Physician recommendations for exercise and physical activity are typically general.
However, exercise counseling based on what kind of exercise, age, chronic condition, or current level of functioning may not always be considered. Prescriptive exercise based on individual differences and level of functioning has proven effective in producing improved outcomes.
Pamela Peeke, MD, MPH, FACP a national spokesperson for the American College of Sports Medicine’s “Exercise is Medicine” campaign, says that ‘exercise prescriptions work’, and that ‘exercise prescriptions get inactive adults moving’. (Archives of Internal Medicine (April 17, 2009).
Physical inactivity ranks as the fourth leading cause of death worldwide. Unfortunately, there are factors that may challenge our healthcare providers in offering a more individualized approach to exercise counseling, such as reimbursement, time, or lack of professional knowledge in exercise programming. According to the Centers for Disease Control and Prevention (CDC), only 23.2% of adults age 18 and over meet the Physical Activity Guidelines for both aerobic and resistance activity combined. Rates of physical activity counseling by physician and other healthcare professionals still remain unacceptably low.
A 2018 published research study in Public Health Research, Practice, and Policy on Preventing Chronic Disease, looked at the percentage of deaths associated with inadequate physical activity in the United States.
To define inadequate physical activity, individuals were categorized into 4 activity levels:
• inactive – no physical activity reported in the past 2 weeks
• insufficiently active – some activity but <150 min/week of moderate-intensity equivalent activity
• sufficiently active – 150–300 min/week of moderate-intensity equivalent activity (per guidelines)
• highly active – >300 min/week of moderate-intensity equivalent activity
~~The results showed that among adults aged 40 to 69 and 70 or older, inactive adults had an increased risk of premature death compared with insufficiently active adults.
~~For adults aged 40 to 69, the difference was also significant for those insufficiently active versus sufficiently (150-300 min/week) active. (Minimum guidelines are 150 minutes/week)
~~For adults aged 25 to 39, inactive adults compared with those sufficiently active had an increased risk of premature death in the unadjusted models; however, once they controlled models for demo-graphic characteristics, that increased risk was no longer significant.
~~No significant differences between those who were highly active versus sufficiently active were observed for any age group.
GOAL: Exercise counseling on meeting the minimum guidelines to be sufficiently active.
Exercise can Boost Energy and Improve Depression
Depression is a leading cause of disability and a major contributor to disease burden worldwide.
Systematic reviews have consistently shown exercise to significantly reduce symptoms of depression.
Physical movement creates energy which is needed to function mentally and physically.
August 2020 – Exercise can improve depressive symptoms and boost energy. Depression can be debilitating. Depression impacts everything. How we eat, how we sleep, how we function, how we care for ourselves, if we care for ourselves. Depression tends to make us want to isolate as it takes energy to converse or ‘put on a happy face’ for the sake of others. During this time of a worldwide pandemic which also isolates, it’s a double whammy for those living with depression. It’s common to get into a pattern of nothingness, of watching TV to distract our minds from whatever is depressing us and putting off the important things until ‘tomorrow’.
As many of us know from experience, ‘tomorrow’ can be even more depressing because there’s so many things to do from yesterday! Feeding the cycle of nothingness comes a lack of physical energy to do anything. I struggle with my own journey with depression. Ironically, procrastination and avoidance of doing things actually feeds my depressive symptoms. A disorganized, and cluttered surrounding feeds my disorganized and cluttered mind and drives me to the couch! I just gave away a sofa that had a nicely formed Netflix dip in the middle. Ready for the next depressed person!
Joking aside, I recognize what stops me in my tracks and by doing something I start to gain more control over the depression that wants me to stop living.
What might stop you in your tracks? Symptoms of depression may include:
- having trouble concentrating
- having trouble remembering things or even making decisions
- fatigue and lack of energy
- feelings of hopelessness or negativity
- feelings of worthlessness and helplessness
- if you find yourself sleeping too much, or difficulty sleeping at night, restlessness and irritability, you may be depressed
- loss of interest in things you once enjoyed is also common, as is persistent sadness, anxious, maybe crying often and sometimes for no apparent reason
- lastly and most importantly are suicidal thoughts and attempts
The one constant thing I’ve always done in my life and remain to do to help manage depression is exercise.
‘How can I exercise if I don’t have the energy or desire to do anything?!’ Listen, there’s days I don’t exercise and what I’ve learned is to not beat myself up about it. But those are just days, not a lifestyle of no physical activity or exercise. The hardest step is the first one. Literally and figuratively speaking. When you choose to go outside for a walk, or some other type of physical activity like working in the garden, that’s YOU taking control over your depression. Sometimes it’s just not enough to read an article and start walking. If you’re anything like me the ‘experience’ of feeling the difference exercise makes is what keeps me choosing to exercise.
Energy is needed for everything we do, even the smallest of things. Seems the less we do the less energy we have, not more. Depression is not a ‘rest stop’ is it? How does the body make energy then? Dr. Cathy Maxwell, an Aging and Frailty Researcher, describes it as our ‘energy engines’, the part of the cell that makes mitochondria, or energy. As we age, we start to lose physical strength and endurance from less production of our energy engines. Our ‘used’ energy engines are removed from the body over time and we can make new ones, at whatever age!
The way we make new energy engines is to create a demand for them. The demand is physical activity and movement. The added energy zapper of depression makes it harder to find the motivation to move. Perhaps we should ‘move anyway’. Sometimes when I’m feeling down and have little energy, I put on my running shoes and head to the front door. IF I make it to the front door I head outside and just start walking. As I start walking, I begin to feel a little more energy and my desire to keep going increases and soon I find I’m running. Choose whatever kind of physical activity that you enjoy, and it may not feel like a chore.
The more we move the more demand we are creating
and the more energy engines our body makes as a result!
We know from research and systematic reviews that regular exercise significantly reduces depressive symptoms for individuals with depression. As a matter of fact, in light of such evidence, depression is the only mental health disorder in which exercise is recommended as an evidence-based treatment in clinical guidelines. Exercise recommendations for those living with depression is based on the best available evidence acknowledging that personal fitness and current and past activity levels also be considered. Check with your physician if you haven’t exercised before. Consider regular exercise spread throughout the week up to at least 150 minutes a week, if not more, of aerobic activity like walking or cycling. Moderate-level intensity such as walking at a pace you can talk but not belt out a show tune is a good guide! Start out slow however maybe 2-3 days a week and work up to 3-5 days a week of 150 minutes or more a week.
Exercising regularly will help lift your mood regularly. Regular exercise may improve your ability to concentrate, provide the mental energy for motivation, better sleep, and God forbid you might even find yourself giggling over something silly! I know what living with depression is like. I know you do too. I also know that physical activity, movement, exercise brings immediate and long-term improvements in mood and better handling of daily living. It will for you too. MyFitScript has a FREE muscle strengthening exercise program that you can do inside, or a walking program you can do outside.
Depression can be debilitating, as we said in the start of this article. However, it doesn’t have to be.
No one can make you do anything you don’t want to do.
So, don’t let your depression tell you what to do.
For FREE exercise programs click here and visit: Did You Know? our Monthly Feature box
July 2020 – Having a strong immunity during the coronavirus pandemic for prevention and recovery is critical. As we continue to look for ways to stay active at this time our choices are limited and exercising at home has become a convenient and healthy choice versus nothing at all. Muscle strengthening exercise can easily be done at home and MyFitScript™ has multiple programs based on chronic disease and age. If you already have a program or routine you follow that’s great! There are many valuable benefits and outcomes we can expect from muscle strengthening exercise.
Muscle strengthening exercise, also called resistance exercise, is an essential component of any exercise program, especially in older adults. There is a consistent decrease in muscle mass of 3-8% every decade beginning at about age 30. With a steady decline in muscle mass comes a decline in muscle strength, functional ability for everyday activities, and frailty leading to possible premature death.
The goals of engaging in resistance exercise include the following:
- Increase lower and upper body strength – having greater body strength takes pressure off the cardiovascular system and therefore lifting, walking or climbing stairs may become easier with less effort.
- Increase and prevent loss of lean muscle mass – improved muscle strength is dependent on maintaining lean muscle mass. Exercise helps preserve lean muscle mass.
- Improve balance and decrease risk of falls – strong muscles help support joint stability and balance that may decrease the risk of falls.
- Improve ability to perform activities of daily living – being able to take care of your self and remain independent is critical to continue living at home. Building muscle strength and endurance can improve selfcare!
Lets look at some of the many benefits of muscle strengthening exercise:
- Improves insulin sensitivity – exercise is especially helpful for those with diabetes. Exercise improves glucose control and may decrease the amount of insulin needed.
- Helps to decrease and control weight – by preserving lean muscle mass, which burns calories.
- Weight bearing exercise helps increase bone density and strength – strong muscles strong bones!
- Helps lower blood pressure – strength training for lowering blood pressure works best when combined with aerobic exercise like walking, swimming, or cycling.
- Helps maintain mobility and function – most age-related loss of muscle function is due to decreased levels of physical activity.
Resistance exercise for muscle strengthening can be effective in assisting older adults in regaining muscle mass. In order to build muscle strength you must work against some type of resistance. There are many different ways to do this to include weight machines in a fitness facility. At home however, you can use free weights, exercise bands and tubes, your own body weight, or even what’s in the kitchen cabinets! Grab a couple cans of beans and do bicep curls! Get up and down from a chair 10 times to build leg strength! Remember to consult your physician before beginning an exercise program.
For a free resistance exercise program visit www.myfitscript.com
June, 2020 – Moderate-intensity physical activity can boost the immune system. The immune system is designed to help keep us free from the risk of infection and disease. Having a higher cardiorespiratory fitness level and performing regular exercise of moderate intensity that fall within ACSM guidelines has been shown to improve immune responses.
Like many of you, I’ve been listening to the experts and trying to absorb the reality of the COVID-19 virus and it’s impact on the safety of ourselves, our friends, families, and the world. It’s easy to crawl into a deep black hole and only come out when we think the air is safe to breathe. However, I’ve also been listening to the experts on physical activity and health… ‘hey I thought you were an expert…” you might be thinking, I am, but I’ve come to find out I’m not the only one!
In a recent article released by Richard J. Simpson, Ph.D., FACSM, he reminds us that moderate-intensity physical activity can boost the immune system. Moderate-intensity exercise can be described as an activity that would burn off 3 to 6 more times more energy than if you were watching Netflix from your deep black hole we mentioned above. An example might be a brisk walk at about 3 to 4 miles per hour. Any activity that raises your heart rate a little, causes you to breathe a little harder but enough to have a conversation. If you can’t finish a sentence then you’re walking too fast or too hard. Or, you’re walking with someone who talks too much.
The immune system is designed to help keep us free from infection and disease. Having a higher cardiorespiratory fitness level and performing regular exercise of moderate to vigorous-intensity that fall within ACSM guidelines has been shown to improve immune responses. Some of those immune responses include improving various immune markers in several disease states like cancer, HIV, cardiovascular disease, diabetes, cognitive impairment and obesity.
- Exercise can boost our immune system.
- By boosting our immune system, exercise can help protect us from infection.
- COVID-19 is an infection.
Another unfortunate consequence of the COVID-19 virus is the negative effects of social isolation and confinement on the immune system. Stress. The hormone cortisol is also referred to as the ‘stress hormone’ and can be elevated during this time of isolation. I know it well because it’s the cause of my belly fat right now. I know it’s not the pizza! When we are stressed our body’s ability to respond to infectious agents is reduced. It’s also important to minimize the impact of the COVID-19 virus and to speed up recovery should we become infected.
Here’s why we talk about the importance of regular exercise. Each time we exercise, especially cardiorespiratory exercise (walking, cycling, running…) we instantaneously mobilize billions of immune cells that are capable of carrying out functions such as the recognition and killing of virus-infected cells.
The immune cells that are mobilized with exercise are ‘looking for a fight.’ These cells are frequently recirculating between the blood and tissue functions to increase immune surveillance. This in turn is thought to make us more resistant to infection and better ‘armed’ to deal with any infectious agent that has gained a foothold on our immune system.
Young or old, the virus does not discriminate. Nor does the impact of exercise.
“Exercise is especially beneficial for older adults who are more susceptible to infection in general and have also been identified as a particularly vulnerable population during this COVID-19 outbreak.” Richard J. Simpson, Ph.D., FACSM.
Exercise may not prevent us from becoming infected if exposed, but it is likely that staying active will boost our immune system. Boosting our immune system can help minimize the effects of the virus, improve our symptoms, speed up recovery times, and lower the likelihood that we can infect others.
Right now we have restricted access to fitness facilities and gyms and no one really knows for how long.
Perhaps this is a time to rethink how we live, work, play, and exercise. Walking can be done in an open area or neighborhood and making sure that you stay clear of others. If you are walking and come across another walker simply keep your distance at 6 feet or greater. T he MyFitScript prescriptive exercise programs are ACSM guideline-driven and the strength-training component is designed for home use. The exercises can be performed with weights, even using your body for resistance, or items of weight like books, soup cans, water-jugs. Yeah I know, it sounds silly but it works! Weight is weight. Just lift it, push it, and pull it.
Keep yourself safe, and fit, and let’s fight this COVID-19 together.