Active Body

SMART Active

We would like to thank you again for participating in this important research project.  SMART Health aims to help people like yourself get regular physical activity. If at any time during the next 12 weeks, you have questions or concerns, please do not hesitate to contact one of the research team. We look forward to working with you over the next few months and wish you continued success and encouragement.  Your participation on this website is completely voluntary, so it’s up to you how often you access it.

There will be a different topic each fortnight, along with a variety of fitness tips, myths and educational resources.  You will notice at the end of each topic of discussion, there is an activity you can complete.

Take this opportunity to browse the website and become familiar with its features.

Practice, practice, practice!

In order to become comfortable with doing physical activity, you have to practice!

If you haven’t been active over the years, it’s important to start out slow and gradually work your way up.  This way you’ll be less likely to be overwhelmed and give up before you even get started.  Your body needs time to adapt to activity so it’s a good idea to start at a pace that is comfortable for you.

One of the best ways to build up your confidence is to try and do things you will accomplish.  For example, start out by walking around the block before you commit to walking 5km.  If you are just starting out, think small.  There is plenty of time to move up to bigger and better things.  When you have accomplished what you have set out to do, give yourself credit.  It is because of you that your goal is achieved.  The following are true stories of people who never thought they would or could do physical activity, but have come to see it as part of their lives.

KATIE – 45 years old

I had been reasonably active in my early 20’s, mainly walking and going to the gym to do aerobics classes.  When I reached my mid 20’s, I began working full-time and I gradually stopped going to the gym and was just walking occasionally. I also had a bit of depression at that time.  I was married in my early 30’s and was still in my healthy weight range (just!), but by the time I’d had my third child 10 years later, I’d put on 17kgs and was still only walking occasionally.  I’d managed to lose a bit of this weight, but by the age of 40, I was still overweight and my blood pressure was starting to climb.  I had started playing soccer, but training was only once a week with games on weekends.  I wasn’t really doing much other exercise apart from that.  A friend at work suggested I try “parkrun” to see if it could help me lose weight and reduce my blood pressure.  I had never heard of parkrun and when I realised it was 5km, I laughed at her as I knew I could not run 5km – in fact I couldn’t even run 1km! “That’s OK”, she said, “You can walk it or run it”.  That was about 3 years ago.  I became hooked on parkrun, and while initially I couldn’t even run a kilometre, I can now run the whole 5kms!  I am almost back to a healthy weight, my blood pressure has come down to normal and my mental health is better than ever.  I have joined a ladies running group and am now running short distances about four times a week.  I can’t imagine turning the clock back now, as running has become like brushing my teeth – I find it hard to start the day without it!  Funnily enough, I feel like I have more energy to do things on the days I go running. (For more information about parkrun see http://www.parkrun.com.au/)

Margie, 45 years old, type 2 diabetes

I am a very busy lady.  I work full time as a manager, am a volunteer on several committees and run a crazy household.

I have always been pretty healthy, but my diagnosis of diabetes scared me.  I went to a diabetes education programme and started eating a bit better.  I also decided I would go back to the gym just 2 days a week.  That’s more time than what I had, but I decided to go in my lunch hour anyway.

I found that the people in my life were proud of me for getting healthy.  I let others help me with things like cooking and cleaning…things I’d never do before, because I had to be in control.  However, I felt like now was the time to take care of me, not only for me, but for my family.

Six months have passed and I go to the gym 4 days a week.  I also do really fun things like golfing and swimming with my husband…..things I used to do when I was younger, but stopped because I was too busy running the ‘rat race’. Life can pass by so quickly….I decided to slow it down.

JOE – 64 years old

I always worked hard and I was always independent.  I never thought the day would come where I would have to quit work because of my health. I wasn’t taking care of myself.  I was stressed and I wasn’t active.  Two months later I had a heart attack.  On top of that, during my stay in hospital, I was diagnosed with diabetes.  My life had really gone downhill. Part of my recovery involved taking an exercise class at the hospital, which I did not find very enjoyable at first.  We would walk on the treadmill, ride bikes, lift weights and go into the community for exercise.  After a while and a lot of effort, I had my strength back.  I couldn’t bounce back like I did when I was a kid but the important thing was that I DID bounce back.  At first I did it so I could be there for my grandkids.  Now I also do it for me.

Today I walk with friends that I met at the cardiac rehab programme.  We all have similar health concerns and we all have been through a lot.  But I won’t forget how I thought my life was ending. I won’t forget how bad I felt. Most importantly, I won’t forget that I was the one who changed things for the better.

Research

Myth busting

Myth: If I didn’t exercise when I was younger, it’s too late.

You are never too old to start exercising even if you weren’t active in previous years – you can reap the benefits at any age.  As you age, exercise can help reduce the risk of osteoporosis and other muscular diseases, as well as enhance your ability to carry out activities associated with daily living.

Education

Walking Programs

Here are examples of two walking programs.  The first program is designed for individuals who are not currently walking on a regular basis.  The second program is designed for individuals who have been active on a regular basis for some time, and are looking for something more challenging. These are just examples that you can use and modify to better fit your schedule and fitness level.

Example Beginner Walking Program

This walking program starts with 10 minute walks and works up to 30 minute walks in 12 weeks. By week 12, you will be getting 150 minutes of moderate physical activity per week.

Your warm-up and cool down are not included in the minutes.  Be sure to take 5 minutes at the beginning and at the end of your walk to warm up and cool down.  An example of a warm up would be walking slowly to start with, and gently stretching at the end of your walk as you cool down.

SUN

MON

TUE

WED

THU

FRI

SAT

TOTAL

Week 1

OFF

10 min

10 min

10 min

10 min

OFF

10 min

50 min

Week 2

OFF

10 min

10 min

12 min

12 min

OFF

12 min

56 min

Week 3

OFF

12 min

12 min

12 min

15 min

OFF

15 min

66 min

Week 4

OFF

15 min

15 min

15 min

15 min

OFF

15 min

75 min

Week 5

OFF

15 min

15 min

15 min

20 min

OFF

20 min

85 min

Week 6

OFF

15 min

15 min

20 min

20 min

OFF

20 min

90 min

Week 7

OFF

15 min

20 min

20 min

20 min

OFF

25 min

100 min

Week 8

OFF

20 min

20 min

20 min

25 min

OFF

25 min

110 min

Week 9

OFF

20 min

25 min

25 min

25 min

OFF

25 min

120 min

Week 10

OFF

25 min

25 min

25 min

25 min

OFF

30 min

130 min

Week 11

OFF

25 min

25 min

30 min

30 min

OFF

30 min

140 min

Week 12

OFF

30 min

30 min

30 min

30 min

OFF

30 min

150 min

Example Intermediate Walking Program

This walking program starts with 10-15 minute walks, and works up to 40 minute walks in 12 weeks. By week 12 in this program, you will be getting 180 minutes of moderate physical activity per week.

Your warm-up and cool down are not included in the minutes.  Be sure to take 5 minutes at the beginning and at the end of your walk to warm up and cool down.  An example of a warm up would be walking slowly to start with, and gently stretching at the end of your walk as you cool down.

SUN

MON

TUE

WED

THU

FRI

SAT

TOTAL

Week 1

OFF

10 min

12 min

15 min

15 min

OFF

15 min

67 min

Week 2

OFF

15 min

15 min

15 min

15 min

OFF

20 min

80 min

Week 3

OFF

15 min

15 min

15 min

20 min

OFF

20 min

85 min

Week 4

OFF

20 min

20 min

20 min

20 min

OFF

20 min

100 min

Week 5

OFF

20 min

20 min

20 min

20 min

OFF

25 min

105 min

Week 6

OFF

20 min

20 min

25 min

25 min

OFF

25 min

115 min

Week 7

OFF

20 min

25 min

25 min

25 min

OFF

30 min

125 min

Week 8

OFF

25 min

25 min

25 min

30 min

OFF

30 min

135 min

Week 9

OFF

25 min

30 min

30 min

30 min

OFF

30 min

145 min

Week 10

OFF

30 min

30 min

30 min

30 min

OFF

35 min

155 min

Week 11

OFF

30 min

30 min

35 min

35 min

OFF

35 min

165 min

Week 12

OFF

35 min

35 min

35 min

35 min

OFF

40 min

180 min

Weekly Fitness Tip

Foot care for walking and other physical activities

Foot care is a very important consideration when maintaining an active lifestyle.  Wearing a good pair of comfortable, supportive shoes is a must for a number of activities, including walking, which require you to be on your feet.  Be sure to wear thick, absorbent socks. Examine your feet regularly and address areas such as sores, blisters, irritation and cuts as soon as they are noticed.  Problems that cause discomfort such as bunions and hammertoes should be evaluated by your doctor or foot specialist.

There are many positive benefits to being active.

Physical activity can help to:

  • Lower blood sugar levels
  • Lower blood pressure
  • Reduce insulin resistance
  • Lower cholesterol levels and
  • Help to maintain a healthy body weight.

Physical activity can also be great for your mental health.  It can help you have a more positive outlook on life and deal with stress more effectively.

If you are just beginning a physical activity program, it’s important to know what to expect.  It isn’t uncommon to feel a little stiff and sore a day or two after exercise; however, this will go away and will continue to be less noticeable as you progress.

What do you see as being the positive benefits of physical activity in managing your health?  Are there any negative consequences you can think of?

  1. Make a list of 5 positive outcomes you would like to see as a result of being active; they don’t all have to be directly related to your health.  Keep the list posted where it will reminder you of what you want to accomplish.

We all expect different results from being physically active.  In many cases we value certain results more than others.  For example, some people place a greater importance on lowering their blood sugar levels compared to losing weight.  Often that value or desire is what motivates us to accomplish our goals.  Therefore, it is important to have physical activity goals that are important to you and that you value.

It is important to remember what it is that YOU value and not necessarily what others want you to value.

  1. From the list of positive outcomes you developed earlier, place a value beside them indicating how important they are for you to accomplish; with 5 being extremely valuable and the highest priority to 1 being valued but lower priority.
  1. Think about why you value these outcomes the way you do. Share these values with a friend and keep this list in mind as you set out your physical activity routine.

Research

Diet and Exercise Can Help Prevent Future Heart Problems

What is the problem and what is known about it so far?

Nearly 1 million people in Australia are diagnosed with type 2 diabetes (T2D). However, this figure is likely to under-represent the true prevalence of T2D in this country as these figures are based on self-report and many people are unaware that they have the disease.  People with diabetes are more likely to have heart disease, high blood pressure, and high cholesterol (a waxy fat-like substance that builds up in the blood vessels). Many studies have shown that exercise and certain drugs can help these people prevent diabetes and heart disease.

Why did the researchers do this particular study?

People who have diabetes or are at high risk of developing diabetes are also likely to have high cholesterol and to develop heart disease. Researchers for the Diabetes Prevention Program (http://www.preventdiabetes.com/) showed that diet and exercise are the best way to help prevent T2D. The drug metformin, which helps control blood glucose, was also shown to help prevent T2D. Because of this, the researchers wanted to see whether changing diet and exercise habits or taking metformin could also help prevent heart disease.

Who was studied?

A total of 3,234 people with high blood glucose made up the study group. These people took part in the Diabetes Prevention Program.

How was the study done?

The people in the study were given metformin or a placebo (a drug that has no effect), or they were told to exercise and diet to lose weight and improve their health. When the study began, the researchers measured each person’s blood pressure and cholesterol and did tests to check the health of their hearts. Every year for about 3 years, the researchers again measured the patients’ blood pressure and cholesterol and checked to see if they had any heart problems.

What did the researchers find?

By the end of the study, blood pressure was higher in the group of patients who were given metformin. It was also higher in the group that was given a placebo. Blood pressure was lowest in the group that started exercising and changing their diet.

Total cholesterol and LDL cholesterol (the “bad” cholesterol) was about the same in all three groups, but HDL cholesterol (the “good” cholesterol) was much better in the group that started exercising and dieting.

Over the 3 years, the three groups had only a small number of heart attacks or strokes.

What were the limitations of the study?

This study lasted only 3 years, which probably explains why there were so few heart attacks or strokes in all three groups. A longer study will give researchers a better idea of how the different types of treatment affect the long-term health of the heart.

What are the implications of the study?

This study showed that changing your lifestyle by eating better, exercising more and losing weight lowers the chances of getting problems that could lead to heart disease, such as high blood pressure and high cholesterol.

Myth busting

Myth: If I can’t exercise regularly then I shouldn’t bother at all

It does take about 10 weeks of regular exercise to see improvements in fitness.  However, even a single bout of exercise can improve your health.  For example, take a 50-year-old man who is somewhat overweight and has moderately elevated blood sugar, triglycerides, or blood pressure. A single bout of exercise of moderate intensity—like 30 to 40 minutes of brisk walking—will lower these.

Education

You know that physical activity is beneficial, but how exactly does it help?

Convincing Evidence:

Blood sugar control: If you have T2D, physical activity can improve your blood sugar control. As your muscles contract and relax during exercise, they use sugar for energy. To meet this energy need, your body uses sugar supplies in your blood during exercise and for a period after exercise, reducing your blood sugar level. The duration and intensity of activity determines how much your blood glucose is reduced.

Physical activity can also increase your insulin sensitivity if you have T2D. That means your body requires less insulin to escort sugar into your cells, which also reduces your blood sugar level.

Cardiovascular health: Cardiovascular disease is the leading cause of death among people with diabetes. In addition to improving your overall fitness and conditioning, physical activity can help counteract the risk of developing cardiovascular disease by improving the flow of blood through small blood vessels and increasing your heart's pumping efficiency. By controlling or reducing high blood pressure and cholesterol, your chance of having further complications decreases substantially.

Weight loss: Physical activity can help you shed a few kilos by burning calories and increasing your metabolism to burn more calories even while you are sitting still. For optimal weight loss, research shows a program including both regular aerobic and resistance training is most effective when combined with a healthy diet.

Psychological Health: The psychological and emotional benefits from physical activity are numerous. Either brief periods of intense training or prolonged aerobic workouts can raise the levels of certain chemicals in the brain, such as endorphins, adrenaline, serotonin and dopamine that are associated with a feeling of well-being. Rhythmic aerobic and yoga exercises help combat stress and anxiety. And of course, weight loss and increased muscle tone from strength training can boost self-esteem.

A review of multiple studies found that physical activity advances the treatment of clinical depression and anxiety, enhances mood and improves self-esteem. Some studies also report that physical activity is as effective as antidepressant agents in relieving depression and it may even be better in maintaining normal mood over time.

Independence: Regular physical activity will enable you to do activities of daily living, such as grocery shopping, household chores, playing with children and grandchildren and being able to move about freely as you age. All of these things are so important, yet we can sometimes take them for granted when we feel healthy.

Weekly fitness tip

When it comes to getting active and burning calories, every little bit counts.  The following chart shows approximately the number of calories per hour an average person would burn doing various activities.

Activity

Calories Burned

Dancing

370 calories/hour

Gardening

324 calories/hour

Playing with the kids/grandkids

216 calories/hour

Brisk walking

297 calories/hour

Swimming

603 calories/hour

Yoga

360 calories/hour

Biking (flat surface)

441 calories/hour

* Note: These figures are estimated for a 68kg person and will vary depending on weight, body composition and intensity.

Adapted from the American Cancer Society.

It may be helpful to set personal goals when it comes to physical activity.

Some people find it easier to accomplish something if they have something to work towards.  The key is setting short-term and long-term goals that are manageable. A short-term goal is a goal that can be achieved within the next couple of weeks while a long-term goal is a goal that could take months or years.  Several short-term goals often help to accomplish long-term goals.  It’s important to set goals that are appropriate for you.

Some examples of short-term goals are:

  • I will increase my walking time 5 minutes by next week or
  • I will start swimming once a week by the end of this month.

Long-term goals can include things like:

  • I will lose 5 kilos by the beginning of Summer or
  • I will enter into a 5km walk for my favourite charity before November.

The next step is to come up with a plan to help you accomplish these goals.  Try and make this part as detailed as possible.  Plan out when you are going to do activity, where you will do it, and what kind of activity you will do, how often and how long you plan to do it. This may help you to determine if the goals you set out for yourself are practical and realistic.  It’s important not to set yourself up for failure at the beginning, so be sure to think your physical activity goals through.

Keeping a physical activity logbook or diary is a great way for you to track your progress and keep on task.  It can help you to examine how much or how little activity you are really doing and provide you with a visual guide towards your goals

.

  1. Over the next couple of days, sit down and write out 3-5 short term goals you would like to work towards, as well, come up with 1-2 long term goals.
  2. Discuss these with a friend or partner to be sure they are realistic.  Post them somewhere visible so you can remind yourself of the commitment you have made.

Research

The Finnish Diabetes Prevention Study (DPS)

by Jaana Lindstrom and colleagues, Diabetes Care, Dec; 26(12): 3230-3236 (2003)

What is the problem and what is known about it so far?

The incidence of type 2 diabetes is rising rapidly in many developing countries.

Why did the researchers do this particular study?

The researchers wanted to find out whether a lifestyle program that incorporated guided physical activity and nutrition counselling would reduce the risk of diabetes in a group of overweight adults with impaired glucose tolerance.  They also wanted to determine the effect of the lifestyle program on hardening of the arteries and cardiovascular events e.g. heart attack

Who was studied?

A sample of 522 overweight adults with impaired glucose tolerance took part in the study.

How was the study done?

Each of the 522 adults was randomly assigned to either a control group or an intervention group. The control group was given general information about the importance of weight loss, physical activity and a healthy diet in diabetes prevention.  They also had an annual check-up with the physician.  The intervention group received individual dietary counselling as well as guidance to increase their overall level of physical activity.  They were also offered a circuit-type resistance training programme.  It was hoped that the participants in the intervention group would reduce their body weight, reduce dietary and saturated fat intake and increase their physical activity and dietary fibre intake.

What did the researchers find?

Researchers found that participants in the intervention group lost more weight 1 year and 3 years after the intervention (4.5kg and 3.5kg) compared with participants in the control group (1kg and 0.9kg).  Participants in the intervention group also showed greater improvements in blood sugar control and blood fats.

What are the implications of the study?

As this lifestyle intervention reduced the risk of diabetes in participants, researchers have suggested that similar interventions be implemented in the primary health care setting.

Myth busting

Myth: Weight gain is inevitable as we age

Weight gain in Australia has become culturally acceptable and an inevitable part of the aging process. In fact, weight gain is often due to getting less exercise.  When people are physically inactive, they lose muscle mass, which in turn, lowers their metabolic rate (or the rate at which they burn up energy).  Starting in their 20s and 30s, adults begin to lose muscle mass gradually if they do not get sufficient exercise.  By age 40, this can result in a loss of 6-8% of muscle mass per decade.

But don’t feel bad if you can no longer fit into those jeans you wore 20 years ago.  It is important that you keep active!  After only two months of resistance-training, women can recover a decade of muscle loss and men can recover two decades!  That's with three 20 minute sessions (to meet the weekly guidelines of 60 minutes) of resistance training done each week, ensuring correct technique is performed throughout the exercises.

Education

There are many different aspects to physical activity and they are all important to keep in mind.  Listed below are basic definitions of the various components to physical activity.

#1 – Aerobic Fitness is:

The ability of the body's heart and lungs to supply fuel during physical activity. To improve your aerobic fitness, try activities that keep your heart rate up at a safe level for a continued length of time such as brisk walking, swimming, or cycling for 150 minutes per week at a moderate intensity. The activity you choose does not have to be strenuous to improve your aerobic fitness.

#2 – Muscular Strength is:

The ability of the muscle to use force during an activity, like carrying groceries, climbing stairs and lifting up your children or grandchildren. The key to strengthening your muscles is to work them against resistance, whether that be from weights or gravity. If you want to gain muscular strength, try body weight exercises (such as squats and push-ups) to start with and progress to free weights, machine weights, joining a fitness strength training class or using exercise bands. It is important that the exercise movement is learned prior to weights being added, e.g. learning how to do a body weight squat before adding a weighted barbell. This will ensure that the correct movement pattern becomes learned and familiar, decreasing the risk of injury from poor technique.

#3 – Muscular Endurance is:

The ability of the muscle to continue to perform a movement without getting tired. The best way to improve your muscular endurance is through body weight and low weighted exercises (either free weights, machine or exercise bands). Due to the low weight added to the movement, you are able to complete more repetitions, which will in turn improve your endurance. An easy way to distinguish between muscular strength and endurance is to remember that strength is “HOW MUCH” (e.g. I can do one squat with a 20kg barbell) and endurance is “HOW MANY” (e.g. I can do 20 body weight squats)

#4 – Body Composition is:

The amount of muscle, fat, bone, and other vital parts of the body. A person's total body weight (what you see on the bathroom scales) may not change over time. But the bathroom scales do not distinguish between fat and fat free mass (muscle, bone, tendons, and ligaments). Body composition is important to consider for health and managing your weight!  If you have a healthy body composition you can better control your blood sugar and you are at a decreased risk for several other health issues (high blood pressure, high cholesterol, cardiovascular disease…the list goes on!). Regular physical activity can help you attain and maintain a healthy body composition.

#5 – Flexibility is:

The range of motion around a joint. Good flexibility in the joints can help prevent injuries, stiffness and soreness through all stages of life. If you want to improve your flexibility, try activities that lengthen the muscles such as yoga or a basic stretching program. You can find stretching programs on TV, YouTube, on exercise DVDs, from fitness specialists (gyms, fitness classes) and from physiotherapists.

Weekly fitness tip

You can use this scale to help determine how moderate physical activity feels.  In order to be doing moderate physical activity, you would need to exercise anywhere from 4 to 6 on this scale.

1

Very Light

I’m relaxing watching TV, reading.

 

2

Minimal effort

I'm comfortable and could maintain this pace all day long; e.g., easy walking, slow cycling with no resistance, light housework.

3

Slight effort

I'm still comfortable, but am breathing a bit harder; e.g., walking at a comfortable pace, cycling with a small resistance.

 

4

Light moderate effort

I'm sweating a little, but feel good and can carry on a conversation effortlessly; e.g., brisk walking, cycling with a comfortable resistance.

5

Moderate effort

I'm just above comfortable, am sweating more but can still talk easily; i.e., this feels challenging, but I feel like I can continue.

 

6

Moderately hard effort

I can still talk, but am slightly breathless; i.e., this feels more strenuous but I feel like I can continue.

7

Hard effort

I can still talk, but I don't really want to; i.e., I am really sweating and feel like I cannot continue this pace for long.

 

8

Very hard effort

I could only grunt in response to a question and can only keep this pace for a short time period.

9

Extremely hard effort

I do not feel comfortable and am completely out of breath, almost maximum effort.

 

10

Maximum effort

This is my maximum effort; i.e., the hardest I can physically exert myself.

In order to be successful in keeping active, it’s important to plan ahead!

You may find it helpful to identify situations that cause you to miss out on physical activity.  For instance, the days are shorter, the weather can be unpredictable and you make have family commitments that take up your weekends…what situations make it difficult for you to keep up with your goal of being active?

  1. Make a list of situations that prevent you from getting regular physical activity. Remember there is no correct answer; people’s situations are different.

Next, it is important to develop an action plan of at least three solutions to the situations that may prevent you from being active. For instance, you may want to go for walks with the whole family, try an indoor fitness class, schedule your time at the gym at lunch or in the morning, or do your exercise before company arrives.

Remember that progress is gradual and we all have occasional setbacks. By having a ‘back up plan’ for these setbacks, you will be well on your way to succeeding with physical activity!

For example:

“I don’t have time”

Solutions:

I will walk briskly for 15 minutes during my lunch break 5 days a week.

I will get up 20 minutes earlier twice a week to do stretching and strength training.

I will cut out one of my TV programs and take the dog for a 30-minute brisk walk instead (3 nights a week).

“I don’t like going to the gym”

Solutions:

I will walk briskly around the neighbourhood or in the local shopping centre for 30 minutes, 2 days a week.

I will purchase a couple of exercise DVDs and do them at home 3 mornings a week for 30 minutes.

Take a moment to work through the personal situations that may prevent you from being active.  Be honest with yourself about the things that really prevent you from getting regular physical activity.

  1. Brainstorm ways to overcome those barriers.  This may help you deal effectively with situations you encounter.
  2. Discuss your personal barriers with your partner/friend. They may be able to help you come up with creative solutions to overcome the situations that are preventing you from getting active.

Research

Being Fit Reduces Risk of Heart Disease

Wessel TR, Arant CB, Olson MB, et al.: Relationship of physical fitness vs. body mass index with coronary artery disease and cardiovascular events in women. JAMA 292:1179-1187, 2004.

What is the problem and what is known about it so far?

Obesity is linked to a higher risk of coronary heart disease (CHD). Most studies of obesity don’t do a good job of linking physical activity and fitness and many studies of physical fitness have not studied women.

Researchers wanted to look at the relationship between physical fitness and obesity with womens’ risk of heart disease.

Who was studied?

A total of 936 women in the Women’s Ischemia Syndrome Evaluation (WISE) study, conducted by the National Heart, Lung, and Blood Institute, were chosen for this study. From 1996 to 2000, women were enrolled at four U.S. medical centres. All the women had been examined for chest pain or suspected heart disease.

How was the study done?

At the start of the study, researchers collected information about each woman, including symptoms, overall health, and results from lab tests. The researchers calculated each woman’s body mass index (BMI). BMI is a measure of weight in relation to height. The women filled out questionnaires and researchers used their answers to estimate how active the women were.

The women were followed for an average of four years. Researchers kept track of heart disease, heart attack, hospitalisation, stroke, heart failure and other aspects or their health.

What did the researchers find?

During the four years, 337 women, or 36%, had an adverse health event. Overweight women were more likely to have heart disease. Women who were more fit had fewer heart disease risk factors or other health problems. Women who were less fit were more likely to have one of these health problems.

What were the limitations of the study?

Women filled out the questionnaires themselves, so their answers may not have been completely correct. Also, it isn’t clear if not being physically active leads to heart disease, or if heart disease causes people not to be active. Researchers did not use the best ways to figure out body fat, and they did not collect information on the women’s eating habits.

What are the implications of the study?

Fitness may be more important for a woman’s risk of heart disease than overweight or obesity. Women with heart disease should be advised by health professionals to be more active.

Myth busting

Myth: No pain means no gain when it comes to exercise

Physical activity does not have to hurt in order to be beneficial.  In fact, if you feel pain when doing your activity, it could actually be doing more harm than good!  Moderate aerobic activity should make you sweat lightly and breathe faster, but it should be comfortable enough for you to carry on a conversation.  Proper resistance exercise with weights will cause a mild burning sensation in your muscles while doing the exercise, but it should not cause pain.

Education

You now know that physical activity is beneficial for preventing and managing diabetes, but how does it help in promoting other aspects of health and preventing other diseases?

Cancer: Studies have shown that physical activity reduces the risk of colon cancer by 30-40% and breast cancer by 20-30%. Recent studies are also starting to show beneficial gains in the battle against prostate, endometrial and lung cancer. For people with cancer, preliminary studies suggest that exercise has a positive physical, mental and emotional effect. It can improve physical strength, functional capacity and the ability to battle the negative side effects of chemotherapy, including nausea and fatigue.

Lung Disease and Asthma: Physical activity can help your body use your oxygen much more efficiently, therefore, making you feel less tired and less out of breath. Great activities involve brisk walking, cycling, fitness classes at your own pace, along with strength training. You may find that you can only do a little bit before you feel tired and out of breath. That’s okay! Try doing the activity for 5 minutes or until you get moderately out of breath, sit for 5 minutes and breathe through pursed lips, then try walking again for 5 minutes. You will improve!

Osteoporosis: Strength training and weight-bearing activities like brisk walking can reverse age-related losses in bone density. People who are regularly active have much better balance and increased muscle mass, both of which reduce the risk of having a fall, as well as making it less likely to suffer fall-related fractures.

Rheumatoid Arthritis/Arthritis: In the past, most people with arthritis were told to rest and take it easy.  Pain, inflammation and fatigue prevented many people from activities such as brisk walking. However, there are alternative activities that can help. Activities such as swimming, exercising in a pool, stretching and chair aerobics are extremely beneficial in reducing muscle fatigue and in increasing flexibility and endurance. Strengthening exercises can also help prevent some muscle weakness caused by inflammation and some of the medications used to treat arthritis. Physical activity can prevent arthritis from getting worse. A special cautionary note: during an arthritis flare-up, rest is advised. When the flare up has gone down, you may resume exercise.

Stomach and Intestinal Health: Experts suggest that moderate regular exercise may reduce the incidence and symptoms of some digestive disorders such as ulcers, irritable bowel syndrome, indigestion and constipation. For example, in one study, exercise was associated with a lower risk of ulcers in men. In addition, older people who exercise moderately may have a lower risk for gastrointestinal bleeding.

Weekly fitness tip

Keep a pair of walking shoes in your car or at work, so they are ready whenever you are!

It’s important to reward yourself when you have accomplished a goal you set out to achieve.

Sometimes that’s what keeps you going.  There are two kinds of reinforcements or rewards: intrinsic (or internal) and extrinsic (or external).  It’s important to identify both as they are both important. For example, when you achieve a goal, you can reward yourself with something you’d like to have or do, like going to a movie or buying a new item of clothing (extrinsic), or reward yourself with the satisfaction that you have accomplished something important (intrinsic). Remember to set realistic goals that you CAN achieve - it’s not about setting yourself up for failure.

Rewards can have a positive impact on your motivation but something as simple as keeping positive can also have a big influence. Practicing positive self-talk is an important concept that many overlook.  Don’t be so hard on yourself; train that little voice in your head to be encouraging and positive.  Tell yourself you are doing something good for your body.  If you’re constantly putting yourself down it will eventually overcome your best intentions and force you to give up.  Everyday is a new day which means a new day to start being positive!

An excellent tool to keep you motivated is having someone to be active with!  Making physical activity a social event is a way to keep it fun and engaging.  Look to those around you for support and encouragement.

  1. What motivates you?  Identify rewards or incentives for each of the goals you have identified two weeks ago.  Be honest in what will motivate you.  Everyone is different and there is no right answer, but also be realistic!   When you accomplish those goals, reward yourself, you deserve it!  This isn’t a free ticket to splurge.  Try to avoid unhealthy foods and beverages as rewards.
  2. Let your partner/friend know the rewards you have chosen. Perhaps they can give you ideas for additional motivation.

Research

Most Australian adults do not meet the national guidelines for physical activity

Pumping Iron in Australia: Prevalence, Trends and Sociodemographic Correlates of Muscle Strengthening Activity Participation from a National Sample of 195,926 Adults by Jason Bennie and colleagues, Public Library of Science, 11, 4:1-15, 2016.

What is the problem and what is known about it so far?

Population studies and exercise trials have demonstrated many health benefits for people undertaking muscle strengthening activities (also known as “resistance training”).  In 2014, the Department of Health introduced muscle strengthening activities to the Australian Physical Activity Guidelines for Australian adults (which had previously recommended aerobic activity only).  In Australia, there has been very little published data that describes how much resistance training Australian adults are doing.

Why did the researchers do this particular study?

The researchers wanted to find out how much resistance training Australians were doing and what socio-demographic factors were associated with those undertaking this type of training.

Who was studied?

A representative sample of 195, 926 Australians over the age of 15 took part.

How was the study done?

The surveys were conducted over the phone as a component of the Australian Sports Commission's 'Exercise, Recreation and Sport Survey’ between 2001 and 2010.

What did the researchers find?

Researchers found that only 10.4% or people surveyed had undertaken the required amount of resistance training in the past year. Those less likely to report adequate levels of resistance training included adults over the age of 50, people who were socially or economically disadvantaged, living in outer regional or remote areas and those with lower levels of education.

What were the limitations of the study?

The survey was based on self-reported physical activity behaviour which is often over-reported so the true prevalence of resistance training in Australian adults might well be much lower than 10.4%.  However, the study was conducted between 2001 and 2010, before the Department of Health introduced muscle strengthening activities to the Australian Physical Activity Guidelines for Australian adults.  The number of Australians undertaking muscle strengthening activities may have increased since the guidelines changed.

What are the implications of the study?

Population health strategies are required to try and increase the number of Australian adults taking part in muscle strengthening activities.  Ideally the strategies should be directed towards Australians > 50 years of age, those living in outer regional/remote areas with social/economic disadvantage and those with lower levels of education.  Strategies to increase the prevalence of resistance training in Australian adults should also be cost-neutral to participants.

Myth Busting

Myth: If I do resistance exercises with heavy weights my muscles will get too bulky.

The physique of a body builder with big muscles, is often associated with weight training.  For some people, especially women, this association can cause them to avoid lifting heavier weights or exercising with any weights at all.  Some women don’t want to become overly muscular, preferring a leaner figure, rather than a ‘bulky’ figure which may come about with weight training. Don’t be fooled by this common myth. Those bulky muscles seen in body builders are obtained by extremely intense training and diet programs, along with hormones like testosterone. Women, as well as some men, do not have enough of the muscle building hormones in their bodies to obtain bulky muscles. An appropriately designed resistance training program, carried out using correct technique, is the best means for both men and women to lose weight and tone their bodies.

Education

There is growing evidence that shows resistance training is very helpful for your health! It’s also a great activity that can fit in to almost anyone’s physical activity routine. Just look at some of the benefits resistance training can bring to you!

Increased:

muscle strength, power, and endurance; bone density and strength; metabolism (burning more calories when at rest)

Lowered:

heart rate and blood pressure after exercise

Enhanced:

balance and stability; performance of everyday tasks

Prevention or improvement:

of medical conditions such as type 2 diabetes, arthritis, and osteoporosis

Regular resistance training involves you working against a resistance such as your body weight, elastic bands, free weights or weight machines. Your muscles will adapt to the resistance over time by developing better nerve control and increasing in size and/or density. It is important to start with body weight exercises to learn correct technique before adding any resistance, in the form of bands, free weights or weight machines.

Basic principles

  • Type of exercise – Your workout should have at least 1 exercise for each of the major muscle groups (i.e., legs, back, chest, arms, and stomach), aiming for 8-10 exercises in total.
  • Volume – Doing each exercise for 8-10 repetitions, for at least 2 sets (up to 4 sets) during your workout is a good rule of thumb. This can be done either in a circuit-based format (as in your resistance training program), or straight after one another – If you do it this way, make sure you allow your muscles adequate rest between sets so you can maximise your performance. Also aim to do your routine 2-3 times per week.
  • Variety – It’s important to change your workout routine regularly as your body adapts quickly to the exercises.  You can do this by changing the exercises you do about every 6 weeks.
  • Progressive overload – As your muscles become stronger, you can continue your progress by gradually increasing the weight that you are adding to your movement during exercise.
  • Rest - You need to rest between each exercise for about 1-2 minutes to allow your muscles to recover. That way, you can get the most out of each exercise.
  • Recovery – Your muscle needs time to repair and adapt after a workout. Rest the muscle group for at least 24 - 48 hours before working the same muscles again.

How Much Weight?

An easy way to determine how much weight to use for each exercise is to start light and work your up from there. It is important to remember not to sacrifice correct technique in order to complete the repetitions with the added weight.

  1. Start with a light weight and do the exercise, aiming for about 8 to 10 repetitions.
  2. If you completed the last set relatively easy, increase the weight for the next set. Complete 8 to 10 repetitions again for this set.
  3. If you completed the last set relatively easy, increase the weight for the next set. You want the weight to be heavy enough so that you can only complete 8-10 repetitions and are in need of a rest following this effort. However, you do not want the weight to be so heavy that you are at risk of injury from completing this number of repetitions.
  4. In general, the weight that can be lifted by each body area will vary. You can often use heavier weights for larger muscle groups such as chest, back and legs, and smaller weights for your arms.

Things to consider

  • Only use safe and well-maintained equipment that you are familiar with.
  • Warm up and cool down.
  • Don't forget to breathe - exhale as you lift the weight rather than holding your breath.
  • Control the weights at all times - don't use body momentum to 'swing' the weights.
  • Make sure you use correct technique. Consult with a qualified exercise specialist.
  • Stretching after your workout will help reduce muscle soreness and improve your flexibility.

Fitness Tip

Can’t find time to fit in activity?  Try doing physical activity during the commercial breaks of your favourite TV show.  Gradually work your way up to do physical activity throughout the whole show.

Physical activity doesn’t have to be something you do alone.

You may find it more motivating if you have some company. Turn a social gathering into a physically active one by going out for a walk, instead of meeting for a coffee. Great conversation can happen over a meal or a walk.  By combining social and physical activity, you can stay connected with family and friends, whilst staying committed to your physical activity goals.

Let others in your life know about your physical activity goals. If others know the goals that are important to you, they can offer support. Encourage others to support you in your plans.  Better yet, ask if they would like to join you! Participating in physical activity with someone else is a great way to stay motivated and committed.  Ask a friend, family member or co-worker to join you in being active and reap the benefits of physical activity and good company.

  1. Can you think of one or two people in your immediate circle of family or friends that you could be active with?
  2. What types of activity could you do together?  Remember it doesn’t have to be anything formal; simply going for a walk together is a great activity.
  3. Make a commitment within the next week to contact those on your list and together come up with a concrete plan to be active together.  For example, agree to meet every Wednesday at 5:00pm to go for a 30-minute walk.  Give it an honest try for at least a month and make modifications if necessary to continue on.
  4. Share your plan or any thoughts with your partner/friend.

Research

Lifestyle changes improve erectile function

Esposito K, Giugliano F, Di Pal C, et al.: Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. JAMA 291:2978–2984, 2004.

What is the problem, and what is known about it so far?

Men with erectile dysfunction (ED) have trouble getting and maintaining an erection. Obese men are more likely to get erectile dysfunction. Healthy men who follow a healthy lifestyle (by eating healthy foods and getting exercise) have fewer problems getting and maintaining erections.

Researchers wanted to find out if losing weight and getting more exercise improved erectile function in obese men.

Who was studied?

A total of 110 obese men between the ages of 35 and 55 years who did not have diabetes, hypertension (high blood pressure), or hyperlipidemia (excess fats in the blood) were studied and followed for 2 years.

How was the study done?

The men in the study were put into two groups of 55 men each. One group (called the intervention group) received detailed advice on how to reduce their total body weight by 10% or more. This advice included how to eat fewer calories, set goals and keep track of what they ate and drank. They also took part in monthly support groups. Each member of the intervention group also got advice on how they could personally get more exercise and had monthly meetings with a nutritionist and exercise trainer during the first year of the study.

The other group (called the control group) received general information about healthy food choices and exercise and had group meetings every other month. They did not have individual counselling like the other group did.

What did the researchers find?

After 2 years, the men in the intervention group ate more complex carbohydrates, protein, and monounsaturated fat (“good” fat); increased their fibre intake; and ate fewer calories, saturated fat (“bad” fat), and cholesterol. Their exercise also increased. The men in this group also weighed less, had better blood pressure, and better levels of blood glucose and insulin. In addition, almost one-third (17 of the 55) of the men in this group regained their ability to get and maintain an erection.

The control group, however, showed no major changes in these measurements. Also, only 3 of the 55 men in this group improved their ability to get and maintain an erection.

What were the limitations of the study?

Because feelings (like stress, anxiety or depression) may affect mens’ ability to get and maintain an erection, it is possible that the men in the intervention group showed better erectile function because of their better self-image from losing weight and becoming more physically active.

Also, because the study required a great deal of support and care that others might not get, it is possible that the study results may not apply to all men.

What are the implications of the study?

The study shows that lifestyle changes, like eating fewer calories and doing more exercise, improves erectile function for obese men.

Myth Busting

Myth: You can lose fat from specific parts of your body by exercising those spots.

There's no such thing as "spot reduction”.  When you exercise, you use energy produced by burning fat in all parts of your body - not just around the muscles that are doing most of the work. In fact, your genes may dictate where you will lose fat more easily. However, working a specific region like the belly still has benefits.  Building strong muscles is important for posture, mobility and independence.

Education

Flexibility!

Plain old stretching can improve your flexibility, which in turn makes it easier to do other exercises.  If you feel stiff and tired, then stretching can help you to become active.  It can also help reduce the risk of injury by increasing the length of your muscles and giving you more range of motion.

Stretching is peaceful and quiet and can help your mind as much as your body -   just what you need to get rid of the Winter cobwebs!

It’s important when stretching to pay attention to your body and how it is feeling.  Do not stretch further than you are able.  Take calm, even breaths into your lungs and as you exhale, stretch a bit further each time.  Hold each stretch for at least 15 seconds.

Here are some simple stretches to help improve your health:

Leg Stretch

While sitting on the floor stretch one leg out in front and place the sole of your other foot on the inside of your thigh. Keeping your back nice and straight, lean forward slightly until you can feel the tension in the back of your leg. Hold and repeat with the other leg.

Arm Stretch

Link your fingers together and raise your arms above your head.  Stand as straight as possible and stretch towards the ceiling.  Lean slightly to one side then the other to target side muscles.

Quad Stretch

Stand next to a wall or chair in order to balance yourself.  Bend one leg and hold on to your foot with the opposite hand.  You should feel the stretch in the front of your leg.  Hold and repeat with the other leg.

Inside Leg Stretch

While sitting on the floor, place the soles of your feet together.  With your back nice and straight, lean your upper body forward over your feet.  This stretches the inside of your legs.

Lower Back Stretch

Lie on the floor with your legs out straight. Bring one knee to your chest and hold it there.  You should feel a stretch in your lower back and the back of your leg.  Repeat with your other leg.

Fitness Tip

Try and devote at least 8 hours a night to sleep. Having enough rest will give you the energy you need to be active throughout the day!

Any health issue or family/personal issue can affect not only your physical health but also your mental health.

You may have and continue to experience, many different feelings and emotions in relation to health, family or personal issues. It’s important to know that you’re not alone.  Try to establish networks with others, share your thoughts and feelings and learn from their successes.  In many cases you can find the support you’re looking for in others and even become a support for someone else.

In stressful situations, you might not make time to exercise, eat right or get the rest you need.  Therefore, it is important for you to recognise stressful situations and try to deal with them in constructive ways.  Stress management can be a difficult skill to perfect, but it’s all about doing activities that work for you and that you enjoy.  For example, some individuals find meditation useful in dealing with stress while others find comfort in a hot bath.  The key is finding strategies to help you deal with both the emotional and physical stressors in your life.  Physical activity can be an excellent stress management technique.  Going for a long brisk walk or doing a yoga DVD in your home can be a great way to relax both your body and mind.  Use this time to gather your thoughts and leave the stresses of the day behind.

  1. Make a list of the stressors in your life that may prevent you from carrying out your normal activities.  Do these stressors interfere with your physical activity habits?
  2. Now, brainstorm a list of ways you can begin to manage these stressors and actively try practicing this list of solutions.

Research

Exercising and eating right can help prevent loss of bladder control

Lifestyle intervention is associated with lower prevalence of urinary incontinence: the Diabetes Prevention Program, by J.S. Brown and colleagues. Diabetes Care 29:385–390, 2006.

What is the problem and what is known about it so far?

Urinary incontinence means that you can't always control when you urinate. Women who have type 2 diabetes are at a 50-70% higher risk for urinary incontinence.

Why did the researchers do this particular study?

The researchers wanted to see if losing weight by diet and exercise could help lower the risk for urinary incontinence.

Who was studied?

Almost 2,000 women who took part in the Diabetes Prevention Program. For more information on the Diabetes Prevention Program, visit http://www.preventdiabetes.com. On average, the women were 50 years old, overweight or obese, and had pre-diabetes.

How was the study done?

One-third of the women were given a diabetes drug (metformin) to treat their pre-diabetes, one-third were told to diet and exercise to treat their pre-diabetes, and one-third were given lifestyle advice and a placebo (a pill that has no effect). The women followed this routine for almost three years.

What did the researchers find?

The women who changed their diet and exercised had a lower risk for urinary incontinence. The researchers believe this is because they lost more weight than the women in the other groups. The women in the diet and exercise group also lowered their risk for type 2 diabetes.

What are the implications of the study?

Eating right and exercising can help women avoid urinary incontinence, and this may be a powerful motivator to eat better and exercise more.

Myth Busting

Myth: When you stop exercising, your muscles turn to fat.

Many people believe that if they stop working out, their muscle will turn into fat. Muscle and fat are two different tissues, however, and one can never be converted to the other. If you stop exercising, muscle tissue will shrink, so you may feel flabbier. Also, when muscles get smaller, they do not need as many calories, so your metabolism slows. With a slower metabolism, you may gain body fat if you continue to eat the same amount of calories.

Education

Question: Why should I warm-up?

A couple of important changes occur during warm-up.  First, the internal temperatures of the muscles increases, making them more elastic.  Also, heart rate and breathing increase, providing greater blood flow to working muscles. You should warm up for at least 5 minutes (10 minutes over the age of 50) and even more on cold days. The warm-up helps to prepare the body both mentally and physically for exercise.  You are at greater risk for injury if you don’t take the time to warm your muscles. It’s a similar concept to letting your car run for a while on cold mornings before taking it out on the road.

Question: Why should I cool-down?

The cool-down is the final part of your workout. The cool-down allows you to bring your body back to its resting state safely. A good cool down should last at least 5 minutes (10 minutes for ages 50+) and should bring your heart rate down to a pre-exercise level. Cooling down ensures that the blood does not pool in the legs. Pooling blood can make you feel dizzy and can result in a headache. Begin your cool-down by doing the same activity you performed during the main part of your workout but at a lower intensity.  For example, a leisurely walk would be a great cool-down following a brisk walk.  Stretching while you cool down when the muscles are warm from the workout is also ideal.

Fitness Tip

Feeling bored with your physical activity routine? Try listening to music, asking a friend to join you or changing scenery next time.  Your favourite music or good conversation with a friend can make time fly by.  By simply changing the route you normally walk or the location you exercise can make it more enjoyable and interesting.  Give it a try!

The Australian Department of Health recommends Australian adults try and:

  1. accumulate 150 to 300 minutes (2 ½ to 5 hours) of moderate intensity physical activity or 75 to 150 minutes (1 ¼ to 2 ½ hours) of vigorous intensity physical activity, or an equivalent combination of both moderate and vigorous activities, each week.
  2. do muscle strengthening activities on at least 2 days each week.

Reference

http://www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-phys-act-guidelines/$File/FS-Adults-18-64-Years.PDF

There are a variety of ways you can achieve this goal.  For example, try brisk walking for 30 minutes a day, 5 days of the week.  You can even break it up into 10-minute bouts throughout the day.  Brisk walking is an activity that almost everyone can do, however, choose an activity that you enjoy or have access to.  If you enjoy swimming and have access to a pool, try that.  Don’t force yourself to do something you won’t enjoy, otherwise you will find it much harder to stick with it.

The activities you choose don’t have to be strenuous or uncomfortable.  Start out slow and work your way up.  Go at a pace that is comfortable for you.  We were all beginners once!  A good pace to work at, is one that makes you sweaty and warm but not exhausted and fatigued. Give yourself time to adjust to an activity and keep at it.

An Exercise Physiologist can be an excellent resource for safe activity ideas.  If you are unsure about doing certain types of activity, consult an Exercise Physiologist to get their advice on the best activities for you.

  1. What types of activities have you enjoyed doing in the past or are currently doing right now?
  2. What is it about those activities that makes them enjoyable?

Research

The effect of exercise on blood glucose control and body mass in type 2 diabetes

Community-based physical activity interventions for treatment of type 2 diabetes: a systematic review with meta-analysis by Ronald Plotnikoff and colleagues, Frontiers in Endocrinology, 4, 1-17 (2013).

What is the problem and what is known about it so far?

Research has shown that participating in regular physical activity can help adults with type 2 diabetes to lose weight, reduce usage of medication and improve blood sugar control.

Why did the researchers do this particular study?

The researchers wanted to find out whether community-based physical activity interventions were effective in treating adults with type 2 diabetes.

Who was studied?

The researchers found 22 studies between 2002 and 2012 that looked at blood sugar control as an outcome measure.  The participants in these studies were adults with type 2 diabetes.

What did the researchers find?

Researchers found that community based physical activity interventions were effective in helping adults with type 2 diabetes to increase their level of physical activity, with improvements in their blood sugar control.  The researchers also found that community based physical activity programmes improved quality of life, psychological well-being, diastolic and systolic blood pressure, dietary intake and physical activity knowledge.

What are the implications of the study?

Microvascular complications and cardiovascular diseases are the major cause of death in people with diabetes.  Effective treatment/management of type 2 diabetes can prevent these complications.  Community based physical activity interventions provide a means for adults with type 2 diabetes to better manage their diabetes and prevent life-threatening complications.

Myth Busting

Myth: The best time to exercise is early in the morning.
Not necessarily true. There isn’t a ‘best time’ to exercise. The best time is the time that appeals to you and fits into your schedule. Some people love to jump-start their day with a morning workout, while others swear that exercising after the workday is over is a great way to energise for the evening and eliminate stress.  Remember only you can say what works best for you!

Education

It’s important to vary your physical activity routine every so often. Your body is very efficient and can adapt to a routine within 3 months. Every 3 months or so, try to change one of the following:

  1. Intensity – change your pace, the amount of weight, the number of hills you climb, the resistance on the bike. Maybe give interval training a try?
  2. Duration – exercise for a longer period of time
  3. Type – try a new type of cardiovascular or resistance exercise. For example, try substituting aqua-aerobics or cycling for two of your weekly walking sessions

When changing from your normal routine, you may find your new workout more challenging.  This is normal; it will take time for your body to adapt to your new routine.  Stick with it and monitor your progress!

Fitness Tip

Be sure to drink at least 8 glasses of water every day.  Your body is made up of mostly water and functions best when you are hydrated. How do you know if you’re drinking enough?  Take the “wee test”; when you go to the toilet, look at the color of your urine.  If you are drinking enough it should be almost clear, if you’re dehydrated it will be yellow.

You might not be aware of it, but the environment that surrounds you can influence how active you are.  Try to make the best of what is around you and work with what you have.

With creative thinking and some determination, you should be able to overcome many of the barriers that are getting in your way.

Little things can help make a difference.

Try including the following tips in your day:

  • take the stairs instead of the lift or escalator
  • park at the back of the car park instead of parking close to the entrance
  • get off the bus 2 stops early and walk the rest of the way
  • walk briskly whenever possible instead of driving
  • do something active during TV commercial breaks
  • try and fit in a 20-minute brisk walk during your lunch break
  1. Are there obstacles in your surroundings that are stopping you from being active?
  2. List them in one column and then list possible solutions beside them.  Be sure to keep your solutions practical and easy.  Solutions that are too hard or impractical will only set you up for failure.

Here is an example:

I am afraid to walk outside alone.

Possible solution: Try going to a shopping centre close to my house to walk indoors or organise to walk with a friend.

Need some help overcoming those barriers? Talk to your SMART Health Psychologist to get their perspective.

Research

Walking towards better health

Walking for exercise—does three times per week influence risk factors in type 2 diabetes? by T. Fritz and colleagues. Diabetes Res Clin Pract 71:21–27, 2006.

What is the problem and what is known about it so far?

Healthy muscles are important for good health, particularly for people with type 2 diabetes. High levels of physical activity help improve the body's ability to handle glucose and insulin as well as lower a person's chance of getting diabetes or cardiovascular disease (disease of the heart and blood vessels).

However, not all people are able to do strenuous exercise.  For some people, walking is about all they can manage. It's not known for sure how much of an effect simple walking has on one's health.

Why did the researchers do this particular study?

Researchers wanted to study people with type 2 diabetes and how low-impact walking affected their ability to handle glucose and insulin, as well as prevent conditions that lead to heart and blood vessel disease.

Who was studied?

The study included 52 people with type 2 diabetes. The participants were recruited at a single primary care medical office

How was the study done?

Half of the participants were instructed to walk for 45-60 minutes three times per week for four months. The other participants, who had similar conditions, were given no exercise instructions.

All participants had a physical examination, which measured their blood pressure and weight. Their body mass index (a measure of weight compared to height) was also calculated and blood was taken for lab tests. The physical examinations and tests were done at the beginning and end of the four-month study period.

What did the researchers find?

Regular walking improved blood pressure, body mass index, and cholesterol levels.  However, there was no difference between the two groups in their ability to handle glucose and insulin.

What were the limitations of the study?

There was no way of measuring the intensity of walks, so there could be important differences in how the participants exercised. Also, there weren't very many people in the study.

What are the implications of the study?

Increasing physical activity to a level of at least 45 minutes of walking three times a week results in some health improvements for people with type 2 diabetes. More research is needed to determine whether different people need different exercise regimens.

Myth Busting

Myth: The only way to burn calories is by doing cardiovascular exercises like walking and jogging.

Although activities like walking and jogging are efficient ways to burn calories, a person also burns calories by just existing (eating, sleeping, digesting food etc.). In fact, activities like strength and resistance training are excellent ways to burn calories and build more muscle. The bonus here is that muscle actually burns more calories than fat, so the more muscle mass you have, the more calories your body will burn naturally.  For best results, aim for a well balanced workout including cardiovascular exercise, strength and stretching activities.

Education

Body Composition

It’s important to be aware of the various components that make up your body.  Here are the basics made easy to understand.

Your body is composed of fat-free mass and fat mass.

Fat-free mass includes: muscle, bone, body fluids and organs.

Muscles are further classified as lean-body mass or muscle mass.

Fat mass is classified as either essential fat or storage fat.

Essential fat is required in order for your body to function normally.

It is stored in major body organs and tissues including heart, muscles, intestines, bones, lungs, liver, spleen, and kidneys and throughout the central nervous system.  Females have additional fat mass in their breasts and pelvic region for child bearing purposes.

Storage fat is the extra fat that accumulates in fat cells around internal organs and below the surface of the skin to help insulate, pad and protect the body from injury and extreme cold.

You need a combination of all the above in order to be healthy and keep your vital organs adequately protected.  This does not mean, however, that excess fat is better. Having too much body fat can lead to many health problems including cardiovascular disease and high blood pressure. Keep in mind that many factors influence body composition including genetics, so, it is not realistic to expect to have the same body composition as people seen in magazines and on television. Be honest with yourself, talk with your doctor about what is appropriate for you to expect and work towards. Don’t be discouraged if you cannot look exactly like the images promoted most often.

Fitness Tip

Another great way to measure the intensity of your workout is a method called the ‘talk test’.  Use the following criteria to figure out how hard you’re working.  A person who is active at a light intensity level should be able to sing while doing the activity. One who is active at a moderate intensity level should be able to carry on a conversation comfortably while engaging in the activity. If a person becomes winded or too out of breath to carry on a conversation, the activity can be considered vigorous.

A great way to stay motivated and learn new skills is by watching others.

You may not realise it, but, observing others perform activities is a common way for us to learn and perfect skills we may have not yet mastered.

Observing doesn’t mean you can’t participate.  We often observe and participate at the same time without knowing it.  By interpreting subtle cues from others we learn more about the activity. Observing others will help develop skills but it can also give you cues about how long and how often to engage in an activity.  For example, you may observe your neighbour walking for 40 minutes three times a week. This observation may help you form similar behaviours (brisk walking).

Being in an environment that allows you to be exposed to others being active is another great way to learn.  Simply being surrounded by others being active can have a positive effect on your physical activity behaviour.  For example, it would be difficult to attend an aqua-aerobics class at the local pool and not participate.  Being surrounded by others participating in the class would probably motivate you enough to want to follow suit.

Use this technique to your advantage!

  1. Can you think of three situations where you could either observe or be around others being active?
  2. Can you come up with two people you know, whose activity levels are similar to what you want to achieve?
  3. Make a plan to join those individuals and participate in activity with them.  Discuss these with your SMART Health Psychologist or Exercise Specialist and get their feedback.

Research

There is a positive association between physical activity and health-related quality of life

Physical activity level and health-related quality of life in the general adult population: A systematic review by Raphael Bize and colleagues, Preventive Medicine, 45:6, pages 401–415 (2007)

What is the problem and what is known about it so far?

There is a lack of research about the impact of physical activity on health-related quality of life (QOL) in the general population.

Why did the researchers do this particular study?

The researchers wanted to systematically review studies that examined the relationship between physical activity and health-related QOL.

What was studied?

A total of 1426 references were found.  Of these, 55 were considered to be most relevant and were further examined by the researchers.

What did the researchers find?

The researchers found a positive association between self-reported physical activity and health-related quality of life.

What are the limitations of the study?

While cross-sectional data studies demonstrated a positive association between physical activity level and health-related quality of life, the limited evidence from randomized controlled trials and cohort studies prevents researchers from making a conclusion about the nature of this association.

Myth Busting

Myth: Home workouts are fine but going to a gym is the best way to get fit.
Research has shown that some people find it easier to stick to a home-based fitness program. In spite of all the hype on trendy exercise programs and facilities, the "best" program for you is the one you will stick with and enjoy.  Many people feel intimidated going to the gym.  Physical activity shouldn’t feel this way.  Do what you feel comfortable with and makes you happy.

Education

What’s your body shape?

The shape of your body and more specifically the location of excess fat on your body are considered risk factors for many common diseases.

Apple shape - fat is located mostly in the abdominal or belly area.  This type of abdominal obesity is linked to an increased risk for coronary heart disease, high blood pressure, high cholesterol, diabetes and breast cancer

Pear shape – fat is located mostly in the lower extremities, around the hips, buttocks and thighs.  Excessive amounts of fat distributed in these areas presents some risk but does not present as great a risk as abdominal obesity.

The type of fat located in each area of the body acts differently.  Abdominal fat has much more enzyme activity, depositing more fatty acids into the blood stream while hip-thigh fat tends to be less active. Hip-thigh fat also appears to be more difficult to lose compared to abdominal fat.

There is no magic formula to changing your body type but it is important to be aware of the risk factors that are associated with it.

Fitness Tip

Place ‘reminders’ in key places to remind you to do physical activity.  For example, put a sticky note on your refrigerator, computer or bathroom mirror reminding you to do physical activity.  You could also include motivational tips as an added bonus.

Physical activity is a lifestyle change that may, at times, seem like it takes more effort than it is worth.

Changing habits is not an easy task but the rewards and benefits of being active and healthy far out way the inconveniences you may face.

In today’s society of quick fixes and modern conveniences it may be tempting to look for that easy option.  Just remember that it’s normal to feel frustrated at times and even have setbacks – it is actually normal for people to relapse.  We’re all human and life gets in the way, even if we have the best intentions.  The key is to not get discouraged and get back on track as soon as possible. Instead of giving up, try to learn from those experiences.

Sticking to your physical activity routine will take flexibility, planning and problem solving.  Don’t be afraid to re-evaluate your plan and make adjustments if you think it’s not working the way it should.  Change is not always a bad thing.

One of the most important aspects of relapse prevention is planning!  This doesn’t necessarily mean you have to come up with a plan and put it on paper but rather, plan ahead for the incorporation of physical activity into your daily life.  For example, if you know you have a busy week coming up, you might have to plan alternate times for your activity.  You may have to wake up a little earlier before the day starts to fit your activity in. Planning will help you stick to your lifestyle change!

Finally, remember to give yourself credit for the positive results you experience.  We too often criticise ourselves when we fail and forget to compliment ourselves when we succeed.  The results you see and experience are because of you and your persistent efforts!

  1. Discuss any concerns you may have with your SMART Health Psychologist or Exercise Specialist around relapse prevention or not being able to continue with being physically active.
  2. Brainstorm a plan to deal with relapse prevention. In other words, come up with a plan to keep you on track.

Research

Nurses with higher dietary intake of whole grains were less likely to develop type 2 diabetes

Whole Grain, Bran, and Germ Intake and Risk of Type 2 Diabetes: A Prospective Cohort Study and Systematic Review by S Jeroen and colleagues, Public Library of Science, 4, 8:1385-1395 (2007).

What is the problem and what is known about it so far?

Balancing energy intake and energy expenditure to normalise body weight is a key strategy for preventing type 2 diabetes.  However, the role of specific dietary factors in the development of type 2 diabetes is not well understood.

Why did the researchers do this particular study?

The researchers wanted to find out the role of whole grain, bran and germ in relation type 2 diabetes risk in prospective cohort studies.

Who was studied?

The researchers followed 161,737 US women (aged 26-65) in the Nurses’ Health Studies (NHSs) I and II.  The nurses had no history of diabetes, cardiovascular disease or cancer at the beginning of the study.

How was the study done?

The nurses completed questionnaires at regular intervals to determine their dietary intake.

What did the researchers find?

The researchers found that whole grain intake was inversely associated with risk of developing type 2 diabetes i.e. nurses with higher dietary intake of whole grains were less likely to develop type 2 diabetes.  The association was stronger for bran than for the germ component of the whole grain.  Findings from prospective cohort studies consistently support the idea of increasing whole grain consumption for the prevention of type 2 diabetes.

What were the limitations of the study?

This study was conducted on a large cohort of American female nurses.  It is not clear whether the results can be generalised to other women including non-nurses and women living outside of America.  It is also unknown whether the findings could be generalised for men as well.

What are the implications of the study?

Findings from these prospective cohort studies consistently support advice to

increase intake of whole grains for the prevention of type 2 diabetes.

Myth Busting

Myth: If you exercise, you can eat anything you want
If you try to make up for poor nutrition by exercising, you are going to be disappointed.  Having an active lifestyle does not allow you to neglect your diet. It is important to practice a well-rounded healthy lifestyle including a healthy diet.  In many cases, being physically active and feeling good about yourself will influence your eating habits in a positive way!

Education

Interested in joining a fitness centre?  It’s easy to be intimidated.  Keep the following tips in mind.

Making the fitness centre less scary

If you would like to try out a public fitness centre but feel uncomfortable, here are a few tips to help get you started:

  • Choose a facility that is convenient for you and suits you.  If it is too inconvenient, it will be harder to get motivated to go.
  • Make an appointment with the Exercise Specialist on site and have them teach you some basic exercises.
  • When in doubt, ask the Exercise Specialist on site.  Don’t go by what you see other people doing, as they may not be doing the exercise correctly!
  • Try out a fitness class.  Many places offer a variety of classes tailored to different needs.
  • Try to go often. The more you go, the more comfortable you will feel.
  • Ask what times the centre is less busy and try to go at those times.
  • Remember that most people are focused on their own workout and do not pay attention to others.
  • Remember that everyone was a beginner once.

Fitness Memberships too expensive?

The cost of a gym membership can be enough to deter even the most motivated person.  Be sure to explore all the options in your community before closing the door on the fitness centre completely!  Organisations like the YMCA often have similar programmes where assistance can be provided if there is a need.

Fitness Tip

For many people, the most convenient time to fit physical activity into their daily routine is in the morning, or straight after work in the afternoon/evening.  Try laying your clothes out the night before, or packing them in a bag and taking them to work. This way, everything is ready for you, either when you get up in the morning or as soon as the work day is over.  This can be a great motivator to help you get active.

Congratulations! This week brings us to the close of the study. We want to compliment each and every one of you for sticking with the programme! We hope that you were able to take away knowledge, skills and motivation to keep at it.

For the remainder of the year this website will continue to hold all the information you had access to. Please continue to access the site if you would like to refresh your memory or just brush up on what you learned.

At the beginning of the study we shared several testimonials of people who have benefited from including physical activity into their lives. Have you experienced something similar? As a final thought, we would like you to email your success story to the SMART Health Team.

Research

Diabetes is a family matter

Long-term (1- and 2-year) effects of lifestyle intervention in type 2 diabetes relatives, by H.K. Brekke and colleagues. Diabetes Res Clin Pract 70:225–234, 2005.

What is the problem and what is known about it so far?

Following a healthy diet and exercising are important factors for staying healthy and preventing type 2 diabetes. Improving one's diet and adopting other healthy lifestyle habits can also improve a person's control over their diabetes.

First-degree relatives (parents, children or siblings) of people with diabetes are more likely to get the disease themselves. However, it isn't known if,or how much, -- a healthy lifestyle benefits first-degree relatives of people with diabetes.

Why did the researchers do this particular study?

The researchers wanted to study the long-term effects of diet and exercise in individuals closely related to people with diabetes.

Who was studied?

The study included 77 people, between 25 and 55 years old, who were first-degree relatives of people with diabetes. All the participants were healthy and didn't have diabetes or other problems related to how the body handles glucose in the blood.

How was the study done?

Participants were put into one of three groups. One group was put on a diet aimed at reducing saturated fats, increasing monounsaturated fats from fish and vegetables and increasing consumption of fresh fruits and vegetables. The diet participants were also encouraged to eat foods that slowly release glucose into the blood (foods with a low glycemic index) and discouraged from eating foods that rapidly release glucose into the blood (foods with a high glycemic index), which is believed to reduce the chance of getting diabetes.

A second group's participants were put on the same diet and were also encouraged to increase their physical activity to at least 30 minutes a day four or five days per week.

The third group, for comparison, was told to keep to their usual eating habits and level of physical activity. At the end of one year, some of these participants were put on the same diet as the first group.

All of the participants were followed for two years.

What did the researchers find?

The dietary changes showed healthful benefits that remained for the entire two-year study period. Participants in the second group also benefited from getting more exercise, and lost an average of 2.5% of their body weight. The improvements were greater among people who changed both their diet and exercise routines, compared to those who followed only the diet.

What were the limitations of the study?

Since the participants who followed their usual routines were put on a diet after one year, there wasn't a group to compare to at the end of two years.

What are the implications of the study?

Relatives of people with diabetes can help avoid getting the disease by adopting healthy eating habits and increasing their physical activity.

Education

Physical activity in not only good for your body, it’s great for your mind as well! The psychological and emotional benefits from physical activity are numerous. Either brief periods of intense training or prolonged aerobic workouts can raise the levels of certain chemicals in the brain, such as endorphins, adrenaline, serotonin and dopamine that are associated with a feeling of well-being. Rhythmic aerobic and yoga exercises help combat stress and anxiety. And, of course, weight loss and increased muscle tone from strength training can boost self-esteem.

A review of multiple studies found that physical activity advances the treatment of clinical depression and anxiety, enhances moods, and improves self-esteem. Some studies are also reporting that physical activity is as effective as antidepressant agents in relieving depression and it may even be better in maintaining normal mood over time.

Aerobic exercise is also linked with improved mental vigor, including reaction time, acuity, and math skills. Exercising may even enhance creativity and imagination. According to one study, older people who are physically fit respond to mental challenges just as quickly as unfit young adults. In fact, a 2001 study reported that older people who regularly exercised had lower rates of mental deterioration, Alzheimer's and dementia of any type.

Myth Busting

Myth: Doing housework is just as good as doing aerobic exercise like brisk walking, swimming, or biking.

Doing housework such as laundry, taking out the garbage and vacuuming does get you up and moving, but does not normally provide the important health benefits of an aerobic activity such as a brisk 20-minute walk. This is because household chores do not normally get your heart and lungs working at a moderate intensity. Also, such activities are often intermittent and so do not keep your heart rate elevated for long enough. In order to improve the health of your heart, you must work towards doing aerobic activity for a minimum of 10 minutes at a time at a moderate intensity.

So it’s important to value household work as moving more but also aim to include more intense cardiovascular activities into your day.

Fitness Tip

Try scheduling physical activity into your daily planner. If you are someone who uses a day planner of some sort, schedule physical activity just as you would a meeting. Block off a section of time and give it the same importance you would for anything else at work. This way you will have made time for the activity and are less likely to skip it. If you don’t use scheduling as part of your job, you can still take advantage of this technique. Block off time to be physically active in your day. Post it on a sticky not on the fridge or your work station and don’t let other commitments take away from that time. Again, treat it like you would any other important scheduled meeting or appointment.

SMART Exercise

Minimum prescription of resistance exercise for individuals with type 2 diabetes or pre-diabetes

Intensity

Time per week

Frequency>

Moderate to vigorous

  • 8-10 exercises
  • 2-4 sets of each
  • 8-10 repetitions of each
  • 1-2 min rest intervals

60 min

At least 2, but preferably more, times per week (30 mins per session, at least twice a week, and can be combined with an aerobic session)

Burpee/Modified burpee

Burpees

Tuck Jump/Leg Lift

Tuck Jump and Leg Lift

High Knees (with or without arm punches)

High Kicks

Jumping Jacks

Jumping Jacks

Mountain Climber

Mountain Climber

Exercise images are courtesy of Accredited Exercise Physiologist, Katie Williams from Exercise & Sports Science Australia, found on the Make Healthy Normal Website (https://www.makehealthynormal.nsw.gov.au/activity/workouts); and Strength and Conditioning Coach/Exercise Scientist, Sarah Kennedy, University of Newcastle.

Calf raises

Calf Raises

Lunges (stationary or walking)

Lunge

Lunge Jump

Lunge Jump

Squat

Squat

Squat Jumps

Squat Jump

Wall Sit

Wall Sit

Lunge Rear Lift

Lunge Rear Lift

Lunge Forward Lift

Lunge Forward Lift

Sit To Stand (with or without jump)

Sit to Stand

Sit to Stand and Jump

Leg Lift (on all fours)

Leg Lift on all fours

Leg Kicks (seated)

Seated Leg Kicks

Single Leg Deadlift

Single Leg Deadlift

Step Up

Step Up

Step Up Squat

Step Up Squat

Donkey Kicks

Donkey Kicks

Exercise images are courtesy of Accredited Exercise Physiologist, Katie Williams from Exercise & Sports Science Australia, found on the Make Healthy Normal Website (https://www.makehealthynormal.nsw.gov.au/activity/workouts); and Strength and Conditioning Coach/Exercise Scientist, Sarah Kennedy, University of Newcastle.

Crunches

Crunch
Jack Knife

Jack Knife
V-Sit

V-Sit
Sit Ups
Sit Up
Russian Twist

Russian Twist
Flutter Kick
Flutter Kick
Oblique Crunch

Oblique Crunch
Plank (hands or elbows)

Plank
Side Plank (hands or elbows)

Side Plank
Moving Plank

Moving Plank
Front Support With Chest Touch

Front Support With Chest Touch
Segmental Rotation

Segmental Rotation
Supine Bridge

Supine Bridge
Bicycle Crunches

Bicycle Crunches
Flying Superman

Flying Superman
Superman

Superman
Reverse Crunch

Reverse Crunch

Exercise images are courtesy of Accredited Exercise Physiologist, Katie Williams from Exercise & Sports Science Australia, found on the Make Healthy Normal Website (https://www.makehealthynormal.nsw.gov.au/activity/workouts); and Strength and Conditioning Coach/Exercise Scientist, Sarah Kennedy, University of Newcastle.

Wall Push Up

Wall Push Up
Bench Push Up

Bench Push Up
Push Up (knees or toes)
Push Up
Suspended Row (from pole)

Suspended Row (two hands)

Suspended Row (one hand)
Bench Triceps Dip

Bench Triceps Dip
Triceps Push Up (hands closer together)

Triceps Push Up

Shoulder Circles

Shoulder Circles

Exercise images are courtesy of Accredited Exercise Physiologist, Katie Williams from Exercise & Sports Science Australia, found on the Make Healthy Normal Website (https://www.makehealthynormal.nsw.gov.au/activity/workouts); and Strength and Conditioning Coach/Exercise Scientist, Sarah Kennedy, University of Newcastle.

SMART Aerobic

Accumulate 150 to 300 minutes (2.5 to 5 hours) of moderate intensity physical activity or 75 to 150 minutes (1.25 to 2.5 hours) of vigorous intensity physical activity, or an equivalent combination of both moderate and vigorous activities, each week.

Intensity

Time per week

Frequency

Moderate (55-69% of maximum heart rate*)

  • This type of   exercise requires a moderate amount of effort and noticeably accelerates the heart rate.
  • You are   generally able to conduct and maintain an uninterrupted conversation during   this activity
  • Lasts between 30 and 60 minutes

150 - 300 minutes

Exercise on most, preferably all days each week. No more than two consecutive days without exercise (30 mins per day, 5 days per week)

Vigorous (70-89% of maximum heart rate*)

  • This type of   exercise requires a large amount of effort, causes rapid breathing and a substantial increase in heart rate.
  • You are not generally able to conduct and maintain an uninterrupted conversation during this activity
  • Lasts about 30   minutes

75-150 minutes

Exercise on most, preferably all days each week. No more than two consecutive days without exercise (15 mins per day, 6 days per week)

*220 minus your age is an accepted, general indicator of an individual’s maximum heart rate

Examples of Aerobic Exercises

  • Running Walking
  • Swimming
  • Cycling
  • Boxing
  • Rowing
  • Dancing
  • Sport (various)
  • Skipping

The University of Newcastle acknowledges the traditional custodians of the lands within our footprint areas: Awabakal, Darkinjung, Biripai, Worimi, Wonnarua, and Eora Nations. We also pay respect to the wisdom of our Elders past and present.