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Nervous System Health

Nervous System Health and Physical Activity

by Bob Gurney

During the months of November and December 2011, Kinesiology/Physical Education students – University of Alberta – PEDS 409 – Research Methodology, provided a presentation, as part of the course assignment requirements. The students are as follows: Lauren Glenister, Amy Heidebrecht, Claire Altares, Jaclyn Ellis, and Christopher Hills. This paper has been edited by Robert Gurney.

Diabetic neuropathy (DN) is the most common form of neuropathy in the western world and is the most prevalent complication currently affecting nearly 50 per cent of patients with diabetes mellitus (Dejgaard, 1997; Aring, Jones & Falko, 2005). Diabetic Neuropathy can develop in patients with type 1 or 2 diabetes and can occur at any stage, however, is more common in patients with Type 2 diabetes mellitus (T2DM) and, chronic poor glycemic control (Aring, et al., 2005). Type 2 diabetes mellitus has achieved proportions of a real epidemic and, according to the International Diabetes Federation (IDF) the disease now affects over 240 million people (Teixeira-Lemos, Nunes, Teixeira, & Reis, 2011). Studies have shown that the longer duration a person has T2DM the higher risk they are for DN (Edwards, Vincent, Cheng, & Feldman, 2008). Early detection and control of diabetes and co-existing risk factors for neuropathy can prevent or delay the progression of DN (Aring, et al., 2005). Symptoms depend on the part of the nervous system that is affected but are commonly associated with muscle weakness, pain, decreased motility, amputation and other co-morbid complications that has a detrimental effect on the quality of life, and has greatly increased the risk of mortality (Edwards, et al., 2008). Classifications of DN can be found in the research of Aring, et al., (2005). Insulin deficiency and hyperglycemia have been found to initiate progression of all types of DN (Tesfaye, Harris, Wilson, Ward, 1992). Therefore, glycemic control has been correlated to reduce both incidence and progression of DN (Edwards, et al. 2008).

Current information included in the National Diabetes Information Clearinghouse provides basic how-to- management information for individuals with Diabetes (National Diabetes Information Clearinghouse, 2009). The problem with the information provided is that the individual is required to seek out many additional sources of information on how they can improve their neural health and eliminate root causes. The goal for our how-to guide is to express specific measures through multiple disciplines. Compiling the information into one how-to guide, will create material that can be referenced to improve neural health and help in the prevention of neural damage.

This guide will be looking at the causes of DN and how it can be self-managed through changes in lifestyle, including physical activity and nutrition. Looking through the research there are no how-to guides, based on scientific evidence, to advise the diabetic population on how to effectively management the progression of their disease through an interdisciplinary approach.

Physiology

Chronic hyperglycemia leads to an inability to transmit signals through nerves, slowing nerve conduction velocity (NCV) and increasing vasoconstriction (Tesfaye, et al., 1992). Nerve conduction velocity is a non-invasive measure of nerve function (Said, 2007). In tissues where glucose is transported independently (nerve, eye and kidney), hyperglycemia causes higher concentrations of intracellular glucose, leading to functional impairment of nerves (Dejgaard, 1997). When high concentrations of glucose are converted to sorbitol within the cell, there is a reduction in myo-inositol, inhibiting ionic activity within the cell. Tesfaye et al. (1992) found that after direct warming of the limb, in subjects with DN and subjects without, NCV increased. This implies that warmer temperature, initiated by a warming modality or exercise can be a potential treatment for DN symptoms.

Balducci, et al. (2006) illustrated that long term aerobic exercise training can prevent the onset or progression of DN. Aerobic and resistive exercise improves sodium, potassium and ATPase concentrations; which are beneficial to NCV, nerve function, vasodilatation, blood flow, and improving oxygen utilization (Balducci, et al. 2006). Improving glucose metabolism through exercise training occurs primarily through 3 distinct mechanisms: 1) stimulation of glucose transport to muscle, 2) increased insulin action on cells of organs involved in exercise, 3) positive regulation of the signalling pathway stimulated by insulin as a result of regular exercise (Teixeira-lemos et. al, 2011). Resistance and aerobic exercise can improve insulin sensitivity to approximately the same extent, and therefore, should be implemented to manage the progression of DN (Signal, Kenny, Wassermam, Castaneda-Sceppa, White, 2006). Continue reading

Winter Fat

Metabolism and Weight Management in the Winter

by Calvin Zaryski

Hunker down, the winter months are upon us and most will gain fat mass. Blame the fact that most mammals fatten up over the winter due to colder temperatures or less daylight, the question remains on how to avoid this phenomenon. Most attribute it to a lowering of metabolism, if so, how can we increase our metabolic rate in the winter months to minimize fat gain.

Metabolism is a combination of physical and chemical processes that are responsible for regulating and maintaining your body health. All of the nutrients responsible for these processes come from your diet. Your metabolic rate is the amount of calories you expend everyday.

Three factors determine your total metabolic rate. The basal metabolic rate (BMR) is the rate your body uses energy for vital body processes. The rate you burn energy during physical activity and the rate you use energy during digestion of food are the two other factors involved in your total metabolic rate.

Research has proven that in order to either lose fat mass or maintain your current state, you metabolic rate and caloric expenditure should be equal or more than the amount of daily calories your consume. If you accomplish several days of this negative imbalance, it is likely that you will lose body fat.

The notion of consuming certain foods that increase metabolism has some validity. Research has shown that chili peppers and spicy foods increases metabolism, but only slightly and only for a short period of time. Even green tea has been investigated but was concluded that normal amounts would have no effect on losing fat mass. There are no foods that have been scientifically proven to increase your metabolic rate enough to shed those unwanted pounds.

The entire process of eating food in general does increase your metabolism. Therefore, eating frequently but in small amounts, is more advantageous than eating two or three larger meals per day. Furthermore, protein requires about 25% more energy to digest when compared to most carbohydrates and could be part of the explanation why higher protein diets tend to have better weight loss results. However, there are some carbohydrates that are termed negative calorie foods. These foods use more calories to digest than the calories the foods actually contain! For instance, a 25 calorie piece of broccoli (100 grams) requires 80 calories to digest, resulting in a net loss of 55 calories.  In fact, there are a large number of foods that combine low calories, delicious taste, and excellent negative calorie properties. Some of these natural foods are asparagus, apple, beet, berries, broccoli, cabbage, carrot, cauliflower, celery, chili, cucumber, garlic, lettuce, grapefruit, lemon, mango, onion, orange, papaya, pineapple, spinach, turnip, zucchini to name a few.

Of course, exercise must be mentioned as a major factor that will increase metabolism. Specifically, the higher the intensity and the amount of time spent at high intensity, the greater the metabolic rate will be elevated and the longer it will remain high. Simply monitor your heart rate after an easy 60 minute run, versus a 10km running race pushing your physiological limits. Also, it seems that exercising in the morning tends to elicit better overall fat loss results, particularly if the exercise is intensive. Morning intensive exercise is more likely to become a habit and an increase in morning metabolism helps burn calories for the rest of the day.

Resistance training also increases metabolic activity and is responsible for maintaining and gaining muscle mass. Muscle tissue burns much of the calories when at rest. Even when not formally exercising, activating muscles, such as fidgeting, walking around while talking on the phone or wiggling your fingers and toes when watching TV, increases your metabolic rate. So always keep moving!

The science is clear on how to ward off that unwanted fat or shed those unwanted pounds. There are no safe long lasting metabolic enhancement foods that can be consume. But rather some simple nutrition tips that, if all are incorporated, results are likely. Bottom line, you must focus on low calorie foods, eat them often in the day but ensure adequate protein and essential fats are being consumed. Couple this eating strategy with regular exercise with at least 2 session per week pushing the intensity with a sprinkle of resistance training and you have the formula to stay trim over the winter.

Author: Calvin Zaryski MKin, CEP

coachcal@criticalspeed.com  CriticalSpeed.com

THE SOCK

by James Kelly

Ahhh, the sock. It’s the last thing you think of unless you live in a place where the floor is constantly cold.

So, you’re buying a suit and the sales guy up-sells you the shirt and the beautiful matching tie. I’m not sure when ties went from being an accessory for a couple of bucks to something that requires refinancing your home to get, but that’s a story for another day.

In the process did he mention socks? Not likely. Why? Because socks are one of those things you can still get for a couple of bucks and they add nothing to your salesman’s bottom line.

If you think socks don’t play a part in your fashion statement, let me ask you this. How many times have you noticed that David Letterman was wearing white socks with his talk show ensemble? How many times have you noticed that the geek in front of you at Starbucks has a pair of thermal work socks on with his shorts and sandals? How many times have you noticed men wearing knee socks with dress shoes and shorts?! See what I mean, people notice these things.

Now some people will wear two different colour socks and tell you that that’s how they roll, but take it from me, that’s not how they roll, that’s how they roll out of bed!

The earliest known cloth sock dates from 300-500AD. They had split toes, designed to be worn with sandals, unlike your wooly workies that you think look so good. Every culture in the world has at some time invented some kind of sock and they have been created from every type of material. Anything from cotton, wool, nylon, acrylic, polyester, polypropylene, and spandex with silk, to cashmere and mohair, used to bring a little softness to the project.

It’s no wonder the sales guy didn’t offer you a pair of socks. He probably didn’t want to spend another half a day trying to figure out which ones would work for you.

I remember the Bermuda knee highs from the sixties, but especially remember the multi-coloured toes socks of the seventies. Not since then has there really been a sock statement, and though they go unnoticed for the most part, they stick out like a sore toe when added to a wardrobe improperly.

Here’s a tip: if you get yourself all dressed up for a night out and when you take that last glance in the mirror you wonder, do these socks look stupid? Then they probably do! So don’t ignore your instincts (or your mirror). Take them off and get some that don’t look like you just came from a “Flash Dance” rehearsal.

If you think that no one will notice that you have plaid socks on with your pin-striped suit, guess again. People notice. Take the time to get some good quality socks. Ones with some taste that match your wardrobe. Unless you are wearing an ascot, ’cause then they’ll just be laughing and pointing at that!!

Can You Be “Addicted” to Stress?

— Part 3 of the Stress Series —

By Lars Gustafsson

Ten years ago I found myself sitting in “Millionaire Mind” – a seminar weekend presented by T. Harve Ecker. Sitting there, I found myself thinking,

“I came here to learn how to become a millionaire (funny right?!) and all I keep hearing is how my blueprint is holding me back… that my THOUGHTS influence my FEELINGS, that my FEELINGS instigate the power of my ACTIONS…ACTIONS that create my RESULTS… I thought wasn’t this supposed to be about making money?!”

Each time I look back on this epic moment in my life, I have to laugh – in that statement, I was spelling out for myself, the secret to success that is discussed in every major personal growth book ever written. As the weekend progressed, it dawned on me that my blueprint was most likely what was holding me back in various areas of my life. I was also stunned into the life-changing realization that the state of my body influenced the state of my mind… and visa versa!

I began to see that I had been pre-programmed to behave in a certain way — my relationships, spending and saving habits, business practices and attitudes, and spiritual conditioning. ALL of this was guiding my life along a deep-set track that was dooming me to repeat past results! To top it off, my nutrition, exercise, sleep and lifestyle habits, along with my environment and friendships were also influencing and strengthening my blueprint. My whole life was bubbling out of a habitual way of being, and my body and results were reaping the outcome!

If one defines addiction as the repeated thought or action out of a bio-chemical or subconscious habit, then, I was deeply addicted to stress and repeated failure!

It’s hard to imagine how someone could be addicted to either of these – especially failure. And yet, I discovered that the repeated failures in my life had given me purpose to succeed and work even harder the next time. How warped was that?!

I KNEW that weekend that I needed a solution to my stress addiction. I KNEW that I had to change at a fundamental level; by taking control of what I thought and felt, I could guide my life in whatever direction I wanted. If I could figure out a few simple things that would influence a positive-feeling state in my body, this would have far reaching consequences in supporting a full and happy life.

Something else remarkable happened that weekend. I had a seed thought of what was at the CORE of all the health, fitness, weight loss and social issues in our society…

“Stress perpetuates stress.” Or in other words, “you become what you think — and act on.”

You literally have to divert your attention AWAY from the things or actions that are causing you stress. This is inordinately difficult in the beginning. It’s tough to look away from the dragon breathing fire in your face… and attempt to focus on something else! But I soon discovered it’s a LOT easier when you have your body on your side.

When I plunged into the research on stress and its many side effects, I was overwhelmed by the number of actions you would have to take in order to completely eliminate stress from your life. I came to a dramatic conclusion about how I was going to approach this personally and in my profession as a coach. It wasn’t about how many things you did to reduce stress but rather about becoming the master of a couple simple thoughts and actions, each of which would have a cumulative effect that would in turn perpetuate more of these conditions, thoughts, emotions and actions. So in other words, it became about … “simple shifts that would last a lifetime.”

I decided to approach my own life in a new way. I focused on the simplest of things that I could do every day. I found that there were a number of habits that were causing me stress, and found it was my thought patterns that were creating the most stress.

I began recording my most predominant thoughts. I noted limiting thoughts in a notebook and made a small line whenever that thought reoccurred.

“I don’t have enough time.” 100’s of times a day

“I’m stressed.” 100’s and 100’s of times a day

“I’m worried about…” Dozens and dozens of times a day

“I can’t …” 100’s of times a day

This was only the beginning! I found this revelation remarkable since everyone, including myself, had thought I was a positive guy! Who knew!? I quickly shifted these limiting thoughts into…

“I always find time to do everything I need to … I have an abundance of time.”

“I feel peaceful, and I think and act in peaceful ways.”

“I am grateful for…” and listed all the things that occurred to me in that moment.

“I know that all things are working out perfectly for every person in my life.”

Just by reading these words I’m sure you notice the difference in how they make you feel. You can imagine how I felt by focusing all my efforts on shifting these and other thoughts for a few weeks — I began to see an incredible change happening in my life. I became more efficient in my habits, work efforts, and daily living. I found amazing spaces in which I could read, take a walk, and have more time for balance and myself. When others asked me how I was doing, I quickly found myself responding with the attitude of gratitude. I noticed that my worry habit was gone and replaced by a deep sense of knowing that everything occurs in the flow of life; that the stresses or ‘negatives’ being experienced by people around me were all part of their transformative gift.

Even more dramatically, I noticed a shift in my body. Remember that your subconscious calculates everything in your 73 trillion cells – from your 100,000 reactions in each cell per second to the subtle (and not so subtle) hormones that are the result of your 60,000 (or so) thoughts you have per day. My shift in awareness was having a profound effect on my cells!

And so — like me, if you practice this one simple shift, you will notice that:

• You will fall asleep faster, and sleep deeper and longer. Your body will recuperate faster from exercise, be less achy and sore, and feel stronger.

• Exercise will improve at all levels – endurance, stamina, strength and power.

• Your relationships will shift – from initially seeing how everyone around you may have the same habits you had, to something more subtle, almost unspoken. People will feel better around you, want to talk to you. They will feel as though they have changed but really, they haven’t – it’s just the new ‘vibe’ you’re giving off.

• Your body composition will shift — water retention will decrease, fat will drop away, and your lean muscle will return.

“Come on Lars, really? All of this from shifting my thoughts?” you ask.

Well, perhaps not all of these things. It is likely that you will see some type of a shift, and if anything you will notice that you look at things differently. You will realize that you take a few more positive actions for yourself each day – which may only be drinking more water and taking a few more deep breaths… but these small actions will add up.

And here’s the curious aspect to a shift in awareness- as your actions change, what you think about and seek out will change as well. You’ll notice that you are making more frequent trips to the supplement or health store, seeking out healthier nutrition options, and overall shifting every other area of life.

Again…“Gratitude perpetuates gratitude and goodness in your life.” Or in other words “You become what you think about.”

THE HUGE KEY that must be thought about and action taken on is in supporting your gut, organs, cells, immune system and mind throughout this transition. From my own experience in my life I cannot relay this to you strongly enough! If you try to go out there and simply ‘think positively’ or ‘change your focus’ — which I will admire and support tremendously — it may not be enough. Taking care of your body is equally important to support this change for a permanent shift in your life.

These EIGHT simple shifts for physical support will elevate your FEELINGS of positivity EFFORTLESSLY:

1. Your gut-brain connection. Take two Probiotic capsules first thing in the morning with a glass of water, pinch of sea salt and tiny bit of juice (1/3 cup). You will immediately begin to see an improvement in your emotions, energy and vitality. Over 90% of your ‘feel good’ hormone Serotonin is made in your gut… “healthy gut – happy mind”. This shift may also increase your bowel movements (BM’s) to a healthy 2-3 times per day. If your BM’s do not reach this level, add 200mg of Magnesium Bisglycinate/Citrate or Malate in the morning. You can add this amount again at lunch and dinner if the first dose doesn’t achieve this goal. BM’s (Bowel Movements) are your gauge into how healthy or stressed you are; when you are at one or less per day, you’re becoming loaded with toxins and physical stress which will only exacerbate any type of mental or emotional stress you are in.

2. Blood sugar levels: Small snacks like dried berries and nuts (1/8 cup of each) or a piece of fruit (apple, orange, berries) between your meals will sustain your blood sugar levels and help drive your Serotonin production. Adding these snacks during the morning and afternoon can dramatically shift your ability to digest and utilize your meals, keep your mind awake and alert, calm your central nervous system, and elevate your moods effortlessly.

3. Hydration: Drinking purified water or spring water with a pinch of sea salt in every liter between meals will instantly turn on a plethora of metabolic function and enzyme systems, all while balancing hormones and elevating your whole sense of well-being. For women, attempt to drink two litres of water (herbal tea definitely counts) and men, up to three litres throughout the day. Begin drinking fluids 60-90 minutes after a meal (30 minutes after fruit) and up to five minutes prior to a meal. If you drink fluids with food, it will prevent the food from digesting properly, leading to fermentation, rotting, putrefaction and a rise in toxicity throughout your body and mind in the following hours and days. Often this simple shift alone can dramatically reduce stress, simply by preventing pounds of toxic matter from entering the body, blood, organs and mind.

4. Deep Breathing – the simplest of all habits. Science has shown us that by simply taking five deep breaths during times of stress, you can dramatically reduce your stress hormones and their damage to your body and mind. Try taking five deep breaths before you begin every meal of the day. Eventually, being more focused on your breath throughout the day will become a subconscious habit.

5. Supplement support: a high quality B-Complex, anti-oxidant, multivitamin and essential fat (1tsp of Krill oil) taken at breakfast can supply all the key elements for enzyme, hormone and metabolic function. Further guidance and customization with a health professional can create a profile that will provide for every layer of your renewal at this time.

6. Natural botanical Support: 1 capsule of Rhodiola with breakfast and lunch can support the anti-stress or peaceful conditions of your mind and body.

“Rhodiola rosea and its positive adaptogenic effects are well documented as being an effective way to assist in dealing with life’s stressful situations. An adaptogen is a botanical that exerts a normalizing effect upon bodily processes, creating an ideal biological environment for the reduction of stress. Everybody deals with the stressors in their life in their own way, but many people in today’s high-pressure, fast-paced workplaces have been looking for simple answers and helpful solutions to this dilemma. Rhodiola rosea has been found to stimulate the neurotransmitters responsible for creating feelings of well-being as well as offering significant relief for low energy conditions like asthenia. The reason that Rhodiola is effective at combating moodiness is due to the fact that it increases levels of neurotransmitters such as serotonin, dopamine and norepinephrine, all of which create “good feelings” in the brain.” (direct quote taken from www.rhoziva.com)

7. Exercise support: a healthy combination of juice (1/2 cup for women and ¾-1 cup for men) mixed with a pinch of sea salt and 2-3 cups of filtered water will amply support your hydration, electrolyte and energy needs during exercise. Immediately following exercise (within five minutes) have a recovery shake with sprouted organic brown rice protein (20g for women and 30g for men) mixed with orange juice (1 cup for women and 1.5 cups for men), a pinch of sea salt and 2-3 cups of filtered water. This will instantly improve your recovery speed.

8. Brain support: the most incredible system for resetting your brain patterns to that of balance and inner peace is Brain Wave Training. My personal experience from this has been nothing short of stunning. It has helped me to achieve a constant state of mental peace and as a result of this, physical peace. To look up a Brain Wave professional in your area or to discover more about this process, check out www.brainstatetech.com – and my interview with the founder, Lee Gerdes at – http://bodymindinstitute.com/health-lifestyle/interview-with-lars-gustafsson-and-lee-gerdes.

Each of these steps is as significant as the next – any that you begin with will become your “simple shift that will last a lifetime.”

Over these last ten years I have used the first seven shifts mentioned above as the baseline for helping clients with every type of goal- from weight loss to improved physical and mental performance. It is remarkable to me that I haven’t found a single scientific study, for supplements or otherwise, that first implements these core elements BEFORE testing the efficacy of any other layer of change. For instance – before testing an anti-oxidant – why not first ensure the person being studied has a healthy gut, is not suffering from intoxication as a result of too few bowel movements, and that they are hydrated and being properly supported with a full nutritional profile? The conclusion I have come to is that scientific studies that show a positive change in the absence of these elements MUST provide a much greater result with them in place. Or perhaps, that supplement or element would not be needed because most of the issues would already be solved.

This is for all of us to discover for ourselves, while scientific studies can be used to provide valuable insights into helping us live healthier and more abundant lives. I hope that in sharing this insight with you, that you will turn to some simple shifts before jumping on a band wagon of expensive supplements and be able to make an informed decision from a healthier place about whether or not you need them.

I will close this article by encouraging you to continue being the observer of your life while incorporating one or more of the simple shifts mentioned above. These tools can only produce lasting results for you, as you choose to take action. And remember – it’s all about simple shifts.

I look forward to bringing you the next keys to living a life filled with fun, power and joy in my next article.

 

In health and inspiration,

Lars Gustafsson

Founder: BodyMind Institute

www.bodymindinstitute.com

Washington, DC

by Ken Eddy

So, you’re going to take a holiday. I’ll bet Washington, DC is not on the top of your list of places you want to go this year.

Could be you want a nice warm beach and an ocean view and if that’s the case, then DC isn’t the place for you. But, if you want a week of great historical sites, amazing insights and tons of fun things to do with the family, then Washington has everything you can think of and more.

First, I have to mention the huge history of the place. From inception to modern monuments, if you’re a history buff you will not have enough time in each day to see and read everything.

Second, everything is free. That’s right, you don’t have to pay a thing to see all of the historical sites, the monuments and the Smithsonians. That in itself is worth the price of admission.

You can take a day to stroll from the Capital buildings to the Lincoln memorial. Summer in DC is warm and humid so take water and flat walking shoes. It’s a beautiful 1.9 miles (3.0 km) walk scattered with memorials and the Washington monuments reflection rising up in the middle of the pool that leads to the Lincoln memorial.

The Mall was designed in the 1850’s by architect Andrew Jackson Downing and is lined with huge American Elms that are a welcome bit of shade in the heat of the D.C. summer afternoon.

A list of landmarks and museums is helpful in deciding where to start you exploration of the great Mall.

National Museum of American History
National Museum of Natural History
National Gallery of Art Sculpture Garden
West Building of the National Gallery of Art
East Building of the National Gallery of Art
Ulysses S. Grant Memorial
National Museum of the American Indian
National Air and Space Museum
Hirshhorn Museum and Sculpture Garden
Arts and Industries Building
Smithsonian Institution Building (“The Castle”)
Freer Gallery of Art
Arthur M. Sackler Gallery
National Museum of African Art
Peace Monument
James A. Garfield Monument

If you’re up for some night life, Old Georgetown is a neighborhood of Washington, DC. Situated on the Potomac River it boasts a healthy nightlife that rivals any hot spot in America. Today, the primary commercial corridors of Georgetown are M Street and Wisconsin Ave, which contain high-end shops, bars and restaurants. The Georgetown neighborhood always has a number of events from music to markets every day of the week and is a great day out for a change of pace.

If you’re looking for a vacation with some history and some fun packed into one, Washington, DC is the perfect mix of new and old, historical and history in the making. With virtually no admission fees to all the great museums, Smithsonians and monuments it’s the perfect place to vacation on a budget.

Physical Activity and Health – Part I

by Bob Gurney

In the previous article presented in ‘the 50 zone’, health providers in sports sciences and medicine were identified and described. In this article, we review challenges and solutions for health care professionals addressing strategies of physical activity in the management of patients.

The increasing burden of chronic disease places greater demands on Health Care Providers to develop and implement strategies to manage lifestyle risk factors presented by their patients. Physical activity has been identified as a prescription for managing health risk factors, however effective prescriptions and exercise management strategies are absent in rural health care. The literature has been extensive over the past few decades, claiming that prescribed physical activity has been effective in managing patients with risk factors of poor health and chronic disease. The literature and practices of exercise strategies are supportive in managing patients at risk, yet neglect the patients who would benefit from exercise/physical activity prescriptions as preventative measures prior to symptoms prompting such intervention.

Primary care may benefit from further counselling, support systems and collaboration with exercise specialists. General Practitioners, (Eley and Eley, 2009) report that there are limited resources available in rural Queensland (Australia), to support family physicians in developing exercise/physical activity prescriptions and counselling for patients. These same physicians recommend formalization of referral pathways and follow-up could be of valuable assistance to rural medical doctors in providing their patients with effective exercise/physical activity prescriptions and counselling.

Buffart and colleagues (2009) describe the literature reporting the importance of exercise and physical activity. Health benefits include a lower risk of hypertension, diabetes, cardiovascular disease, obesity, overweight, some forms of cancer, depression and many other factors that improve quality of life. Physical inactivity and a lack of exercise are recognized as a leading contributor to disease. Medical practices should be an important setting for promoting physical activity, for several reasons. First, health professionals can reach a large population because the majority of people visit a health professional at least once a year. Second, patients have identified health professionals as a credible source of information and their abilities to provide patients with referrals to address their health concerns, issues and interests. Third, health care professionals usually have a long lasting relationship with their patients, which enable them to offer long-term health management and follow-up. Fourth, a range of intervention studies and numerous literature reviews have reported that health care provider’s recommendations of patient referrals to exercise/physical activity specialists can increase the adoption of exercise by patients. The American College of Preventative Medicine takes the position that primary care health should include physical activity counseling into routine patient visits.

Aittasalo (2008) describes the attitudes of health care professionals towards exercise/physical activity counseling as being positive, and the importance of exercise/physical activity for long-term health is well acknowledged in the literature. However, the practice of providing exercise/physical activity counseling is generally low among physicians. Physicians that provide exercise/physical activity counseling neglect the use of formalized instruments, written materials, and referrals are seldom practiced. Physician counseling also lacks patient-centeredness, which is an important factor from the effectiveness point of view. The most frequently indicated barrier for not promoting exercise/physical activity to patients has been reported by physicians, indicating the lack of time. Other barriers have included the physician’s lack of skills, confidence and knowledge in the field of exercise/physical activity prescriptions and counseling. The literature acknowledges that to effectively promote and implement exercise/physical activity through the medical professions, support through pathways of patient referrals to exercise specialists is critical to the success.

References

Aittasalo, M. (2008). Physical activity counseling in primary health care.

Scand J Med Sci Sports: 18: 261-262.

Buffart, L.M, et al (2009). General practitioners’ perceptions and practices of physical activity

Counseling: changes over the past 10 years. Br J Sports Med: 43: 1149-1153.

Eley, D. and Eley, R. (2009). How do rural GPs manage their inactive and overweight patients? A pilot study of rural GPs in Queensland. Australian Family Physician. Vol. 38, No. 9, September.

Author: Bob Gurney


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