Keeping up the pace in Winter

During the week I was busy motivating a patient to exercise when she asked me very directly what keeps ME motivated when it is so freezing cold. There and then I started to think. Even on my afternoon run I had to think about this and this is what I came up with:

1. Having a goal:
The GLD has said this before and will say it again. Set a goal within a given time frame. Without a deadline it is difficult to stick to an exercise regime. Remember that goals are different in winter compared to summer. Winter is for maintenance of the work done in summer. When summer comes again, you will be able to put in the extra work.


2. Having a running buddy:
When my previous running buddy got injured I could see the lack of motivation and how skipping a few runs were not an issue. Having someone who also depends on you for exercise help you to stick to your workouts even when it is freezing


3. Social networks:
The one thing that really motivates me is fitness, running and cycling magazines and sites which I follow via Facebook or Twitter. This way I know how other members of the running community is doing. Some will head outdoors in the darkest winter mornings where others will declare that they are not brave enough. Support, ideas and loads of inspiration- I get fired up just by reading comments, statuses and tweets. We can recommend: Runners World SA, Fitsugar and Bicycling magazine.


4. Head indoors:
Kick up the pace with group fitness classes or hit the treadmill when weather is unbearable.


5. Getting into workout clothes:
The patient mentioned that getting out of her working clothes, and into her workout gear (especially her sports bra) was a mission when she is already freezing. We suggested getting the correct clothes as a bottom layer even to work. Check out this post on how to wear your workout outfit to work without anyone noticing



Remember that when we lose our fitness during winter, it will be much harder to get into action when summer comes around. Get out there! There are many others who are also cold- but they are out there exercising!

Exercise to manage Parkinson's Disease

Parkinson's disease is one of the most debilitating of diseases. Biokineticist Nicole Picas says that with the help of a biokineticist one can still have prolonged functional ability and a good quality of life.

What is Parkinson’s disease? Parkinson’s disease is a progressive disorder that affects the central nervous system. According to MedicineNet.com, it is the most common movement disorder. This condition occurs when there is an insufficient production of the chemical – dopamine – in the brain. Dopamine is a messenger in the brain that is responsible for producing smooth, coordinated muscle movements. Thus, in people with Parkinson’s disease, this lack of dopamine in the brain results in limited and uncoordinated movement.

Causes The cause of Parkinson’s disease is unknown; however genetic and environmental factors, such as exposure to toxins, are potential contributing factors.

SymptomsThe following symptoms may occur with Parkinson’s disease:·         

• Tremors
• Rigidity
• Bradykinesia (limited movement of the extremities)  
• Poor motor control when rising form a chair   
• Stooped posture
• Shuffled and stiff gait (walking pattern)

http://parkinsonsymptoms.net/wp-content/uploads/parkinsons-symptoms2.jpg

The figure above illustrates the typical standing posture of an individual with Parkinson’s disease.


Treatment and Exercise Parkinson’s disease is treated with medication. But, because it is a movement disorder, it is essential that people with this condition also receive supervised physical therapy on a regular basis, in order to maintain functional ability for as long as possible. The condition is progressive; however, exercise can help to slow the progression and maintain mobility.

Falls are a common problem in people with Parkinson’s disease because of the shuffled and stiff walking pattern. Individuals with this condition will tend to stoop forward, shuffling their feet along the ground instead of picking them up. This may result in them tripping over the smallest uneven surface and possibly falling. These people also often have a slower reaction time, meaning they are less likely to catch themselves if they lose their balance. Falls are very serious in elderly people, as their injuries become more severe, resulting in less mobility, thereby creating a vicious cycle.

So, the first and most important aspect to consider when working with a Parkinson’s patient is that of gait, or walking pattern. It is essential to make these people aware of how they walk and make the necessary corrections, explaining why these corrections are made. Also, practice walking in various directions and around different objects, so that they become comfortable with moving in different directions.

Fluid movements must be encouraged. These include walking, cycling and swimming, amongst others. If a person has already developed a tremor, one does not want to exacerbate this by getting them to lift excessive weights. Keep weight training to a minimum and rather do more repetitions, keeping the movements smooth and manageable. This will also create a feeling of achievement which is important for motivation.

Stretching and flexibility exercises are important to maintain range of motion. Therapists must be aware of how the person is feeling. If one overstretches a patient, they may respond by tensing up the muscles, thereby exacerbating rigidity. The patient must remain relaxed during stretching.

It is important to m.ensure that exercises are functional, thereby assisting patients to maintain their ability to perform the activities of daily living. Find out what an individual struggles to do at home and work on ways to improve those movements.

So, for those of you who may have been diagnosed with this condition, don’t sit back feeling sorry for yourself. Get up and keep moving! With the help of a Biokineticist, you can still have prolonged functional ability and quality of life.

For more articles by Nicole, visit her blog: www.nicolepicasbiokineticist.blogspot.com.

Get your DIET RIGHT in just 7 DAYS

Day 1: Analyze your eating

Few people are truly conscious of how much they eat, how often they eat, and exactly what they eat and a food diary is a great tool in increasing such awareness. Most women are in denial about their eating habits and a food diary or reporting their daily intake may be a reality check. Seeing your habits in black and white will give a true idea of the cause and effects in your diet. This can be a daunting prospect initially, but while you may be hesitant to look at your habits this closely, it is a vital step to switching from a mindset of dieting to a focus on lifestyle change.

 A good food diary should record more than just calorie intake. Use it to record the emotions, situations, and triggers that cause you to overeat or make poor food choices. In fact, your food diary may end up being more about your feelings than food which is valid as there is more often than not a connection between emotions and food.

 A food diary will help you identify your emotional eating triggers, and guide you in making the link between eating and emotional queues or triggers. Once aware, reviewing a food diary will allow you to plan alternate activities to eating before the eating behaviour or situation arises again and it will be a tool to trace back in time to see where you went wrong when the number on the scale does not leave you satisfied.

Day 2: Feed your cells

Our bodies have trillions of mitochondria— components of our cells that crank out adenosine triphosphate, the molecule essential to all metabolism and energy creation. To keep them “fat and happy,” try to eat a diet high in the B vitamins (including B6, B12, folic acid, niacin, riboflavin and thiamine).

Most people consuming a varied and balance diet of whole-grains, meat, chicken and fish will be consuming enough B-vitamins. Those who exclude certain food groups from their diet should discuss with their dietitian or doctor before taking a supplement.

The B-vitamins are a group of vitamins that play a role in metabolism of the cell. The B-vitamins include:

·        Vitamin B₁ (thiamine):

·        Vitamin B₂ (riboflavin):

·        Vitamin B₃ (niacin or niacinamide):

·        Vitamin B₅ (pantothenic acid):

·        Vitamin B₆ (pyridoxine, pyridoxal, or pyridoxamine, or pyridoxine hydrochloride):

·        Vitamin B₇ (biotin):

·        Vitamin B₉ (folic acid): involved in the development of growing embryons, thus pregnany women and thos trying to conceive should consider folic acid supplements to their diet. Dietary sources include dark green leafy vegetables such as spinach, cabbage, Swiss chard, broccoli, watercress, as well as dried beans, peas and legumes

·        Vitamin B_1s: Vitamin B₁₂ is of concern in vegetarians and vegans as it is not available from plant sources and only in animal sources. Those with a diet deficient or animal products should consider taking a B12 supplement.

Day 3: Sip it good

One of the corner stones of a healthy diet and clean system is good water intake. Toxins building up will contribute inflammatory responses. Aim for at least 8 glasses (or 2L) of water per day or 30-40ml/kg/day. A good indication of sufficient fluids is pale coloured urine. Jazz up water with slices of lemon or orange and fresh mint leaves for a refreshing drink, or add lemon juice to a cup of hot water in the cooler months.

Day 4: Start strong

Eating soon after you wake up will awaken the body and kick start your metabolism for the day. Start the day with a well balanced breakfast of lean proteins, complex carbohydrates and healthy fats for sustained energy levels. Adding sufficient protein and healthy fats aids in the slower digestion and release of sugars into the blood resulting in constant blood glucose levels. Oat based cereals with milk and pumpkin seeds or nuts, scrambled egg on low GI bread or berries and plain yogurt as protein source srinkled with some nuts and seeds will all do the trick.

Day 5: Manage the munchies

Snacks should be readily available to prevent you from reaching for convenience and most of the time not-so-healthy options. Preparing a daily lunchbox is one of the better ways of making sure your food for the day is ready. Snacks should be low in GI to prevent energy spikes and drops. This may include low GI crackers with cottage cheese, biltong, a small tub of yoghurt with a fruit or a handful of nuts. Again, combining the carbs with a protein and a fat will slow down the digestion and regulate the release of the sugars into your blood, controlling both sugar and insulin levels.

Day 6: Go pro

In recent years probiotics have become the new buzzword in scientific circles. Probiotics are good bacteria that confer health benefits when eaten in adequate amount. Probiotics can be consumed in the form of supplements, or included in the diet in foods such as fermented products like yoghurt, milk, kefir, sauerkraut, and tempeh.

Optimally, the good beneficial bacteria should predominate over potentially harmful bacteria. During illness or through poor dietary practices, the unfriendly bacteria are afforded the chance to multiply and grow causing gastrointestinal upsets and ill health. Consuming probiotics leads to an increase numbers of probiotic bacteria in the gut, which would naturally decrease over time once ingestion stops. When ingested, probiotics pass through the stomach unaffected by acids and enzymes, entering the intestine and multiplying to live on the intestinal cell surface.

Through a combination of these mechanisms, bad bacteria are effectively booted out of the gut and the good bacteria thrive and grow.

Some of the potential health benefits of probiotics in adults include alleviation of conditions of the gut such as:

- irritable bowel syndrome (IBS),

-  inflammatory bowel diseases (IBD) such as Crohn’s disease and ulcerative colitis);

- treatment and prevention of diarrhoea (particularly in diarrhoea associated with anti-biotic use),

- thrush,

- lactose intolerance

Other health condition still under investigation includes colon cancer, peptic ulcers. Probiotics are also recommended for general health and well-being as evidence suggests they may improve immune function.

Day 7: Just brew it!

Recent revelations about the power of green and white tea are impressive. One of the most useful properties of the surely is the relaxing effect as stress can spur on the inflammatory effect. Furthermore, it is loaded with antioxidants which fight against free radicals, all the bad guys present in an inflamed body. Even when you are using it just for comfort, don’t hold back- d

Blood Sugar Levels in Pregnancy

It is not uncommon to hear that many pregnant ladies experience hypergylcemia (high blood sugar levels), glucosuria (glucose in the urine) or even full blown Gestational Diabetes (diabetes during pregnancy) without having diabetes prior to their pregnancy. This diabetes or blood sugar levels are usually detected at your frequent check-ups as part of the routine.

What causes high blood sugar during pregnancy or gestational diabetes?

-        You develop insulin resistance or glucose intolerance with the onset of pregnancy

-        Prior undiagnosed diabetes or insulin resistance

-        Diet and lifestyle reasons

Those who experience hyperglycemia or gestational diabetes have a risk of having diabetes after delivery but a typical case of gestational diabetes will have the hyperglycemia disappear after delivery. In Gestationbal Diabetes there might be no symptoms of hyperglycemia within the first trimester and it will only manifest later in the pregnancy due to an increase in progesterone and cortisol levels. Therefore, it is safe to say that the gestational diabetes and high sugar is contributed to increased pregnancy hormones.

What can happen to me and the fetus?

-        You can develop pre-eclampsia and high blood pressure

-        Decreased kidney functioning

-        Growth retardation within the uterus leading to low birth weight infant

-        An increased risk of a microsomal baby (large for age) which may lead to problems during natural birth

-        Risk of the child developing early insulin resistance

-        Risk of the child being obese

What should I do about it?

1.      If you are at risk (Overweight prior to pregnancy or already insulin resistant) take special precaution and discuss this with your gynaecologist.

2.      Try to stick to the amount of weight that you should gain. See this chart to determine your ideal weight gain

3.      Follow a LOW GI  diet with controlled amount of carbohydrates.

4.      Small frequent meals: These low GI carbohydrates should be spaced evenly throughout the day to prevent spikes and falls in blood glucose levels.

5.      See your dietitian as soon as you hear that you are battling to tolerate glucose to have an individualised eating plan.

6.      Discuss exercise with your doctor and biokineticist as this has an effect of lowering the blood sugar.

After to baby is delivered:

1.      Get back into an energy controlled low GI diet to lose the weight and prevent retaining some symptoms of diabetes

2.      Breastfeeding can help you lose the weight and control your sugar levels

3.      Eat small frequent meals

4.      Check your blood sugar regularly! Especially if you are not losing the weight. You might be at risk for permanent insulin resistance and diabetes putting you ate risk of many other diseases and might prevent you from having another healthy baby

Asthma and Exercise

 Do you have asthma and aren't sure how to start an exercise regime? Biokineticist Nicole Picas writes about exercise in asthma.

According to the American College of Sports Medicine (ACSM), asthma is: “a syndrome characterized by reversible obstruction to airflow and increased bronchial responsiveness to a variety of stimuli, both allergic and environmental”. In other words, asthma is a chronic inflammation of the bronchi (airways) in the lungs.

Asthma varies from person to person and ranges in severity from mild to severe. It is induced by different stimuli, such as allergens or exercise. The stimulus that brings on an asthma attack in a particular individual must be known and considered when establishing an exercise regimen for that individual.

Exercise capacity can either be limited as a result of having asthma, or exercise can in fact induce an attack, thereby exacerbating the condition. This may cause individuals to avoid exercise wherever possible.

The symptoms of exercise-induced asthma include the following (ACSM):

• Wheezing
• Coughing
• Shortness of breath
• Chest discomfort

The symptoms may last up to 30 minutes after an exercise bout. If the exercise bout is prolonged, then symptoms may occur during the session. If the condition is mild, then individuals can usually exercise at an intensity of 75% of maximum heart rate before symptoms are induced. In more severe cases, mild exertion may induce symptoms. Although exercise may induce symptoms, it is important to include exercise in the management of this condition.

Individuals with well-controlled exercise-induced asthma are able to exercise with little or no symptoms. The training effects will be the same as in individuals who do not have asthma. Thus, these individuals should follow the same exercise guidelines as those for individuals who do not have asthma and thus should include cardiovascular, strength and flexibility exercises into their routines. In more severe cases, where exercise intensity is limited by symptoms, individuals can concentrate on improving endurance, rather than high-intensity fitness and should also include resistance and flexibility exercises.

It is important to realise that one can and should continue to lead a very healthy and active lifestyle, even if they have been diagnosed with asthma. You must consult your doctor with regards to exercise and to take the medication that has been prescribed by your doctor in order to keep the condition under control and to reduce symptoms during exercise. If you have asthma and don’t know how to start an exercise programme, starting off with a biokineticist can point you in the right direction.

Does your cycle influence the amont of food you need?

Although your body is tempting you to empty out your fridge, there’s little evidence to prove that you physically need more kilojoules during your monthly menstruation. “However, during this time some women do experience dysmenorrheal symptoms such as fever and pain, both of which are known factors that increase energy needs,” say Melissa van der Westhuizen and Monique dos Santos from the Good Life Dietitians.





1.     Why we crave food during our periods

Hormones:

According to Pretoria-based dietitian Careen Geldenhuys, “cravings result because of all the hormonal changes during menstruation which have an impact on your blood sugar control.” She explains that the more you give into these cravings – specifically when indulging in refined high-carbohydrate foods like chocolates, sweets, chips, cake, bread and pastries – the more your blood sugar spikes. “This sends a message to your pancreas to release more insulin. This hormone then has an impact on other hormones,” explains Geldenhuys.

Loss of iron:

“The other reason for these cravings is because women lose a lot of blood during their periods and, with this, a lot of iron,” says Geldenhuys. “The loss of iron will leave you feeling tired which, in turn, will have you craving high energy foods in an attempt to raise your energy levels.”

2.     How can we beat these cravings?

Geldenhuys offers these tips:

 Include small quantities of low-GI carbohydrates with each meal like a slice of low GI seeded bread, brown rice, small portion of baked sweet potato or durum wheat pasta. Otherwise, you’ll have really severe cravings for something sugary later in the day and chances are that you’ll go for chocolate or a packet of chips.

Eat good-quality, lean protein foods like chicken breast, fish, lean red meat, egg or plant protein like tofu, lentils, chick peas with at least two of your meals, as this will contribute to your iron intake.

Eat large quantities of a variety of different colours of vegetables, salad, pulses and fruit. The more colour, the wider the variety of different vitamins, minerals and phyto-nutrients to support your body. They’re also a great source of fibre.

 Before giving into the cravings, make sure that you drink plenty of water and other healthy fluids, and eat small portions of fresh or dried fruit and nuts between meals.

3.     How can I help alleviate the symptoms associated with my periods?

The Good Life Dietitians offer these tips:

-  If you’re prone to heavy menstruation, remember that you lose water through menstruation. Make sure that you’re well hydrated by drinking at least 8 glasses of water a day.

-  Calcium supplementation has been found to alleviate the symptoms of PMS.

-  Keep exercising. Symptoms of depression and pain will both be kept at bay by a serious workout.

-  Watch out for salt. High intakes of sodium causes bloating. During a woman’s cycle, the changes in oestrogen causes more sodium to be retained than normal. Therefore bloating may be worsened by a high intake of salt and salt-containing foods like takeaways and processed foods.

-  Evening primrose oil has been found to help alleviate PMS and, in particular, breast tenderness. If you tend to have PMS, supplement with evening primrose oil five days prior to the start of your period and continue for two days after the end of your period

head over to SHAPE to read this and other articles by Shape and the Good Life Dietitians