Patients often tell me that they would like to exercise but hesitate due to their knee or hip pain. They want to know what type of exercise is best for those suffering from osteoarthritis (OA). Osteoarthritis is also known as degenerative arthritis. It is the most common form of arthritis in the knee. Osteoarthritis is usually a gradual, slow and progressive process of “wear and tear” to the cartilage in the joint which eventually wears down to the bony joint surface. It is most often found in middle-aged and older people and in weight bearing joints such as the hip, knee and ankle. It causes gradual onset of pain, swelling and stiffness in the involved joint, especially after increased activity and weakness with loss of function due to disuse.

However, OA is not an excuse to avoid exercise, but it is important to be smart about it. Regular exercise is essential to maintain a normal lifestyle for those with OA. However, if you do the wrong exercise, use poor technique, or are too aggressive, you could flare up your joints and do more harm than good.

Benefits of Exercise for Those with Osteoarthritis:

When performed correctly, exercise for those with Osteoarthritis has many benefits:

• Pain Control
  • Exercise controls OA pain by releasing natural pain control chemicals in the body called endorphins. It also controls pain by assisting in weight loss and improving range of motion.
• Weight Control
  • We all know how well exercise burns calories and that increased body weight creates increased stress on the joints.
• Prevention of Joint Stiffness
  • Exercise will help maintain joint range of motion. A stiff joint is a painful joint.
• Prevention of Muscle Weakness
  • Exercise will help maintain muscle strength. Weak muscles will allow or increase in joint wear and tear.
• Maintain Lifestyle
  • If a joint is stiff and weak, then they become painful which negatively impacts your lifestyle. Exercise can prevent this problem.  

Tips How To Exercise With Osteoarthritis:

• Start Slowly
  • Wean into exercise because if you advance too quickly, you will flare up the joint and have increased pain. For example, walk for 5-10 minutes the first session. If you do not have pain, add 1-2 minutes each session.
• Lose Weight
  • Every pound lost equates to less stress on your joints. For example, a loss of 5 pounds of body weight translates to 20-30 pounds of stress through the knee, according to David Borenstein, MD, President of the American College of Rheumatology. Also, body weight has a direct impact on daily activities. For example, walking upstairs creates stress through the knee equal to 4 times body weight and seven times body weight going downstairs. Therefore, less body weight equals less stress.
• Low Impact Workouts
  • Low impact exercise creates less stress on the joints while strengthening leg muscles and those who maintain leg muscle strength have less stress on their joints. It is even important not to load your arms with heavy objects when walking or using stairs to limit joint stress.
  • Some examples of low-impact exercises are walking, swimming, elliptical trainer, and biking. Strength training is also low-impact and should be performed with low weight and high repetitions. Water therapy is great for those with OA, especially in a heated pool. It is a great low-impact exercise with less gravity and stress on the joints. Walk, swim and do mild resistance exercises in the water. Use a snorkel and mask for swimming to limit excessive neck turning and back extension.
  • Walking is a great form of exercise; however, walking softly is important for those with OA. Wear good running shoes and orthotics if necessary. Discuss this with your physical therapist or podiatrist. When possible, use soft surfaces like cinder, mulch or rubber. Avoid grass and soft stand due to instability and torsion that may irritate your joints.  
• Warm-Up
  • Warming up your body is critical to prevent injury to the muscles and tendons. This can be done by marching in place or using aerobic equipment such as a bike for 5 to 10 minutes before exercise. Always perform the warm-up activity at ½ your normal pace.
• Balance & Relaxation Techniques
  • Tai Chi and ballroom dancing are two good examples of activities which promote balance and relaxation. Studies showed that those with OA who participated in Tia Chi two times a week for eight weeks reported less pain, increased range of motion and improved daily activities and function. They also noted less low back pain and better sleep.
• Proper Clothing
  • Stay warm in winter and consider wearing compression shorts. Be cool in the summer months with Drytech^R type material.
• Pre/Post Exercise First Aid
  • If you are sore for longer than 12 to 24 hours after exercise, then you overdid it and must adjust next time. Otherwise, use hot packs, bath or shower before you exercise to loosen up and apply ice to your joints after exercise, especially if they are sore.
• Post Exercise Stretch
  • Gentle, active range of motion stretches after exercise is important to maintain mobility. Do not bounce or cause pain. For example: Low Back – knees to chest; Arms – row –the – boat, arms behind head, arms behind back; Legs – wall lean calf stretch, bend and extend knees, open and close hips.

SOURCES: Rothman Institute, Philadelphia, PA and American Academy of Orthopaedic Surgeons; www.lifescript.com

Visit your doctor regularly and listen to your body.     

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

Education, Medication, Diet, and Exercise

The list of diseases such as high blood pressure, diabetes, and stroke that can be managed, cured or prevented is endless. Certainly, cholesterol and heart disease are at the top of the list. Studies clearly demonstrate that managing cholesterol through education, medication, diet and exercise can significantly reduce the risk of heart disease.

Education –

Know your numbers. Learn the difference between unsaturated and saturated fats. Make yourself a student of healthy living through diet and exercise. Avoid fads and focus your effort on scientifically proven methods. Many experts feel that those with genetically high cholesterol should use exercise and diet to maintain health but will also need require the addition of a statin drug to manage cholesterol effectively.

Statin Drugs -

There are many methods to lower your LDL (bad cholesterol). However, no method has been proven more successful than statin drugs. Multiple landmark studies confirm that for those individuals needing statin drugs to control their cholesterol, the benefits far outweigh the risks.

By inhibiting an enzyme in the liver, statin drugs limit the liver’s ability to produce cholesterol thereby significantly lowering LDL (bad cholesterol) and triglycerides and modestly increasing HDL (good cholesterol). As a result, their unique benefits include preventing and reducing plaque in arteries, stabilizing existing plaque, reducing inflammation of the arterial wall, and improving overall vascular function. Statin Drugs Include: Lipitor (atorvastatin); Lescol (fluvastatin); Mevacor (lovastatin); Pravachol (pravastatin); Zocor (simvastatin); Crestor (rosuvastatin).

Clinical studies that have shown that statin drugs significantly reduce the risk of heart attack and death in patients with proven coronary artery disease (CAD) and can also reduce cardiac events in patients with high cholesterol levels who are at increased risk for heart disease. And although statins are best known for lowering cholesterol, they may also have several other benefits: they may prevent Alzheimer’s disease, and they may also have a positive impact on diabetes and blood pressure.

Exercise –

Second only to statin drugs, no other method of the prevention of CAD has proven more effective than exercise, specifically aerobic exercise. It is well documented that physically active people have a lower incidence of CAD than sedentary people. For the prevention of CAD, the following exercises are defined as aerobic: High Amount/High Intensity – a caloric equivalent of jogging 20 miles per week at 65 -80 percent intensity, Low Amount/High Intensity – a caloric equivalent of jogging 12 miles per week at 65 to 80 percent intensity, Low Amount/Moderate Intensity – a caloric equivalent of walking 12 miles per week at 40 to 55 percent intensity.

Exercise is a valuable prevention tool on many levels: it reduces weight, LDL, and blood pressure, and it increases HDL. Research has found that the amount of exercise matters more than the intensity. For example, those exercising 5 or more days per week benefited more than those exercising less often. However, it is important to remember that ALL exercise groups showed improvement.

Diet –

Following a Mediterranean diet is one way you can reduce CAD and cut your risks for other diseases. While no Mediterranean diet has more value than another, the following equation highlights the factors that make a Mediterranean diet so valuable. First, eat a variety of fruits, vegetables, whole grains, beans, nuts, and seeds, with olive oil as an important source of fat. Then, add moderate amounts of fish, poultry and fresh dairy. Finally, subtract red meat from your diet, or at least limit your consumption.

The Dietary Approaches to Stop Hypertension (DASH) diet is the American version of the Mediterranean diet and has been found to reduce blood pressure and LDL levels. It is rich in fruits and vegetables, moderate in low-fat dairy, and low in animal protein. It promotes the use of legumes and nuts as plant sources of protein.

Along with increasing your plant-based foods and decreasing your consumption of red meat, you may also want to replace some of the carbohydrates in your diet with proteins or monounsaturated fats. This switch can improve lipid levels.

Fiber, Nuts, Tea, and Alcohol –

Dietary soluble fibers such as pectin, wheat dextrin, and oat products will reduce LDL. Some suggest that a combination of soluble fiber with plant sterols may be beneficial. Walnuts, high in polyunsaturated fatty acids, have been shown to positively impact serum lipid levels. Almonds, pistachios and other nuts have shown similar results. Those consuming nuts more than four times per week showed the most significant improvement. Also, those with moderately high LDL who drank green tea once to twice per day while following a low-fat diet found more improvement in LDL reduction than they did with a placebo. Moderate alcohol consumption (1-2 drinks per day) has been shown to improve HDL levels. Red wine has the added antioxidant benefit even in its non-alcohol form. 

Weight Loss –

Fat cells secrete chemicals that negatively affect lipid metabolism. “Maintaining a body that is slim and trim with consistent exercise and a low-calorie diet limited in saturated fats is the key”

Supplements –

While the internet is littered with information on thousands of supplements claiming to lower cholesterol and provide other life enhancing outcomes, few are proven effective. Of these, only fish oil, taken in concentrated high doses (> 6g/day) has been proven to lower triglycerides and LDL.

Multivitamins, soy proteins, and other grain products, while not cholesterol reducing, are valuable to many. But when it comes to reducing cholesterol, garlic, policosanol, Vitamin E, and isoflavone supplements have failed the scrutiny of scientific research. Plant sterols such as Benecol^R sisosterol and campesterol, found in Promise activ^TM, have been shown to slightly reduce serum cholesterol levels; however, no studies have demonstrated their ability to lower the incidence of CAD. In fact, the Nutrition Committee of the American Heart Association has suggested that the general population not use these products until further studies determine their safety and efficacy, due in part to potential side effects.

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

Have you ever noticed high level athletes warming up before a game or competition walking or running backwards? You may also see fitness enthusiasts in gyms emulating these athletes to improve their fitness or performance. I found the concept of backward walking (also called retro walking) interesting and decided to research the topic for more information and validation. Walking backward does have many therapeutic benefits, however, before you attempt this activity on a treadmill or elliptical, please consult your physician and physical therapist and have a spotter nearby.

Strength Improved in Leg Muscles:

At a recent meeting of The American College of Sports Medicine, several studies were presented on the topic of backward waking. Most of the research was conducted while moving backward on a treadmill and an elliptical machine. When comparing two groups recovering from knee injuries, the backward motion group showed significant improvement in strength in the quadriceps (front thigh) and hamstring (back thigh) muscles when compared to the traditional forward walking group. Furthermore, the muscles of the front (tibialis anterior) and back (gastro/achilles) of the shin/ankle also demonstrated an increase in strength and endurance with backward walking. One explanation is that forward motion is routine in daily living that it has become very efficient and does not tax or stress the muscles the body. While this efficiency prevents fatigue in daily activities, it may not stress the muscles enough to gain strength as quickly as an unfamiliar exercise.

Cardiovascular Benefit/Calorie Expenditure:

Due in great part to the increased strain of performing unfamiliar exercise, backward walking on a treadmill or backward pedaling on an elliptical, offered a greater cardiovascular benefit and caloric expenditure than forward motion at all levels. Specifically, walking backward on a treadmill at 2.5 mph at grades of 5% - 10% has been found to significantly increase cardiovascular endurance than walking forward under the same conditions. This knowledge is useful for healthy individuals in need of greater cardio exercise. However, it may also serve as a precaution for those with cardio problems and should consult their physician prior to engaging in this activity.

Weight Loss:

A recent study in the International Journal of Obesity, found that those who performed new activities or increased the intensity of an activity, even if for a short duration (interval training) expended more energy and burned more calories than those who worked out at the same pace consistently for a longer duration. Moreover, when engaging in a new activity such as backward walking, even more calories were burned. This phenomenon may be due to the fact that routine activities such as forward walking are performed more efficiently and easily.

We challenge our body when we inefficiently perform a new motor skill such as backward walking and burn more calories. In other words, if you want to burn more calories without exercising for longer periods of time, then try a new activity and engage in higher intensity, intermittently, for part of the time. For example, walk backward on the treadmill for 30 minutes at 2.5 mph, but do so at a 5 – 10% incline for 1-2 minutes every 5 minutes.

Protection for Your Muscles, Tendons and Joints:

Some studies show that using other muscle groups by performing different exercises not only prevents boredom but also protects your muscles and tendons from overuse and joints from wear and tear. Specifically, the knee joint and the patella joint (the joint where the knee cap glides on the knee), benefit from backward walking due to less stress and compression forces on the joint. The thigh and ankle/foot muscles benefit from using a different form of contraction while lengthening the muscle. Some authors propose that this may also prevent strains and pulls and may be valuable to strengthen those with a history of shin splints and flat feet (pronation).   

Prevents Boredom:

Mixing up your program prevents boredom. As a rule, those willing to change their exercise routine are more compliant and continue to exercise longer than those stuck in the same routine. A new challenge to improve distance, speed, and resistance while exercising in a different direction will be refreshing to your program.

Improved Balance and Coordination:

Prevention of falls by improvement in balance and coordination has received a great deal of attention in the past few years. This is not only valuable to the athlete but may be even more important to those over 50. With age, balance centers are slow to react to changes in inclination, elevation, rotation and lateral movements. This slow reaction time leads to falls that may cause fractures, head injuries and more. Working on this problem by challenging the vestibular and balance centers before it is seriously compromised is important and backward walking is one way for this to be effectively accomplished.

Treadmill Backward Walking MODEL: Lexi DiGregorio, PTA

• NOTE: When walking backward, hold on to the grab bars on the treadmill and make sure to have a spotter to supervise the new activity until you become accomplished.
• NOTE: Reduce the treadmill speed and elliptical resistance until you become more familiar with this new technique.

Visit your doctor regularly and listen to your body.     

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

A health column about sugar for Easter??? Well, maybe this information will be more appropriate next week! For those trying to lose weight or “get in shape” for the “bathing suit season,” a better understanding of the role sugar plays in your diet and overall health may be valuable. You have probably noticed a lot of attention being paid to sugar lately. Many television stars and other celebrities have shared their experiences using a “sugar cleanse” when they need to lose a few pounds and get healthier.

 I have had several patients and friends tell me the same thing. For 4-6 weeks these people decide to avoid all refined sugars with the goal of losing weight and improving their health and wellness. Well, what is all the fuss about? Terms like simple sugars and simple carbs, which are purported to be bad, and complex carbs, suggested to be good, are being used ad nauseam. While medical research does not support the value of a short term “sugar cleanse,” it may have value for another reason. For example, it would be very beneficial if one engages in a “sugar cleanse” for the purpose of changing their palate with the hope of developing long term healthy eating habits, especially for those with diabetes…to be implemented AFTER the Easter candy has been consumed!

So, with this in mind, I decided to find the answers to some simple questions about the fuss over sugar. What is a simple sugar? What is a complex sugar? Which sugars are good for you?

WHAT IS A SIMPLE SUGAR (CARBOHYDRATE)?

Sugars, along with starches and fibers, are one of three types of carbohydrates (also referred to as a carb). A carb is “simple” or “complex,” based on its chemical composition and how it is processed in the body. It gets a little complicated because some foods have both simple and complex carbs.  Typically, simple carbs are chemically more “simple” and basic, and therefore they are broken down more easily and serve as a quick source of energy. Some of these carbs are naturally simple (like fruit and milk) while others are processed or refined sugars such as those used in candy, soda and baked goods.

To determine if a food product has good or bad simple sugar, you must also know how much fiber, vitamins and minerals are in the food. A food with a higher sugar content combined with a low fiber, vitamin or mineral content will be worse than a food with the same sugar content but high fiber and vitamins or minerals. For example: a candy bar, which is high in sugar without fiber or vitamins or minerals, is not as healthy as a fresh orange, which contains fiber, vitamins and minerals along with its simple sugar (fructose).

Examples of simple carbs:

• Most candy products
• Non-diet soft drinks
• Cookies and cakes
• Iced tea and lemonade with sugar
• Energy drinks
• Ice cream

WHAT IS A COMPLEX SUGAR (CARBOHYDRATE)?

Complex carbs have a more complicated chemical makeup and take more time for the body to break down for use as energy. Therefore, these are considered “good” carbs because they provide a more even distribution of energy for the body to use during activity. They cause a more consistent and gradual release of sugar into the blood stream (as opposed to peaks and valleys caused by simple carbs) and provide energy to function throughout the day. Additionally, “good” carbs have the added benefit of providing vitamins, fiber, and minerals that are missing from simple carbs.

Examples of complex (carbs):

• Whole grains: buckwheat, brown rice, corn, wheat, barley, oats, sorghum, quinoa, breads and pastas made with whole grains
• Dairy: low fat yogurt, skim milk
• Nuts, Seeds, Legumes: lentils, kidney beans, chickpeas, split peas, soybeans, pinto beans, soymilk
• Fruits and Vegetables: potatoes, tomatoes, onions, okra, dill pickles, carrots, yams, strawberries, peas, radishes, beans, broccoli, spinach, green beans, zucchini, apples, pears, cucumbers, asparagus, grapefruit, prunes 

WHY EAT COMPLEX CARBS INSTEAD OF SIMPLE CARBS?

Remember that carbohydrates fuel the body and are an important source of energy, especially for active and athletic people. However, carefully selecting the type of carb you eat is critical to peak function and performance.

Simple carbs taste great (according to our modern brain raised on simple sugars) and are easy to break down into a quick source of energy. However, the sensation of hunger is quick to return because the sugar is released and used up in the body quickly, giving the sensation of needing more.

Simple carbs are often “refined” and therefore stripped of their fiber, vitamins and minerals, which is why they are often referred to as “empty” calories.

Simple carbs lead to rapid spikes in blood sugar and insulin levels after meals. When these levels are not controlled over time, it can lead to obesity, which is ultimately related to adult-onset diabetes and high blood pressure. 

Complex Carbs:

• make you feel full faster and longer and therefore are an important component to weight loss.
• keep the body fueled for an extended time.
• easier to digest, and the fiber content allows for smoother digestion with less bloating and gas, and improved toxin removal.
• from vegetables have been found to lower LDL cholesterol, blood pressure and heart disease.

TIPS TO EAT MORE COMPLEX CARBOHYDRATES

• Eat whole grain (instead of white) pasta and bread
• Eat raw vegetables instead of pretzels and chips
• Add fruit to your yogurt or oatmeal instead of sweetener
• When baking, try cutting the recommended sugar in half and/or use a sugar substitute
• Drink water or diet soft drinks instead of sugared soft drinks, juices or teas
• Eat dessert like the Europeans…fruit and cheeses instead of cookies or cake
• Be aware of condiments such as ketchup and barbeque sauce which contain much more sugar than mustard 
• Eat beans or quinoa instead of rice as a base to a meal
• Add chickpeas, beans, or beets to a salad
• Drink skim milk and eat low-fat yogurt
• Examine the labels on store bought food and look for low-fat/healthy options on the menus

Sources: www.everydayhealth.com; www.yourdictionary.com; Mayo Clinic

Visit your doctor regularly and listen to your body

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

NEW YEAR’S RESOLUTION: GET A “RUNNER’S HIGH” ON LIFE!

The number one New Year’s Resolution in the United States is to lose weight. A close second is to gain control over one’s life. One of the best ways to lose weight is thought diet and exercise. It can also be a very effective method to begin taking control of one’s life. This is especially true for those suffering from stress, anxiety and depression. This year make your New Year’s Resolution to “Get a Runner’s High on Life!”        

Specifically, aerobic exercise (exercise that increases your heart rate for 30 minutes or more) such as walking, biking, running, swimming, hiking, elliptical & stepper machines to name a few, is the secret to “runner’s high.” This exercise euphoria is not limited to runners alone, but all who engage in aerobic exercise are more likely to experience high energy, positive attitude, and mental wellness – not to mention burn calories.

Physical activity, specifically aerobic exercise, while well known for its importance to one’s physical well-being has also been scientifically proven valuable for preventing and easing stress, anxiety and depression. Studies have found improvement in mental health for groups that engaged in aerobic running, jogging or walking programs, 30-45 minutes 3-5 days per week for 10-12 weeks when compared to a control group and a group in counseling.

EXERCISE FOR PHYSICAL HEALTH:

• Loss or Maintained Body Weight
• Reduces LDL /Raises HDL Cholesterol
• Improves Circulation and Blood Pressure
• Reduces Risk of Heart Disease
• Prevents Bone Loss
• Reduces Stress/Muscle Tension
• Lowers Risk of Depression
• Improves Sleep Pattern
• Improves Strength and Flexibility
• Improves Balance/Reduces Risk of Falls
• Improves Immune System
• Improves Pain Threshold

EXERCISE FOR MENTAL HEALTH:

• Helps a person gain control over their lives
• Increases self-esteem
• Diverts attention away from worry, concern or guilt
• Improves mood – with visible signs of improvement in physique & body weight
• Increases sense of pleasure and satisfaction
• Anger management – release pent-up frustration, anger and hostility
• Increase in brain serotonin (natural mood elevator chemical in brain)
• Increase in beta-endorphins (natural mood, stress & pain control chemical in brain)
• Improvement in natural sleep patterns

HOW TO BEGIN EXERCISE TO GET THE “RUNNER’S HIGH” ON LIFE:

• Consult your primary care physician. Be sure that your symptoms are not related to other health problems. Also, if you are using antidepressants or other medications discuss the impact it may have on your exercise program with your physician.
• Recognize and fight stress, anxiety and depression symptoms that are contrary to or prohibit physical activity such as: fatigue, lack of energy, slow motor skills. Work hard to recognize and overcome these symptoms to begin an exercise program. An aerobic exercise routine should eventually lessen these symptoms.
• Be realistic. Expect that aerobic exercise will take time to have a noticeable benefit. Do not get overly ambitious and set yourself up for failure.
• Begin with an aerobic exercise program that is practical and destined to succeed. For example: inactive and deconditioned people should begin walking 5 minutes per day, 3-5 days per week for 1 week. Then, add 3-5 minutes each week until you attain 30-45 minutes per walk 3-5 times per week. Younger and fitter people can begin to walk for 15 minutes and continue until they attain 45-60 minutes per walk, 3-5 times per week. Remember, what seems impossible today will be easier and become routine in 3-4 weeks so JUST DO IT!

• Find a pleasurable environment: a beautiful park (Nay Aug), a scenic lake (Lake Scranton), quiet countryside (rural farmlands of Dalton). Use a mall in inclement weather.
• Find a friendly, uplifting group or individual to walk, talk and exercise with. This may be more appropriate for people feeling isolated or withdrawn. Others may enjoy the peace and quiet of exercising and meditating alone.
• Be specific and compliant! Make a serious commitment. Keep a journal or exercise log. Mark a calendar. 30-45 minutes, 3-5 days per week – NO EXCUSES! Get and exercise buddy you can count on and help keep you compliant!
• Make it fun! Mix it up. Walk 3 days, swim or bike 1-2 days, some days alone, some days with a buddy.
• BE RELIGIOUS! Be religious about exercise BUT don’t get too compulsive!

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

The number one health and wellness goal shared by most patients is …to lose weight! Today, this column will offer some sage and practical advice on satisfying hunger with healthy snacks and to help avoid unhealthy carbs. You have probably noticed a lot of attention being paid to sugar lately. In fact, some people have decided to avoid all refined sugars with the goal of improving their health and wellness. Terms like simple sugars and simple carbs, which are purported to be bad, and complex carbs, suggested to be good, are being used ad nauseam. While medical research does not support the value of a short term “sugar cleanse,” it may have value for another reason. For example, it would be very beneficial if one engages in a “sugar cleanse” for the purpose of changing their palate with the hope of developing long term healthy eating habits.

While I am an advocate of moderation, I decided to provide my readers with some answers to some simple questions about the fuss over sugar. What is simple sugar? What is complex sugar? Which sugars are good for you? What are some good low-carb snacks?

WHAT IS A SIMPLE SUGAR (CARBOHYDRATE)?

Sugars, along with starches and fibers, are one of three types of carbohydrates (also referred to as a carb). A carb is “simple” or “complex,” based on its chemical composition and how it is processed in the body. It gets a little complicated because some foods have both simple and complex carbs.  Typically, simple carbs are chemically “simpler” and more basic. Therefore they are broken down more easily and serve as a quick source of energy. Some of these carbs are naturally simple (like fruit and milk) while others are processed or refined sugars such as those used in candy, soda and baked goods.

To determine if a food product has good or bad simple sugar, you must also know how much fiber, vitamins and minerals are in the food. A food with a higher sugar content combined with a low fiber, vitamin or mineral content will be worse than a food with the same sugar content but high fiber and vitamins or minerals. For example: a candy bar, which is high in sugar without fiber or vitamins or minerals, is not as healthy as a fresh orange, which contains fiber, vitamins and minerals along with its simple sugar (fructose).

Examples of simple carbs:

Most candy products, non-diet soft drinks, cookies and cakes, iced tea and lemonade with sugar, energy drinks, and ice cream.

WHAT IS A COMPLEX SUGAR (CARBOHYDRATE)?

Complex carbs have a more complicated chemical makeup and take more time for the body to break down for use as energy. Therefore, these are considered “good” carbs because they provide a more even distribution of energy for the body to use during activity. They cause a more consistent and gradual release of sugar into the blood stream (as opposed to peaks and valleys caused by simple carbs) and provide energy to function throughout the day. Additionally, “good” carbs have the added benefit of providing vitamins, fiber, and minerals that are missing from simple carbs.

Examples of complex (carbs):

• Whole grains: buckwheat, brown rice, corn, wheat, barley, oats, sorghum, quinoa, breads and pastas made with whole grains
• Dairy: low fat yogurt, skim milk
• Nuts, Seeds, Legumes: lentils, kidney beans, chickpeas, split peas, soybeans, pinto beans, soymilk
• Fruits and Vegetables: potatoes, tomatoes, onions, okra, dill pickles, carrots, yams, strawberries, peas, radishes, beans, broccoli, spinach, green beans, zucchini, apples, pears, cucumbers, asparagus, grapefruit, prunes 

WHY EAT COMPLEX CARBS INSTEAD OF SIMPLE CARBS?

Remember that carbohydrates fuel the body and are an important source of energy, especially for active and athletic people. However, carefully selecting the type of carb you eat is critical to peak function and performance.

Simple carbs taste great (according to our modern brain raised on simple sugars) and are easy to break down into a quick source of energy. However, the sensation of hunger is quick to return because the sugar is released and used up in the body quickly, giving the sensation of needing more.

Simple carbs are often “refined.” Therefore stripped of their fiber, vitamins and minerals, which is why they are often referred to “empty” calories.

Simple carbs lead to rapid spikes in blood sugar and insulin levels after meals. When these levels are not controlled over time, it can lead to obesity. Ultimately relates to adult-onset diabetes and high blood pressure. 

• Complex carbs:
  • make you feel full faster and longer and therefore are an important component to weight loss.
  • keep the body fueled for an extended time.
  • are easier to digest, and the fiber content allows for smoother digestion with less bloating and gas, and improved toxin removal.
  • from vegetables have been found to lower LDL cholesterol, blood pressure and heart disease.

10 Healthy Low-Carb Snacks:

• Fruit and Cheese
  • Sliced apples or pears are a great compliment to a variety of cheeses. With only 10 grams of carbs, the combination of protein, fat and fiber is, not only tasty, but will sustain you for hours.
• Avocado Spread on a Low-Fat Cracker
  • Mash a ripe avocado and spread on a low-fat cracker or crisp. This delicious high-fiber snack has 17 grams of carbs.
• Yogurt and Cucumbers
  • Greek and Middle Eastern cultures have long known the value of yogurt. By adding cucumber (slices or spears) for dipping or diced, the snack becomes high in protein (21 grams) while low in carbs (10 grams).
•  Chicken, Turkey, Porketta Lettuce Roll-Ups
  • Use healthy, white deli meat but avoid the bread. Instead, use lettuce to wrap the meat and maybe add spicy mustard. 1 ounce of sliced turkey has only 3.7 grams of carbs.
• Cottage Cheese and Fruit
  • Add your favorite fruit, (blueberries, strawberries, raspberries, pineapple, peaches, etc) to low-fat cottage cheese and you get tasty, healthy low carb (17 grams), low-fat with the additional benefit of fiber and protein. 
• Celery and Peanut Butter
  • 2 stalks of celery filled with 2 tablespoons of natural peanut butter creates a simple, yet healthy snack loaded with fiber and protein and only 10 grams of carbs.
• Nuts
  • Mixed nuts, in moderate quantities, are a good snack because they offer a crunchy, salty, high protein option with 6 grams of carbs per ounce. However, some nuts are better for you than others: macadamias have more heart-healthy monounsaturated fats, cashews are high in iron, and zinc and almonds are very high in fiber and vitamin E.

• Edamame
  • Edamame are high-fiber, high-protein soybeans have only 6 grams of carbs in a half-cup. A frozen bag pops into the microwave to become a quick easy healthy snack.
• Hummus
  • Hummus is a very popular and healthy chickpea dip. And, if not eaten with copious amounts of pita bread, it can also be low carb. Instead, dip carrots, celery, red bell pepper wedges, and zucchini (16 grams of carbs).
• Tuna-Stuffed Tomato
  • 3 ounces of tuna stuffed into a fresh tomato half offers a healthy snack with only 3.5 grams of carbs.

Sources: webMD, NIH, CDC

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

EXERCISE IS A CRITICAL COMPONENT IN THE CURE!

The World Health Organization has classified obesity as a chronic disease and determined that it is reaching epidemic proportions, not only in the United States, but globally. Moreover, closer to home, the Pennsylvania Department of Health has determined that PA ranks 17^th among all states in the country for percentage of obese residents. Childhood obesity is defined as having a body mass index (BMI) at or above the 95^th percentile for age and sex in children aged 2 and older.

People have theorized for many years that obesity must be genetic. Scientific research has validated this theory and more importantly, a recent study has shown that while there is an obesity gene that may predispose one to obesity, one can control the outcome with exercise. The fat mass and obesity gene (FTO) is linked to a high body mass index according to a new study in the Archives of Internal Medicine. More importantly, this study found that exercise can offset a genetic predisposition for obesity. Aerobic exercise 30-45 minutes 3-5 times per week coupled with mild weight training and other physical activities can overcome the FTO. With new knowledge, it becomes apparent that it is critical to promote a healthy lifestyle with exercise and physical activity at an early age to prevent childhood obesity.

Childhood Obesity as a Medical Problem:

Obesity increases with age and its prevalence among obese children will continue to be obese with age. Childhood obesity is the leading cause or is associated with: hypertension, Type II diabetes mellitus, coronary heart disease, lower extremity joint stress and pain, lower self-esteem and other psychological problems. 

Causes of Childhood Obesity:

As with adult obesity, childhood obesity is most often caused by multiple problems including: nutritional, psychological, familial, and physiological.

1. The Family
   • The risk of becoming obese is very high for those children with two obese parents. Strong genetic factors as well as parenting habits of eating and exercise may play a role.
2. Low-Energy Expenditure
   • The average child in this country spends several hours watching TV or playing video games. Childhood obesity is greater among those who exceed this average not only because of low-energy expenditure, but also due to the consumption of high-calorie snacks and drinks while watching TV. Previous generations spent this time engaging in physical activity. Only one-third of grade-school children have daily physical education in school.
3. Heredity
   • Not all children who eat badly and lack physical activity are obese. As shown in the Archives of Physical Medicine study the FTO gene has shown that there are other causes for obesity, such as heredity. 

Treatment of Childhood Obesity:

Weight loss is not the primary role of a good childhood obesity program. The goal is to limit or stop weight gain so the child will eventually grow into their body weight over a period of many months or years. One study suggests that it requires 1 ½ years of body weight maintenance for every 20 percent excess in ideal body weight for a child to ultimately attain ideal body weight.

1. Physical Activity
   • Increasing physical activity or engaging in a formal exercise program is essential to burn fat, increase caloric expenditure to lose and/or maintain weight. However, studies show that exercise alone is not nearly as effective as when it is combined with proper nutrition/diet and behavior modification. Physical activity is also critical for the health of the child. Blood pressure and lipid profiles improved in children/adolescents who engaged in 50 minutes of aerobic exercise, 3 times per week, even when weight loss was only minimal. In view of this, I recommend 45-60 minutes of exercise and physical activity as a minimum of 5 days per week and preferably 7… walk, run, bike, swim, play tennis, pickleball, soccer, and walk when you golf.
   • Use technology to promote fitness with physically active video games such as the “GET STRONG” Kids Workout and “Kids Daily Exercise” that children expended significant energy when they play video games that require physical activity. Many studies have found that kids expended three times more energy than traditional video games played while sitting or when compared to watching TV while walking on a treadmill. There may be hope for our kids!
   • Also, some personal trainers and fitness clubs specialize in programs exclusively for children such as “My Gym Scranton” on Birney Avenue, Scranton.  
2. Diet Management
   • Extreme dieting and fasting is not appropriate for children. It is emotionally stressful and physically harmful to the growth and development of a child/adolescent. A balanced diet with moderate caloric and portion restrictions coupled with exercise and counseling is the proper combination.
3. Behavior Modification
   • Behavioral strategies are found to be very successful in children/adolescence. Self-monitoring and keeping a record in a journal of food intake, activity and exercise are helpful. Also, rewards and incentives can be effective. Parent/child counseling programs are most effective.

In conclusion, childhood obesity is a serious epidemic. It is physically and emotionally stressful for the child/adolescent and family. This problem requires a comprehensive team approach including: family, physician, educator, dietitian, psychologist, physical therapist and other health and exercise specialists. Lastly, to be successful, it must involve the entire family and be a lifetime lifestyle change 7 days a week regarding diet and exercise, not a 3-to-6-month fad. It must be a long-term program with a long-term goal!

Sources: World Health Organization (WHO), Archives of Physical Medicine, 2008, Vol 168, 1791 – 1797

Visit your doctor regularly and listen to your body.     

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

82 million adults spend an estimated 28 billion dollars on gym memberships each year! WHY? There are many reasons we exercise. Some people exercise to prevent illnesses such as cardiovascular disease or osteoporosis. Others exercise for mental health and as a stress release; others do it to improve strength, flexibility, and endurance to prepare for a sport. However, the number one reason people exercise is TO LOSE WEIGHT!

When it comes to losing weight, patients have asked me a wide variety of questions over the years. However, certain questions are consistent. “What exercise is the best to burn calories?” “Even though I exercise 2-3 times per week, why can’t I lose weight?” “What is BMR?” “If I eat a Snickers bar, how much exercise do I need to do to burn it off?” “Are there any tools that I can use to help me track my calories and exercise output?”

Which Exercise is the best to burn calories?

Have you ever heard people say that they never felt better or burned more calories than they did when they ran? Well, they may be right! The following numbers are based on the average male weighing 150 pounds: running 6 miles per hour will burn 700+ calories (11-12 calories per minute); vigorously skipping with jump rope or fast cycling will do the same; vigorous walking at 4 miles per hour and moderate biking will burn 600+ calories (10 calories per minute). The 400-500 calorie club includes the following activities: slow jogging, swimming, football, basketball, baseball, tennis, skiing, and moderate walking (3.5 miles per hour).  Light gardening burns more calories than golfing using a cart (250 vs. 180).

Do you have difficulty losing weight even though you exercise? What is BMR?

How many times have you heard people say, “It is hard for me to lose weight because I have a slow metabolism?” What does that mean? To explain this in detail you first must understand BMR. BMR is basic metabolic rate. It is the number of calories that your body requires to operate basic body functions that you don’t actively control, such as continuing to breathe, and keeping your cells and organs working each day. The BMR is influenced by age, height, gender, body fat, and fitness level. BMR is inherently different (high or low) in everyone.

While you can’t change your gender or height, you can influence some things to influence your BMR and burn more calories at rest. One, exercise for longer durations, with greater intensity and more frequently. Two, lower body fat by eating less calories, especially fat and carbohydrates in your diet. Simply, eat less calories than you burn! Three, improve your muscle/fat ratio by weight training.

Basic Metabolic Index (BMI):

BMI:           < 18.5  = Underweight

BMI:   18.5 – 24.5  =  Normal Weight

BMI:    25.  -  29.9  =  Overweight

BMI:            >30.    =  Obestiy

For example, I am a 66-year-old male, weighing 155 pounds at 5 feet 8 inches tall with a BMI of 23.6

*Calculate your BMI by entering your gender, height and weight and find how many calories per food item at:

www.calculator.net

Are there any tools for tracking calories and exercise?

There are several tools available for free online to help with tracking calories and exercise visit Prevention Magazine at: www.myfooddiary.com or try the App “Lose It”

BMI Calculator – to calculate your BMI

Calorie Burner – to calculate how many calories are burned with various activities

Daily Calorie Calculator – Find how many calories are in specific foods and what you need to do to lose or gain weight.

So, remember, the number one reason we exercise is TO LOSE WEIGHT! But depending on exercise alone to lose weight is an exercise in futility. Losing weight is an intelligent and consistent combination of a balanced diet with portion control, proper nutrition, adequate exercise and activity grounded in lifestyle changes.

FOOD (CALORIES) AND ACTIVITY REQUIRED TO BURN:

Mayo Clinic –December 2009

                                                    (Body Weight)                                   (Body Weight)

                                       125#       175#       225#                       125#       175#       225#

SNICKERS BAR            65           48           37                           28           20           16          

(2 oz. - 271 cal)

APPLE                                17           13           10                           8              5              4

(Med  - 72 cal)

ROOT BEER                      37           27           21                           16           11           9

(12 oz. – 152 cal)

SPARKLING WATER    0              0              0                              0              0              0

(0 cal)

GROUND BEEF               51           38           29                           22           16           12

85% lean

(3 oz. – 213 cal)

WHITE TUNA                   26           19           15                           11           8              6

Water Packed

(3 oz. – 109 cal)

ICE CREAM                       66           48           37                           29           21           16

Vanilla

(1 cup – 274 cal)

STRAWBERRIES             13           9              7                              6              4              3

(1 cup – 53 cal)

GLAZED DOUGHNUT   57           42           33                           25           18           14

(med – 239 cal)

TOAST                                 30           22           17                           13           9              7

Whole-grain – 1 slice

(1 tbsp jam – 125 cal)

STARBUCKS CAFFE’    65           48           37                           28           20           16                                          

MOCHA

2% milk – whp crm

(12 oz. – 270 cal)

COFFEE                              10           7              5                              4              3              2

1 tbsp half/half – 1 tbsp sugar

(12 oz. – 40 cal)

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

What is a myth?

A myth is a traditional story, idea, or belief, especially one concerning early history of a people or explaining a natural or social phenomenon. It is a widely held but false belief or idea. In medicine, health myths are also widely held beliefs about health issues such as medicines, herbs, treatments, cures, antidotes, etc. which are partially or totally false and unsubstantiated in the scientific literature. This is a partial list of the most common health myths:

1. 8 GLASSES OF WATER IS ESSENTIAL FOR GOOD HEALTH
   • You don’t need to search very long to find copious information purporting the value of water to maintain good health. Sources suggest between 8 and 15 cups of water per day! Despite the plethora of contradictory information, there is no research to support an exact amount. In fact, most scientifically validated research suggests that healthy adults do not need to count cups and those who drink water when thirsty receive adequate hydration for good health. Remember, there are many water-rich foods to provide hydration; soup, fruit, vegetables, juice, coffee, and tea. However, be aware that if your urine is dark yellow you need more hydration. And, if you are very physically active or live in a warm climate, you may require more water.
2. EATING EGGS WILL LEAD TO HEART DISEASE
   • In the late 70’s, eggs received a bad reputation when high cholesterol in the blood could increase the risk of heart disease. The love-hate relationship with eggs and egg products has continued to grow since. However, recent findings suggest that eating an egg or two a day will not raise the risk of heart disease in healthy adults. While egg yolks do contain cholesterol, the amount is relatively small and is offset by the fact that eggs also have many nutrients such as omega-3’s, which are associated with lowering the risk of heart disease.
3. ANTIPERSPIRANTS CAN LEAD TO BREAST CANCER
   • Some research attempted to link the preservatives (parabens) used in some deodorants and antiperspirants with the activity of estrogen in the body’s cells because these parabens are found in breast tumors. However, there is no scientific evidence that parabens cause breast cancer. So, don’t sweat it!
4. SPENDING TOO MUCH TIME IN THE COLD AIR WILL LEAD TO A COLD
   • Sometimes “old wives tales” are true…but not this one! Grandparents and parents have been telling their grandchildren and children to button up and don’t spend too much time in the cold. In fact, one study found that healthy men who spent several hours a day in cold temperatures (just above freezing) had an increase in virus-fighting activity in their immune systems. Moreover, documentation supports that spending too much time indoors, especially during winter flu season, puts you at risk for getting the flu…so circulate fresh air or get outdoors!
5. EVERYONE NEEDS A MULTIVITAMIN TO BE HEALTHY
   • Research does not support this theory that everyone needs a multivitamin to supplement for nutrients not in your diet. In fact, most medical experts agree that healthy adults receive all necessary nutrients and vitamins from a well-balanced diet including; fruits, vegetables, whole grains, nuts and healthy oils. However, if your physician recommends a vitamin, do so. It may be that you are insufficient or at risk due to other medical conditions. If you are pregnant, for example, you will need to take folic acid to lower the risk of birth defects. 
6. EATING A GOOD BREAKFAST IS NECESSARY TO LOSE WEIGHT
   • Some diets purport that eating breakfast is necessary to stimulate your metabolism in order to lose weight. This theory is not confirmed, and for those who enjoy breakfast, it may limit hunger sensation and prevent unhealthy snacking. However, a study from Cornell University found that those who did not eat breakfast did not overeat at lunch and dinner and consumed approximately 400 fewer calories per day. So, for some healthy adults, eliminating breakfast can help lose weight…the premise of “intermittent fasting.”
7. GREEN MUCUS IS A SURE SIGN OF INFECTION
   • Most would agree, the slimy green mucus in your tissue is disgusting. However, without a lab test, it is not a sure sign of an infection or need for antibiotics. Often, clear mucus indicates a sinus infection, while green mucus represents a common cold.
8. TOO MUCH SUGAR MAKES KIDS HYPERACTIVE
   • Sugar making your kids hyper? Maybe it’s just kids being kids! It is widely accepted that sugar is not good for kids (unhealthy calories leading to obesity, etc). However, Research shows that it is not the cause of hyperactivity (caffeine or chocolate may). It may be that parents are so focused on their behavior after sugar intake that they expect their kids to be wired when it may just be attributed to the normal behavior of kids just being kids!
9. A TOILET SEAT IS A COMMON AREA TO SPREAD DISEASE
   • Believe it or not, toilet seats are not the most unsanitary item in the bathroom. So, if you can’t cover it, don’t sweat it. Bugs such as E. coli, norovirus, and other flu viruses cover bathroom doors, door handles, and floors. Thorough hand washing is essential and use a paper towel for door handles.
10. CRACKING YOUR KNUCKLES OR OTHER JOINTS WILL LEAD TO ARTHRITIS
    • One thing is certain…cracking your knuckles is annoying to everyone around you! But studies show that it is not harmful to your joints or causes arthritis. The popping noise is not because the bones are grinding together; it is due to movement of gas bubbles in the joint capsule.  
11. ELIMINATING FAT FROM YOUR DIET WILL MAKE YOU HEALTHIER AND HELP YOU LOOSE WEIGHT
    • Total elimination of fat from your diet is not only unnecessary to be healthy and lose weight, but is unhealthy and harmful. Fat provides essential nutrients and is an important component of a healthy diet. Due to the fact that fats have more calories per gram than protein or carbohydrates, limiting fat intake is necessary to avoid extra calories. Instead, chose low fat dairy products (milk, yogurt, cheese) and consider eating small amounts of food with healthy fats, such as avocados, olives, or nuts. 
12. CHILDHOOD VACCINES LEAD TO AUTISM
    • Vaccines do not cause autism. Despite much controversy, there is no scientific evidence that supports a connection between autism and childhood vaccines. In fact, the original study that started the debate years ago has been disproven and retracted. Fact: childhood vaccines protect children from a variety of serious or potentially fatal diseases.

SOURCES: WebMd; National Institutes of Health, Mayo Clinic

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

This article does not intend as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

Kick Start Your Wellness New Year’s Resolutions: PART II OF II

January is the time of year that many people set goals and resolve to be their very best. Not surprisingly, weight loss and fitness are the most common resolutions. It is also a time when many residents of NEPA will plan vacations and travel to warmer climates. Well, it may be that you can do both… This year consider visiting a “Fitness Resort.” According to “FitStays,” fitness resorts are rapidly gaining popularity for people of all sizes and shapes. Last week in Part I of “Fitness Resorts” we discussed value of fitness resorts. This week we will present “a typical day, how long you should stay, expected costs, and some recommended resorts.

What is a Fitness Resort? (fitstays.com)

A fitness resort is a vacation destination where travelers go to exercise and lose weight. Sometimes called a “weight loss resort”, “fitness retreat”, “wellness resort”, “weight loss boot camp”, or “adult fat camp”, fitness resorts around the United States cater to people of all shapes and sizes.

Most fitness resorts consist of pre-determined, calorie-limited menus to help travelers in their weight loss journey. Some resorts promote menus of 1,000 to 1,500 calories-per-day, which is fewer than most people burn naturally via their resting metabolic rate (RMR).

In addition to net-negative calories through nutrition, fitness resorts and retreats typically have an extensive workout plan as part of their standard program. Many resorts and retreats offer daily hiking, in addition to strength classes, cardio, sports, and other physical activities.

The combination of healthy nutrition and active exercise means that most visitors can expect to lose weight at a fitness resort. Specific weight loss goals are determined by which fitness resort you pick, how long you stay, and how strenuously you want to stick to the program.

Fitness Resort – What’s it all about?

Fitness resorts (fitness retreats) are not your average “Reality TV Fat Camp.” In fact, your do not have to be excessively overweight to attend as people of all shapes and sizes benefit and enjoy the experience. Thousands of people chose to visit fitness resorts and fitness retreats every year because they are looking for a healthy alternative to a typical vacation. Instead, many want to “kick-start” a healthy lifestyle in a controlled environment. The basic concept of combining a limited-calorie diet with daily exercise, most people will have net-negative calories every day, lose weight, and gain strength and endurance at a fitness resort—provided they stick to the program.

Length of Time/Cost

Typically, fitness resorts offer one week programs but multiple weeks with a variety of options are available. However, for the best outcomes and carryover, experts recommend 2-3 weeks for your first visit to a fitness resort.

Fitness resorts, like everything else, vary in cost. According to FitStay, programs cost as little as $1,500 per week (all-inclusive), while some are more than $7,000 per week.

To choose the best fit for you, your budget, and goals, visit fitstay.com. Remember, most fitness resorts are all-inclusive, meaning that you won’t need to budget any extra for food. The program includes meals. Also, when choosing a fitness resort consider: location (where would you like to travel?); cost (how much can you afford to spend?); how long can you stay (one, two or three weeks?)

FitStays – Top 20 Fitness Retreats (7 of these discussed below):

NOTE: One of these includes a fitness retreat in our very own Pocono Mountains!

• Structure House - a residential weight loss center in Durham, North Carolina. This all-inclusive health resort promotes physical, nutritional, and behavioral principles for helping guests achieve their wellness goals. Packages at Structure House can be purchased for weekly, monthly, or longer stays.
• Skyterra Wellness Retreat - an all-inclusive fitness resort and wellness retreat designed to help guests lose weight, gain muscle, and feel-better. Located in Pisgah Forest, North Carolina, Skyterra offers year-round packages in their lodge-style accommodations which include all meals, fitness classes, activities, and education.
•  Live In Fitness - Originally located in Long Beach, California, “Live In Fitness” has temporarily moved to a new location in Scottsdale, Arizona. It is an all-inclusive fat camp and promotes weight loss results rather than spa services.
• Weight Crafters - a popular weight loss camp located in the Tampa-St. Petersburg Florida area. The all-inclusive retreat program is focused on helping guests relieve stress, maximize wellness, lose weight, and improve their physical fitness
• Pocono Trails Adult Fitness Camps - offers fitness camps for young adults, moms, and families. Their young adult camp is designed for men and women ages 18 to 25. While the mom and family camps are open to those respective groups each summer. All camps take place at the Pocono Trails location in Reeders, Pennsylvania, along with their standard Camp Pocono Trails weight loss camp and Internet Habit Reversal Camp for kids and teens.
•  Biggest Loser Resort - a fitness resort in Java Center, NY. While the resort is named after the popular reality TV competition, the program itself is designed around healthy weight loss, rather than dramatic, short-term results.
• The Biggest Loser Resort places a major emphasis on exercise and calorie-controlled meals, with programs designed to accommodate multiple fitness levels.
• Hippocrates Health Institute - is located at the Hippocrates Health Institute in West Palm Beach, Florida. At this wellness resort, there is a heavy emphasis on diet and nutrition. Fitness may be a secondary focus, but you will still expect to exercise 4 hours every day, with a mix of strength and cardio classes.

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!