I am well and truly getting old. Not only have I recently run a race in the 50-59 category (albeit 7 months before my time), I had a fall today. It absolutely knocked the stuffing out of me.  Had to take myself for a little sit down and a good swear. In fact I was too shaken up to swear too vigoursly, just a couple of quiet “buggers”.

Whilst there was definitely a reason for my falling – inappropriate footwear, rushing over rubbly rocks and broken bricks, carrying large plastic parts of a climbing gym, trying to get something done in a rush before taking the kids to school – it did get me to thinking how awful it would be to fall when you are 80, especially if there was no apparent reason for it.

• One in three people aged 65 and over report falling at least once/year.
• About 10% result in serious injury such as fractures
• Falls can lead to the need for residential care – don’t know that I’m ready for a nursing home just yet, but then, who ever is?

Falls are not an inevitable part of ageing. There’s lots you can do to prevent them.

Falls Risk Factors

• Age: The risk of falling increases as you age. Women are more likely than men to fall
• Previous falls: Approx 60% of people who fall, will fall again in the next 6 months
• Decreased bone density. This both contributes to the risk of falling, and often can mean worse injuries as the result of a fall
• Lack of regular exercise. This can cause poor muscle tone, decreased strength, and loss of bone mass and flexibility, which in turn will increase the risk of a fall.
• Side effects of medication can make people dizzy and susceptible to falling
• Environmental hazards
• Inability to realise own physical limitation (NOTE TO SELF)

Fall Prevention

• One of the keys to preventing falls, is to get active before you reach middle age, and stay active with good muscle tone, bone strength, balance and flexibility into old age.
• Take it easy if you’re not as young as you used to be
• Address environmental factors
• Address any side effects caused by medication by speaking with your supervising doctor about it

The Department of Veterans Affairs document “PreventingFalls” has some good info on the subject. There are a couple of exercises below which they recommend. They will be familiar to those of you who come to our FitSquad and Circuit Classes. The full document can be found at:

http://www.dva.gov.au/aboutDVA/publications/health/Documents/preventing_falls.pdf

Strengthening exercises:
Adapted from the Otago Exercise Programme to prevent falls in older adults – ACC (New Zealand)

Knee Bends

Stand up tall and look ahead
Place your feet shoulder-width apart
Squat down half way, bending your knees
The knees go over the toes
When you feel your heels start to lift, straighten up

 

 

 

Sit To Stand

You can do this exercise while you watch TV
Sit on a chair which is not too low
Place your feet behind your knees
Lean forward over your knees
Stand up slowly without usingyour hands
Stand for five seconds, then sit down slowly without using your hands Repeat

Note: use one hand for support if having difficutly

 

Balance exercises:
Adapted from the Choose Health; Be Active booklet,
Department of Veterans’ Affairs and Australian Government
Department of Health and Ageing.

Single Leg Balance

Stand next to the kitchen bench or the back of a sturdy chair– hold on if you need to
Lift your right leg and stand for 10 seconds on your left leg
Repeat 5 times
Repeat with other leg
If you feel steady enough, do it without holding on
If you are very steady on your feet, try this with your eyes shut

 

 

Heal Toe Walking

Stand next to a support (the kitchen bench will do) for this walking exercise
Step forward by putting the heel of one foot directly in front of the toes of the other foot, so that they touch (or almost touch) and then step forward with the other foot
Repeat for 2 minutes
If you can do this easily without holding on, try it with your eyes shut. Have someone stand next to you to support you if you need help

 

 

 

 

 

 

Watch this one minute video on resting heart rate and its significance as an indicator of heart disease risk.

 

 

Runners and other exercisers regularly swig water from plastic bottles. For the most part, we’re aware of the dangers of using drink bottles containing BPA, and more than likely, you choose to drink out of a BPA-free plastic bottle.

Many manufacturers are aware of our fear of exposure to BPA, and our fear of exposing our children to BPA. BPA-free has become a marketing mantra.

We all slavishly buy drink bottles which are BPA free so that we’re not consuming those nasty chemicals, and we all send our kids off to school secure in the knowledge that they are packing the latest BPA-free drink bottle in their holster!

 

Drink bottles are not the only products that contain BPA however, and BPA is not the only chemical contained in plastics that we should be wary of.

What is BPA?

BPA (Bisphenol A) is a chemical used in the manufacture of two common synthetic products

• Polycarnbonate – that’s the clear, rigid plastic found in a large number of consumer products including food containers and drink bottles
• Epoxy resins – used in industrial adhesives and coatings. Epoxy coating lines most of the food and drink cans you buy in the supermarket

Other BPA containing products

• Certain thermal paper products such as cash register receipts
• BPAs may also be used in toys and some dental sealants and composites

BPA is a synthetic oestrogen that can disrupt the endocrine system. Even small levels of BPA in the body has been linked to conditions such as infertility, breast and reproductive system cancer, obesity, diabetes, early puberty, behavioural changes in children and resistance to chemotherapy treatments. http://www.ewg.org/bpa/

But Are BPAs really harmful?

• The Environmental Working Group (EWG) asserts that BPA can seep into food and drinks from containers, and into your body when you handle products made with BPA. “This is well researched and widely acknowledged” They say that even low levels of BPA in the body has been linked to fertility issues, diabetes, obesity, early puberty, behavioural changes in children and breast and reproductive system cancer.
• The American Chemistry Council contends that BPA poses no threat to human health. The American Chemistry Council represents plastics manufacturers. http://www.mayoclinic.com/health/bpa/AN01955
• The US  Dept of Health and Human Services has “some concern’ about the health effects of BPA on the brain, behaviour and prostate glands of fetuses, infants and children. “ Some concern” is the middle of its five point scale which ranges from serious to negligible.
• The US FDA is taking steps to reduce human exposure to BPA in the food supply by finding alternatives to BPA in food containers, but is it enough to limit our exposure to BPA containing products?

But I Use BPA-Free Plastic…….so I’m right, right?

 Research shows that BPA –free plastics also release chemicals which mimic oestrogen, ie they have Oestrogen Activity (EA)

In a 2011 study, more than 500 BPA-free consumer products were tested for chemicals similar to BPA.  92 percent of the products released potentially hazardous compounds after undergoing wear and tear, such as through dishwashing, microwaving, or exposure to sunlight.

The research reports that many BPA-free products, from baby bottles to plastic food wrap, had more oestrogen activity – which is linked to birth defects, cancers, and other health issues – than those products containing BPA.

“We found that exposure to one or more common-use stresses often increases the leaching of chemicals having EA. In fact, our data suggest that almost all commercially available plastic items would leach detectable amounts of chemicals having EA once such items are exposed to boiling water, sunlight (UV), and/or microwaving. Our findings are consistent with recently published reports that PET products release chemicals having EA (Wagner and Oehlmann 2009) and that different PET products leach different amounts of EA”. Chun Z. Yang,¹Stuart I. Yaniger,²V. Craig Jordan,³Daniel J. Klein,² and George D. Bittne
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3222987/

Recent studies on chemicals having EA show these chemicals produce changes in various cells, organs and behaviours, and that chemicals having EA produce measurable changes in the health of human populations. Chemicals having EA have also been shown to change the structure and function of many human cell types, often at very low doses.  (Yang et al)

 How to Limit Your Exposure to BPAs and Other Similar Chemicals

• Use BPA free products Not necessarily as easy as it sounds! Most aluminium cans or bottles have linings that contain BPA. Steel bottles or cans do not. In reality, this means reducing your use of canned foods, as most of our foods come in aluminium cans. Look for cans labelled BPA free-good luck!
• Polycarbonate plastic is generally hard, clear and lightweight. Plastics with recycling symbols should have a number in the middle of the symbol. Those with the number 7 are usually made from polyarbonates. Check the recycling symbol, and avoid food storage containers with the number 7. This will steer you away from BPA containing plastic, but not necessarily plastic which contains other chemicals which can leach into the food inside.
• Stay away from receipts and other carbonless paper which often contain BPA. If you handle large numbers of receipts, wash your hands or wear gloves
• Do not microwave any plastic containers, even if they are BPA free. Many plastic containers do have the words “microwave safe” printed on them, but that just means that the container won’t get wrecked in the microwave. It doesn’t take into account whether or not it’s safe for humans to continue using them once the harmful chemicals in the plastic have been liberated.
• Similarly, do not leave plastics out in the sunlight, or in your car where they  can heat up.
• Avoid washing plastics in your dishwasher where the material can be heated to high temperatures and be exposed to harsh detergents.
• Use glass, porcelain or stainless steel containers for hot foods and liquids instead of plastic containers.

 A look on the bright side.

Yang et al, in their 2011 study concluded that plastics having comparable physical properties to the plastics we already use, but that do not release chemicals having detectable EA could be produced at a minimal additional cost. Now we just need to convince the food manufacturers!

 References:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3222987/
http://www.mayoclinic.com/health/bpa/AN01955
http://www.ewg.org/search/site/bpa

 

A couple of incidents this week had me scurrying for my icepacks, so I thought it might be useful to take a look at ice and heat treatment. So here’s the conventional wisdom on the topic.

 

Generally, ice is used in acute injuries. These are generally caused by trauma, such as rolling your ankle, twisting your knee. Acute pain refers to any specific sharp, pain with rapid onset, so does not necessarily have to be associated with trauma, but often is.  Chronic injuries are more generally overuse injuries, or acute injuries which have not healed properly and have hung around. Chronic injuries have usually developed slowly over time and are persistent and long lasting.

 

Ice

Use ice

• As soon as possible after an acute injury such as a sprain.
• If you re-aggravate a chronic injury, such as shin splints.
• If you’re brave enough, an ice bath will help with muscle recovery after long training runs or races!

Ice treatment promotes:

•  Pain relief
• Prevention or reduction of localised swelling after acute injury. It’s best combined with a compression bandage
•  Prevention or reduction of bleeding in combination with compression
• Reduction of inflammation

 

Heat

Use heat on:

•  Chronic injuries which have been present for over a month without improvement, but have not become worse within the last week or so.
• Chronic conditions such as plantar fasciiosis, BEFORE activity but never after activity or on a newly injured area.

Avoid using heat:

• On acute inflammatory injuries such as ankle sprains – it can increase swelling and bleeding around the injury
• On acute Rheumatoid Arthritis
• Over an area of recent or potential bleeding
• On thrombosis or other areas of impaired circulation
• For Lymphoedema
•  Over or near malignant tissue
• People with neuropathy such as caused by diabetes or other impaired sensation
• Over open wounds
• Over areas of metal implants

Heat treatment promotes:

•  Relaxation of tense muscles/reduction of muscle spasm
• Pain relief (but not in acute inflammation or with an inflammatory condition-any condition which ends in it is, such as tendonitis, is an inflammatory condition)
• Increased joint range of movement and decreased stiffness in a joint
• Blood flow to the injured area (important for delivering nutrients)

 

How To Ice an Injury

Icing an injury is an important aspect of the R.I.C.E.R principal (See below)

 

• Most effective in the first 48-72 hours after an injury-efficacy diminishes significantly after 72 hrs.
• for acute injuries-ice for the first 24-48 hrs
• for chronic injuries such as shin splints, ice after activity if you’re feeling pain in the injured area
• ice for 10-15 minutes, and no longer than 20
• ice packs should be placed in a cloth so the cold pack is not in direct contact with the skin
• Ice massage can be performed with ice in contact with the skin.

 

Ice Massage

Great for shin splints. Simply rub an iceblock over the effected area. It can generally deliver a greater drop in temperature without the risk of ice burn. Use your standard every day ice cube, or fill a polystyrene cup with water and freeze it. You can then peel the polystyrene off the ice a bit at a time so that you expose some of the ice block whilst still having something to hold onto. If you come up with a more environmentally friendly version of this, let me know.

 

What is the RICER principal?

R is for Rest: Resting means avoiding as much movement or weight bearing in the injured area as possible to reduce further damage.
I is for Ice: for 10-15 minutes every 2-4 hours in the first 24 hours and every 4 hours after, for up to 72 hours.  Ice cools the tissue and reduces pain, swelling and bleeding.
C is for Compression: cover the injured area with moderately tight (not too tight) bandage including the areas above and below the injury. Compression reduces bleeding and swelling.
E is for Elevation: Keep the injured body part elevated above the heart while icing to further reduce swelling.
R is for Referral: Refer the injured person to a qualified professional such as a doctor, podiatrist or physiotherapist for precise diagnosis, ongoing care and treatment.
So, there you have it. The lowdown on the conventional way to use heat and ice in the treatment of injury.

 

I have frequently wondered why we try to inhibit the body’s natural reaction to acute injury. I’ve never really got a satisfactory answer from physios and doctors, so I’m off to do a bit more probing into why we do it. It seems counter intuitive to me, and always has. So stayed tuned. I may just find some supporting evidence which turns the theory on the use of ice treatment in acute injury on it’s head!

Kind of gets your attention, doesn’t it?

A recent documentary from the BBC’s Horizon Team, (the same guys who gave us the fascinating doco on Fasting), looked at two main areas of exercise and their health benefits.

Firstly, using presenter Michael Mosley as the guinea pig, the team looked at the type and quantity of exercise required to reduce the risk of heart disease and diabetes.

There are two significant markers of health relating to the development of these two diseases, blood glucose levels and Maximum Volume of Oxygen Uptake.

 

Blood Glucose When we take food it, it starts to be broken down in the mouth (both mechanically by chewing, and chemically with saliva), and then continues to be broken down in the gut. The nutrients leave the gut and enter the blood stream. The blood then transports the nutrients from the broken down food to areas of the body where they are needed. The speed with which the body can deal with an intake of sugar/carbohydrate by transporting it from the blood into the cells is important for maintaining blood glucose levels. The body’s ability to maintain a healthy blood glucose level is a significant health marker.

 

When our body loses its ability to transport sugar from our blood into our cells, a chronic high blood glucose level develops, which becomes toxic, destroying cells in particular parts of the body. You would have heard of this condition, it’s called DIABETES.

 

Maximum Volume of Oxygen Uptake (Max VO2)

This is the maximum amount of oxygen we can uptake and use during aerobic activity (the type of activity that gets you huffing and puffing). A higher figure means our cardiovascular system is strong and helps reduce the risk of heart disease.

 

High-Intensity Interval Training (HIIT)-Just Three Minutes Per Week

Researchers have found that performing very high intensity exercise for very short periods of time improves the body’s ability to move glucose out of the bloodstream — where it can become toxic and lead to the build-up of dangerous visceral fat (fat surrounding organs) — and into muscle tissue, where it is of benefit.

 

They have found that just three twenty second intervals of this high intensity exercise, three times per week WILL HAVE SIGNIFICANT EFFECTS on both glucose levels and Max VO2.

 

The Workout

The exercise is best performed on a stationary bike for ease of monitoring time and controlling the resistance, and to improve consistency of training.

Warmup Even though the “selling” point of the workout is 3 mins of exercise per week, you do actually need to do a bit more than that. You need to warm up first so that your body can reach close to maximal effort.

The Session Pedal hard, hard as you can, go like the clappers, for 20 seconds. Then take a breather. Then do it again, and again. Total is 1 minute of high intensity exercise.

Cool Down I’d advise at least a couple of minutes (though 5 mins would be better) of slow cycling to cool down to help pump your blood out of the working muscles more quickly.

 

Perform 3 times per week for 12 weeks and according to the latest research, you body’s ability to handle blood glucose will significantly improve.

 

Incidental Exercise

The other area of exercise which the documentary looked at was incidental exercise, This exercise is part of everyday living: going to the coffee machine, the photocopier, taking the stairs instead of a lift, walking to the shops, washing your own car, household chores, and playing with the kids.

 

It’s quite easy to accumulate a net 500 calorie deficit a day by increasing your incidental exercise. Walk a little further and a little faster. This 500 calorie energy expenditure is not only important in burning excess body fat, but helps in ‘oiling the wheels’ of our body. Pumping the heart that little bit more, moving blood and oxygen around, contracting muscles are all essential in reducing the risk of heart disease and cancer, two of the big premature killers today.

 

The Bottom Line

The notion that three minutes a week of HIIT can replace all other exercise and cater for every aspect of fitness is not one that sits well with me. It is sufficient for some aspects of fitness, but the documentary tends to over simplify and gives a misleading message. HIIT would seem to be useful in modifying blood sugar levels, but other studies also show that just getting up and walking around every twenty minutes or so will do the same.

So, if what you want to get from exercise is a reduction in your risk of heart disease and diabetes, knock yourself out doing HIIT three times per week. I’d caution against this if you don’t’ have a good level of fitness already, and my advice would be to build up slowly to this very high level of intensity over a number of months. Like anything new, build up to new levels of intensity or volume slowly.

But if you exercise because you enjoy it, or it makes you feel good, or you like being strong, or you like the social interaction, or you like the clarity of thought you gain from running on your own and getting away form it all, you like your muscles, you like strong tendons, you like your joints to work well, you like the endorphins, you like sweating, you like training for an event and feeling a sense of achievement when you complete it, you don’t like the quick fix attitude of our society, don’t give up on the more traditional exercise routines just yet.

Do include more incidental exercise in your day, and by all means, include HIIT as part of your overall exercise plan, as long as you work up to it gradually. After all, it is only three minutes per week.

If you’re thinking of tackling the hilly Lindfield Rotary Fun Run this year, take advantage of our FREE training programs.

Choose from 3 different levels over each of the 5km and 10km distances.

View the training programs.

Happy hill running.

 

 

An interesting question which comes up for discussion in my line of work fairly frequently is “How do you get around your kids being given “treats” by their soccer coach/tennis coach/doctor/teacher/other authority figure. In many cases, quite young kids attend sports training sessions or events, and at the end of the session, all the kids line up and receive a lolly. It’s something I’ve heard time and time again, and I’ve had similar experiences with my own kids. Having sports coaches (or doctors or teachers) giving kids lollies just sends such a bad massage. These are the people who kids generally look up to, who kids model their health related behaviour on, and it simply isn’t healthy for kids to be given a sugar hit at the drop of a hat. In the case of sporting activities, these are often not every-so-often event. They are every week, each and every time a child attends a session.

 

“But it’s just a little treat”! Yes, it is just a little treat, but when so many people are giving your kids little treats, it turns into one constant stream of treats. It becomes the norm.

 

Week two of year one for my youngest son and cupcakes were on the menu for someone’s birthday. That’s fine, I knew it was happening and I could adjust anything else he was eating accordingly. Same day, a very kind hearted parent brought iceblocks to the school for all of his class because it was such a hot day. Great idea, and very nice gesture, but for most kids it meant two lots of junkish food in one day. It also meant that the frozen watermelon balls I’d so lovingly prepared for my boys to have for afternoon tea had to wait for another day! I miss out on sharing the guilty pleasure of a chocolate popped into the mouth when no-one’s looking, the stop off at the bakery on the way home from school for am apple turnover, because someone else has already got there with the junk food before me.

 

It’s hard to resist yummy stuff when it’s offered to you, even more so when you’re a kid. Even more so when it’s offered to you by someone who is teaching you about good health – a tennis coach, a soccer coach, a doctor a teacher…. you get my drift. So it’s our job to make sure our kids have a healthy diet. And the only way we can do that is if people don’t keep mis-treating our kids.

 

No-one else knows what my kids have been eating – they could have been on a 2-day food fest and are now not eating junk for a month. The point is, each family is different, each kid’s eating habits are different and we should take that into consideration when considering whether it’s appropriate to offer kids a “treat”.

 

Stop the press. My six year old has just this very minute come home with a chocolate from one of the girls in his class for Valentines Day (not that she has a soft spot for him, everyone got one). So this week (so far) it’s been one cup cake, one iceblock, one rather delicious looking heart shaped chocolate. This is what I know he’s been given. On offer also this week at school have been iceblocks being sold for the year six fund raising effort!

Take a look at the extra calories kids are given in the couple of weeks before Christmas.

 

So what can you do about it?

• Firstly, be polite when you are asking people not to give your kids sweets. No matter how much your blood may be boiling, keep calm and try to explain why you don’t want that for your child. Come up with another suggestion. When my kids did Minitots soccer – a great soccer program for pre-schoolers, which handed out sweets at the end of a short session of soccer skills, I simply said they weren’t to have lollies, and perhaps a sticker would be appropriate (I really thought nothing would have been more appropriate, but thought that may have been pushing it).
• Let your child’s teacher know how you feel and ask them to make sure your child brings home any cupcakes, lollies etc he’s been given so that YOU can decide when and if they have them
• Talk to your children to try to get them to understand why it’s important for them not to just take every bit of junk food that comes their way. My kids both spent 4 yrs at long day care having rice crackers and homus or tahini, or their favourite, vegemite and avocado, for morning and afternoon tea instead of the biscuits and cakes which were standard fare. They still shared birthday cakes It didn’t seem to bother them that much, but my oldest hasn’t eaten avocado in a while come to think of it.
• Try to let your kids have a part in the decision making process of whether or not they should eat something. I try to get them to think about what else they’ve been eating lately. We also look at the amount of calories in some things, and then decide if it’s worthwhile giving up half their dinner for a couple of lollies.

 

Had enough? add your voice below. Had enough of me talking about it? Tell me that as well.