Does Exercise Increase Longevity?

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Doing a few hours of exercise every week will probably help you live longer.

JAMA Intern Med. 2015 Jun;175(6):959-67. doi: 10.1001/jamainternmed.2015.0533.Leisure time physical activity and mortality: a detailed pooled analysis of the dose-response relationship.

Study size: 660,000 people ages 21 to 98.

People who got some exercise, but not enough to meet the physical activity recommendations to get 150 minutes of moderate activity per week or 75 minutes of vigorous activity per week were still 20 percent less likely to die over a 14-year period than those who did not do any physical activity.

People who engaged in the recommended level of physical activity saw even more benefit: They were 31 percent less likely to die during the study period, compared with those who did not engage in any physical activity.

The maximum benefit was seen among people who engaged in three to five times the recommended levels of physical activity; they were 39 percent less likely to die over the study period than people who did no exercise.

Found no link between very high levels of physical activity (10 or more times the recommended level) and an increased risk of death.

The people most likely to benefit from increasing the amount of exercise they do are those who do not currently do any.

Study author said: “Doctors should target this group with exercise counseling. Physicians who seek out the segment of the population that performs no leisure-time physical activity could receive the most payback in their patient’s health”.

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For the trainer or dietitian: Helping a Client Past A Plateau

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This is from an article I wrote that was published in the magazine IDEA Fitness Journal.

I am Registered Dietitian and a personal trainer who specializes in weight loss management incorporating lifestyle changes and behavior modification, nutrition and fitness. I’ll share with you the process I go through when a client’s weight loss stalls.

When a client has stopped losing weight on his or her program, rather than simply concluding that the fix lies within their workout or nutrition regimen, experience tells me there’s more than meets the eye; and this is where many trainers miss the mark and often fail to take the necessary next steps to delve deeper into the root of the problem.

Perhaps the client is not following their program as diligently as they did in the beginning.  Maybe they are having challenges with following the program and need fresh ideas and suggestions. They may say they want to do it, but despite their best efforts can’t seem to because they have conflicting feelings about change. Maybe they simply aren’t ready to make any changes at this time; or perhaps there is a medical reason weight loss has stalled.

If a client has stopped losing weight, I assess their adherence to the nuts and bolts of the program.  Are they are still following their program as attentively as they did in the beginning?  Sometimes I find that after some initial weight has come off, clients are not as diligent as they were at the beginning of their program.  A typical pattern I see is that cardio isn’t performed as often or as long; portions start to slowly creep up in size; treats make their way back into their diets; their meals aren’t being logged anymore and/or meals aren’t planned as attentively.

To assess if a client is following their program I ask a few key questions:

  • Are you following the meal plan that I have created for you? (Remember I am a dietitian and can create specific meal plans)
  • Are you planning out your meals in advance?
  • Are you measuring your food and logging your food and beverage intake?
  • Are you reviewing your journal to see if you have met your nutrient targets that I (as a dietitian) have set? (Calories, carbs, protein, total fat, saturated fat, fluid, sugar and fiber).
  • Are you taking your multivitamins and any other supplements that I have recommended? (Remember I am a dietitian and can make these recommendations)
  • How many minutes of cardio have you done this week? What type and what was your heart rate range)?
  • Did you get two weight training workouts in this week?
  • Did you get at least 7 hours of restful sleep?
  • Are you experiencing chronic stress?

Aside from the stress question, if the answer to any of these questions is “no”, then we then (together) come up with some actions that might help them get back on track to reinstate their positive practices into their daily regimen.

As we speak to our clients, it is important to remember that making changes is difficult, and falling back into patterns or unproductive ruts is far too easy. Listen carefully for indications that the client is facing challenges incorporating the new changes.  Perhaps work stress is setting in; the new baby is keeping them up at night; maybe they’re worried about money. You get the point.  The list can be a mile long, and we all know that it doesn’t take much to derail someone from a once-effective program.

Most often, he or she just needs a few suggestions on how to incorporate new behaviors into a daily routine. Ask what challenges they are having and together, come up with some ideas to overcome them.

You may however, face a situation where your suggestions just aren’t met with much of a positive response or action.  Have you ever heard a client saying things like, “I know I need to exercise but I hate to do it,” or “I know I need to stay away from treats but it’s just so hard”. I call that the “yes, well, but” syndrome. These statements signal ambivalence and conflicting beliefs, desires and behaviors. The client “knows” they “should” make some changes but can’t seem to. If a client is ambivalent, they are not going to be moved to make changes if your response is to give them more suggestions.

This client may not be ready to make any big changes. Take a step back at this point and assess their readiness to change.

I have found two counseling techniques which are helpful in increasing intrinsic motivation:  Readiness to Change and Motivational Interviewing.

-Readiness to change provides a framework for understanding the behavior change stages that people go through.

-Motivational interviewing is a counseling method that helps facilitate motivation within the client.

Utilizing these methods, especially motivational interviewing, takes education and years of practice to be effective. It is invaluable for every person working with others to make lifestyle changes to become more competent in this area.

If you don’t feel skilled and think this person may benefit from some help exploring their ambivalence, I’d recommend asking them if they feel that talking to a psychologist might be helpful in helping them explore and resolve ambivalence.

Of course, it is certainly possible that a medical issue exists which lends to the reason for not losing weight. Such issues may include hormonal changes, Cushing’s syndrome, hypothyroidism, PCOS, or insulin resistance, and a visit to the doctor may be justified.

 

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Maria Faires’ Instant Pot Mushroom Risotto

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This is an elegant, intensely mushroom flavored risotto. The soy sauce and miso bring out the fresh flavor of the mushrooms.

·        4 cups homemade or store-bought low-sodium chicken stock or vegetable stock

·        1 ounce dried shitake mushrooms

·        1 1/2 pounds of any or a mixture of mushrooms, such as cremini, shiitake, oyster or chanterelle, trimmed and thinly sliced

·        4 tablespoons extra-virgin olive oil

·        4 tablespoons salted or unsalted butter

·        Kosher salt and freshly ground black pepper

·        6 ounces of about 1 medium yellow onion, finely chopped

·        2 medium cloves garlic, finely minced

·        1 1/2 cups risotto rice, such as Aroborio, Carnaroli, Vialone, Nano, or Baldo

·        2 teaspoons soy sauce

·        1 tablespoon white or light miso paste

·        3/4 cup dry white wine, such as Pinot Grigio, Sauvignon Blanc, or Unoaked Chardonnay 

·        1 ounce finely grated Parmigiano-Reggiano cheese, plus more for serving

·        ½-1 cup minced fresh parsley

Place stock and dried mushrooms in a microwave-safe 1.5 quart capacity bowl and microwave on high power until simmering, about 5 minutes. Remove from microwave. Set aside and let mushroom hydrate as you do other prep.

Turn the instant pot onto sauté. Heat olive oil and butter in the base of a stirring, until butter has melted. Add fresh mushrooms, season lightly with salt and pepper, and cook, stirring occasionally, about 8-10 minutes.

Using a slotted spoon, transfer rehydrated mushrooms to a cutting board and roughly chop.

Add onion, garlic, and chopped rehydrated mushrooms and cook, stirring frequently, until onions are softened, about 4 minutes.

Add rice and cook, stirring, until rice grains start to look translucent around the edges and milky/cloudy in the center. This takes about 10 minutes.

Stir in soy sauce and miso paste until evenly incorporated.

Add wine and cook, stirring, until wine has almost fully evaporated, about 2-3 minutes.

Pour stock into pot. Scrape any grains of rice or pieces of onion from side of pressure cooker so that they are fully immersed. Close pressure cooker and press “steam” and 5 minutes. The instant pot will take about 10 minutes to get up to pressure then “5” will appear on the display. When the timer goes off, safely release the steam vent and allow to vent.

Open the instant pot and stir to combine the rice and cooking liquid. Stir in cheese and parsley. If the risotto is too soupy, cook on the sauté function for a few minutes longer, stirring, until it begins to thicken more. If it is too thick, stir in some hot water.

How to Tell If Risotto Is Cooked Perfectly

Take a grain or two of rice out of the risotto and press against a cutting board with your finger to smash the grains. If the rice is not done, you’ll notice a small hard white piece that remains (the uncooked part of the rice grain). If there is no hard white piece is left, the risotto is done.

Season to taste with salt and pepper and serve immediately on hot plates, passing extra cheese at the table.

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