blood pressure, accelerated heart disease, joint pain, and many other medical conditions. But also important are the social, financial and psychological aspects of overweight. Thin and fit is still the general desire of most people. Some of us would become depressed over gaining weight and the inability to lose it, and others would feel that they lost a promotion opportunity because of it. Very few of us would enjoy buying a new, larger wardrobe, or the inability to fit into our summer vacation clothing.

So what are you going to do about it?

Losing weight is a full time job; you have to be aware of your goal at all times. Some of us can do it without much help. Decrease food portions, decrease fat intake, increase exercise --- the usual steps --- works. For others, professional help is a must.
Professional weight loss focuses on the entire person and his/her needs, and includes:

Establishing realistic goals. The ultimate goal of weight loss has to be a target weight that can be both achieved and maintained. This target weight may not be immediately identifiable, but becomes apparent as you work with your health care provider.

Portion control. Both the portion size and content of the food you consume need to be controlled and monitored. Accurate record keeping, while tedious, is extremely important. Your ability to keep records is a good indicator of how successful you'll be in controlling your weight.

Increase in exercise. Exercise helps burn excess calories, but don't count on exercise alone to reach your target weight. Cardiovascular exercise is best, but stretching and muscle strengthening are very important. Exercise at least four days a week, don't be a weekend hero. Special testing before taking on a rigorous exercise program is advisable, talk to your doctor.

Use of appetite suppressants when appropriate. The days of fen-phen long gone, but other medications are available. Stay away from over-the-counter preparations and "miracle drugs," they can be harmful, and, at best, you'll waste your money.

Use of meal replacement. Low calorie meal replacements have been available in super markets for several years. Others, of much higher quality, are available through some physician offices, including ours (e.g., HMR products). These products help in portion control and record keeping, and may keep you from binging.

Treatment of depression. Depression is frequently a cause of weight gain, and if it exists, it must be addressed.
What about weight loss spas? Many of them are very good, effective while you're there. But when you're back at home, you may still need to consult your health care professional.

When addressed correctly, overweight is manageable. And when you need professional assistance, go with those who will focus on your overall medical needs, not just weight loss. We're here to help!