My gym offers several dance-themed exercise classes like Zumba. The brochure claims that dance may have more health benefits than standard exercise. Is that true?
We dance to express joy, celebrate life events and as a form of exercise. It turns out that the combination of music and dance may have benefits beyond those of exercise alone.
The evidence for the health benefits of exercise is unquestioned. Regular activity builds muscle and bone, reduces fat, increases aerobic capacity and lowers blood pressure. It also improves the ratio of “good” to “bad” cholesterol.
Dance has physical and cognitive benefits that may exceed those of other forms of exercise. It has been shown to improve balance, gait and quality of life in people with movement disorders like Parkinson’s disease. And several studies show that mastering dance movements and patterns improves memory and problem-solving skills more than walking does.
Then there’s the music that comes with dance. Music stimulates the brain’s reward centers, reaching us in a very special way. In the remarkable documentary movie “Alive Inside,” you see how music can “awaken” people lost to Alzheimer’s disease. People who haven’t uttered a sentence longer than four words in a long time suddenly start singing complex lyrics from songs. People who haven’t expressed happiness in a long time suddenly start beaming as they sing along.
Then there’s the fact that dance is a way of celebrating, and we all need to celebrate from time to time. And when you celebrate along with many others on the dance floor, you compound the power of celebration.
There are many ways to enjoy dancing:
Take a class. Many Y’s and senior centers offer some type of group instruction for people at all levels. You’re most likely to find lessons in tai chi (a meditative exercise that is often performed to relaxing music) and Zumba (an aerobic workout that combines steps and moves from a variety of traditional dances, often to Latin music). Learning new types of ballroom dance can also be fun and challenging. If you don’t have a partner, many folk and line dances can be done solo.
Dance at home. If you want to practice in private, the internet has a variety of dance instruction videos. Your public library may also stock instructional dance videos. All you need is comfortable clothing, a pair of supportive shoes and enough space to move freely.
Finally, remember that dancing can be modified for almost everybody. People who can’t stand up can use their arms. People who have lost movement in their arms can dance with their torsos and legs. It’s a way to connect to your own body, to music and to other people.
Many years ago, a couple in my practice were having difficulties. A marriage counselor learned that they loved to dance when they first met, but that they hadn’t done it in recent years. The counselor suggested they learn to tango. It may have saved their marriage.
What’s the difference between strength and power training? Is one better than the other?
Your muscles enable you to carry groceries, climb stairs, get out of a chair and swing a golf club. The stronger and more powerful your muscles are, the easier all of these everyday tasks and others will be. But weak muscles turn seemingly simple tasks, like walking, into a chore. They are a primary reason why many people lose their independence as they age.
Strength and power training can curb or even halt these changes. They help your muscles function at a high level as you get older. And there are additional benefits. As you strengthen your muscles, you tone your arms and legs. You also burn more calories, since muscles require energy (calories) in order to function.
You can even help control various medical problems. For example, you can reduce your risk of heart disease, slow the advance of osteoporosis, ease arthritis pain, and help manage or prevent Type 2 diabetes.
So exactly what are strength and power training?
Strength training is a popular term for exercises that build muscle by harnessing resistance — that is, an opposing force that muscles must strain against. Strength training is sometimes called resistance training or weight training. Resistance can be supplied by your body weight, free weights such as dumbbells and weighted cuffs, elasticized bands or specialized machines. No matter what kind of resistance you use, putting more than the usual amount of load on your muscles makes them stronger.
Power training is aimed at increasing power, which is the product of both strength and speed. Power reflects how quickly you can exert force to produce the desired movement. Power can help you react swiftly if you trip or lose your balance, helping you to avoid a fall.
Some power moves are just strength-training exercises done at a faster speed. Other power routines rely on the use of a weighted vest. The vest is worn while performing exercises aimed at improving functions such as bending, reaching, lifting and rising from a seated position.
Try to do strength and power exercises two or three times a week. Allow at least 48 hours between sessions for your muscles to recover. (I’ve put descriptions and illustrations of a few strength-training exercises, along with their power variations, on my website, AskDoctorK.com.)
When I urge my patients to consider strength and power training, they understand the merits of keeping muscles strong as they age. But they often ask if strength and power training are as good as aerobic exercise in reducing the risk of heart attacks and strokes. There is growing evidence that they do, although the evidence is not yet as strong as for aerobic exercise.
I’ve adopted an exercise program of aerobic exercise four to five days a week and strength training twice a week. If new evidence causes me to change my mind about what’s best for me, I’ll change my routine.
I heard about a new drug that can help people lose weight. I’m overweight. Should I give it a try?
You’re likely referring to Contrave, a drug the FDA approved in September of 2014 to help people lose weight along with a reduced-calorie diet and exercise.
Contrave combines two drugs, naltrexone and bupropion. These drugs are already approved for other uses. Naltrexone is used to help kick alcohol and narcotic addiction. Bupropion is used to treat depression and seasonal affective disorder. Many people also take bupropion to stop smoking. Neither naltrexone nor bupropion by itself has been approved for weight loss.
Why should the combination of these drugs help with weight loss? It’s likely that the drugs act on impulse, reward and/or hunger centers in the brain to decrease appetite and dampen the reflex to seek food for comfort.
Not everyone who is overweight needs a weight loss drug. Contrave is approved for adults who are obese and for certain people who are overweight. Obese is defined as a body mass index, or BMI, of 30 or higher. Overweight adults have a BMI between 25 and 30. Overweight adults should only take Contrave if they also have at least one other weight-related condition, such as high blood pressure or Type 2 diabetes. If you don’t know your BMI, you can look it up on the BMI table below.
The FDA approved Contrave based on the results of several clinical trials that included 4,500 overweight and obese men and women. All were treated for one year.
In one trial of people without diabetes, 42 percent of those who took Contrave lost at least 5 percent of their body weight, compared with 17 percent of those who took a placebo. In a trial of people with diabetes, 36 percent of those taking Contrave lost at least 5 percent of their body weight, compared with 18 percent of those taking a placebo.
Like any drug, Contrave can cause unwanted, sometimes serious, side effects. Used alone, bupropion has been linked to suicidal thoughts, as well as seizures. And naltrexone use has been linked to seizures. I think the drug should be avoided by anyone who:
Has had seizures in the past
Has had an eating disorder (bulimia or anorexia nervosa)
Is taking an opioid pain medicine or a medicine to treat addiction to opioids
Is taking an antidepressant medicine called an MAOI
I am reluctant to get enthusiastic about a new medicine until some time has passed. The 4,500 people who participated in studies is a pretty large number. However, it is a very small fraction of the total number who are likely to be prescribed the medicine. Rare but serious side effects could have been missed in the early studies.
Also, about half of the people in the studies saw no benefit. If you take the medicine for 12 weeks and see no benefit, it’s wise to talk to your doctor about stopping it.
Please settle a long-running argument between me and my sister. What’s more effective for weight loss, diet or exercise?
Losing weight can be a challenge. The best approach is to eat lessand exercise more. But that’s not what you asked me.
Let’s say one person cuts back on calories without exercising and another person increases exercise without cutting back on calories. The first person would probably find it easier to lose weight. That’s because it’s easier to cut 500 calories a day from your diet than to burn 500 extra calories through exercise.
But there’s more to it. If you cut back only on calories, you’re more likely to regain the weight you lose. Why? The body reacts to weight loss as if it were starving. In response, the body slows its metabolism. When your metabolism slows, you burn fewer calories — even at rest. Even if you continue eating fewer calories, you will either stop losing weight as quickly as you have been, or you’ll stop losing weight altogether.
The solution is to increase your physical activity. Doing so will counter the metabolic slowdown caused by reducing calories. You’ll burn more calories just by sitting and daydreaming if you have been exercising regularly.
With regular exercise, you don’t just burn calories when you’re active; you increase the number of calories you burn at rest. This is called resting energy expenditure. Any increase in resting energy expenditure is extremely important for weight loss, because most of us are at rest the greater part of the 24-hour day. In addition, physical activity temporarily curbs appetite in the time immediately following exercise.
Your resting energy expenditure remains elevated as long as you exercise at least three days a week on a regular basis. Vigorous activities that can stimulate your metabolism include walking briskly for two miles or riding a bike uphill.
Moderate-intensity activities, such as taking a short walk or raking leaves, won’t raise your resting energy expenditure as much as high-intensity activities will. But they have other advantages. For one thing, they help reduce body fat and build muscle — and muscle tissue burns more calories than fat does. (I’ve put a table listing several moderate- and vigorous-intensity activities below.)
Examples of moderate or vigorous activity
Jogging or running
Doing water aerobics
Riding a bike on level ground or a few hills
Riding a bike fast or on hills
Playing doubles tennis
Playing singles tennis
Pushing a lawn mower
One last thing about exercise: Many people believe that regular exercise is healthy for you only because it helps you lose weight. Surely, having a healthy weight reduces your risk of many diseases, and regular exercise can help you get down to a healthy weight.
But what many people don’t know is that regular exercise powerfully protects you against major diseases such as diabetes, heart disease, stroke and many types of cancer — even if you don’t lose weight. Regular exercise changes the chemistry of your body in ways that improve your health.
So, try to eat healthy and exercise regularly. These are the two most powerful, and natural, things you can do to protect your health.
For 20 years, I’ve substituted artificial sweeteners for sugar in my coffee, and switched to diet soft drinks to avoid obesity and the diseases that overweight people are prone to, like Type 2 diabetes. Now I hear that new research says that’s a bad idea. What is going on?
Here’s what’s not confusing: More than a modest amount of sugar each day is not good for you. Nothing’s changed there. The sweet tooth that many of us have (I plead guilty) leads us to eat too much sugar.
Sugar contains easily absorbed calories. That makes it harder to maintain or achieve a healthy weight. It also increases our risk of developing Type 2 diabetes, the most common form of diabetes. Sugar-sweetened soft drinks and fruit juices are particularly bad actors.
The development of no-calorie artificial sweeteners, like saccharine, sucralose and aspartame, seemed like a godsend. Like you, I switched from regular drinks to “diet” drinks a long time ago. Artificial sweeteners taste as sweet as (or sweeter than) sugar, but contain virtually no calories. What’s not to like?
In previous columns, I’ve said that there was some evidence that consuming artificial sweeteners might increase our appetite for sugar-containing sweets. That is definitely not a good thing, if true. I still regard it as unproven.
But recently, a scientific study was published in a prestigious scientific journal, Nature, that set me back on my heels. If other scientists confirm this work, it has important implications for all of us. To tell you what the study showed, I first need to explain a little biology.
Many foods contain carbohydrates (“carbs”). Carbohydrates resemble a chain with multiple links. When they enter our gut, the links in the chain are separated by digestion. Table sugar is a simple chain: just two links, easily separated. It’s the single links that mainly are absorbed into our blood. The most common is called glucose. When your doctor measures your blood sugar, glucose is what is being measured.
Any food, say a slice of an orange, contains calories. But those calories add to our weight, and influence whether we might develop diabetes, only if they are efficiently broken down into single links — glucose — and then are absorbed into our body.
Our intestines contain trillions of bacteria of different types. Some types are very good at breaking up carbohydrates into glucose; other types are not. If you’re a person with lots of the first type of bacteria living inside you, every slice of orange you eat will lead to more calories getting into your blood.
The recent study presents evidence indicating that artificial sweeteners may encourage the growth of the types of bacteria that generate more glucose — and, hence, lead us to absorb more calories. In other words, while the sweeteners don’t contain calories, they may cause us to absorb more calories.
If other scientific studies confirm these findings, I will be further lowering my modest consumption of artificial sweeteners. I’ll keep you posted.
I’m in my 80s. I recently stopped driving, and now I can get around independently only by walking. Can you tell me how to improve, or at least maintain, my mobility?
Mobility is one of those things most of us take for granted until we begin to lose it. That’s when we realize that even a simple, relatively uneventful day requires a great deal of physical stamina, strength, balance, coordination and range of motion.
The single most important thing you can do to remain mobile and independent is to engage in regular physical activity. I can’t emphasize this enough: You need to be active to stay active.
When I give this advice to my older patients, they sometimes reply that “it’s too late.” They say they haven’t really been physically active since they were in their 20s, and ask what good it would do if they started now.
For the vast majority of my older patients, the answer is that it is never too late to start. The evidence shows that starting a regular exercise program even after decades of inactivity brings great health benefits.
People who are older and out of shape will need to start slowly and increase their exercise program incrementally. Sometimes I recommend that they start with a trainer to get them going on a program they can maintain themselves. But that usually is not necessary.
You can start by doing more physical activities throughout your day. For example, take the stairs instead of the elevator, do some gardening, or walk around your living room while talking on the phone. Several of my patients deliberately replaced their traditional home phones with cordless home phones to make this easier. (And some have replaced home phones entirely by cellphones.)
You’ll also want to start, or continue, a regular exercise routine. Aim for 30 minutes of moderate aerobic exercise a day, at least five days a week. Good options include walking, swimming, water aerobics and riding a stationary bike.
Try to do strength-training exercises twice a week. Strength training protects against bone loss and builds muscle. It also provides the functional strength you need for everyday activities like lifting groceries or rising from a chair. Doing yoga and climbing stairs involve strength training. However, it’s best to perform a group of strength-training exercises that use different muscle groups. You can also incorporate elastic resistance bands, free weights or weight machines into your strength-training routine.
Finally, be sure to make balance exercises a part of your exercise program. Better balance reduces your risk of falls, which can be disabling or even fatal in older adults. Below, I’ve put photos and descriptions of balance exercises you can do at home, without any special equipment. Or learn yoga or tai chi. Both activities also improve balance.
Ideally, we’d all like to keep walking as long as possible. But remember, losing the ability to walk doesn’t mean the end of your mobility. You can still remain mobile by using a wheelchair or other assistive devices.
Stand up, sit down:
Reps: 10 Sets: 1–3 Intensity: Moderate to high Tempo: 4–2–4 Starting position: Sit in a chair with your hands crossed on your chest or held out in front of you at chest level. Movement: Slowly stand up. Hold. Slowly sit down with control. Tips and techniques:
Press your heels into the floor and squeeze your buttocks as you stand up to help you balance
Steady yourself before you sit down
Exhale as you stand, inhale as you sit
Too hard? Use your hands to assist you as you stand up and sit down, or do fewer reps. Too easy? Extend your right leg out in front of you with your knee slightly bent, ankle flexed, and heel on the floor. Stand up and sit down. Finish all reps, then repeat with the left leg
Reps: 10 Sets: 1–3 Intensity: Light to moderate Tempo: 2–2–2 Startingposition: Stand up straight behind a chair, holding the back of it with both hands. Position your feet hip-width apart and evenly distribute your weight on both feet. Movement: Lift up on your toes, letting your heels rise off the floor until you’re standing on the balls of your feet. Try to balance evenly without allowing your ankles to roll inward or outward. Hold. Lower your heels to the floor, maintaining good posture as you do.
Tips and techniques:
In the starting position, think of each foot as a room and stand evenly on all four corners. When lifting, try to balance evenly on the front two corners.
Zip your abdominal muscles up and in as if you were wearing a tight pair of jeans while contracting your buttocks, squeezing your inner thighs, and balancing on the balls of your feet.
Imagine you have a string at the top of your head pulling you up.
Too hard? Sit down in a chair. Lift your heels off the floor. Hold. Lower your heels to the floor.
Too easy? While holding on to the back of a chair, bend your left knee slightly to lift your foot a few inches off the floor. Do heel lifts with your right foot. Finish all reps, then repeat on the other side.
Standing hamstring curls
Reps: 10 on each side Sets: 1–3 Intensity: Light to moderate Tempo: 2–2–2 Starting position: Stand up straight behind a chair, holding the back of it with both hands. Extend your right leg behind you with your toes touching the floor. Movement: Bend your right knee and try to bring the heel toward your right buttock. Hold. Slowly lower your foot to the floor. Finish all reps, then repeat with the left leg. This completes one set.
Tips and techniques:
Maintain good posture throughout.
Keep your hips even, squeezing the buttock of the standing leg to help you balance.
Too hard? Lift your leg less, or do fewer reps. Too easy? Close your eyes.
Call Jeff at Top Fit Pros Training If You Have Any Questions, Comments Or Helpful Data You Would Like To Share Also: 772-708-2328