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Recent Weekly Well Newsletters

Get 150 minutes of exercise a week

1/17/2020

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(Part of our 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.
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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:
  • 21–25% of breast and colon cancers
  • 27% of diabetes and 
  • 30% of heart disease burden
(From: Global health risks: mortality and burden of disease attributable to selected major risks. Geneva, World Health Organization, 2009)

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:
  • Improved sense of well-being
  • Improved self-esteem
  • Increased strength
  • Increased energy levels
  • Improved mood
  • Decreased depression and anxiety symptoms
  • Decreased stress
  • Improved immune function
  • Lower blood pressure
  • Improved glucose levels
  • Improved cholesterol levels
  • Improved bone density
  • Decreased symptoms from arthritis

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:
  1. Do something aerobic most days - improve cardiovascular fitness
  2. Do resistance training some days - maintain/build muscle and strength
  3. Do functional movement work some days - maintain/improve functional movement

Some ideas from Participaction: ; 
  • Join a weekday community running or walking group
  • Go for a brisk walk around the block after dinner. 
  • Take a dance class after work.  
  • Bike or walk to work every day.  
  • Rake the lawn, and then offer to do the same for a neighbour.  
  • Train for and participate in a run or walk for charity!  
  • Take up a favourite sport again or try a new sport. 
  • Be active with the family on the weekend!

Pick a time. Pick a place. Make a plan and move more.

For other posts in this series:

  • S3 Weight Management - A systematic, stratified and sustainable approach
  • Taking the First Step
  • Eat Real Food
  • Hydration without calories
  • Go 12 hours a day without eating
  • Get lots of fibre (from real foods)​
​
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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High Blood Pressure - 7 ways to take control

5/10/2018

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50% of Americans have high blood pressure according to the new guidelines from American College of Cardiology and the American Heart Association.

Lost in the debate about whether this makes sense to label so many people with a disease was the recognition that normal blood pressure is now defined as 120/80 and the acknowledgement that the risks from blood pressure increase progressively, and linearly from levels as low as 115/75 in people from 40 to 89 years of age.  

For every increase of 20 mmHg systolic and 10 mmHg diastolic there is a doubling of mortality from both heart disease and stroke. 

Here is the Wellness Garage strategy for high blood pressure:

1. Know your blood pressure:
  • be confidant that your blood pressure is normal. 
  • If you get high readings in the doctor's office - get an automated BP cuff for home.
  • If your doctor is not using an automated cuff - ask her why?  New guidelines are clear that physicians should be using automated cuffs.
  • If your arm is large be sure to have a large cuff - make sure the doctor uses a large cuff.

2. Know whether you have insulin resistance:
  • if your blood sugars are abnormal then you already have insulin resistance
  • if your blood sugars are normal and you have abnormal lipids (high triglycerides and low HDL) and a waist size of >102 cm (40 in) in men or >88 cm (35 in) in women - you likely have a degree of insulin resistance
  • insulin resistance disrupts one of the key hormonal systems regulating BP - the Renin-Angiotensin system (RAS)
  • if you have insulin resistance - decreasing carbohydrates through a low carb, whole food approach makes the most sense - see #3
  • if you are diabetic these changes should be medically supervised

3. Get moving - exercise is key
  • aerobic exercise has been shown to lower BP 5-7 mmHg 
  • resistance exercise lowers BP 2-3 mmHg
  • these effects rival first line drug therapy and lower risk by themselves 20-30%
  • recent evidence shows that exercise is superior to drug therapy in preventing death from stroke and is equal to drugs in prevention of heart disease mortality.
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4. Eat better - lose weight
  • optimizing your nutrition to lose weight makes a big difference - real whole foods with adequate protein, healthy fats and low glycemic carbodyrates. 
  • studies show that in overweight or obese people a weight loss of 8kg will lower BP by 8.5 mmHg systolic and 6.5 mmHg
  • these effects rival drug therapy and are though to be independent of exercise

5. Salt - stop eating packaged food and decrease how much you eat out - see #3
  • for years the linkage between salt (sodium) intake and elevated BP has been clear and part of the established recommendations for preventing and treating hypertension
  • more recently this has been challenged on at least two fronts
    • there is great variability between people on the basis of race, gender, age and dietary factors - resulting in the observation that some people at some times are salt sensitive - meaning that their BP increases with salt intake.
    • there is little convincing evidence to link decreased salt intake over time with better health outcomes.
  • our advice is to start by eliminating the real culprits in the high salt world we live in - restaurants (especially fast food) and packaged food.  Eating real whole foods that you prepare yourself will result in a significant reduction of salt intake and will help with #3. 
6. Reduce Stress - meditate
  • there is growing empirical evidence that the exposure to chronic psychological stress leads to the development of high blood pressure
  • while many relaxation therapies are recommended and are effective in reducing stress, so far only meditation has been shown to reduce stress and lower blood pressures
  • learning to meditate has never been easier with the introduction of apps like Headspace and Calm - finding 10-15 min per day to meditate will reduce stress and help you improve your blood pressure

7. Sleep - develop a great sleep routine
  • depriving people of sleep in the short-term clearly increases blood pressure
  • chronic sleep deprivation of < 5hrs per night doubles the risk of hypertension, while 
    • insomnia and restless leg syndrome have also been shown to increase incidence of high blood pressure
  • if you snore regularly or stop breathing during the night -see you physician and get assessed for Obstructive Sleep Apnea
  • develop a great sleep routine - get 7-8 hrs of high quality sleep

This 7 step strategy will allow you to take control of your blood pressure and do everything you can to either avoid medication or take as little as possible.
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Backgrounder on Hypertension:

What is it?
  • When your heart beats, blood is pushed through your arteries and veins.  The pressure the blood exerts on the walls of the artery is appropriately called blood pressure (BP) - systolic BP represents the pressure during the heart's contraction phase, diastolic BP the pressure during the relaxation phase, and BP is recorded as systolic/diastolic.  Blood pressure is controlled by two variables: the amount of blood pushed out of the left ventricle of the heart (cardiac output) and the resistance of the circulatory system to the flow of blood (peripheral resistance). This resistance is managed through complex mechanisms mediated by our autonomic nervous system that dilate or constrict our blood vessels.  At the same time our blood volume is adjusted by our kidneys with the retention or excretion of salt and water.  
  • Blood pressure, like all of our physiology is homeostatic - meaning that stability is generated through a balance or equilibrium of seemingly competing systems.

How is it defined?
  • Blood pressure is measured in mm of mercury (Hg). The American College of Cardiology and the American Heart Association recently released new guidelines (2017) that will increase the number of people diagnosed with hypertension to over 50% of the US population.
    • Normal - systolic < 120 AND diastolic < 80
    • Elevated - systolic between 120-129 AND diastolic < 80
    • Stage I Hypertension - systolic between 130-139 OR  diastolic 80-90
    • Stage II Hypertension - systolic greater than 140 OR diastolic greater than 90
    • Hypertensive crisis - systolic >180 OR diastolic >120
  • These guidelines reflect evidence that normalizing blood pressure to a target of 120 decreases risk significantly.

Why is it important?
  • Left uncontrolled high blood pressure can damage your arteries, increasing the risk of atherosclerosis, a disease where plaque builds up in the wall of your artery narrowing blood flow, and potentially blocking flow completely through plaque rupture or extreme narrowing and occlusion.  Atherosclerosis has multiple outcomes depending on the arteries affected:
    • in the arteries of the heart: angina (chest pain)  and myocardial infarction (MI or Heart Attack),
    • in the brain: stroke, from blockage or bleeding
    • in the kidneys: kidney failure
    • in the aorta (and other vessels) - ballooning (aneurysm) or rupture
  • Hypertension also can damage the heart, initially causing the heart muscle to expand and the heart to dilate (Left ventricular hypertrophy and dilatation) resulting in heart dysfunction and congestive heart failure
  • In addition to damaging the larger arteries of the kidney - hypertension damages the glomeruli - the small blood vessel clusters that are the filtration units of the kidney; and as a result of the effect on both the large and small arteries, hypertension is one of the most common causes of kidney failure.
  • These same effects to small blood vessels also damage the blood vessels of the retina (retionopathy) resulting in vision loss and even blindness

What causes it?
  • Most hypertension is from causes unknown and is characterized as primary hypertension.
  • The risk factors for primary high blood pressure are:
    • family history
    • age
    • race
    • obesity
    • physical inactivity
    • kidney dysfunction
    • high sodium diets
    • excessive alcohol
  • Causes of secondary hypertension
    • Medications - oral contraceptives, anti-inflammatories, antidepressants, decongestants being among the most common
    • Drugs - cocaine, metamphetamine
    • Kidney failure 
    • Endocrine disorders - both hypothyroid and hyperthyroidism and a multitude of other more rare.
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    Author

    Dr. Brendan Byrne

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