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Surprise: Salty Diet May Make You Drink Less Newser (Newser) An international team of scientists studying the effects of salt intake on our bodies has discovered a surprise: High-salt diets seem to make us less thirsty over time. Reporting in the Journal of Clinical Investigation, they confirm ...

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Surprise: Salty Diet May Make You Drink Less - Newser

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Are you eating the same foods you were eating in your 20s and 30s? Well, sticking to your old ways can cost you. As you may know, the body experiences rapid changes after age 50. Its ability to absorb nutrients fades, metabolism slows down, bone density declines and immune function weakens.

To combat these changes and maintain optimal health, you have to change your diet. Here are diet changes that will keep you healthy at age 50 and beyond.

Vitamin B12 deficiency has been linked to anemia, digestive issues and fatigue. And its estimated that 47 million Americans are vitamin B12 deficient. In fact, 80 percent of vegans and 50 percent of vegetarians are deficient in B12.

You have greater risk of vitamin B12 deficiency after 50 since your body doesnt have enough stomach acid to breakdown B12 from food. To make up for low vitamin B12 absorption, increase your intake of beef, fish, eggs, and milk. If you are vegan consume; fortified plant milks, fortified soy products, and vegan B12 supplements.

Unlike other nutrients which can be harmful when you go overboard, vitamin B12 is totally safe. According to Washington Post, this vitamin is water soluble, which means the body will flush excess amounts.

Related:How to Get Vitamin B12 on a Vegan Diet

According to research, bone loss triples in women after menopause. Increasing calcium intake will help keep the bones healthy and prevent fractures.

Calcium is also essential for muscle contractions and balancing pH levels (reducing acidity) in the body. The daily recommended calcium intake for women over 51 is 1200mg and 1000mg for men.

Here are the best vegan sources for calcium. Note that excess calcium intake can cause kidney stones, digestive problems and heart disease.

High fiber foods have been proven to reduce risk of colon cancer, heart disease, diabetes, constipation and promote weight loss. Unfortunately, most women dont consume the recommended 25g per day (30g per day day for men).

If you want to prevent your waistline from expanding, increase fiber intake and steer clear of processed carbs.

Vitamin D also helps prevent bone loss. Youll even be surprised to find out that adequate intake of vitamin D can lower mortality rate, research shows.

Its harder to get enough vitamin D as we age because our bodies absorb fewer nutrients from food sources. Plus the skin cant change sunlight to vitamin D as efficiently as it used to when you were younger.

Get vitamin D from food sources such as whole eggs, salmon, mushrooms and fortified foods. In fact, you may need to supplement to reach the recommended daily dose.

Related: 11 Reasons to Love Vitamin D

The recommended daily intake of magnesium is 400mg. People who dont reach this daily value have higher risk of heart disease, high blood pressure, fatigue and weak immune system.

If you choose to use supplements, make sure they dont exceed 400mg. Here are foods that fix magnesium deficiency.

Omega 3s can help you stay young. They fight inflammation, which is known to increase risk of diseases and promote aging. Fish is the most popular source of omega 3s. Vegans can get this fatty acid from flaxseeds and almonds. Feel free to take supplements. Aim for 1000mg per day.

Which diet changes have you made as you age?

Disclaimer: The views expressed above are solely those of the author and may not reflect those of Care2, Inc., its employees or advertisers.

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6 Ways to Alter Your Diet as You Age - Care2.com

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KANNAPOLIS - Anytime Fitness, the world largest and fastest growing 24-hour co-ed fitness franchise, is open for fitness in Kannapolis at the Afton Ridge Shopping Center. A grand opening celebration will take place on Monday, May 1, from 4:30 to 8 p.m.

For many people, joining a gym can be an intimidating experience, said James Sorey, Anytime Fitness club owner. Our gym is big enough to feature everything you need for a great workout and small enough to provide personalized attention for all of our members. Whether weight-loss is your goal, or increased strength or improved balanced and flexibility or a combination of some of those things at Anytime Fitness, were able to help you achieve whatever results you seek.

To celebrate its grand opening, Anytime Fitness is hosting a sampling of our training programs in the evening, prize drawings and healthy eats for all who stop in.

To help celebrate our Grand Opening, new members can join for $1 now through May 6.

Club tours will also be available. For membership information, call or email the gym at 704-273-1616 or

KannapolisNC@anytimefitness.com.

Nationwide, the average Anytime Fitness club has about 800 members. The gyms are staffed roughly 8 hours a day, but members can access the club whenever they like even during unstaffed hours using a computerized key-fob system.

We make it easy for our members to exercise whenever and however they like, said Sorey. We have personal trainers available to help you learn how to use all of the equipment and to develop an individualized workout plan, if you like. And, our state-of-the-art video projection system allows members to choose from dozens of video classes whenever its most convenient for them.

Membership at one Anytime Fitness club gives members access to more than 3,000 clubs worldwide at no extra charge.

The layout of every Anytime Fitness club is designed for quick and effective exercise. At the new club, members have full use of top-quality equipment and amenities, including:

Circuit and resistance training machines

Free weights

Cardio equipment, including treadmills, elliptical machines, and stationary bikes

Team Training

Private bathrooms, changing rooms and showers

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Anytime Fitness opening at Afton Ridge - Independent Tribune

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By Sara Aucoin and Melissa McGowan, Correspondent

Participating in an exercise program while pregnant can have many benefits for both the mother and baby, including maintenance of the mother's fitness level and prevention of pregnancy-related pain or other health-related issues.

Exercising during pregnancy has been shown to reduce the incidence of pain (commonly low back pain), and has positive effects on mental health, including postpartum depression and other pregnancy-associated conditions such as gestational diabetes and hypertension. About 50 percent of pregnant women experience pain in the low back region, and may require the need to take a leave of absence from work. It may also put women at risk for experiencing long-term symptoms. If you are experiencing this kind of pain or any pain during or after your pregnancy, it is important to contact your medical professional. Physical therapy and exercise are safe, noninvasive ways to address aches and pains that occur during pregnancy.

For women who are not having pain, exercise has been recommended and proven to provide benefits. The American College of Sports Medicine recommends that non-pregnant women exercise moderately for 30 minutes or more daily. This is similar for pregnant women if they were previously active in an exercise program. If women are exercising on a regular basis prior to becoming pregnant, then it is safe to continue with exercise on a daily basis at a similar intensity. However, if a woman is planning on beginning an exercise program when pregnant, the safest and most recommended way would be to contact their medical professional and follow their guidance to ensure safety and gain medical clearance to continue exercising. According to the American College of Obstetricians and Gynecologists, it is important to discuss your medical and exercise history with your medical provider as some women may need to limit their exercise routine based on underlying heart disease, anemia, presence of bleeding during second and third trimesters, and risk for premature labor.

Women should avoid high-impact exercise or exercise that puts them at risk of falling or of causing trauma to the abdomen, such as skiing, hockey, horseback riding or jumping sports. Appropriate exercises include walking, stationary cycling and swimming. You should be able to maintain a conversation while exercising. Resistance training can also be beneficial and can be modified by decreasing resistance intensity and increasing repetitions to focus more on endurance and stability benefits. It is also extremely important to prevent breath-holding during the activities.

There are some precautions that pregnant women should keep in mind if they are interested in completing an exercise program. During the second and third trimesters, women should avoid any exercises while lying on their back. The added weight of the baby can put pressure on important blood vessels in your body. It is additionally important to drink plenty of water before, during and after you work out as you want to prevent dehydration. Drinking water will also prevent you from becoming overheated. Other steps you can take in order to avoid becoming overheated are to wear loose-fit clothing and try to exercise in a temperature-controlled room. Avoid completing any exercise during really hot or humid weather.

Exercising can be very beneficial for the health of the mother and baby during ones pregnancy and safe when completed in moderation. If you are having any pain or questions about maintaining or beginning an exercise program while pregnant, it is important to contact your health-care provider.

Sara Aucoin PT, DPT is a physical therapist at Spaulding Outpatient Center in Framingham. Melissa McGowan, PT, DPT, CLT is a physical therapist at Spaulding Outpatient Center in Framingham.

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FLEXIBLE FITNESS: Exercising safely during pregnancy - Wicked Local Hudson

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Youths in the Teens Into Fitness program at Reeves Community Center in Mount Airy are allowed to be who they are while also learning the value of exercise and nutrition in promoting good health.

Americas gung-ho sports culture that stresses competition while branding winners and losers often overlooks the fact that not everyone is prone to be an athlete, or even tuned in to physical fitness at all.

But it is precisely those kinds of individuals who are the focus of an after-school program at Reeves Community Center which basically lets kids be who they are while also learning the value of exercise and nutrition in promoting good health.

With the program being mostly female, this makes it even more important to me, RCC Health and Wellness Supervisor Kasey Summers explained in describing the Teens Into Fitness initiative she heads, which is geared toward ages 11-15.

I want these girls being confident in their own skin and knowledgeable about a healthy lifestyle early.

The Teens Into Fitness program was created for kids in an age group facing a challenging time in their lives on physical, social, emotional and other levels. It seeks to engage youths whether they are physically active on a normal basis with sports or not, according to Summers.

The idea behind it was to introduce different aspects of health and wellness without a focus on how much they weigh or weight loss/gain, the program leader added.

I just wanted them to learn about fitness and nutrition and that it can be fun with their friends, as well as start early with showing how it is an important part of our lives.

Non-threatening environment

Andi Morris had high praise for the program in which her twin daughters Caroline and Lily have been participating in for a good while.

The local mom said she appreciates the fun, non-threatening environment it offers.

The program runs six weeks on and two weeks off, which allows participants to have breaks and avoid getting burned out, Summers related. It is now on such a break, in anticipation of the next six-week cycle starting in early May.

When in session, the group meets on Monday, Wednesday and Friday from 3:30 to 4:30 p.m. and typically has a different focus each day.

But if the kids request something special or get excited about something we do we try to accommodate them because, again, its about them enjoying health and fitness, Summers mentioned.

Mondays generally are set aside for what she calls strength days, with a focus on different methods of strength training, from weights to mind/body approaches using yoga and meditation.

Wednesdays are cardiovascular-based days. The youths sometimes go outside, venture to RCCs Nautilus room, play games or can participate in formatted group fitness classes.

Friday is Nutrition and Free Play Day, when RCC partners with Surry County Health and Nutrition Center.

On those days, Allie Willard and a team from the center come and offer different activities and treats to the kids to help teach them about healthy eating.

When the nutrition portion is finished, the group plays games, talks about the week and all the good things that happened and ends on a positive note until Monday.

Lily Morris, 11, said that in addition to learning about nutrition, she has become more attuned to fitness due to her exposure to the exercise classes and Nautilus machines that are part of the program. It is loaded with fun things that have made a difference in her life, she says.

For example, before she became involved, the youths after-school schedule might have included going outside to play or not.

The program has taught her the value of a daily exercise regimen, the participant said.

Striking a balance

Its important to me that these kids have positive role-models with their instructors, so I have a great team of certified group fitness and certified personal trainers along with myself to work with them in this program, Summers continued.

With the pressure of social media and society to look certain ways, I feel it important to bring to this program a positive self-love/acceptance aspect and help teach them to be the best them that they can be, she pointed out in further describing its goals.

I want these kids to leave this program each day feeling better about themselves inside and out.

Youths in the Teens Into Fitness program at Reeves Community Center in Mount Airy are allowed to be who they are while also learning the value of exercise and nutrition in promoting good health.

http://mtairynews.com/wp-content/uploads/2017/04/web1_Teen-Fitnesss-1.jpgYouths in the Teens Into Fitness program at Reeves Community Center in Mount Airy are allowed to be who they are while also learning the value of exercise and nutrition in promoting good health.

Tom Joyce may be reached at 336-415-4693 or on Twitter @Me_Reporter.

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Unique fitness program targets teens - Mount Airy News

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Saving money for emergencies is good advice and important for maintaining quality of life in the event of lost employment or other financial crisis. While this may seem like common sense, many people have been caught without enough savings when they needed it and found it difficult to meet basic needs.

This principle can also be applied to fitness. When you are healthy, you can maintain a high level of fitness. This makes your day-to-day activities easier and serves as a reserve or bank to draw on when you need it. Your good fitness now can get you through a health crisis just like saving money can help you through a financial crisis. This health crisis could come in the form of an injury or illness that keeps you from being active for several days or a hospitalization that keeps you in bed for a week, a month or longer.

The problem with periods of inactivity, like bed rest or hospitalization, is that there are severe physiological effects that occur within days and get worse over time. You may have noticed this as weakness and fatigue after spending a few days in bed with a cold. Muscle strength declines with each day of bed rest and can be 50 percent lower following as little as three weeks. That reduction in strength could limit a person who was already deconditioned to a point where he or she would have difficulty completing the most basic activities of daily living.

A person who was fit and strong when they went into the hospital would certainly be better off when released. Older adults fare worse than younger individuals. According to one study, the decline in strength seen in older men in just 10 days was equivalent to the change measured after 28 days in men 30 years younger.

Its not just the muscles that are affected; the bones get weaker, too. In fact, 12 weeks of bed rest can reduce bone density by as much as 50 percent, exposing patients to a greater risk of fracture. This is due to the reduced stress on the bone from not standing and walking as well as the lack of muscle activity. Two of the most effective ways to build bone density are putting stress on bones through weight-bearing activity and the action of the muscles pulling on the bones from resistance training. Because bed rest eliminates these stresses, bone density declines rapidly.

One unique study from the 1960s had healthy young men complete three weeks of bed rest. They all experienced a rapid decline (over 20 percent) in their aerobic fitness but recovered quickly after the experiment ended. These individuals also had their fitness tested again 30 years later. It turns out that the decline in fitness in those young men in three weeks of bed rest was greater than the decline in fitness that occurred over 30 years of aging!

The good news is that most patients are encouraged to move around as much as possible. Some receive inpatient physical therapy or rehab, even after major surgery, to help lessen the effects of prolonged bed rest. It is important to take advantage of these opportunities if you, or a loved one, are hospitalized.

There are many reasons to exercise and be fit, but the most important reason may be to develop a fitness bank you can draw on if you become injured or hospitalized. Since the effects of bed rest are seen in people of all ages, everyone can benefit from a good fitness foundation. Just like putting money in the bank, doing a little now can have great benefits later when you need it most.

Brian Parr, Ph.D., is an associate professor in the Department of Exercise and Sports Science at USC Aiken where he teaches courses in exercise physiology, nutrition and health behavior. You can learn more about this and other health and fitness topics at http://drparrsays.com or on Twitter @drparrsays.

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HEALTH AND FITNESS: Your fitness bank - Aiken Standard

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Chicagos Fitness is a band that hit me out of nowhere. We get a handful of bands like that every year, the sort that send you reeling with a name youve never heard and a sound youre glad you had. In this case, the connection was Dont Panic Records, who handled the vinyl of the fantastic Davey Dynamite release last year. Fitness Puppet Show and Fitness is a six song EP, a youthful and scrappy concoction of pop punk with tons of guitar leads, self loathing, and sing a longs.

Puppet Show and Fitness grabs you from the first song, immediately familiar and simultaneously new. If you sniff around, you can hear the influences, but none of them ever quite come to define their sound. The first one that came to mind for me was Hot Water Music, whos dueling guitar leads became an oft-copied sonic idiosyncrasy, but Fitness dont play it with the same post-hardcore edge. When Fitness plays them, they have a more electric, less serpentine and melancholy feel. Its this pop sensibility that signals Fitness as more than a band of Gainesville acolytes. They dont have that droney edge, that sense that they ended up writing singalong songs through mad scientist potion mixing, deconstruction and rebuilding. No, Fitness has a knack for pop songwriting, strong melodies are the glue that holds their songs together, and in this sense they sound a bit like Junior Battles or Problem Daughter. But, Fitness is propulsive, more straight-ahead than either of those when a song gets out of its cage, it rampages.

Album opener Road Lizard is a good example of this: guttural vocal delivery, guitar leads flexing at each other over an insistent beat. It has its own mix of energies, and it always comes as a surprise, that the vocals are as raw sounding as they are. Separated from the rest of the track, they couldve been from a hardcore band thats how much snarl they put on the words. But with the instrumentations bouncy energy, it becomes this airy and energetic brand of pop punk.

Theres a difference between good playing and good songwriting. One of them allows a band a spot on bills, it sounds tight live but doesnt stick with you for the drive home. The latter keeps the songs stamped on a time and place, we grow on them and they grow on us. Fitness has a cool sound, but what they also have is songwriting chops to spare. Puppet Show and Fitness reminds me of the Dead Bars EP, in that is expresses a sharp and consistent songwriting vision, with defeatist lyrics met with triumphant melody. Roseannes Bars 60s pop chorus starts with the line Call me a liar, call me pathetic, sounding like a Phil Spector penned Nirvana song. These are the types of decisions that make the sort of inward-focused punk that has become popular in the last ten years stick, rather than remaining a competent copy of a copy. The best airings of grievances come with a hook, a recognition in the crowd that as you sing along, theres a kindred spirit out there, a conversation between artist and audience where the response is: me too.

To sum it all up with a thesis logline: Puppet Show and Fitness is a great EP from a band poised to do a lot more in the future. Theyre exciting, theres a sense of urgency to their music thats infectious, enough aggression to sell the venom in the lyrics. Each song is an experience, with busy leads that bounce off each other like billiard balls on break, full throated singalongs begging to be shouted back; songs that come out swinging, gloves in the air and a pep in their step, hungry for connection.

4/5 stars

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EP Review: Fitness Puppet Show and Fitness - Dying Scene

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Robert Rodriguez - Tribune News Service

Dina Juve, a rising star in Fresno's health and fitness community, didn't always have a sculpted body, a taste for healthy foods or a positive attitude.

At one time, she was known as the fast food queen, weighed 202 pounds, and was an 18-year-old single mom. She suffered from juvenile arthritis and autoimmune disease. She was in physical pain most of the time, depressed and had little energy to keep up with a toddler.

"I sat on the couch on day, looked at him and just started crying," says Juve. "I didn't want him to see me like this, I wanted him to be healthy and happy."

It was a low point for Juve, but also the beginning of what would become her new life. She gave up sugary soda and eating fast food. She focused on healthier, minimally processed food. After a while, she also began to exercise. She stayed out of the health clubs in favor of her VCR at home and exercise tapes of Buns of Steel and Tae Bo.

"I was too embarrassed to go to a gym; I did not want people to see me trying," she says. "What if I failed?"

Except Juve didn't fail. She got stronger, she got healthier and she became a new person. She immersed herself in the study of nutrition and exercise, earning certifications in kettle bells and TRX _ a band resistance program. She's a battling ropes coach, Barre instructor and a weight-loss specialist, counseling clients on how to live and maintain a healthier lifestyle. She dropped 90 pounds and her weight these days ranges between 110-114.

Along with her business partner, Melissa Oberti, she also founded FitnessSocial, a northeast Fresno fitness studio with a growing following.

Juve, who admits to living comfortably outside of the spotlight, was thrust into the public eye by friends and clients. With their encouragement she rose to national prominence after being selected one of five women vying for Women's Health 2015 Next Fitness Star. She appeared in the July/August issue of Women's Health magazine. Although she didn't win, she appeared on the "Today" show twice and made many valuable connections.

Today, the 43-year-old wife and mother of four is in demand as a public speaker, cooking instructor, and weight-loss expert. She has a spot on the Patio Cafe's menu under the label Dina's Picks where she and restaurant owner Robyn Richardson have come up with menu items that are under 550 calories. And this year Juve will be speaking at Central California Women's Conference on Sept. 19. Her topic is "Real Fast Food."

Friends say they aren't surprised that Juve has become a health and fitness guru.

"People talk about finding their passion or their calling and for Dina it is fitness and nutrition," says K.C. Cornwell. "I really think that Dina was put on the planet to make people feel better about themselves."

Hillori Hansen, culinary director for Whole Foods Market Fresno, has tapped Juve to lead several cooking classes. Recently, Juve and Hansen taught a class on how to make a healthier hamburger using five ingredients or fewer.

"One of things that people love about Dina is that she is real, she has gone through struggles in her life and has overcome them," Hansen says. "I can see her taking her message to a national stage."

That may be happening as Juve explores writing a book and more speaking engagements.

"This is a whole new life for me," Juve says. "But it is one that allows me to share my story and help others become healthier and happier."

To help you get started on living a healthy life, Juve has come up with 10 tips to follow:

1. Before embarking on a change in your diet, ask yourself why you are doing it. If you can dig deeper than just vanity, you are more likely to be successful. If you don't know why you are doing it, chances are you won't continue to truly live a healthy lifestyle. If you are doing it to feel better, have more energy, for health reasons, to be around for your children and grandchildren, etc., then you stand a better chance of success.

2. Drink water. Every system in your body depends on water. My recommendation to my clients is to drink 16 ounces of water before each meal and snack to keep it simple. On average, try drinking 48 to 96 ounces of water per day. I find that when my clients have water before eating they tend to eat less.

3. Stick to whole, real food. Avoid foods that are heavily processed or contain large amounts of artificial sweeteners, dyes or chemicals. Try to eat foods with ingredients you can pronounce. Think fresh fruits, vegetables, complex carbohydrates, and animal- and plant-based proteins.

4. Add healthy fats from fish, avocado, olives, nuts and tropical oils. Nuts have a lot of health benefits and help you lose fat by improving metabolism, balancing hormones and eliminating constant cravings by keeping you feeling full longer. Healthy fat calories do add up quickly, so be mindful of portion sizes if you are trying to lose weight.

5. If you crave something, eat it _ guilt free _ just don't overdo it. Eat the serving size, enjoy it, savor it and be done with it. If your indulgence doesn't satisfy you, ask yourself why. Are there other things going on in your life that need to be addressed?

6. Avoid categorizing foods with words like good or bad. Negative words make you feel bad about yourself and that's not helpful. Aim to eat foods that give you energy and not make you sluggish.

7. Mindful eating. Eat when you are hungry and do not eat when you are not. We have gotten into a routine of eating on a schedule, even when we are not actually hungry, or we skip meals. Try listening to your body. When you pay attention to your body, you will find yourself fueling your body and using that fuel before you eat again.

8. Slow down when you eat. Try to take 20-30 minutes to eat a meal. Put your silverware down between bites. Try to chew your food fully. You will most likely find yourself eating less. Try to not eat when you are stressed, anxious, angry or rushed because this can be the cause of overeating.

9. Aim to eat the rainbow by adding more fruits and vegetables. The more colorful your plate looks the more appetizing it will appear to your eyes. It will also most likely ensure that you will receive the vitamins and minerals your body needs.

10. Yes, you can still eat out and have the body you desire. You just have to balance it like a checking account. If you overeat the debt will show up on your body. If you do not go out to eat, stay at home and do not enjoy life, that's not creating a long-term healthy enjoyable lifestyle you can maintain. We call that a diet and diets don't last long term. A healthy eating lifestyle has variety and it includes occasional indulgences. You know you have the plan that works best for you when you feel, move and look your very best. It really is not as hard as it seems.

___

(c)2017 The Fresno Bee (Fresno, Calif.) at http://www.fresnobee.com

Distributed by Tribune Content Agency, LLC.

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Fitness guru has 10 tips for people unhappy with their weight. Why? She's been there - Times Herald-Record

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Bastian Schweinsteiger has made quite an impression in his first few weeks with the Chicago Fire, buthis best might still beto come.

The German midfielder has gotten off to a good start with the Fire by scoring two goals and delivering an assist in his first four appearances for the club, but herecently confessed that he is still not at his top level in terms of fitness. Part of this is aproduct of riding the bench for much oftwo seasons at Manchester United, but he'sconfidentthat he willget back into tip-top shape withmore MLS matches under his belt.

"I would say around 70 percent," Schweinsteiger told Chicago Fire Weekly when asked where he is at right now. "[There are moments] in the game you feel like you want to do something andyou can't really do it because of the energy. I try to,of course, play with my brain. My brain is 100 percent, so that's working, but I feel as a player ifyou play 20 games in a row you have a better rhythm, feeling for the game. That's what I'm working on."

Schweinsteiger will have another opportunity to improve his fitness and help the Fire pick up another win on Saturday, Apr. 29, when they visit the New York Red Bulls (7:30 pm ET | TSN2 in Canada; MLS LIVE in US).

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Chicago Fire's Bastian Schweinsteiger says he is at 70 percent ... - MLSsoccer.com

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By Dr. Mark Windt

As easy as breathing... is a phrase we frequently hear, but for many of my patients, breathing does not come easy.

As a pulmonologist, I have spent the better part of my career working to find methods and treatments that will improve lung function for my patients and allow them to breathe easier. One treatment that has proven to have remarkable success, with patients suffering from asthma, COPD, and other illnesses, is pulmonary rehab. However, the benefits of targeted, clinically overseen exercise and its success in treating and improving lung conditions, is not widely known. Not that long ago, patients with lung conditions were encouraged to rest and not exert themselves. Now, research shows that lung function can be improved thanks to exercise. Lets talk about the origins and benefits of pulmonary rehab.

A brief history of pulmonary rehab

Up until the 1950s, the prevailing school of thought was that those with lung diseases should rest and save their breath. Children with asthma were advised not to run or play; adults with lung disease were encouraged to rest and live quietly. Exertion can trigger difficulty breathing with some conditions, but not exercising at all has also proven to be harmful. In 1952, Dr. Alvan Barach, a leader in oxygen therapy and a faculty member at Columbia University College of Physicians and Surgeons, was conducting research on COPD and first noted the benefits of an exercise program that was geared to markedly improve the capacity to exercise without oxygen. He likened this program to the training efforts undergone by athletes to improve lung function.

Another 10 years would pass before the first pulmonary rehab program would get underway.

In 1969, Dr. Thomas Petty, an international authority on respiratory disease and professor of medicine at the University of Colorado Health Sciences Center in Denver, launched a program that provided patients with sessions geared toward walking exercise, bronchial hygiene techniques, supplemental oxygen therapy and breathing techniques. The sessions were aided by a personal instruction manual that patients took with them.

What conditions can pulmonary rehab treat?

Currently, pulmonary rehab is being used to successfully treat asthma, COPD, pulmonary fibrosis, interstitial lung disease, lung volume reduction, pulmonary hypertension and bronchiectasis, a condition where the bronchial tubes become permanently damaged, thickened and widened, often because of infection. Pulmonary rehab is also an important tool in aiding people who have had lung cancer or a lung transplant. And, it is being used more and more in the treatment of obstructive sleep apnea more on that later.

In addition, it is important to note that pulmonary rehab can be helpful to people of any age. It does not matter with adults how old or young you are. I have seen successful treatment with many senior patients. People with COPD or pulmonary fibrosis who qualify for rehab can see improvement even if they are in their eighties. No one should give up on trying to improve their ability to breathe better due to age. Pulmonary rehab also works well for patients who have asthma, are fairly healthy, but want to improve lung function. Some asthma patients may already be active, but targeted breathing exercises, such as those found in a rehab program, can improve their breathing and allow them to be even more active.

What are the benefits of pulmonary rehab? As early as Dr. Pettys time, the benefits were clear: Reduced hospitalization, improved exercise tolerance and a faster time frame in returning to work after illness or flare-up. We also notice improved activity levels, better quality of life and greater independence among our patients who have undergone rehab.

Patients with specific conditions also see specific gains. For example, for patients with COPD, exercise strengthens the heart as well as the muscles used for breathing so this can help alleviate shortness of breath. People with COPD tend to limit physical activity because they are fearful of becoming short of breath, but inactivity causes muscle strength and heart health to decline. Pulmonary rehab helps patients maintain physical fitness and regain control of their breathing. They can then pursue activities to the full extent of their abilities.

For patients with asthma, the goal is to help them keep an active lifestyle. Regular exercise can help them maintain control of their asthma symptoms, and reduce the risk of flare-ups, as well as the use of medication. It also boosts the immune system (it is important for asthmatics to avoid flu and other respiratory illness), aids in weight management (being overweight increases the strain on your cardiovascular system), and improves the bodys oxygen efficiency, which leads to improved cardiopulmonary fitness.

People with obstructive sleep apnea share many of the same symptoms and complaints as those diagnosed with COPD and/or asthma. Participants with OSA see an improvement in their capacity for exercise and the activities of daily life. Their balance improves, and they have increased strength in the muscles they use for breathing. An increased ability to exercise, along with a healthy diet, may lead to weight reduction, which is a goal for many with OSA.

How does such a program work? Each exercise program is customized to the participant, providing them with specific exercises based on their individual abilities and personal goals. All participants undergo a cardiovascular fitness assessment, cholesterol evaluation, body composition measurement, and testing of their strength and balance; they also provide a comprehensive medical history and complete lifestyle and fitness questionnaires. These tests are important as they provide a good baseline as to the patients overall health prior to starting rehab.

The program is then designed by a pulmonologist and exercise physiologist, and held in a controlled setting. The Pulmonary Rehabilitation Programs at the Center for Asthma, Allergies and Respiratory Disease run for 90 minutes once a week for eight consecutive weeks. Each session focuses on a different topic, such as balance and mobility, fitness and strength, nutrition, controlled breathing techniques and stress management tools.

All exercise therapy is overseen by a masters degree exercise physiologist who monitors each patients oxygen level, heart rate and blood pressure. In addition to the educational component, each week includes a cardiovascular session with activities such as walking on a treadmill or riding an upright bike. Strength training may include working with lightweight dumbbells or resistance bands. Poor balance is a medical issue affecting numerous people and the pulmonary rehab program specifically addresses this issue with exercise and instruction. Balance training may use stability balls, chair and wall support, and dynamic body movements. If someone is arthritic or has an orthopedic condition or other infirmity, those are taken into account and exercises are modified to accommodate their needs.

What are some of the challenges?

One of the challenges facing pulmonary rehab is getting patients to continue with the program once they graduate. Joining a medically-affiliated fitness center can help, as can online support groups. Telemedicine may also be a good tool. Being able to access instruction and advice via computer allows people to exercise in their homes but still be able to check in with a professional if they have questions or need encouragement. Telemedicine is also a good way to help people in rural areas maintain their programs.

Another challenge is the educational factor. We still need to make more people aware that pulmonary rehab can potentially help their conditions, and also make more doctors aware so that they can refer patients for pulmonary rehab.

Where is pulmonary rehab headed?

I think you are going to see the benefits of pulmonary rehab continue to expand. I started my pulmonary rehab program at CAARD seven years ago. It was designed as an outpatient program to improve health benefits for COPD patients, asthmatics, and those with obstructive sleep apnea. A few years later, the American Thoracic Society recommended asthma as a condition that would benefit from pulmonary rehab (previously, it had only looked at COPD). Ive been doing research on the benefits of pulmonary rehab to those with OSA for some time, and am hoping that with the publication of that research, the ATS will add OSA as another condition where pulmonary rehab can make a difference.

I think it's important to remember that the body likes to be active. There are few conditions that do not improve if the body is allowed to be active in some fashion. In fact, studies have shown that one of the key markers of longevity is how physically active you are. You may be battling a serious illness or condition, but if you are still able to be up and about and get in some form of exercise, then you have a greater chance at maintaining quality of life and living longer.

If you are interested in learning more about pulmonary rehab and whether it might help you or a family member, contact CAARD at 964-3392 for a consultation.

Dr. Mark R. Windt is an allergist, immunologist and pulmonologist who has been treating allergies, including food allergies and respiratory illnesses, for more than 30 years. He is the medical director for the Center for Asthma, Allergy and Respiratory Disease in North Hampton, NH, a facility he started in 1985. Dr. Windt is also an adjunct professor at the University of New Hampshire's School of Nutrition and founder of the Probiotic Cheese Company (www.theprobioticcheesecompany.com). For information, visit http://www.caard.com or call 964-3392.

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Breathe better: Understanding pulmonary rehab - Foster's Daily Democrat

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