The big ‘O’ word: Osteoporosis and Exercise

The big ‘O’ word: Osteoporosis and Exercise

Osteoporosis is a global disease in which the remodelling process (replacement of new bone for the old) results in an excessive loss in bone mass. This issue here is that it leads to an increase in our fracture rate (and severity), musculoskeletal impairment and mortality.

 

Why should we care about Osteoporosis?

By 2022, it is estimated there will be 6.2 million Australians over the age of 50 with osteoporosis or osteopenia. That is a 31% increase from our 2012 figures! Improving our lifestyle factors such as eating a well balanced diet, not smoking, minimising alcohol consumption and engaging in regular exercise are the easiest and most cost effective treatments in reducing our risk. Although osteoporosis is determined primarily by genetic factors, our environmental and lifestyle choices can modify around 30% of  ourbone mass, 

Women have higher risk of osteoporosis than men. Why the gender gap?

 

Did you know that women start with a lower bone density than their male counterparts. This becomes especially evident in postmenopausal women due to the decreased levels of estrogen production. This is because estrogen helps regulate a woman’s reproductive cycle as well as plays a role in maintaining bone density.

 

So what is actually happening in our body?

Human bones are constantly changing, our old bone cells are being replaced with new cells. The removal of old bone is controlled by cells called osteoclasts, while the formation of our new bone is controlled by cells called osteoblasts. Like a simple mathematical equation, bone growth is achieved when there is higher activity of osteoblasts. This is present in children up to early adulthood, where it peaks by 20 years of age. From our 30’s  this process starts to reverse, which is why it’s so important to maintain bone strength through proper diet and physical activity.

The role of exercise in osteoporosis is well known, especially in promoting calcium intake, maintaining bone mass and strengthening the functionality your bone. Regular exercise is believed to be the most important factor to increase or maintain bone mineral density (BMD). Basically the mechanical forces placed in the skeletal system when you exercise stimulate bone size, shape and strength. 

 

So what about Osteopeania then?

Osteopenia refers to a decreased BMD, but not low enough to be classified as osteoporosis. Having osteopenia means that there is a greater risk that you may eventually develop osteoporosis.

 

Good news

Well the good news is that osteopenia is reversible. A balanced diet and regular resistance based physical activity will help slow the loss of bone density and delay or better prevent osteoporosis. So lift some weights, get some sun and eat healthy to give yourself the best chance of maintaining a healthy BMD and decreasing the risk of fracture.

Exercise and cancer: Move it or lose it!

Exercise and cancer: Move it or lose it!

Trying to put cancer into words is beyond difficult. It is more than just a series of statistics; it is a ruthless disease is something that has devastated us all in one-way or another, whether we have personally been affected or we have seen loved ones go through the battle.
In stark contrast, the aim of exercise is to build up the human body and make it more resilient to what life throws at it. It can increase our aerobic capacity, strength, endurance, immunity, mental health, metabolism, and the list goes on.
So, why is there is a still a longstanding misconception that once diagnosed with cancer that individuals should generally rest and recover?
Research and clinical practice have both proven unequivocally that appropriately prescribed exercise is safe during and after treatment. Much more than that, appropriately prescribed exercise can be used to make treatment more effective, decrease adverse acute side effects, and minimize the long-standing consequences of the brutal regimes it is put through.
In fact, 62% of people with cancer are sedentary. 75-90% of those with cancer don’t perform any strength based exercise. It is important to caveat this blog with the understanding that side effects of treatment can leave the body unable to do what it used to. But! And here is the big BUT! As Robert Newton (a leading exercise oncology professor) states “some activity is better than none, more is better than less.” Patients may not be able to go for that 6 km long hike or run like they used to, but what ever stimulates change and growth within the body will be effective.  More importantly, it gives people the chance to do something positive with their bodies rather than just constantly be broken down!
This blog begins a series of cancer specific articles taking an in depth look at the how’s and the why’s exercise oncology, so keep a look out! If you ever have any questions or queries, please feel free to have a chat with me.
My final thought is this… Exercise has now been proven to be a drug, which should be prescribed appropriately and individually in those undergoing cancer treatments… so why are we not using it!

 

Relieving the pressure: How does exercise affect your blood pressure

Relieving the pressure: How does exercise affect your blood pressure

Before we begin, I just wanted to pop these stats in front of you….

·         34% of Australians (over 18) are have high blood pressure (BP) – that’s about 6 million people

·         4.1 million Australians have uncontrolled or untreated hypertension

So, let’s answer a few commonly heard questions around iNform:

1)
 How does a bout of exercise affect my BP?
A single episode of exercise is able to reduce BP post exercise. The magnitude (−2 to −12) and duration (4 to 16 hours) vary considerably between individuals as the environment, exercise prescribed, duration of exercise and genetic components can all affect change.

Let’s get scientific for a second:
Systolic BP (the first number) refers to how much pressure goes through the arteries as the heart is contracting. We would love it to be around 120.
Diastolic BP (the second and typically smaller number) refers to the arterial pressure during the relaxation phase of the heartbeat. The recommended value is approximately 80.

When we begin exercising our systolic BP increases because we need to pump more blood around the body to deliver oxygen and get rid of waste products. Our heart rate increases and the overall amount of blood moving through the arteries increases.  Therefore the pressure the blood creates on the arteries also increases. However BP does not usually fly off the charts because our arteries dilate to allow the extra blood through and as such the resistance (and the pressure) decreases. Think of it like opening doors wider to allow more people to shop during the post-Christmas sales.  So we would tend to expect a gradual increase in systolic BP until we hit a plateau at our exercise peak. Interestingly our diastolic does not often change much except in static exercises like wall sits.

How does it work?
This happens through a variety of ways including increased hormonal activity, decrease in heart rate and nerve activity (sympathetic  – due to decrease in circulating catecholamines).

However, given the many factors in our body that help regulate our BP, it is still proving difficult to identify a single mechanism for this drop. What is important though is the beneficial effects on the body!

2) Can regular exercise help me control my high BP
The big new is yes! Regular physical exercise has been recommended for the prevention and treatment of hypertension. We have had a range of clients who begin to exercise regularly, decrease their BP and thus the decrease or even cease the medication they are on (based on GP’s clinical decision).

3) What exercise is best for individuals with high BP?
Decrements in BP have been widely found in a majority of aerobic exercise including walking, running, cycling. Resistance training is a little more controversial is it tends to exhibit greater BPs during the exercise, however it does exhibit post exercise BP decrements. Each training mode produces different effects on the body so it highly encouraged to completing both modes.

4) How long should I exercise for?
The acute decrease in BP has been observed after as little as 10 minutes and as long as 170 min of exercise, although the majority of studies have used exercise lasting between 20 and 60 min. So if time is a factor, you still gain benefits from a short bout of exercise.

To make long term changes, research shows that there seems to be a positive association to 3-5 days of exercise for approximately 30-60mins at greater than 65% intensity levels. However, just remember any type and duration will have a positive response when compared with no exercise.

5) What is the best way to work out my BP response to exercise?
Here at iNform, if we feel it is required we measure BP pre and post (sometimes during). This happens over a course of sessions and allows us to monitor the responses to the exercise prescription. It also allows us to change intensity, duration and mode to see how these effect individuals. We find different individuals respond better to different modes so we take an individual approach to determining it.

6) What risks are there of exercising with high BP?
Both aerobic or resistance training can increase systolic BP, so ensuring that this rise does not exceed approximately is important. If systolic BP rises greater than 250 mmHg and/or diastolic BP >115 mmHg during exercise, the training session should be terminated.

Ways to decrease risk:
a) Ensuring steady breathing during exercise is important to decrease build-up of pressure in arteries. This is especially evident in resistance training
b) Completing dynamic movements rather than static exercises (such as wall sits) are important to decrease risk of excessive BP
c) Upper body exercises tend to lead to an increase BP when compared to lower body exercise, however this is not saying no upper body exercise (just be mindful).
d) Ensuring a progressive build-up of intensity during warm up and slow down when cooling down to reduce risk of sudden drops or increases.

Mild_elevation_of_blood_pressure
Happy Psychology week!

Happy Psychology week!

As the nation goes through a messy haze, filled of negativity biases left right at your doorstep or television screen. It feels refreshing to  promote psychology week.
In between all the Trump & Clinton concoctions, horrific weather and so-forth. Psychology week, promoted by the Australian Psychology Society  is another wonderful intervention to promote health and well being. One is going to discuss the power of social connection; and the importance on combating disease and social isolation.
To read on: Please click here

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Are ‘YOU’OK?

Are ‘YOU’OK?

One is in awe of all the Facebook love; to promote the awareness of mental health. ruokWith all the ‘likes’, sharing and so forth (bless our nucleus accumbens!). The second Thursday of September 2016 marks  “Are you OK day?”. One doesn’t need to  explain the definition.

But; Perhaps flip the coin, directing attention on the self. Why the self?. When was the last time you got in touch with your inner meta-cognitive dialogue? I will touch on reaching out at the end….However, placing emphasis on the self first, can then enable the opportunity to reach out to others.

Three words…

Vulnerability

Shame

Compassion

To be vulnerable, one must surrender shame. When shame is surrendered, one can be ready to show compassion. When feeling numb, self cannot connect, because self is dis..connected. The same can be said with mental health. Mental health is much more than depletion of neurotransmitters & a lottery of SSRIs & MAOIs!

To further delve, please do follow the links above to find out more…

Let’s say that self is ready to reach out to others in need. Trying to say/think of the right words can be incredibly difficult, especially if the topic is sensitive. However; listening, reading facial expressions, feeling ones pain (without taking on the burden) and touch (within respect), are all powerful non-verbal tools, which can assist the compassionate empath…YOU!

My dream for the future, is that humanity won’t need a day of recognition to remind us all to be self compassionate, emotionally intelligent, empathetic… Friend, husband, wife, brother, sister, colleague and neutral.

As Donald Hebb once postulated…

“neurons that fire together, wire together”

Repetition, repetition, repetition!

However; it is wonderful to see so many organisations getting behind mental health & starting the conversation.

Be well, be kind & BE compassionate🙂

James Smith

Bones – Do we care for them as much as we should?

Bones – Do we care for them as much as we should?

This week is Health Bone action week…. So why do we need a week about Bones?HBAW_FF50_2016_600x600tile

4.7 millions Australians over the age of 50 have Osteoporosis or poor bone health (Osteoporosis Australia, 2014). It is also alarming that the prevalence of bone disease has continued to increase in recent years. Good bone is essential as it is the tissue that provides the structure for muscle to attach, protect our more delicate tissues and act as a reservoir for both calcium and phosphorus (really important in blood cell formation). Healthy bones week is a good opportunity to reflect on whether we are taking as much care of our bones as we could.

As we age the human body increases its fragility which is a somewhat inevitable process due to ageing.

On the contrary, a well-rounded, healthy lifestyle will delay the changes associated with ageing. Along with maintaining a balanced diet, regularly exercising as we age is crucial to prevent bone deterioration. The literature has found that weight-bearing exercise can trigger a response in the body that increases bone formation. To put it in really simple terminology, muscles pull on bone, and to protect itself the bone gets stronger. The increases in bone mineral density when the body is put under significant load is important in fighting Osteoporosis (which is caused by decreased bone mineral density).

So what exactly is weight bearing exercise?
Exercise that requires you to experience the force of gravity is considered weight bearing. Examples include weight training, walking, running, ball sports or pretty much anything where you are on your feet. Exercise such as cycling or swimming, while excellent for cardiovascular fitness, will not elicit enough strain on the bone to strengthen them.

Exercise prescription for improving bone mineral density
Research by Turner & Robling (2003) provided evidence that is is better to do more sessions with more load/intensity more often with less duration for bone strength. A practical way of looking at this would be performing weight bearing exercise twice per day for 20 minutes each time rather than one 40 minute session. In the same article it was stated that proper exercise can reduce the likelihood of damage to the bone even without having a significant impact on the bone density. This is especially important later in life  as by improving balance and postural stability the risk of falls decreases.  (Turner & Robling 2003).

Quick tips to increase bone strength:

  • Exercise outside where safe to increase exposure to vitamin D
  • Ensure adequate calcium consumption
  • Perform a combination of weight-bearing exercises regularly

“Old age is like everything else. To make a success of it, you’ve got to start young”
– Fred Astaire

 

 

For more information, please visit: http://www.healthybones.com.au/

References:
Turner, C & Robling, A 2003, ‘Designing exercise regimens to increase bone strength’, Exercise And Sport Sciences Reviews, vol. 31, no. 1, pp. 45-50.