Month: December 2018

Categories
Health

8 Tips for a Healthy Holiday

Merry Christmas to all my readers!

I thought I’d share a few tips for a healthy holiday with you for my Christmas blog…

  1. Keep moving

  2. Have a plan

    • As I always like to say, “everything in moderation”. So, enjoy the special holiday goodies, but make a plan to avoid excess. Your plan could be to take half a piece, or to sample only a certain number of treats to limit your intake. Try to stay aware of how much you’re having.

  3. Stay hydrated

    • Sometimes you’re thirsty, not actually hungry.

    • Alternating drinks with a glass of water helps to moderate alcohol intake too. It’s easiest if you fill your wine or drink glass with water so you won’t be tempted to refill your drink before you’ve finished your water break.

  4. Make lists

    • The holidays can be a hectic time. Making a “to do” list is a good way to reduce the stress of worrying that you’ll forget something important.

  5. Forget perfection

    • The holidays are a time for enjoying time with family and friends. When entertaining, plan to make it casual. Do a “pot luck”, ask for help when you need it, and make cooking and decorating a group activity.

  6. Exercise early in the day

    • I have a little routine I try to do each morning. Especially during the holidays, something to do can easily crop up later in the day, thwarting your plan to exercise.

  7. Plan outdoor activities

    • Even if you have a house full of guests, an after dinner walk or other outing gives everyone a change of scenery, fresh air and some exercise. And any elderly or unwell guests will have a peaceful break while the rest of you are out!

    • We always have a “beach walk” after Christmas dinner… and our doggie visitors love it too. (All 3 of my children have dogs… we had 5 dogs here one holiday!).

  8. Only indulge for the day

    • Splurging on one day will never make or break your fitness plan – as long as you keep it to a day or two and not a whole month of indulgence! Enjoy the holiday with all its special treats (in moderation) then get back to your healthy life plan!

This will be my last blog for 2018 and I plan to take a little break for a while. My book about balancing hormones is ready to self-publish and I have a big learning curve ahead of me (that I’ve been putting off for far too long). And my hubby and I are planning a trip to Spain for 3 months…

So, have a wonderful holiday season and all the best for 2019… and I’ll write from time to time when I find a topic that’s especially interesting!

Reference:

US News-Health

Categories
Health

Exercise: An ideal "prescription" for chronic disease

“If it was a pill, exercise would be a trillion-dollar money-maker prescribed to everyone.” Dr. Scott Lear, heart disease prevention researcher at Simon Fraser University, British Columbia, Canada.

A prescription for exercise?

Exercise is so effective at preventing and treating some chronic diseases, doctors are being encouraged to write prescriptions for it… Exercise decreases the risk of many diseases, including heart disease, stroke, Type 2 diabetes, depression (as discussed in last week’s blog ), and many cancers. Here are a few statistics for lowering chronic disease risk, as quoted on the website, Moving Medicine (a beta site being developed to encourage doctors to “prescribe” exercise to their patients):

  • Type 2 diabetes -40%

  • Cardiovascular disease -35%

  • Falls -30%

  • Dementia -30%

  • Depression -30%

  • Joint and back pain -20%

Physical activity is as important for health as many medications, but without the side effects. Humans were made to move, and inactivity is believed to be as harmful to our health as cigarettes. But, the more affluent our society becomes, the less we tend to move.

Who needs this prescription?

A global study of activity found that, on average, more than one-quarter of adults worldwide are not getting enough physical activity. And high-income Western countries (like us in North America) have inactivity rates twice as high as those of poorer countries, over 50% in some areas.

And women tend to be less active than men – up to 20% less in some countries. A 2017 survey published in Health Reports found that only 2% of girls aged 12-17 met the Canadian Movement Guidelines that include adequate sleep and at least 60 minutes of moderate to vigorous activity. A Dalhousie University study noted that teenage girls are concerned about appearances when they exercise: they worry about being pretty but natural-looking, thin but not too skinny, fit but not too muscular. Their responses in the study suggest that outdoor activities can provide an important venue to feel comfortable, safe and confident doing physical activity, compared to a gym setting where, as self-conscious teenagers, they felt they needed to be more concerned about clothing and appearances.

How to get more people moving…

Community infrastructure can influence activity in the young and old. Open spaces, like parks and walking/biking paths, provide enjoyable and convenient opportunities for physical activity. A visible example is the throngs of people who use the skating oval added to the Commons in downtown Halifax. You can even borrow skates and helmets there for free!

High quality public transport and incentives to use it rather than motorized vehicles can result in an overall increased population activity being incorporated into daily routines for those who use the systems. I noticed a marked increase in my activity level when using public transit while travelling in Europe, just by walking to and from the nearest system access.

With statistical evidence that inactivity is worsening in too many areas year by year, and with a corresponding increase in chronic diseases like diabetes and heart disease, it is time to think seriously about ways to increase physical activity levels across populations.

So, if you want to reduce your chances of developing a chronic disease as you age, look for ways to incorporate more exercise into your day, and it doesn’t have to be a session at the gym. Remember that ten minutes of activity three times a day is considered equal to a single 30-minute session. Park farther away from the door when doing errands or take the stairs instead of the elevator – it all adds up. My husband and I enjoy a daily 25-minute walk to check our mailbox most days and climbing up and down the stairs in our 3-story house adds to the daily total.

How much should you exercise to benefit?

The World Health Organization guidelines for physical activity recommend a minimum of 150 minutes per week of moderate-intensity activity like brisk walking, biking or dancing… or 75 minutes a week of vigorous activity like jogging or playing an active sport. If you have a chronic disease, check with your doctor first, start slowly and increase activity gradually. You can expect a few sore muscles as you begin but stop exercising and contact your doctor right away if you experience any chest pain or other alarming symptoms. Any exercise that makes it difficult to speak is likely too intense and could be a risk to your immediate health. Specialized exercise programs are available in some areas to help those with chronic diseases, such as heart disease or back problems, to get started safely. The cardiac rehab program my husband took after his heart attack 14 years ago was a game-changer, and we’ve worked to keep up our activity level since then.

So, don’t be surprised if your doctor gives you an unusual prescription…

In addition to the Moving Medicine program in UK mentioned above, Canadian medical schools are also revising their curricula to teach future doctors about the benefits of exercise to prevent and treat chronic diseases. It’s better and less costly to prevent diseases than to treat them!

(Please note that underlined phrases above and in the references are links to the source of the information)

References:

Exercise is Medicine, and Doctors are Starting to Prescribe It, The Conversation

Prescribing Movement (UK website under development to encourage doctors to prescribe exercise)

Girls and Women Need More Time in Nature to be Healthy

Worldwide Trends in Physical Inactivity 2001-2016

Categories
Uncategorized

Antidepressants or Natural Therapies – Which works better?

The surprise answer is that in many cases they are equally effective.

Antidepressants have been used for decades and billions of dollars have been spent on these drugs, but they are surprisingly ineffective. The difference between the drug effect and a placebo (or sugar pill) is almost undetectable except in the most severe cases of depression. Placebos themselves are surprisingly effective – when a person expects to get better, sometimes that is all that’s needed to help the mind heal itself.

The US Centers for Disease Control and Prevention report that the rate of suicide has increased by 30% since 1999. At the same time, the use of antidepressants has increased by 65%. This suggests the drugs are not great at preventing suicide. In addition, some of these drugs have a “black box” warning, the highest level that can be applied to a drug. It warns doctors to monitor patients for new suicidal thoughts that may occur shortly after beginning therapy.

Statistics show that more people are on long-term financial assistance due to mental illness than before these drugs were introduced in the 1950s. One analysis suggests that the drugs may actually block a full recovery, even though symptoms appear to improve in the short term. Studies have found that more patients who used non-drug therapies had recovered and returned to work after one to two years of treatment compared to those who took medications.

At an educational session many years ago, the speaker told us that mental illnesses were a result of a chemical imbalance in the brain. Depression was caused by too little serotonin or norepinephrine. They explained that antidepressants re-balanced these chemicals (called neurotransmitters), by increasing the available amount of the ones believed to be low in depression. I often explained this to patients when I counselled them about their medication in my pharmacy.

However, newer studies have shown that the brain changes how it functions to accommodate for the effect of the drug. When the patient tries to stop the medication, it takes a while for the brain to return to normal. This manifests as a return of the mental illness, sometimes more severe than it was before. This has often been interpreted as a need to continue treatment, rather than a withdrawal effect of the medication. As a result, sometimes patients are kept on treatment for many years.

The longer the person has been taking the medication, the longer it can take for brain function to return to normal. This can make it very difficult to stop the medication. It is recommended to taper the dose gradually when attempting to discontinue treatment to reduce withdrawal effects.

As well, antidepressants have side effects that range from weight gain to erectile dysfunction. The small benefit these drugs provide needs to be weighed against the side effects they cause.

So, do studies show that alternative “natural therapies” work for depression?

The answer is yes! Good quality scientific studies are available to support some of these non-drug treatments:

  1. Exercise

    1. A 2007 study at Duke University Medical Center in North Carolina found that 30 minutes of walking or jogging three times a week was more effective than an antidepressant or placebo. (Psychosomatic Medicine, Sept 2007, 69(7), p. 587-96)

    2. A review (or “meta-analysis”) of studies that included exercise and antidepressant medications in 2016 confirmed the effectiveness of exercise. (Journal of Affective Disorders, 15 Sept 2016, vol.202, p.67-86)

  2. Bright light therapy

    1. Bright light (10,000 Lux, 30-60 minutes daily first thing in the morning) attempts to duplicate the effect of being in sunshine. A review of studies showed significant effect, with the largest study showing an effect approximately equal to antidepressants when added to medication. Of course, spending time in actual sunshine could be expected to give the same beneficial effect.

  3. Mediterranean diet

    1. While less studied, a small Australian study, the “SMILES Trial” suggests a Mediterranean Diet that includes local unprocessed foods may work better than antidepressants. After 12 weeks on the diet, 32% experienced remission compared to only 8% of those who received only social support.

  4. Cognitive behavioural therapy (CBT)

    1. Cognitive Behaviour Therapy, or CBT, is a non-drug, “talk” therapy used to treat psychological illness. It aims to help people understand their thoughts and feelings, and what makes them feel positive, anxious or depressed. It helps people to identify the problems that are troubling them and find different ways to think and behave to manage their feelings.

    2. The evidence for benefit from CBT is indisputable. It is as effective as antidepressants but, unlike medication, the effect continues after the therapy is completed. The other plus is that a person can’t overdose on a bottle of “therapy”, unlike antidepressants…

So, if you get the “blues” this winter, talk to your doctor. But, before they take out the prescription pad, be sure to ask whether non-drug therapies might be appropriate for you. While you may benefit from medication, or a combination of medication and non-drug therapy, it’s worthwhile discussing your options first.

Of course, considering the positive effect of exercise, sunshine, a healthy diet and discussing ways to deal with problems effectively with someone you trust, perhaps these are things we should all be doing every day anyway to keep our bodies and our minds healthy!

References:

Anatomy of an Epidemic, by Robert Whittaker

Why Natural Depression Therapies are Better Than Pills, Dr. Matt Strauss (Pharmacy Practice Journal)