Body & Mind
2016
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ow that you’ve dieted to your goal weight you’re breathing a sigh of relief as you anticipate returning to normal eating. Don’t let your guard down. The real challenge – maintaining your weight loss – is just beginning. “Weight loss is easier than weight maintenance,” says Dr. Taraneh Soleymani, assistant professor, departments of nutrition sciences and medicine, co-director, UAB Weight Loss Medicine, University of Alabama at Birmingham. Unfortunately, everything from your food environment to your altered metabolism primes you to regain weight. However, if you know the pitfalls you can be prepared to face and overcome them. Here are five things you could be doing to sabotage your success and how to avoid them. 2
Body & Mind | January 10, 2016
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FOOLPROOF STEPS TO KEEP OFF WEIGHT
EATING TRIGGER FOODS AGAIN
Conventional wisdom says all foods are OK in moderation. You’re counting on it. Maybe you even keep a list of foods you’ve been craving. But if you couldn’t control yourself around certain foods before, what makes you think you can now? “I don’t agree with the idea that you can eat everything in moderation,” says Dr. Stacey Cahn, Ph.D., associate professor of psychology, Philadelphia College of Osteopathic Medicine, Philadelphia. The problem is that people overindulge in their favorite foods after they lose weight and tend to regain the weight, according to Michael R. Lowe, Ph.D., professor of psychology at Drexel University, Philadelphia, Pa. Does this mean you’ll be deprived forever?
No, says Lowe, an expert on eating disorders and obesity. Instead you have to be sparing in your splurges. If apple pie is your downfall, don’t bring a pie home. Enjoy a slice in a restaurant on occasion, Lowe says. You could also embrace a healthier alternative. “Find a snack that becomes your new potato chip. Maybe sugar snap peas satisfy your itch for something crunchy,” Cahn says.
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EATING A VARIETY OF FOODS
The problem with an abundance of food choices is that you don’t get tired of the taste and are more likely to overeat, according to research in the Psychological Bulletin, from the American Psychological Association. So, it stands to reason that taking the opposite approach could be beneficial. Consuming a relatively unvaried diet is a common tactic among successful dieters who are part of the National Weight Control Registry, a long-term study of people who lost considerable amounts of weight and kept it off for significant periods of time. To make limited choices work for you, develop habits that make it easier to stick with the same foods. For example, if you decide you’re going to have a salad every day for lunch, make it the night before, Cahn says. That way you won’t be distracted by other more caloric options. And, stay away from buffet tables.
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EXPECTING SATIETY CUES
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LETTING DOWN YOUR GUARD
Remember how your body used to signal that it was full? It might not get the message after you’ve lost weight. “Hunger and satiety hormones completely change after losing weight. It takes more to make you feel full,” Dr. Soleymani says. You’ll have to find ways to trick your body into feeling full on fewer calories. Diet experts suggest filling up with more highfiber foods and low-calorie fruits and vegetables. You can load your salad plate with a cup each of sliced cucumber, shredded romaine and a small tomato for about 50 calories.
Your body got used to a higher weight and would like to get back there, according to Lowe. “Research suggests that the BMI [body mass index, based on your weight and height] that we reach and maintain for a year or two becomes our set point,” he says. This isn’t inevitable. The key to keeping weight off is to “truly accept it as a lifestyle change,” says Dr. Soleymani. That includes staying on a low-calorie diet, not skipping meals, weighing in consistently, whether daily or weekly, and finding peer support, according to the physician. © CTW Features
THINKING YOU CAN EAT NORMALLY
You burn a certain number of calories a day based what your body requires to function and your level of physical activity. Unfortunately, those calorie requirements decrease after you lose weight, according to Dr. Soleymani. You’ve most likely lost muscle mass along with pounds and your metabolism is down. The bottom line: “You can’t consume the same number of calories you did before weight loss,” Dr. Soleymani says. However, you can compensate by exercising more. Ninety percent of the participants in the weight control registry exercise and they put in about an hour a day. Boosting your exercise regimen could prevent a reduction in the energy (calories) your body needs, according to research in the journal Medicine and Science in Sports and Exercise. The Arizona Daily Sun
EVALUATING YOUR COPING STRATEGIES
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ften times stress can become a barrier to a healthy lifestyle. Not only can it interfere with your daily life, but the way you deal with it can impact your overall physical and mental well-being. Keeping stress under control in a healthy way can help improve your health and prevent future problems. Take a few minutes to evaluate how you deal with stress. Think about short-term, high stress situations, as well as everyday worries. What did you find? Do you tend to yell or become aggressive? Eat too much or too little? Smoke? Avoid people? Drink? Shop? Or do you tend to talk it out with a trusted friend? Listen tow music? Read a book? Exercise? Meditate? Create an action plan you can stick to? Or seek out counseling? All of these are coping strategies that people use to deal with stress. Some are healthy and others are unhealthy. Some are okay once in a while, but can be harmful if used consistently for a long period of time. When considering your personal strategies for managing stress, think about
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how effective your techniques are for making you feel less stressed, better or more full of life, and for how long this improved feeling lasts. Also, are there any negative consequences to your strategies? If so, this could indicate unhealthy ways of managing stress. Certain behaviors are helpful indicators of how well you handle stress. For example, if your method involves yelling, becoming aggressive or avoiding people, over time that will interfere with relationships, potentially leading to additional stress. Many people use alcohol or drugs to deal with their problems. Drinking alcohol, smoking or taking drugs to “escape it all,” may be effective temporarily, but it can be difficult to maintain that “escape” without continuing to drink or use. This can lead to dependence or addiction, particularly if you find you need more of the substance in order to maintain the “good” feeling. The good news is that it is possible to incorporate healthy coping skills at any time. You can begin to replace unhealthy
strategies with positive ones. Taking care of your physical health is one of the best ways to keep stress low and to be able to manage it when it happens. Some additional stressrelieving ideas include: go on a hike, write a story, sing, study the sky, play with a pet, hug a pillow, draw a picture, create or build something, make a list of what you are grateful for, watch a funny movie, etc. While you have a choice in how to respond to stress, sometimes it becomes difficult to manage and although you already use healthy strategies, you still struggle. Luckily there are several options to help you manage life’s stressors, including counseling. A counselor can provide support, helpful tips, as well as an overall new way of looking at things. If you find you have more stress than you can handle, contact a local counseling center for help. A support network or professional counselor can not only help you manage life’s challenges, but can help you establish and practice positive ways to cope with stressful situations in the future.
January 10, 2016 | Body & Mind
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Chronic back pain conditions the brain to make you hurt even after you’ve started to heal, but you can break the cycle By Dawn Klingensmith CTW Features
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Body & Mind | January 10, 2016
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o one who suffers from chronic back pain wants to be told, “It’s all in your head.” But in a literal sense, it is. Even after the soft tissues in the back have begun to heal, the brain produces ongoing pain and assigns it to the back. That’s because the initial back injury sets off “pain impulses” that form neurological pathways over time, and once those pathways are in place, they are there for good, says Seattle-based orthopedic spine surgeon Dr. David Hanscom, author of “Back in Control” (Vertus Press, 2012). Because stress plays a role in carving these pathways, treatment programs for chronic back pain had best include a stress reduction component, he adds. Chronic stress typically accompanies and exacerbates chronic pain by activating pain receptors in the brain. Stress sends the body into fight-or-flight mode, releasing a surge of adrenaline
and ratcheting the nervous system as a whole into a “heightened state,” says San Diego-based corrective exercise and biomechanics expert Justin Price. This, in turn, causes muscle tension, which the brain reads as pain because of those previously established, ineradicable pathways to its receptors. The process is similar to an athlete or musician mastering a technique through repetition, except the brains of chronic back pain sufferers “learn” that any signals it receives from the nerves in the back warrant a pain response. And the more stress hormones surging through the body, the worse the back will hurt because “more lights in the brain light up,” amplifying the pain, Price says. Although pain pathways are “permanent, etched-in and deep,” according to Hanscom, it is possible to develop new pathways and redirect nerve transmissions. It involves identifying and addressing the stressors that increase the perception of pain, which may require talk therapy for some people, Price says. However, the starting point for most people is getting more sleep. It’s easier said than done. “Most patients with chronic pain sleep poorly and are tired during daylight hours,” and without sleep, “quality of life is compromised and day-to-day stress and pain are harder to handle,” Hanscom says. In this compromised state, “The perception of the pain increases,” he adds. To alleviate back pain in bed, people who sleep on their back should place a large pillow under their knees to prevent overarching, while side sleepers should place a long pillow between their legs so the knees are about hip-width apart “to protect the natural spinal curve,” says Samantha Traylor, a chiropractor, physical therapist and acupuncturist at Lumin SpineCARE in North Texas. Sleep is so critical to reducing stress and rerouting the brain’s circuitry that Hanscom recommends the use of medication for people who
are kept awake by pain or anxiety. Once patients are sufficiently rested, Hanscom prescribes a writing regimen to further distance them from their pain. The object is to write down negative thoughts and then immediately destroy the paper. To keep a journal is to hold on to those thoughts, so journaling is counterproductive, he says. In Hanscom’s program, physical rehabilitation starts only after patients feel consistently rested, and their anxiety and anger have abated. Patients start working with a physical therapist if necessary and are encouraged to begin light weight training and gentle, low-impact exercises like walking or swimming. “You need mental as well as physical strategies to deal with chronic pain,” Price agrees, and there’s a range of physical approaches that people swear by. But there is no one-size-fits-all strategy, and none are effective if they cause or accompany stress or frustration. For example, “You have to be careful about the types of exercise you introduce because high achievers always strive to do more and be better, and those people will overdo it and perhaps make things worse,” says Price, author of “The Amazing Tennis Ball Back Pain Cure” (The BioMechanics, 2013). Massage isn’t for everyone because some people feel uncomfortable disrobing and are unable to relax. And a person can set up the most ergonomic workstation possible yet still experience back pain if their job is constantly stressful. There are people whose back pain is caused by an underlying structural problem requiring injections, surgery or some other medical intervention. Chronic back pain sufferers generally don’t fall in this category, but they should see their physician to rule out a spinal injury as the cause. After all, peace of mind is a large part of beating chronic back pain. © CTW Features
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High intensity interval training (HIIT) can do more for your body in less time. What’s not to love? By Dana Carman CTW Features
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itness trends, like fad diets, come and go and, often times, come around again. Still among one of the hottest trends for the second year, according to the American College of Sports Medicine’s annual survey of fitness trends, is HIIT, otherwise known as high intensity interval training, which is short periods of intense exercise followed by slower recovery periods done in repetition. While the science behind HIIT is more recent, the method has actually been around for quite some time. (Sitting number one on that list is also a blast from the past that has risen to prominence due primarily to the popularity of CrossFit – bodyweight training. Think pushups and squats.) Why the emphasis on HIIT now? For one thing, it’s more bang for your buck. Harder, repetitive intervals followed by recovery have been shown to improve fitness gains, strengthen cardiovascular health and burn more fat than its endurance counterparts in a shorter amount of time (particularly of note is that studies show it continues to boost metabolic rate after the workout is complete). It also doesn’t require a gym or studio membership (though both things can enhance HIIT) and in as low as 20 minutes you can have a workout in which you’re affecting real change within your body. Now that’s an oldie, but goodie. The Arizona Daily Sun
NO PAIN, NO GAIN When talking about high intensity, it is typically defined in terms of a percentage of one’s peak heart rate or heart rate maximum (which is roughly 220 minus your age, though this formula is different for women. See sidebar.). There are some variations on what is considered “high intensity,” but it’s somewhere in the neighborhood of 80 to 90 percent of heart rate max. “Eighty-five percent is a good number to remember,” says Dr. Martha Gulati, director for Preventive Cardiology and Women’s Cardiovascular Health, Ohio State University Wexner Medical Center. However, Dr. Gulati notes, simply using heart rate can be tricky and not always an accurate measure of how hard someone is working. “For some people, the lower level of the zone is where they will be at high intensity because they have a resting heart rate that might be low and they may not even be able to push their heart rate to 90 percent of the age-predicted heart rate despite feeling the burn.” Similarly, she says that in contrast, some may increase their heart rate with exercise but may not be having an intense workout. “Some doctors instead rely on patients’ perceptions of their exertion level using a scale of six to 20, aiming for as high as 17, to determine how hard they can go, rather than a heart rate response.”
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Sean Bartram, author of “High Intensity Interval Training for Women” (DK Publishing, 2015) concurs that perceived effort is a good marker for whether or not you’re in the zone. “If someone asks you a question during class, you should not be able to answer them,” he says. “You may glare at them and in between gasps of air tell them to ‘Shut up and work harder,’ but if you can hold a conversation, you aren’t pushing to your max. [HIIT] demands your full commitment for the results it promises.” However, if sticking with the heart rate as an indicator of intensity, strive to work in the 80 to 90 percent zone with recovery in the 50 to 65 percent zone.
CALCULATING HEART RATE FOR WOMEN Dr. Gulati, has created a free app called “Saving Hearts,” which uses a more precise formula for predicting heart rate that she developed for women. The formula, “206 minus 88 percent of age, gives you 100 percent of your age-predicted heart rate and this formula has been validated and is better for women,” Dr. Gulati says. The app will sync to heart rate monitors so women can see what zones they’re in during workouts.
GETTING IN THE ZONE Knowing how hard to work is half the battle but for how long and with what sort of exercise is where the beauty of HIIT really lies. “You can play with recovery and workload,” says Franci Cohen, exercise physiologist and owner of Fuel Fitness in Brooklyn. “There are maybe hundreds of thousands of different combinations and ways to achieve proper training.” If that feels like the door is too wide open, rest assured there is a place to start. Some studies have shown that the shorter bursts of intensity (as in it really, really hurts), somewhere around 30-60 seconds long, followed by a minute or more of rest are most beneficial. Obviously, where one starts depends on a person’s level of fitness. While HIIT workouts can be done alone and at home if you’re already active, exercise newbies or those experiencing any health issues should see a physician before undertaking HIIT. Anyone new to the concept of HIIT may also want to try a class at the gym until you feel comfortable tackling it on your own. For one thing, it will provide motivation. Cohen points out that studies have shown that those who exercise with a partner tend to go harder than those who don’t. Additionally, mixing up workout combinations keeps things fresh and classes provide plenty of examples. Most
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Body & Mind | January 10, 2016
FEEL THE BURN
importantly, classes can teach proper form, technique and work to rest ratios, as high intensity can increase the possibility of injury. As with all things, balance is essential. Cohen recommends two to three HIIT sessions a week at most. Steady-state workouts, such as running, swimming, rowing and cycling, along with lower impact exercise (yoga, Pilates, walking, etc.) and weight training, should still very much have a place within one’s repertoire. The benefits of high intensity interval training are bona fide but that doesn’t mean that more is better. In fact, what HIIT illustrates is that you can do more with less time. Those intervals may hurt but recovery is oh-so-sweet. Your body will thank you for it all. © CTW Features
High intensity interval training can be done in any number of ways using many different types of exercise. An example might be running on the treadmill at full tilt for 30 seconds followed by four minutes of recovery and repeating that three to five times. Another might be a series of exercises in a set, such as pushups, jumping jacks, squats and in-place sprints, each performed for 15-30 seconds at maximum effort, followed by one to three minutes of recovery. Sean Bartram, author of “High Intensity Interval Training for Women” (DK Publishing, 2015), notes that the combinations are virtually endless, but that one staple in HIIT classes is the Burpee. “The Burpee is the bastion of the bodyweight fitness revolution and epitomizes what a HIIT exercise is – an explosive multiple muscle (compound) exercise,” Bartram says. Remember that attention must be paid to form so if you’re new to Burpees or any of these exercises, a class is a great place to start to learn proper technique and avoid injury. Also, working up to challenges is a good way not only to stave off injury but also to avoid the staleness that plagues so many workouts and leads to ditching it altogether. So, mix it up and HIIT it.
The Arizona Daily Sun
USE THE FOLLOWING FOUR EXERCISES IN A SET
‘FUN’ HIIT WORKOUT Courtesy of Sean Bartram, author “High Intensity Interval Training for Women” (DK Publishing, 2015)
Perform each exercise for 30 seconds (two minutes per set) with a 30 second rest for a challenge (4:1 work to rest ratio) or take a one-minute rest between sets for a slightly less intense experience (2:1 work to rest ratio). Modify it for your level of fitness and perform four sets for a 10 to 12 minute workout.
WHAT ABOUT TABATA? When discussing high intensity interval training, you may hear the term “Tabata workouts.” Named for the Japanese physician and researcher whose work yielded the formula, Dr. Izumi Tabata, these workouts combine short, very intense intervals of 20 seconds with short rest periods of 10 seconds for eight rounds equaling a total of four minutes (and sometimes repeated four times with a one minute rest between Tabata sets for a total workout time of 20 minutes not including a necessary warm-up and cool down). This is not for the faint of heart, literally. Tabata workouts are for very active, physically fit people, so if you’re not at that level, don’t undertake Tabata, yet. Save it as a goal for the future. Trust us, it’ll still hurt then.
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January 10, 2016 | Body & Mind
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