Once Upon a Thigh: March 2006

Table of Contents

Notes from the Editor

I am so excited to write this month's newsletter. So much information and I want to share it all. Important to remember: Always call the day of the IR Class (that is the first Wednesday of each month) to make sure that it is being held. In the last 2 years I have only had one problem and that was last month. I am sorry for the inconvenience. This month's class will feature NEW information and OLD (that we may have forgotten) about IR.

In trying to stay up to date with all the weight loss, exercise and Insulin Resistance information, I do quite a bit of reading. I purchased a great book this last month from Prevention: Firm Up in 3 Weeks. What was impressive was the menus for three weeks and then another 50 for future use. I have been faithful for the last week, eating 3 meals a day with 3 snacks and exercising 20-30 minutes each day and have found that already my clothes are fitting better. So much of this month's newsletter will be taken from this book---get ready to LEARN.

Metabolism Meltdown

One of my patients yesterday was sure she had gained a significant amount of weight since last year. When I checked, she had only gained 1 pound, but she said, “My clothes just don't fit like they used to.” Then I remembered a quote from Reader's Digest: “I have the perfect hourglass figure, only time has settled in the wrong place.”

As we age, we lose muscle mass and our figures begin to change. Usually in your 30's or even as early as your 20's, if you are inactive, muscle mass begins to decrease. Muscle fuels the metabolism so about 30 something your metabolism starts slowing down by about 5% every decade. That is why you can't eat the same amount of food this year as you did last year and not gain weight. Every pound of muscle you lose can decrease the number of calories you burn by as many as 30 a day. In your late 30's and during your 40's you lose about 1/2 pound of muscle a year and that loss can double once you hit menopause. So by the time you are 65 that means you could have lost 1/2 of your muscle mass and see your metabolism slowed by 200-300 calories a day. One pound of muscle lost = 2 lbs of fat gained = increase in the scales.

Interesting information about strengthening the abdominals-the bicycle move that we all remember is much more successful than the traditional crunches.

Goals

January 1st probably brought more goals to do our best, which means eating healthier, exercising more, eating less. We are in March now and this diddy applies TO MANY OF US.

For those of us who made goals for 2006, here are some realistic suggestions:
  1. Try not to get behind.
  2. If you get behind, try to catch up as soon as possible.
  3. If you get behind and don't catch up as soon as possible, try to catch up eventually.
  4. If you get behind and you don't ever catch up, your net gain will be what you have learned up until the time you got behind, plus what you learned trying to catch up.
Keeping this in mind, if you make a chart showing where you were at the start to the present point, there is no way to show a loss. Being unable to show a loss is always an enviable position, don't you think

Exercise

You can get a high intensity workout just by pushing yourself out of your comfort zone. High intensity exercise can burn 25-75% more calories than low intensity exercise. After a high intensity activity, the number of calories that you're burning can stay elevated for up to 15 hours which means that you could burn an extra 75 calories a day. The fitter you are, the more calories you burn while digesting food.

The one thing that I found interesting was that I was having more success doing 20-30 minutes a day as compared to my 1 1/2 hour typical workout. The reason was the types of exercise and the constant changing of exercise, intensity, and duration so that my body did not get used to the same exercise.

One study showed that people who exercised and used different weights and varied the number of repetitions lifted had more success losing weight and being toned with increased muscle. In fact the results were double if you only did a single set routine. Lifting weights demands many calories and when you perform three sets, that calorie burn can increase threefold.

People who walk actually stick with it: My husband recently purchased a treadmill and I have enjoyed walking and watching HGTV during that time. I have learned much about decorating and some fun quilting tips. If you sneak a few high intensity walks (90 seconds) 4 times, into your routine you will burn more calories and thus firm up more quickly.

One of my patients this week came in and told me she had decided to take control of her life. She was decreasing the caffeine intake and also decreasing the sugar intake of pop, switching over to diet. (Hopefully I can switch her over to water later). She has had success because she decided to DO SOMETHING. Good job.

So what about aching muscles? That is a sign you have overworked your muscles. Get moving again. Muscle soreness is relieved by exercise. The extra fluid that is formed by overwork is moved out by low intensity activity like easy walking and gentle stretching.

CHOOSE ICE:
After an injury and within the first 24-48 hours, apply for 20 minutes then off for 20 minutes. Repeat as needed. Always apply a thin towel first to your skin then wrap an ice pack or frozen bag of peas around area.

CHOOSE HEAT:
After the first 48 hours you may apply heat 20 minutes at a time. Place a heat pack on top of the injured area. Do not sit the injured area on top of the heat pack. If there is broken skin, do not apply heat.

COMBINE ICE AND HEAT:
After 48 hours you may do heat and cold for 10 minutes at a time, alternating.

Remember the pathophysiology here. Ice keeps the injury from swelling initially. The heat dilates the blood vessels and allows the fluid (which is causing pain) to leave the area more quickly.

Shoe Shopping Hints
  • Shop at the end of the day (aren't your feet largest then?)
  • Go to a store that carries a wide variety of brands and styles so that you have the best chance of finding the right shoes for your feet.
  • Tell the salesperson your foot type and how often and how far you'll be walking or running.
  • Get your foot wet and see what your foot print is like.
    • If it is neutral you have about a 1” strip of wetness in the arch area. Yours is the easiest foot to fit. You may use soft or supportive shoes.
    • If your foot print is rigid your arch is so high that you may not see any imprint in the mid foot area. Your foot rolls inward very little during walking and tends to be stiff so it doesn't absorb shock very well. You need soft shoes that are well cushioned. Go for a roomy upper to accommodate your high arch and instep. A higher heel is good if you have a tight Achilles tendon. Your foot will tend to curve so look for a shoe that does likewise.
    • If your footprint is flexible, your foot will leave the fullest imprint, with the arch area showing the most contact with the paper. Your foot rolls in too much when you walk. It absorbs shock well, but is not as stable as needed. It changes an entire size when you stand on it. Your feet are flat with a low instep. You need a shoe with low volume, shorter inside from the laces to the sole. You don't need a lot of cushioning, but you do need good arch support. A lower heeled shoe will help keep your foot be more stable when you walk.
  • Wear your walking socks when you go shopping for new shoes. If they are thick ones you may need to get 1/2 larger size shoe.
  • If you are going to jog during your walk, wear running shoes. It requires more cushioning and stability for your feet.
Cholesterol

We all know men should have HDL(the good cholesterol) 40 or higher and women's levels should be 50 or higher. HDL is usually increased by exercise. If your cholesterol levels are high and you are exercising daily, ask yourself if you are doing a cardiac exercise program. Also, trans fats can decrease your HDL and increase cholesterol. The government has passed a law that trans fats need to be listed on all products, so do your homework. You should not be having any trans fats if at all possible.

Tip of the Day

Complete an emergency contact card and make copies for each member of your family to carry with them. Be sure to include an out of town contact on your contact card. It may be easier to reach someone out of town if local phone lines are out of service or overloaded. You should also have a least one traditionally wired landline phone, as cordless or cellular phones may not work in an emergency. Visit www.redcross.org or www.ready.gov for sample emergency contact cards.

Pertussis (Whooping Cough)

There is an increase of this disease among adults. New studies show that the DTAP that we all took as children probably had immunity for 5-10 years. So we are not covered. If you have NOT had a tetanus booster within the last 10 years, talk with your health care provider about being injected with a new immunization which includes the tetanus and whooping cough. It is available at the Health Department. The cost is $50.00. Depending on your insurance policy, it may be covered, but you will need to submit it yourself for reimbursement.

Good luck. Take charge and look for the crocus.