American Heart Month is a time to battle cardiovascular  disease and educate Americans on what we can do to live heart-healthy lives.

Heart disease, including stroke, is the leading  cause of death for men and women in the United States.

You are at higher risk of heart disease if you are:

• A woman age 55 or older


• A man age 45 or older


• Or a person with a family history  of early heart disease

Heart disease can be prevented. To keep your heart healthy:

• Watch your weight.


• Quit smoking and stay away from  secondhand smoke.


• Control your cholesterol and blood  pressure.


• If you drink alcohol, drink only  in moderation.


• Get active and eat healthy.


• Talk to your doctor about taking  aspirin every day if you are a man over the age of 45 or a woman over 55.


• Manage stress.

Source: Healthfinder.gov

Heart Disease Resources:

• Heart Diseases. Information from MedlinePlus including overviews, latest news, diagnosis/symptoms, treatment, prevention/screening, research, multimedia, research, and more.


• Interactive Heart Attack Tutorial


• For Your Heart Survey


• My Blood Pressure Wallet Card (PDF - 665KB)


• Heart Health


• Eat Healthy


• Get Active


• Act in Time to Heart Attack Signs


• American Heart Association


• National Heart Lung and Blood Institute

If you would like more information, please feel free to contact a Lake Health Professional Librarian

Between February, 1966 and December, 2003,  children living in Arizona’s Gila River Indian Community were part of an ambitious study. Nearly 5,000 kids born between 1945 and 1984, were examined and followed.  The question under study was this:  To what extent would obesity, glucose problems, blood pressure, and cholesterol effect the lifespan of these children?  Specifically, which factors would be associated with death before the age of 55?

During the study period, 559 of the subjects succumbed to premature death.   The strongest predictor for dying young was obesity.  Kids who had been at the highest weights had about 230% the chance of dying early than did kids at the lowest weights.   Blood sugar and blood pressure in childhood also raised the risk of dying young, but not as much.  In addition, these two factors were almost exclusively tied to the degree of obesity.  An interesting sidebar was the observation that childhood cholesterol elevations did not effect the risk…at least in this population.  Cholesterol levels tend to be lower in Native American populations in general which may have explained this finding.

The new England Journal  http://content.nejm.org/cgi/content/full/362/6/485 references similar childhood studies conducted earlier in the 20th century.   One of the problems with these studies was that there weren’t enough heavy kids to follow.   In a study done in Wales, for example, just 4% of the children had a BMI that was higher than the 90th percentile.    The Arizona study, on the other hand, looked at a population in which 28.7% of the children were obese.    This is because the Arizona researchers studied Pima Indians, a group which is particularly susceptible to the harmful effects of the western diet.   The Pimas’ problems with obesity go back many decades.

In the United States, the current prevalence of overweight and obese kids stands at 15%.  This is TRIPLE what it was in 1960.   The news is worse for  African-American and Hispanic kids, who have O and O rates that are similar to those of the Pima.  These data are extremely important for readers of this site.  The tendency to react poorly to the American diet is a reflection of genetics.  This is clearly demonstrated by the Pima Indians.  It is also clearly demonstrated in the tendency of families to become overweight and develop its related illnesses.  Unfortunately, this genetic intolerance to the SAD has gotten muddled up with a lot of pop science and magazine talk.  We are searching for the cause of our problem in bizarre explanations that range from broken metabolisms, to infectious causes,  to lack of running the marathon.  Here’s the point.  If you are a maintainer and have struggled with weight throughout your life, it is highly probable that your kids (even if currently skinny) will be in the same boat eventually.  As parents, you can prevent this.  You can give them the best odds of living long and healthy lives.  All you need to do is to promote the very diet that you consume as a maintainer.  Whatever diet has enabled you to keep weight off is a healthy variant of the SAD.  That diet is likely to be the one that will prevent gain in your kids.  This stuff is for real.  Each of us can build a healthier America by working family by family.  If we do, we won’t have to worry about a bankrupted health care system or a country in which life expectancy plummets for the first time.  Let’s spread the word.

At this time of the year I’m always searching for motivating tips that will help my patients get through the holidays.   I often remind people that their new eating habits are a gift they are giving themselves.   “If you are going to give yourself that gift,” I say, “then DO it!  Don’t pull it back at the last moment just because of the Christmas cookies!”  I think that maintainers understand more about this gift than dieters do.  This is because we have to experience a period of prolonged maintenance to “get it”;  to feel the true benefits of changed eating.   While staying at a lower weight is part of that benefit, it is often a smaller part than we might have expected.  The gift we receive is a feeling of being in healthy harmony.   This harmony allows us to enjoy powers of energy, a new smoothness of mood, a feeling of strength, and a body that stays well when other bodies fail.   Escaping from the daily fear of illness---that’s probably the ultimate maintenance gift.

We know that maintenance makes us feel better.  But could the gift be even greater?  Could maintenance be helping us to live longer?

Recent research in the field of caloric restriction continues to be intriguing.   As most readers know, cutting calories leads to longer life and slower aging in most species.  But how does that happen?  A study from Mount Sinai School of Medicine, http://www.sciencedaily.com/releases/2009/11/091118143217.htm  looked at this question and came up with the following answer.   “It may not be about counting calories or cutting out specific nutrients, but how a reduction in dietary intake impacts the glucose metabolism, which contributes to oxidative stress.” (Dr. Charles Mobbs, principle investigator).

Oxidative stress is the damage done by substances called “free radicals”  which are created as a byproduct of certain body processes.  You can think of these free radicals as rogue particles which shoot through cells causing injury.  When we take “anti-oxidant” vitamins, we are attempting to sop up these free radicals and thus get rid of them.   A better approach would be to generate fewer free radicals (and less damage) in the first place.  As it turns out, overeating— the great American pastime--- appears to increase free radical damage.   Restricting calories means less oxidative stress and healthier cells.

The Mt. Sinai team discovered that caloric restriction increased body levels of a substance called CREB binding protein, or CBP.   High levels of CBP were associated with longer and healthier lives in worms and mice.  In mammals, Dr. Mobbs believes that an equivalent effect might be seen at about a 30% reduction in calories.  If CBP levels are known to be high in mice who eat less, what would they look like in mice with sugar problems---in other words diabetic mice?  Mobbs’ team discovered that CBP was low in these animals, predisposing them to accelerated aging and disease. It seemed that CBP might work by blocking glucose (sugar) processing in the cells.  Higher CBP might mean less glucose metabolism and less free radical damage.   Most intriguing,  Mobbs found that  CBP levels were quite fluid and responded to changes in blood sugar within hours  of feeding.   Calorie restriction elevated CBP for as long as restriction was maintained.  This research is another small piece of evidence that points to the wisdom of primary diet (eating as anciently as possible).  It is intriguing on two levels.  First is the issue of optimal meal frequency.  Paleo diet afficianados  have become interested in figuring out how often our ancient ancestors ate.   It appears that many tribal peoples ate one large meal per day.   This means that we may be optimally adapted to spending longer amounts of time in the non-eating state.  The SAD encourages us to eat constantly and in large quantity.  If Mobbs’ data translates to humans, overeaters would theoretically have a low level CBP and a higher incidence of aging and disease.   Maintainers generally eat many fewer calories per day than their free-eating counterparts.  The second important issue raised by this study is the suggestion that cell aging and glucose metabolism are linked.    If aging and age related disease can be lessened by reducing glucose metabolism,  does this mean that we can create the same effect by lowering our S Food consumption? As we know, ancient diets were low in starches and sugars (carbohydrates).  Our body design seems to reflect this by having difficulty dealing with large amounts of these substances.  Might eating anciently raise CBP levels?  We won’t know until studies target humans. For now, most research is geared toward finding drugs that can mimic the effects of caloric restriction.  But here’s the problem.  Drugs take years to develop and, once developed, have the pesky habit of manifesting unpleasant side effects.   If CBP turns out to be a real marker for the pace of aging wouldn’t it be great to have a portable CBP monitor?  Perhaps someday, people will carry an “age-meter” instead of a glucometer.  If you could painlessly monitor your longevity factor and aim to keep it over a certain level, wouldn’t it be easier to wait another hour for dinner or pass up pasta in favor of salmon and salad?  In the meantime, I strongly believe that the gift of longer and healthier life is there for the taking.  Keep starches and sugars low, eat with less frequency and in smaller quantities and use your scale as your longevity tester.  If you are maintaining weight, chances are you have things in the right balance.  Enjoy the holidays with the knowledge that your heart, your eyes, your kidneys, your liver, and your blood vessels--- right down to your tiniest capillaries--- are sending you grateful messages of thanks.        

 

Negotiating success in maintenance reminds me of so many things:  balancing on a bongo board, walking a tightrope, learning to sprint on tiptoe through a vast field of food, negotiating a temptation-jungle with blinders on. We tame the hungry lion with nothing more than our wits.  We balance on the tip of a skyscraper-high food pyramid and all the while…. we dance.  Maintainers are artists.  They are skilled professionals.  Their tricks and focus put others to shame.  Don’t try this at home.  Maintainers are the Cirque du Soleil of the diet world. Like the final act of any circus, the end of the food year is our crucible, our most daring trick.  From Thanksgiving to Christmas, it will all be thrown at us.  The cocoa, the cookies, the emotion, the cinnamon, the chocolate, the tear-jerker movies, the alcohol.  We will need to somersault, leap and dodge in order to avoid being annihilated.   And who will be triumphant?  Not the most virtuous.  Not even the most deserving.  The ones left taking the final bow will be the most skilled.

I am now entering my sixth year of Primarian eating.  Tonight, I prepare myself like a gladiator getting ready for battle.  I sharpen my swords, I gird myself, I imagine the inevitable pumpkin-scented opponent.   I am determined to remain standing at the end of it all.  Are you preparing too?

My skills?  Nothing fancy.  Sometimes it’s mastery of the most basic techniques that gets a maintainer the furthest.  So here are some of the skills I’ve practiced over and over.  Hopefully, they are routine by now, ready for deployment as the year’s food circus comes to a close with its final eating lollapalooza: 1.       The Old Scan and Plan:  Don’t ever get caught in a corner.  You should know what’s coming and have a plan to counterpunch.  Imagine each holiday situation in as much detail as you can way before it ever happens.   Plot a course through the food challenges.  When the day comes, mentally check off each situation as you enact your plan.  It’s your private game.

2.       The Switcheroo:   Everyone’s there for the food.  Except you! Switch your reason for being at the dinner, family gathering, office party.  You’re there to gather information by finding out at least one thing you never knew about five people in the room.  You’re there to advance your career by finding someone at the party who can give you a lead.  You’re there to see how many people you can get to ask you about your weight loss and how you did it. You’re there to change someone’s life by inspiring them to eat healther, be more like you.  Set a goal.  Keep track.

3.       The Stare Down:  For advanced maintainers only!  For the true gladiator, there’s nothing more enjoyable than challenging yourself to a direct face-off with the food that used to control you.  If you’ve passed the invisible barrier that separates maintenance junior (early maintainer) from SLIM (senior level maintainer), you might enjoy this trick, which is the equivalent of facing down a lion with nothing more than your expression.  Go to the table, look at everything, and laugh.  A good, loud, internal “HAH!”  and a head toss help a lot.

4.       The Dress for Success:  Wear your best looking and most form fitting clothes.  Let them talk to you as you negotiate that dangerous territory.  The pressure of snug clothing will remind you of what your body has achieved and prevent you from filling up.

5.       The Bring Your Own:  A good trick for buffets, pot lucks and other challenges too.  Bring a safe dish and make it something you can really load up on if there is little else that fits your rules.  Generally, these clean, simple dishes go fast.  After all, everyone recognizes healthy food..even if they don’t want to admit it.

 

There are lots of other tricks I use, but enough about me.  Do you have holiday skills?  Send them in.  Tag them with a punchy name and include a short description.  Let’s share the wealth!  You’re not dancing alone, you’re not fighting alone, you’re not balancing alone.  You’re part of a growing acrobatic troupe.  A veritable army of skilled maintainers.   Are you ready for the challenge?  If so, I salute you!  “Merry Christmas to All and to All a Good FIGHT!”

            The first step is to know your feet and the easiest way to determine what kind of running shoe your feet need is by using the Wet Test.  The test is done simply by wetting your feet and stepping on a dry surface.  The wet footprint is the determining factor for the type of shoe you might need.  Shoes are split into three groups (cushioned, stability and motion control); and three subgroups (performance training, racing and off-road).  The first group is specific to your biomechanical requirements.  The subgroup is specific to your type of training and terrain. 

What to look for when evaluating your wet footprint? 

You are looking to see what kind of arch your feet display.  Arches can be normal, flat, or high.  The arch of your foot can help you determine the proper amount of stability, motion control and shock absorption required for desired running results and to prevent injuries or pain. 

Footprint Analysis

• Dry space around the arch that is similar to a half circle correlates to a normal foot.
• No dry space, or very little, is indicative to flat feet.  This is a result of overpronation.
• Excessive dry space around the arch identifies a high arch, resulting in underpronation.
• Evaluate the wear of the shoes soles is another way to identify your foot type. If the wear is on the inner side of the shoe you most likely have flat feet, if it's on the outer side, you most likely have a high arch.

More information coming…………

The old phrase “less is more” can be very helpful in the world of running.  Now, don’t get me wrong, I do believe in pushing beyond physical and mental limits, when done appropriately.  However, keep in mind there is a fine line between consistency and compulsivity. 

Rest should include sleep and scheduled days off from running. Rest is planned as a recovery from intense training. Sleep allows your body to repair itself from the adversities of training allowing you to proceed with further advancement.  As for myself, I often get caught up in the excitement of starting a different running program or running in a new location. I have made the mistake of increasing my mileage too quickly and ignoring the signs of fatigue- all with best of intentions, of course! On the other hand, if changes are not made, I will one day find myself injured and unable to finish my goals.  So, the question everyone wants and answer too is… how do you know what your limitations are?

Factors that may indicate lack of proper rest:

• Fatigued all the time.
• Your workouts are not improving.
• Weak and heavy legs during workouts.
• No longer like running and dread working out.
• You just want to shut off the alarm clock and go back to sleep…your gusto is gone!
• Elevated resting heart rate. Elevation of 10 beats or more from normal baseline may indicate fatigue, dehydration, or early stages of a virus.

Recovery is broken down into to categories: active and passive.  Active recovery is low intensity exercise.  Walking, spinning, yoga, and swimming are examples of active recovery.  Resistance is low and pace is very relaxed. The benefits of active recovery are improved endurance and increased blood volume.  Passive recovery is nothing but REST.  This recovery time allows your body to restore glycogen stores and decrease inflammation, which may lead to overuse injuries.  Passive recovery is also a key to preventing mental burnout. 

On Saturday, I had the opportunity to meet hundreds of people with diet and weight issues at the opening of the new TriPoint Medical Center in Concord, Ohio.   The community open house for this gorgeous facility was attended by approximately 7000 people.  As medical director of weight management services for the hospital system, I was there to lecture and to encourage visitors to register for our weight loss programs.  

Whenever I talk with people about weight issues, I come away with impressed with two things.  First, I am amazed at how interested people are in learning more about nutrition.  Despite the glut of information in magazines, on TV and on the web (or perhaps because of it) most people are deeply confused about what to eat.   The second thing that always impresses me is how few dieters are able to keep the weight off permanently.  Of course helping with that issue is the purpose of this site.   I hope that some of those I spoke with on Saturday are reading our site today and that they will become part of our internet community.  Refuse to Regain is a blog about maintenance, but it is meant for anyone with a weight issue, whether they are just beginning to lose pounds or have kept them off for years.  If you are new to us,  Lynn and I hope you will explore our site and become active contributors!

The first year or two of maintenance is like a course in yourself.  It can yield fascinating and very specific information if only you decide to show up for school. 

Most people who finish a weight loss return to a modification of old habits.  Habit is the operative word.  If your previous dietary style made you fat, it is likely to do so again, even with modifications.  If you couldn’t control the elements of your eating plan in the past, re-exposure to those elements will probably lead to a similar fate in fairly rapid order.

During the weight loss phase, most of us are very wrapped up in our progress.  This self-examination is often lost once the weight comes off.   I tell my patients that the principles of weight loss are pretty much the same for everyone:  1. Reduce calories enough to force the body to burn what it has in storage and 2. Reduce insulin enough to facilitate that process.  Maintenance is a different ballgame.  The rules vary widely.  The only way to discover what works for you is to discover YOU. 

For this reason, I suggest that  new maintainers think about the first couple of years as a basic science experiment.  Experiments require staying educated on your subject,  close observation, recording of results, and a well-planned way of changing variables.   Research also works best when it is dispassionate.  By this I mean that your maintenance experiment  needs to avoid emotion.   If a scientist does an experiment and gets an unintended result, he or she does not indulge in agonies of self-blame.  In maintenance, it’s important to look at results with curiosity but not with frustration.  If one method isn’t working, draft another strategy and record results.

If you are just beginning your maintenance experiment you may be uncertain as to how to proceed.  Here are a few suggestions.  No doubt our experienced readers will offer others.

1. Work on the type of structure you need.  Do you do best with points, calories, portion control, or simply with diet changes based on daily weighing?

2. Identify your trigger foods.  These are the foods which you really must avoid.  Most people find that there are certain things they simply can’t eat moderately and that they feel a sense of peace once they are eliminated.

3. Tread carefully around your food addictions.  Foods that you have eaten for pleasure can be addictive, but they are not always triggers.  You may be a chocoholic but actually be able to control chocolate consumption.  On the other hand, bread may cause you to fall off your diet.

4.  Observe your reaction to salt.  Salt acts like carbohydrate does in causing water retention.  It can cause unintended weight gain that is hard to get rid of.  The most common source of salt is restaurant food (have you ever really tasted the soup in most restaurants??) If you note that you are gaining after eating out, be careful of foods that may be hiding salt. 

5.  Pre-plan your reversal strategy (and refine that strategy if it doesn’t work).  Every maintainer needs a way to quickly reverse small regains.  What will that be for you?  

6.  Observe the effect of exercise.   No one knows exactly how much will help to keep you stable.  So keep a log that includes your activity, frequency of exercise and weight response.   If walking is doing the trick, you don’t necessarily have to escalate to running.  It is probably also possible (although not recommended) to maintain without exercise. 

7.  Set up some personal dietary rules.  Maintainers often bristle at the idea of rules preferring to  say that they will never rule out any particular food.  OK.  That principle can be part of your rule package, but what’s the rest of it?  No one says you have to follow your own rules…after all, you created them….but having rules gives you a plan to shoot for.   Follow, then observe the result.  If the plan isn’t working, it’s time for an overhaul.  

8. Observe the situations and environments that cause trouble for your diet.  One of the most powerful tricks a maintainer can employ is keeping physically away from food.  You may observe that being at home is toughest because food is always as close as your kitchen.  Work on physically removing yourself from food by asking that food be kept away from you at work and bringing nothing into the house which triggers you.

9.  Keep a number of basic, “safe”, meals in your rotation.  Feel free to eat these frequently and to experiment only when you feel quite anchored in maintenance. 

10.  Most importantly from my point of view, do all that you can to keep insulin stimulators low.  Insulin stimulators are the starch and sugar foods including whole grains, pasta, cereal, bread, potatoes, rice and sweets.  Insulin is the fat storage hormone.  As long as it is not deployed, you can’t store fat.  When it IS deployed, you can’t break down fat.  So keep the carbs (except for fruits and veggies) LOW.

If you are a successful maintainer, please help us by sharing the things you’ve found out about yourself.  The more models we have, the more possible paths we all have to try.   While the basic outline above is a general scaffold, it says nothing about  individual experience.  What lovely, strange and unique things have you discovered as a result of your own maintenance experience.  We would love to hear.

The Eskimos, who live in intimate contact with fluffy white precipitation, have developed more than one hundred words to describe it.   These include: aput ("snow on the ground"), qana ("falling snow"), piqsirpoq ("drifting snow"),  qimuqsuq ("snowdrift"), "pokatok" ("grainy, salt-like snow"), "mauyak" ("soft snow"), and "ayak" ("snow on your boots”).  English speakers, on the other hand, are left empty handed.  We call it snow and that’s the end of it.

 Language reflects experience and engagement.  The things that we’re interested in tend to develop complex language around them.  That’s why I find it particularly interesting that---just like the word snow---- English speakers only have one word for physical activity:  exercise.

From my point of view, “exercise” is a very limiting and highly unsatisfying word.  Exercise is the stuff Jack LaLanne used to do on television when I was a kid.  Push ups, jumping jacks, marching, weights.  Exercise is a word that has regimentation built into it.  It reminds you of marine boot camp.  Exercise is what you force yourself to do.  Exercise is what happens when your all too human body is forced into interaction with cold hard machinery:  the treadmill, the stationary bike, the metal pulleys, the levers and the iron weights that make up gym equipment.   Exercise is a word with bad karma.

If our culture was more in touch with the physical body, we might have 100 words for exercise.  We could use them.  They would have definitions like these:

• Exercise that creates a trance like state of deep thought.
• Exercise that stimulates bursts of intense joy.
• Sweaty activity that loosens the body and spirit.
• Calming exercise.
• Heart pounding, elating exercise Exercise that connects inner and outer worlds.
• Magical exercise

If we had these words, perhaps we could convince people to find the magic that is found in moving their bodies.

My patients have been willing to do all sorts of things.  They have been willing to eat bizarre diets composed of pots of cabbage soup, mounds of grapefruit and odd assortments of bars and supplements.  They have been willing to have surgical treatments and to undergo the slashing of their stomachs, intestines, and extra skin folds.  They have been willing to have suction catheters shoved under their skin to forcibly vacuum out the fat.   They have been willing to purchase totally unproven remedies sold by snake oil salesmen on radio and in magazines.  They have been willing to ingest these unknown substances in the hope that their cortisol levels will be suppressed, their carbs will be blocked,  or that they will lose the 20-30 pounds that “some experts say are stuck to the colon walls like spackle or paste” (!). 

But a large number of them are not willing to exercise.

The woman sitting in front of my desk has just lost 50 pounds.  “And what are you doing about getting some exercise?” I ask.   Despite the fact that I have warned her repeatedly that she will not be able to maintain her weight loss without physical activity, she is unconcerned.  “I haven’t had time to get that in”, she says with a bit of annoyance (directed at me).  “Yes, I know I have to, but I just don’t like to sweat.”

It’s that “e” word again.

I simply don’t have the descriptors to let her know that exercise is a sublime addiction and she doesn’t believe me when I try to tell her.  Like all addictions, exercise starts out badly.  Remember that first cigarette?  That first beer?  UGH!  My first inauspicious experience with exercise occurred when I was 35 years old.  Prior to that I’d been an utter couch potato and the flabby thighs I referred to in an earlier post were a testament to my love for Mallomars and inactivity.  A friend suggested that I accompany her to something called “aerobics”.   It was painful.  We gathered in a circle in a poorly lit gym.  The instructor stood in the center while an odd disco tape played and we tried to imitate her kicks and knee lifts.  Well, that wasn’t something I was ever doing again.

Until almost a year later.  One day, while walking down the Main Street of a new town,  I heard a commotion coming from above me.  I looked up, and there, in the plate glass window, above a stationery store, were about 30 women in tights jumping up and down on little purple platforms.  They were shouting, sweating and hooting.  I wanted to be up there with them.  And so I was, after I finally drummed up enough to courage to mount the dark, dank staircase that led to Patty White’s studio.  From Patty, I learned that aerobics could be joyful, social and even a bit raunchy.  Patty had a penchant for sharing stories about her sex life while teaching class.  It was quite the education. 

I stunk at aerobics for a long time.  There were always these women in the front row who knew Patty personally, looked incredibly trim, and could do the class from start to finish without stopping to catch their breath.  I, on the other hand, stood in the rear gasping. 

It took about two years to begin moving forward, but move I did.  It became my goal to make that front row.  Along the way, I got to meet a lot of really great people who stood in all sorts of positions throughout the room.  Once I got good enough to stand up front, I chose to stay in the back with some other friends.  We were that cool.

In the years since, I’ve followed Patty, Tami, Reggie, Dale, Michael and Joe through various iterations of aerobic nirvana. When I travel, I take class.  And I’ve done that all around the country and outside its borders.  For me, it’s about the music, the energy, the people in the class and the dancing.  It’s been an experience that has only become more important as I’ve gotten older.  I never feel as alive as I do when I’m taking a class with people who are half my age and I can marvel at the fact that my body still responds, still works for me, still craves this experience.  None of this is specific to aerobics.  I just happen to like that particular form of work out.  I see the same expression on the faces of distance bikers, karate enthusiasts, kick boxers, tennis players, line dancers and runners.  Discovering the right exercise connection is a direct line to bliss.

I try to share this with my patient…the one who won’t exercise.  Finding the right words is impossible when you speak a language that doesn’t encompass the subtleties of the physical.  Instead, I simply advise her to find a kind of exercise that she thinks she could love….someday.  There has to be an attraction at the very beginning, I say, or she’ll never last through the tough times.  I tell her that if she waits it out and starts falling for her chosen exercise, it will change her life. But I can see that she hasn’t moved past the “e” word.  In her mind, I’m still asking her to do something painful and horribly sweaty. 

I suspect that most of you who are reading this have discovered that you can’t do maintenance without exercise.   I only hope that you have moved past the “e” word and into that undefined region where physical activity brings you into direct connection with the body you are protecting and the joyful spirit that cares for it.  

I have prepared an example for the first phase of an eight-week training program for runners. This program I am developing assumes that you can run at least 2.0 miles. Please do not attempt to start running if you have no previous training or health issues without consulting a physician.

Phase I of Program Information:

Choose two days out of the week for rest days.  This may very from week to week depending on your schedule and commits.  For example, I like to have Thursdays and Sundays for my rest days.  Remember this is imperative for proper recovery and injury prevention. The muscles in your body actually build and repair themselves during your rest days. So with that said, if you run every day, you won’t see much improvement.

Mondays, Wednesdays, and Fridays: After you warm up with dynamic stretching, run at a relaxed pace for the selected mileage. After you run, make sure you cool down muscles and reduce heart rate prior to static stretching.

The goal is to increase your runs by a quarter mile each week. Can you recall running farther because you feel good from the endorphins kicking in?  Unfortunately, I have found this to not always be beneficial because it’s easy to loose track of your progress and you almost always think you can run more during your next run.  Which leads you down the road for overuse injuries. Running on a track or treadmill makes it very easy to keep track of mileage, but it is also really monotonous.  Trail running is very adventurous, dynamic and, challenging.  The surface is usually easy on the joints, unless the terrain is rocky.  When trail running, I use time to keep track of my distance.  If you find that most of your runs take place on the road and you’re not sure how far you ran, there is a website that figures out the mileage, MapMyRun.com. My last option is to drive my running route and measure the mileage using my car’s odometer.  But, who wants to do that with the outrageous gas prices and when they tired from running.  

Tuesdays: Cross-training activity (biking, swimming, elliptical trainer, roller blading) performed at easy to moderate effort for 30 to 60 minutes. If you're feeling very lethargic or sore, take a rest day.

Saturdays: This is an active recovery day. Your run or walk/run combination should be at an easy, comfortable pace, which helps release muscle tightness.

 Example

Running Program

zSB(3,3)  

The Lake Health Patient & Community Library has compiled authoritative websites containing the latest information on the H1N1 Flu (Swine Flu) pandemic to help keep you up-to-date and to answer questions you may have. If you need further information, please contact the Lake Health Patient & Community Library:

Email: library@lakehealth.org
InformationRx (Online Information Request Form)
Phone with voice mail: 440.639.4387

State of Ohio Information
Ohio Department of Health.
Access the Ohio Information Line, current H1N1 statistics for the State of Ohio, Latest Statistics, Travel Guidelines, General and Specific H1N1 Flu Information.

PandemicFlu.gov
One-stop access to U.S. Government H1N1 and other pandemic flu information.

National Information
Centers for Disease Control.  CDC website containing the latest information about the H1N1 Flu pandemic.

MedlinePlus
A service of the U.S. National Library of medicine and the National Institutes of Health.  Contains a wealth of information on the H1N1 Flu including a health check tool, interactive tutorial, and video. Available in Spanish and other languages.

International Information
World Health Organization.
World Health Organization (WHO) website about the swine influenza outbreak.