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When it comes to lifestyle and health, we sometimes over-index on exercise while ignoring the role of physical activity. We actively encourage 150 minutes a week as being the right starting dose for exercise but we often neglect to emphasize the importance of activity, or the deleterious effect of sedentary behaviors. From a health perspective, exercise and activity are different and complementary. They are the two sides of the MOVE pillar - each contributing different, synergistic benefits to your overall health.  But first, what’s the difference between movement and exercise? (as defined by the World Health Organization)
Independent of exercise, physical inactivity or sedentary behaviour is recognized as one of the leading risk factors for noncommunicable diseases and death worldwide. For individuals, the failure to enjoy adequate levels of physical activity increases the risk of cardiovascular disease (heart attack and stroke), cancer, and diabetes by 20–30% and shortens lifespan by 3–5 years. Sedentary behaviour, cardiovascular and metabolic health Sedentary behaviour negatively affects the way our bodies process the two major energy sources from our diets: fat and glucose. Even short periods of sedentary behaviour decreases our body’s ability to both use and store fat. Being inactive decreases levels of lipoprotein lipase (LPL) the enzyme that facilitates the uptake of fat into muscle and adipose tissue. Similarly, sedentary behaviour has been shown to decrease the expression and concentration of glucose receptors in muscle. These combined effects make lack of activity a particularly potent risk for both cardiovascular and metabolic risk. Hamburg et al. (2007) took 22 adult volunteers and had them remain in bed for 23.5 hrs per day for 5 days. At the end of the study - despite no change in weight they experience significant disruption of important cardio-metabolic biomarkers - increased cholesterol, increased triglycerides, higher glucose, and signs of insulin resistance, the process underlying Type II Diabetes. In fact when challenged with glucose their body’s had to release 67% more insulin in order to maintain normal blood sugar levels. In short - being sedentary rapidly increases your risk of cardiovascular disease and diabetes. Vascular Health Being sedentary, decreases vascular function independently of the effects on cardiometabolic risk factors with apparent effects on endothelial dysfunction. Cancer Multiple studies have shown links between sedentary lifestyle and increased cancer risk specifically for colon, endometrial, ovarian and breast.  Bone Health It has been well documented that lack of activity leads to decreased bone mineral density and the corresponding increase in the risk of fracture from the development of osteoporosis. In young healthy men, 12 weeks of bedrest can decrease bone density by 1-4% Mental Health & Psychosocial Well-being Physically active people have higher physical and mental quality of life as well as self esteem. Whether this is due to the increase of physical activity or the reduction of sedentary lifestyle is not entirely clear but it is safe to say that increasing physical activity and being less sedentary is associated with improved mental health and psychosocial well-being. All of these effects combine to create a dose-response relationship between time spent in sedentary behavior and mortality. Much of the research on sedentary behaviour has focused on TV viewing time and more recently screen time. Each 2 hour per day increase in TV time was associated with a 14-20% increase in the risk of diabetes independent of other physical activity. How can you be more physically active?  Planning is essential to make this part of your life. When planning your week be sure to block times to include both
 Both exercise and physical activity have independent and synergistic effects on your health, be smart and get both.
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With the spread of COVID-19, our public health leaders have been very clear: The time is now to stay home, social distance and physically self-isolate to prevent the spread of this epidemic. It is important to remember that these sacrifices are not necessarily for you but will help the most vulnerable amongst us avoid this illness As we make such massive changes to our lives, we understand that these are extraordinary times and for many people the thought of making lifestyle changes may feel overwhelming. However, we at Wellness Garage believe that a healthy lifestyle is one of our best defenses we have against fighting off infections and disease. Now, as much as ever, is the time to make sure that you are taking care of yourself! And we want to be with you to support you on your health journey as we tackle these uncertain times together. Consider, we are here to support you so that you can continue to support those around you. Our staff has moved to work from home in order to follow social distancing recommendations from public health. And just like all of you, we are getting creative and finding resourceful ways to stay connected and stay healthy. 10 Things To Help You Stay Healthy (and sane) in a Time of COVID-19 Get outside (but remember social distancing): walk- bike- hike- whatever suits you! Nature is a powerful medicine and we are fortunate in BC to have an abundance of outdoor space. Social distancing recommendations are to stay 6 feet apart from each other- which isn’t hard to do when you consider how much green space there is all around us.  Try a new recipe: With many restaurants closed, it is a great time to try a new recipe. We have a number of favourites available through our meal planning resource. Reach out to us (recipes@wellnessgarage.ca) if there is something specific you are looking for.  Learn to cook more plant-based: Check out Rouxbe, a Vancouver-based professional online cooking school offers courses for as little as $39. That is less than a meal for two at many restaurants. Now just may be the time to learn to cook! Try yoga from home: Glo Yoga- has a variety of different yoga and meditation options to try for for FREE. YYOGA- (Vancouver & Toronto) studios are also offering online options with free trial memberships. Check with your local studios as many are offering virtual options.  Image by Benjamin Balazs from Pixabay Learn to meditate - now you cannot say that you don't have the time! Start with 5 min a day. Download an app: Calm, Headspace, 10% Happier, Waking Up are a few of our favorites. Meditation has many proven health benefits, but one of the first that you will realize is a reduction in stress - something we all can use a dose of right now!  Develop a home workout routine and stick to it! - Whether you have equipment or not, we have developed a number of minimalist workouts that might be just the thing you need to develop a new routine that you can easily do at home. Email fitness@wellnessgarage.ca and we will send you a quick & easy resource to guide you. We recommend planning your workouts and. keeping track of how many you do a week. Try a challenge with a family member or. co-worker to help keep you accountable. We are exploring ways to deliver virtual work-outs to you- Stay Tuned! Challenge yourself to stay off your phone: As the news of COVID-19 keeps rolling in, it will become more and more challenging to keep from reading the news as quickly as it pops up on your news feed. Try limiting yourself to specific times of the day to check for updates. Avoid reading or watching the news before bed when it can stimulate stress hormones known to interfere with sleep. With all the time you save, you can make it through that much neglected novel on your bedstand!  Image by Wokandapix from Pixabay Plan a family games night: and another one, and another one,... Consider this time to hang low with family and take out the Yahtzee, scrabble board or puzzle that is hiding in the cupboard. Try reaching out to other friends and play a virtual card game through Facetime of Google Hangouts! Laugh, Share Uplifting Stories: Take note of the funny and inspiring things that are happening all around us. During challenging times, it is difficult to notice all of the good that we share. Life will return to normal and in the meantime, laughter helps to keep us connected and releases necessary endorphins that send positive messages to the brain! Watch a documentary about health: Take the extra time when you may be homebound to watch some of the health documentaries that we have been talking about at the Garage: Game Changers: Explores the benefits of plant based eating with a focus on how athletes are benefitting from a plant-based diet. Definitely controversial in some of it's claims but it has emerged as one of the most popular documentaries ever! Fed Up: Explores the prevalence of sugar in the standard North American diet and how it is driving an obesity epidemic. Embrace: Is a powerful movie about embracing your body for what it can “do” rather than how it looks. Cooked: Michael Pollan explores the connection between food and culture through this Netflix series. Supersize Me: The documentary to stop your fast food habit! Food As Medicine: Explores the role of food in healing. One last word - remember to take care of yourself. Give yourself space to rejuvenate, explore your (at home) hobbies, take a long bath, stretch, drink tea. Whatever ritual you find comforting, find time to work it into your day! By taking care of ourselves, we will have more to offer others in this challenging time.
Stay safe, stay connected and be well! (Part of our January series on S3 Weight Management - Systematic, Stratified and Sustainable) There are multiple lines of evidence to support that getting a good night's sleep is important in order to be able to lose weight. From an evolutionary perspective sleep and energy management are intricately linked. Poor sleep dramatically alters the way the body responds to food.  When you do not get adequate sleep, your hunger hormones send signals to your brain to eat more.
As a result studies have shown that people who have inadequate sleep consume more calories. Compounding this, sleep deprived individuals have been shown to preferentially choose calorie dense foods rich in both fats and carbohydrates. Inadequate sleep also increases the release of the stress hormone cortisol, which in turn signals the brain to increase appetite via the release of another hormone orexin. High levels of cortisol may explain why sleep deprivation appears to lead to loss of muscle mass and increased abdominal (visceral) fat. Independent of its effect on appetite, cortisol also counters the actions of insulin, leading to insulin resistance the result of which can be high levels of insulin. Insulin is a storage hormone promoting the storage of prompt storage of glucose as glycogen and fats within adipose tissue. With high enough levels of insulin, fat will be quickly stored and lipolysis (the breakdown of fat for energy) will be suppressed, resulting in one-way storage in other words "a moment on the lips, forever on the hips" This cortisol induced insulin resistance can be demonstrated in as little as one week of sleep deprivation. Other studies have shown that a lack of sleep can
As a result of these effects it is not surprising that inadequate sleep is associated with weight gain. Large observational studies, like the Nurses Health Study, following 68,000 nurses, demonstrated that short sleep duration increased the likelihood of obesity by 15%. Of course, observational research can show associations it cannot prove causation, however shorter term sleep deprivation studies also show weight gain. The recent PREDIMED Plus study showed that lack of sleep affects weight loss during a trial of the Mediterranean Diet , as overweight people who did not sleep well lost less weight that those without sleep issues. Finally, sleep apnea one of the most devastating sleep disorders is both associated with and worsened by weight gain. This sets up a vicious cycle where poor sleep can lead to weight gain, and potentially sleep apnea and sleep apnea in turn leads to further weight gain. So we can see from this
The resulting vicious cycle can set up a progressive deterioration of sleep with a corresponding weight gain. The key to reversing this cycle is to prioritize sleep:
For more on this, see some of the previous blog posts on sleep
For other posts in our foundational behaviours for weight managemetn series:
On January 29th- we will launch a new group program - fully covered by MSP (for those with a BMI >30 or a BMI between 27 and 30 and a weight related diagnosis). During the month of January - we will be posting about the foundational behaviours for sustainable weight management - stay tuned. If you would like to learn more about the S3 program and whether you are eligible please check out our Sustainable Weight Management program page. (Part of our January series on S3 Weight Management - Systematic, Stratified and Sustainable) One of the best ways to improve your overall health is to exercise. Yet from a weight loss perspective, exercise on average yields modest results. The explanation for is captured eloquently by the saying “you can’t outrun a poor diet”. Increasing physical activity increases energy expenditure - the challenge is that it increases appetite. If you have not made changes to your nutrition (eating real food, hydrating without calories, going 12 hours without food and increasing your fibre), then by increasing exercise and your appetite, you run the risk of actually gaining weight as you eat more. Where exercise has it main role in weight management - is helping to prevent you from regaining weight. Once you have lost weight, exercise does a great job of maintaining or increasing your metabolic rate.  Beyond weight management, exercise has numerous health benefits and lack of physical activity has been identified as the fourth leading risk factor for global mortality and has been estimated as being the principal cause for approximately:
It has been estimated that for every hour you exercise you increase your longevity by 7 hours (up to a total benefit of an additional 3 years) and exercise can reduce premature death from all causes by 16% and from cardiovascular disease by about 25%. Simply put, exercise helps you to avoid premature death and live longer. Exercise also has many benefits for the here and now:
Despite these benefits, only 17% of Canadians meet the current guidelines of 150 minutes of “moderate-to-vigorous physical activity” per week. (2019 Canadian Health Measures Survey) This recommendation supported by the WHO reflects the amount of exercise necessary to get most of these benefits. It can be broken down into as little as 10 minute increments. Moderate intensity physical activities will cause adults to sweat a little and to breathe harder - up to the point that you could still have a conversation. Vigorous intensity activities will cause adults to sweat more and be ‘out of breath’. In our Wellness Garage Principles, we recommend:
Some ideas from Participaction: ;
Pick a time. Pick a place. Make a plan and move more. For other posts in this series:
On January 29th- we will launch a new group program - fully covered by MSP (for those with a BMI >30 or a BMI between 27 and 30 and a weight related diagnosis). During the month of January - we will be posting about the foundational behaviours for sustainable weight management - stay tuned. If you would like to learn more about the S3 program and whether you are eligible please check out our Sustainable Weight Management program page. (Part of our January series on S3 Weight Management - Systematic, Stratified and Sustainable) Most often when we think about food, we think energy to fuel us: carbohydrates and fat; or we think about protein to build us up; but one of the most important, and all too often over-looked component of our food is one that we don't even absorb. I'm talking about fibre. OK, sure we think about fibre when we are constipated, but really, fibre does much more than provide regular bowel movements. It is estimated that only 3% of the population eats the recommended fibre intake of 30 g per day - compare this to protein where 97% reach the daily recommendation. Yet we hear so much more about protein. Getting enough fibre is one of the most powerful habits for sustainable weight loss.  Fibre is the fuel of our gut microbiome. The bacteria that live in our gut have been called "the forgotten organ" - they weigh more than a kidney and they may be more metabolically active than our livers.
Healthy bacteria in our guts feed on fibre and in the process create short-chain fatty acids (SCFA's) These fatty acids can be used as fuel: in fact, 10% of our caloric intake comes from SCFA's including 60-70% of the fuel our colons use. In addition to their role as fuel, SCFA's are important messengers and play a key role in hunger, appetite, satiation, fat and glucose metabolism. SCFA's bind to receptors in the colon and fat cells to affect ALL the major hunger hormones
SCFA's have powerful effects on fat metabolism
SCFA's also improve blood glucose regulation by
Simply put, eating more fibre will increase circulating SFCA's resulting in:
Even the inert aspects of fibre are important, eating a meal with significant fibre will:
Bottom line - maintaining adequate fibre in your diet is one of the best ways to lose or maintain weight. Looking at this another way, one of the worst aspects of highly processed foods is the removal of fibre. In 2019, Kevin Hall et al demonstrated that ultra processed foods is not as satiating and resulted in extra food consumption of 500 calories per day! Where is the best place to get fibre?
For other posts in this series:
On January 22nd - we will launch a new group program - fully covered by MSP (for those with a BMI >30 or a BMI between 27 and 30 and a weight related diagnosis). During the month of January - we will be posting about the foundational behaviours for sustainable weight management - stay tuned. If you would like to learn more about the S3 program and whether you are eligible please check out our Sustainable Weight Management program page. (Part of our January series on S3 Weight Management - Systematic, Stratified and Sustainable) In the past year - one of the hottest health trends has been intermittent fasting and one it's most commonly used variants - time restricted eating. A recent New England Journal of Medicine article highlights the physiology of fasting as well as the potential benefits. Two years ago on the Better Blog we wrote on "Why time restricted eating makes sense (and maybe you should try it) which provides much of the scientific evidence for the benefits of fasting. What we want to emphasize here is something a bit different and even simpler:
 Why is this important?
From a weight management perspective - the simplest answer is that you will eliminate the empty or extra calories of night time snacking...and that might be all that there is to it. But I do think there is more; our bodies follow a diurnal rhythm that very closely follows a 24 hour light dark cycle. During the light part of the cycle, many genes are activated, while others are turned off, preparing our system for what is expected during the day:
During the dark part of the cycle, genes that were activated in the day get turned off, and others get activated, again in the effort of setting our system up for the expected activities
Up to 40% of our genes are affected by the diurnal rhythm - many by light, but some by the presence of absence of food. Putting this more simply, our bodies expect food in the daytime and fasting in the evening - evolution has designed us this way. Other benefits from going 12 hours without food is that it will improve metabolic flexibility - that switch that allows the body to go from utilizing stored carbohydrates to burning fat. If we want to lose weight, we obviously need this flexibility. In our thinking, we don't really think about going 12 hours a day without food as being a form of intermittent fasting - we think it is normal (and optimal) human behaviour. It is most likely what most of our grandparents did and it is certainly what you see in traditional societies. Consistently going 12 hours without food will likely provide many of the demonstrated benefits from intermittent fasting:
If you are interested in intermittent fasting, starting with 12 hours without food is the logical first step. We recommend that before starting IF, you have these foundations in place:
After 4 to 6 weeks extending the fast is something you can explore. The one major caveat to this is really important - if you are taking medications - please check with your doctor and come up with a plan before you start any time of fasting or time-restricted eating. For other posts in this series:
On January 22nd - we will launch a new group program - fully covered by MSP (for those with a BMI >30 or a BMI between 27 and 30 and a weight related diagnosis). During the month of January - we will be posting about the foundational behaviours for sustainable weight management - stay tuned. If you would like to learn more about the S3 program and whether you are eligible please check out our Sustainable Weight Management program page. (Part of our January series on S3 Weight Management - Systematic, Stratified and Sustainable) If you are trying to lose weight - here is a very simple rule - stay hydrated and do not drink your calories.  As Dr. Yoni Freedhof put it recently - "Drink only the calories you love", we might add "Learn to live water!"
Satiate your thirst with clear liquids - water, green tea, black coffee, seltzer. Drink when thirsty and then some. You’ll know your hydration level as the lighter your urine, the more hydrated you are! Liquid calories are always extra - they do not fill you and do not register in your brain’s satiation centre. Most calories in drinks come from either sugar or alcohol - and neither will help you with your goals. As with food, bio-individuality also applies to the amount of water our bodies need to function properly. On average men should ingest about 3.7 liters and women about 2.7 liters of water each day. This may seem like a lot, but this includes water that we get from our food, which accounts for an estimated 20% of water consumed daily. Try these tips and tricks for staying well hydrated!
For other posts in this series:
On January 22nd - we will launch a new group program - fully covered by MSP (for those with a BMI >30 or a BMI between 27 and 30 and a weight related diagnosis). During the month of January - we will be posting about the foundational behaviours for sustainable weight management - stay tuned. If you would like to learn more about the S3 program and whether you are eligible please check out our Sustainable Weight Management program page. (Part of our January series on S3 Weight Management - Systematic, Stratified and Sustainable) The simplest and most profound change you can make for your health is to eat real food or put another way:
Simply put - our bodies were not designed for the processed foods of modern life.  As with most most behaviours there is an evolutionary mismatch between what the environment that we evolved into and our modern world.
From an evolutionary perspective we are omnivores and were hunter/gatherers until about 10,000 years ago. Our bodies are designed for nutrient dense but calorie poor foods with lots of fibre NOT nutrient poor, calorie dense, fibre free processed food. This change in foods hijacks our appetite control and leads to overconsumption. This phenomena was best illustrated by the 2019 Kevin Hall study that showed people over- eat by over 500 calories per day on an ultra processed vs whole food diet. The combination of excess calories, high fat, and high refined carbs (or sugar) sets you up for insulin resistance (IR) - the process underlying Type II DM - where your body produces increasing amounts of insulin to store the same amount of glucose. Insulin is a storage hormone - so high levels lead to increased fat storage and decreased ability to burn fat. In effect with insulin resistance you get one-way fat storage - ‘a moment on your lips, forever on your hips’. So processed foods—-> overconsumption ——> weight gain —-> insulin resistance ——> weight gain - a truly viscous cycle. Fortunately we can stop this cycle by eliminating/reducing the processed foods, refined carbohydrates, added sugars by eating real foods What is processed food? (Food Engineering Definition)
What is processed food? (Nutritional Definition)
Applying the 'better' mindset and decreasing the processed food in your life may be the single biggest thing you can do to take control of your health For other posts in this series: On January 22nd - we will launch a new group program - fully covered by MSP (for those with a BMI >30 or a BMI between 27 and 30 and a weight related diagnosis). During the month of January - we will be posting about the foundational behaviours for sustainable weight management - stay tuned. If you would like to learn more about the S3 program and whether you are eligible please check out our Sustainable Weight Management program page. (Part of our January series on S3 Weight Management - Systematic, Stratified and Sustainable) The first step in transforming your health and gaining control of your weight is knowing your health. Understanding whether your extra weight is caused by a medical condition OR whether your weight is contributing to a medical condition. Or put another way: Are there medical reasons why you have gained weight or why you may be struggling to lose weight?  Fortunately this is not hard - a review of your medical history, current symptoms, and a few lab tests will give you clarity.
In terms of conditions causing your weight gain the most common in our experience is insulin resistance. Insulin resistance (IR), as we have written elsewhere on this blog, is a process where, for a variety of reasons, your body requires more insulin to store the same amount of glucose. These reasons include age, genetics, sedentary lifestyle, poor diet (high in CRAP - calorie rich and processed foods), stress and sleep disorders. IR can cause weight gain because high levels of insulin suppress your ability to burn fat. In turn, weight gain worsens IR. This vicious cycle is common, and left unchecked leads to progressive weight gain, metabolic syndrome, pre-diabetes, and diabetes. Fortunately IR is reversible - using the 4 + 2 Strategy - and this reversal generally leads to significant and sustainable weight loss. Other conditions that can lead to weight gain that can be ruled out include inflammation, liver disease, thyroid dysfunction, and abnormal sex hormones. Pairing this medical assessment with a behavioural review to understand how your core behaviours - nutrition, movement, sleep, stress tolerance, relationships and purpose - are affecting your health is the KEY to unlocking the right strategy for weight loss. From a sequence perspective - we start with getting the behaviours right and addressing any medical cause or consequence of weight gain. For most people - this simple alignment of behaviour with their health, combined with the ‘better’ mindset is all that needs to be done. Simple, but not easy. The right behaviours are all very simple - they are unfortunately not all easy to apply consistently, and it is consistency over time that delivers results. Over the next few weeks we will review the foundational behaviours of health and some tips and tricks to apply the ‘better’ mindset to change you habits one small change at a time. For other posts in this series: On January 22nd - we will launch a new group program - fully covered by MSP (for those with a BMI >30 or a BMI between 27 and 30 and a weight related diagnosis). During the month of January - we will be posting about the foundational behaviours for sustainable weight management - stay tuned. If you would like to learn more about the S3 program and whether you are eligible please check out our Sustainable Weight Management program page. Many of you have learned the hard way - diets do not work. Most diets are temporary and highly restrictive programs of eating pursued purely for the purpose of losing weight and are unfortunately damaging exercises in futility. If you are going to lose weight and keep it off - you have to address the root causes of your weight gain. We believe a stratified, systematic approach is the best and most reliable approach to sustainable weight loss.  To start there are two vital questions?
If there are significant medical or behavioural reasons for your weight gain - correcting these comes first. Embracing a flexible, “better mindset”, where you seek small incremental changes in behaviour works better than a rigid, “perfect” mindset. Sustainable, lifestyle change happens one healthy habit at a time. Over time, you find that you are eating real whole food, exercising regularly, sleeping well, coping with stress, and happy and fulfilled in relationships and purpose. For many people these changes are sufficient to unlock their ability to lose weight. For others we need to go deeper. In the end, all weight loss requires becoming efficient at burning fat for fuel. Unfortunately, some people, despite good nutrition are unable to effectively burn fat: they lack metabolic flexibility. Physiological testing provides the answer to whether you are metabolically flexible and able to burn fat. If the answer is no, pursuing specific strategies to unlock your ability to burn fat comes next. If at this stage you are metabolically flexible, have healthy behaviors, and have dealt with any contributing medical issues, the next thing to examine is your resting metabolic rate as determined by physiologic testing and compare it to your actual caloric intake, ensuring that there is a sufficient deficit to ensure weight loss. Our experience along with medical evidence has shown that this type of structured, behavioral program stratified on the basis of your personal data will lead to improved health and sustainable weight loss. On January 22nd - we will launch a new group program - fully covered by MSP (for those with a BMI >30 or a BMI between 27 and 30 and a weight related diagnosis). During the month of January - we will be posting about the foundational behaviours for sustainable weight management: If you would like to learn more about the S3 program and whether you are eligible please check out our Sustainable Weight Management program page. |
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