Freshman Weight Gain—Fact? Fiction?

“My relationship with food was about social and family bonding as well as security,” explains Daphne Oz, recent Princeton graduate and author of The Dorm Room Diet. “It was only when I was a senior in high school that I realized that I had unhealthy associations with food, using it to synthesize good feelings and comfort.”

As college loomed in her immediate future (with the concurrent media reports about “inevitable” weight gain) Oz made a decision to assert her adulthood and embrace the possibility that she could lead an enjoyable life and still have a healthy relationship with food, not one where food was a crutch. And, that she would do it right at the beginning of her college career.

Oz, who grew up in a medical family (her father is cardiac surgeon and best selling author, Mahmet Oz, M.D. and two grandfathers are also cardiac surgeons) knew how to eat for good health but saw a need for specific information that dealt with the reality experienced by students. So she wrote a book. “My book is the result of developing a framework that applied all of the knowledge I grew up with in a way that would be accessible to my peer group,” explains Oz.

*The Food Fight

College freshman can easily get caught up in the exhilarating flush of nascent adult independence and the stress of academic responsibility, especially when it comes to food and exercise. The cafeteria allows unlimited visits to the buffet. Vending machines stocked with chips and sweets beckon at all hours and classmates take food breaks together during all-night cram sessions. Stress released on the weekends is almost always accompanied by food and drink. The demands of class work can shove regular exercise aside, sleep becomes erratic with deprivation the norm.

Hence, the unfortunate annual media exploitation of a largely mythical phenomenon labeled “The Freshman 15.” Other than being a snappy alliteration, this declaration of inevitable corpulence is mostly hyperbole. It is not true that most freshmen gain 15 pounds the first year. Weight can go up or down and if there is some general weight-gain, it is more like four to five pounds versus 15.

There is so much misinformation flying around regarding food, nutrition, and weight loss and how it all relates to good health that it is often difficult to get to the truth. Stepping into adulthood often means stepping up and finding answers that are relevant to you.

Alisa Shanks, Ph.D. and psychologist on staff at the Wardenburg Student Health Center at Colorado University, Boulder, wishes that the media would stop its annual lathering of the subject. “This is not accurate at all,” emphasizes Shanks, “and is not even close for most students. What this perpetuates is fear which leads to overcompensation. Some students become too focused on the fear of the “Freshman 15” which leads to skipping meals and/or over-exercising.” For some young people who struggle with poor self- image, especially in the area of the body, this can lead to destructive behaviors ranging from experimenting with unhealthy dieting to eating disorders like bulimia and anorexia.

“It is already difficult to be a young person in America with all of the media attention where stars are thin and svelte and are deemed too fat, even at a size six. Fat prejudice is a problem and can lead to serious eating disorders,” says Shanks. “Young women in particular subject themselves to mythical standards that become an internally abusive voice that says, ‘You are undisciplined, sloppy, bad,’ where how you look is THE most important thing about you.”

College creates a large identity shift. High school, where everyone knew you, is no longer relevant at a more complex school where nobody knows you. Quick social decisions are made and students often fear being unacceptable to others, which means they may feel unacceptable to themselves. This may result in students seeking ways to change their appearance by regulating their weight.

Natalie Murphy, R.D, also with the Wardenburg Health Center, points out that when students experience the stress of new surroundings their normally stable internal cues regarding hunger and fullness may be replaced by fear of weight gain which can lead to misconceptions about food. Often this will result in students categorizing foods into categories of good and bad or healthy and unhealthy. And they may even further speculate that if they eat ‘bad’ foods they will gain weight or start telling themselves, ‘I am a bad person.’

“We need to clarify that food is not a moral issue,” Murphy emphasizes. “Every person needs regular meals and snacks. In fact, this is the key to providing sustainable energy for studying and going to classes. All foods can be included in a healthful intake. There really are no ‘bad’ or ‘good’ foods.”

Murphy counsels students to explore what is going on in their particular life, emphasizing that we all come in every shape and size. Long hours of studying and classes scheduled back-to-back can affect meal scheduling so finding a way to be mindful of choices as well as questioning the conflicting and often specious messages they receive on food is key. “It can be difficult for students to think critically on their own so a supportive environment where they can clarify their own issues around food is part of what health professionals can do to help. “

One way to stay on balance is by using the acronym, HALT: Am I Hungry? Anxious? Lonely? Tired? If you answer yes to being Anxious, Lonely, or Tired, then accept that the perceived need to eat may be less about hunger than emotions. Otherwise, by all means have a healthy snack.

The Community Health Department at Wardenberg Health Center, CU, Boulder, meets with all new students to try to get them focused on good health as they start their college careers. “We cover mindful eating, encouraging students to not dwell on calorie counting or numbers on a scale,” says Anne Schuster, professional staff member with the department. “We also encourage joyful movement by doing physical activities that make them feel good instead of compulsively exercising to burn off the previous evenings party or in preparation for one coming up.”

They also inspire students to look at the long-term impact of their decisions and to focus on nutrition in general. “Students come by the Center with all of the usual questions on how, what and when to eat,” says Schuster. “We encourage eating as close to nature as possible while also enjoying a wide spectrum of foods.” The staff advocates for as much positive talk as possible on body image, food choices, and nutrition by providing classes and outreach at the residence halls and Greek houses. “We know that behavior change requires sustained conversations so we work to reach as many people as possible.”

EXERCISE—Yes, you can!

One “nutrient” that is essential for stress relief, weight control and overall good health is “vitamin X”…..EXERCISE. Even taken in small doses, physical exertion can clear the mind, calm the nerves, and elevate the mood. Adding this “nutrient” can positively enrich campus life.

Denver University’s Director of Aquatics and Fitness, Tiffany Ulatowski, observes that this year’s freshman class seems to be very fitness oriented, filling the yoga, kickboxing, and boot camp classes offered free to students. “The majority of students seem to be more aware and engaged, understanding the value of staying fit,” says Ulatowski. “The Ritchie Center is also a social gathering place for students. Large recreation centers are the coming thing for many colleges now.” Many universities even have small fitness areas in the residence halls.

If going to the campus fitness facility is not appealing, campus layouts themselves can provide great opportunities for getting in a little exercise. Anna Palij, A&E editor for the Temple Column, Temple University, PA, says she did not notice any weight gain due to all the walking she had to do between buildings at this large urban university. “Not having a car is a great way to stay more fit,” suggests Palij.

HEALTHY DORM ROOM

It is difficult to avoid mindless snacking on high calorie/low volume/low quality foods, especially when studying or socializing with friends. Stock your dorm room with fruit, veggies, and whole grain granola-type snacks. If you are able to have a small refrigerator, stock it with hummus, peanut butter, and other high-fiber items.

HEALTHY DINING HALL

Natalie Digate Muth, RD, University of North Carolina, suggests:

1. Walk through the entire line first. Scope out the most appetizing choices before deciding.
2. Make one trip through the line and select foods based on nutritional value.
3. Wait at least 10-20 minutes—the time it takes to feel full—before deciding to eat dessert.

Making a point of adding high-fiber vegetables and fruits to your main meal choices can easily become habitual.

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Joan Salge Blake, RD, and Associate Clinical Professor at Boston University, suggests the following for avoiding some of the pitfall of the new college experience:
1. Don’t skip breakfast. This can lead to extreme hunger later in the day, as set up for impulsive snacking calorie dense/nutrient starved foods.
2. Study at the campus library. Snacks are not permitted here so temptation is reduced.
3. Walk off the stress. A quick walk can reduce stress and clear the head as well as provide necessary physical exercise.
4. Add fruits and vegetables to your meals. High fiber foods like these are higher in volume than most processed foods. Adding these to your meal choices is good to the waist and much more nutritious.
5. Don’t drink your calories. Low fat or skim milk or water is far healthier a choice than sodas which are high in calories (250 per 20 ounces in many cases!), and offer little nutritionally. Alcoholic beverages weigh in at seven calories per gram.

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RESOURCES:

*Books:

“The Dorm Room Diet” and “The Dorm Room Diet Planner,” Daphne Oz, Newmarket Press, 2006/2007, $16.95/$12.95 respectively

“Rice Cooker Meals, Fast Home Cooking for Busy People,” Neal Bertrand, Cyprus Cove Publishing, 2008, $12.95

“Do I look Fat in This?” Jessica Weiner, Simon and Schuster, 2006, $17.99

“Life Doesn’t Begin Five Pounds From Now,” Jessica Weiner, Simon and Schuster, 2007, $12.95

*Web Sites and other support:

US Agricultural Department, mypyramidtracker.gov

“Health at Every Size,” Peggy Elam, Ph.D., HealthAtEverysize.info

Body Positive, BodyPositive.com

Daphne Oz’s, “The Dorm Room Diet,” suggests and eight-step program of, down-to-earth suggestions that the busiest of college students can apply immediately:

Step One: “Get Inspired.” Nothing begins without a decision to do something and formulating a goal.
Step Two: “Get Informed.” Addresses the myths and facts of weight gain, stresses of college, and figuring out a food plan.
Step Three: “Get Started.” Among other things, offers ‘Five Principles for Health Eating.’
Step Four: “Get a Grip.” Looks at time, money, and space constraints of college life.
Step Five: “Get Prepared.” Examines the usual college pitfalls and provides tips on how top stay in control and on course.
Step Six: “Get Moving.” Presents the benefits of exercise and even illustrates workout routines for the dorm.
Step Seven: “Get your Vitamins.” Looks at essential nutrient intake and how to insure that you get what you need in your diet.
Step Eight: “Get Happy.” Addresses the importance of emotional and mental health in conjunction with the rest of the book's focus on physical health, with relaxation tips to help center your purpose-driven life.

Ski and Snowboard Preparation

“I am 50 and run daily but this does not seem to be enough for when I go skiing. What else should I do?” S. Ramirez, Fremont, CA

As champion freestyle skier and coach, Chip Richards, says, “The broader the base, the higher the peak.” Training as much as possible in all of the basics is essential for a safe and successful skiing adventure (regardless of whether you enjoy Alpine, cross-country, or snowboarding). This includes every one of the following:

*Cardiovascular endurance
*Muscular strength and endurance
*Core strength, balance, and control
*Agility and explosive power

Andy LeRoy, head coach of Alpine skiing at Denver University suggests, “Get in some hikes in the mountains, even if it is just in the foothills, to get the heart rate going at higher altitudes because the altitude almost doubles at the ski areas.” Gliding over the snow may not seem like much of a cardiovascular workout when compared to activities like running or cycling, but at higher altitudes, heart and lung conditioning means better endurance and mental alertness which are both essential for avoiding injury.

Your running provides a good cardiovascular base but mix in some “interval training” (sprints) where your heart rate varies between 65 and 85 percent of that same target heart rate. This combination not only provides good general conditioning but also bolsters the anaerobic energy system, characterized by stops and starts and bursts of intense action.

Coach LeRoy recommends weight training organized into a circuit to create an efficient workout session and keep the heart rate up. The basic exercises for a leg circuit would include squats, hamstring curls, leg presses/squats, calf raises, and lunges. Perform each set with moderately challenging weights where 15-20 repetitions can be accomplished without too much strain. After minimum rest (keeping your heart rate at about 50% of your target), perform another set, then another. After one to three sets, change exercises, again without allowing your heart rate to drop.

For the rest of the body, basic exercises for the circuit will include chest presses, pulldowns and rows for the back, shoulder presses, biceps curls, and triceps pushdowns. Other great exercises are pushup and dips. “One of the most neglected areas for most people are the muscles of the back and abdominals, or core,” reminds Coach LeRoy. “The midsection takes the brunt of the work. Legs act as shock absorbers but after a day of 10-15 runs and six to eight hours on the slopes, most people feel the midsection the most.”

The strength needed for skiing, snowboarding, and cross-country emanates from our center. But it is not enough to lie down on the floor and pop out a few crunches. To really get it right the elements of posture and balance must be part of the training. By using a Swiss Ball as your platform for crunches, for example, more of the body’s balance mechanisms are challenged.

Explosive power is achieved through “plyometric exercise,” which means explosive actions performed in short bursts. Examples of plyometric exercises are “squat jumps” where you squat to parallel and try to jump as high as you can. Another is the “box-shuffle” which requires a stable box about nine inches high. Start with one foot on the box and one on the floor. Push up with both legs and switch your feet in mid air. Land with the opposite foot and repeat.

CARE AND FEEDING OF THE OLDER ATHLETE

“Growing old is not for sissies,” said Betty Davis. Older athletes (for the sake of focus, let’s define that as over age 50) have already confronted the notion of being wimpy in the face of time’s steady onslaught. And they say, “No, I am going to stay fit, independent, and do what I want to do, age be damned.”

Regular exercise is a must for anyone who wants to live vibrantly in the later decades of life. As we age, we lose lean muscle and gain fat, a constant struggle for everyone, even the physically active. While regular aerobic exercise keeps the body leaner and the cardiovascular system healthier, aerobics do not preserve muscle mass. This means that strength training must be incorporated in order to preserve muscle and fend off joint, tendon, and ligament problems.

While in our heads we may be 24 years old, the fact is that our bodies change as we get older, regardless of how diligent we are with our exercise regimens. The question from older athletes is “What do I need to do to take care of my body so that I can continue to do what I want to do without getting so tired? What are my options for a better recovery?”

Nancy Clark, R.D. and author of “Nancy Clark’s Sports Nutrition Guidebook,” notes that active people need to eat more fuel in general in order to keep up energy stores. “What are you trying to be?” she posits. “If you are 60 and trying to be 24, you can’t; if you are 60 and trying to be a fit 60-year old, you can.” Clark points out that, by staying active, muscles are stimulated to grow whether you are age 40 or 90. “If you are tired or low in energy, it is a good idea to meet with a sports nutritionist to find out why you are tired,” Clark suggests. “Are you iron deficient? Getting too little sleep? Overtraining? Are you getting the proper balance of protein and carbohydrates to fuel the muscles?”

For pre-exercise snacks, Clark suggests about 200 to 300 calories of an easy-to-digest carbohydrate with some protein component, such as yogurt or toast with a little peanut butter, depending on what you can tolerate. As far as supplements specifically (and allegedly) designed for the female athlete, older athlete, and so forth, Clark believes that real food is a much more valuable tool than any pill or potion to boost energy. “As people age, weight gain can become an issue which often precipitates improper dieting, like cutting out breakfast or lunch,” Clark points out. “At the same time, our physical capacity reduces so fuelling properly at breakfast and lunch can make all the difference in keeping our energy up for strong workouts and our recovering from them much quicker. Real food has the nutrients the body needs and is always the better choice.”

Olympic running coach, Bobby McGee, Boulder, CO, points out, “The older athlete has a dated understanding of what good nutrition really is as opposed to what we know now; it is not just meat and potatoes.” McGee explains that “periodized” nutrition is the way athletes are coached today, eating differently when in training, before a competition as well as during an event. Or, as 60-year old marathoner, Marci Roschke succinctly summarizes, “Your groceries determine your race.”

William Evans, Ph.D. is a nationally known aging expert, author, professor, and director of the Nutrition, Metabolism and Exercise Laboratory at the University of Arkansas Medical Center Institute on Aging. (One of his landmark studies has demonstrated the ability of older men and women to improve strength, fitness, and health through exercise, even into the 10th decade of life.)

In the area of nutrition, Evans points out that the need for dietary protein nearly doubles for those older adults over age 60, and especially for those who are physically active. The normally recommended intake is 0.8 grams of protein per kilogram of body weight; this increases to 1.6 grams per kilogram of body weight. In other words, a person weighing 176 pounds (about 80 kilograms) would need 120 grams of protein per day. “There are about seven grams of protein in each ounce of chicken or beef, so this would translate to about 17 ounces of lean protein a day; the current RDA is about half this amount,” explains Evans.

“Because older athletes have a higher percentage of body fat compared to musculature, they must be very careful to stay with very low-fat protein options,” suggests McGee. “The older athlete must, therefore, pay particular attention to muscle work, not just aerobic work.” McGee also reminds older athletes that, since their cells are less able to hold onto water, they need to hydrate more frequently.

Supplements are another option to support athletic demands on our bodies. The two that are mentioned by researchers like Evans are DHEA and creatine. DHEA (dehydroepiandrosterone) is a hormone made in the human body, produced from cholesterol by the adrenal gland. DHEA is a precursor to both male and female hormones. Levels of DHEA naturally start to decrease after about age 30.

Supplementing with DHEA, therefore, should help maintain muscle mass (which also starts to decrease after age 30) and, therefore, act as a sort of “fountain of youth” for aging athletes and others. The truth, however, is that the research is proving to be far from conclusive. As is often the case, the marketing hype far exceeded the science.

In 2000, researchers studied the effects of DHEA replacement on bone mineral density and body composition in elderly men and women. They concluded, “DHEA replacement could partially reverse age-related changes in fat mass, fat-free mass, and bone mineral density (BMD).” Research conducted in 2006 focused more specifically on BMD in older adults. They found that “DHEA replacement for one year improved hip BMD in older adults and spine BMD in older women.” Studies on the affect of DHEA on muscle mass were inconclusive.

Creatine, however, is a much safer option for active adults. Creatine monohydrate is the form most commonly taken as a supplement because, in this form, it is able to pass through cell membranes. Creatine supplementation is especially effective for high intensity exercise of short duration, such as weight lifting and sprinting. It is also being studied to see if it could improve the health of those with muscular dystrophy, ALS, congestive heart failure, and rheumatoid arthritis.

Creatine phosphate, concentrated mainly in muscle tissue including the heart, is essential for the production of ATP (adenosine triphosphate), the fuel every muscle needs in order to contract. When a muscle contracts, the ATP is “burned” and loses one of its phosphate molecules, becoming ADP (adenosine diphosphate). Creatine phosphate donates its phosphate molecule back to the ADP (diphosphate), turning it back into ATP (triphosphate) so that the
muscle can continue to work. By loading the body with extra creatine, we are filling our potential stores right to the brim. This allows the muscles to work harder, longer, and recover faster--a real benefit to anyone who is trying to increase muscle size and power.

Evans notes that creatine is safe, inexpensive and easy to find. He suggests that four to five grams per day is safe as both an initial dose as well as for maintenance, but is primarily useful only for those who lift weights or engage in other anaerobic activities. Creatine has not been found to be effective for those engaged exclusively in aerobic endeavors.

In summary, McGee coaches older athletes to keep two things in mind:

1. Older athletes can do just as much training but need more recovery time (where a 35-year old may need a week to recover from an event, a 60-year old may need 10-12 days).

2. Understand and pay attention to age-graded performances; compare your performance to others in the same age group. “Compare apples to apples, not to pears; do not negatively compare yourself to younger athletes.”

Resources:

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To find a local sports nutritionist for personal nutrition check-up: SCANdpg.org, (800) 249-2875

"Nancy Clark's Sports Nutrition Guidebook, Fourth Edition" Nancy Clark, RD, Human Kinetics, 2008, $19.95

“Biomarkers: The Ten Determinants of Aging You Can Control,” William Evans, PhD and Irwin Rosenberg, MD, Simon & Schuster, 1991, (price will vary depending on availability)

“Astrofit: The Astronaut Program for Anti-Aging” William Evans, PhD, Simon & Schuster, 2002, $16.95.
 

ALTERNATE TRANSPORTATION

“Getting there is half the fun,” said the famous ad from Cunard. Maybe by cruise ship, but anyone stuck in traffic knows that the “fun” has been gone from commuting by car for a very long time. It is possible that getting to work and running errands can be enjoyable—certainly cheaper-- and a lot healthier if we think beyond the automobile. Today, thanks to increasing civic support for alternate by-ways around town, it is possible to roll to our daily destinations via bicycles, tricycles, unicycles, skates, rollerblades, and skateboards, all fueled by human power instead of gasoline.

Bicycles in particular are on a huge comeback in popularity. In fact, business is good for bike shops these days. The Cherry Creek Bike Rack, an extension of Campus Cycles by Denver University, is the only bicycle commuter station in Denver. This means they cater to bicycle commuters, providing free and secure bike parking, bike rentals, and repairs. “There has definitely been an increase in biking over the last two summers,” says Cherry Creek Bike Rack manager, Tracy Fifer. “Our goal is to get people to come to Cherry Creek without the auto and, since so many errands are within a mile or three of home, we suggest that it is as fast and as efficient to do them on a bike as in a car. We are all about transportation other than the auto.”

Mark Jaeger, manager of Campus Cycles, has noticed that a lot more people are bringing in their old bikes to be made user-friendly for commuting. “They are having them tricked out by adding fenders, smoother tires (for use on roads and city bike routes), racks, baskets, and panniers,” he notes. More people are figuring out that the few miles they need to travel to get to work or to run errands are just as easily accomplished on a bike as in a car. “I sold a bike this spring to a woman in her mid-40’s who had not been on a bike since high school,” says Jaeger. “She was tired of driving the few miles to work and wanted to feel healthier so now she commutes by bike; we are seeing more and more people with this same motivation.”

Fifteen city employees (who call themselves “The Siberians,” because they do so even in the snow) have been biking to work daily for over a decade. One member is Denver County Judge, Ray Satter, a 12-year veteran of the daily bicycle commute. Apparently, a lot more downtown workers are catching on to the joys of bicycle commuting. “I bike in real early so I miss most of the traffic but on the six-mile ride home, I see many more of us on the road.” Attorney, Wayne Fowler, who has been riding his bike into work since 1961, concurs. “I used to be the only one in our bike storage and changing room at our office building. In the past four months there are now 12 bikes.”
According to Qwest paralegal, Stacy Hanson, who started biking from Aurora to downtown Denver four years ago, “There are more bikes on the trails and on the bike racks at work.” Hanson dislikes driving in traffic; so biking to work is her solution. “Biking is a great way to start the day because it not only allows for some good ‘alone time’, but also gets in my workout,” says Hanson. “I don't experience those mid-afternoon "blahs" like I used to, and I have a feeling of satisfaction when I get home in the evening.”

Could you give up your car completely? Carolyn Pooler, who works at National Jewish Health, sold her car last September because she did not want to spend money on repairs, licensing and insurance. “Since I only live 12 blocks from work, I thought I would try to adopt a car-free lifestyle for a year and found that I really enjoy it.” She walks or rides her bike, (taking the bus or a cab when absolutely necessary). “Walking to work warms up the body and the mind and ‘defrags’ me after work,” says Pooler. “I had high cholesterol in the high 200’s before getting rid of my car and now it is in the 130’s.”

Her 19 year-old son, Nathan, uses his bike 100-percent of the time to go to school and to summer jobs. He not only enjoys biking but also feels it is an important way to express his personal feelings about helping the earth. And, the bike does not have expensive repairs, fueling needs, or high insurance bills that are standard for teenagers.

Ty Steinbrook, 46, head mechanic at the Cherry Creek Bike Rack, who gave up his car five years ago, can testify to the cost savings of biking versus driving. “I estimate a savings of $6,000 versus about $300 a year that I spend on my bicycles,” says Steinbrook. According the 2001 statistics from the Department of Labor, Americans spend 19.3 percent of their income on transportation—that is almost as much as we spend on housing and more than we spend on food and clothing. Since 2001, the Department has estimated that automobile costs have increase by over 12 percent.

What if you did not want to bring a bike into town but would still like to use one to get around during the day? To fill this need, communities around the globe are getting involved in bike sharing programs. “Freewheelin’” is an American bike share program, started by Humana for its employees in Louisville, KY, that has formed in partnership with municipalities, bike industry leaders, and Fortune 100 companies to combine, health, environmental conservation, and community.

For both the Democratic and Republican National Conventions, Freewheelin’ teamed up with Boulder non-profit, Bikes Belong, and Humana, providing 1,000 bikes for use in and around the city for a fun, free, and healthy experience. This puts Denver and Minneapolis on par with Amsterdam, Brussels, Lyon, Paris, Stockholm, Vienna, New York City, and London where the free bike programs were started in 2007 and early 2008. Dan Oftedahl, president of Humana’s Colorado operations, mentioned that Humana would donate 70 bicycles to the city of Denver following the convention. While “Freewheelin’” is available to assist with logistical resources and planning, it is now up to us to incorporate this program permanently into the fabric of our world-class city.

CALORIES UTILIZED

The following is the estimated caloric expenditure for a 160-pound person for one hour of the activity listed:

Cycling (at 10-12 MPH) =435 calories

Skating, roller =508 calories

Skateboarding =363 calories

Driving a car =153 calories

SAFETY FIRST

It is easy to forget that once we climb onto a bicycle, we leave the pedestrian world and become individual vehicles and drivers. The rules of the road now apply to you:

Start With These Traffic Basics:

1. Ride with traffic, not against it.
2. Ride as close to the right side of the road as you can.
3. Use appropriate arm signals when turning or stopping.
4. Obey all traffic signs and traffic signals.
5. Use the shoulder or a bike lane instead of the road whenever possible.
6. Unless specifically designated as a bike trail, sidewalks are NOT for bicycles.

SUPPORT ORGANIZATIONS for COMMUNITY—Advocacy and promotion of alternative forms of transportation:

Transportation Solutions
280 Columbine Street Suite 306
Denver, CO 80206
303-377-7086
info@transolutions.org

“Walk or bike for short trips. ?American drivers now make an average of 3.4 vehicle trips per day, many of these to destinations within one mile; replace some of these short trips with a walk or bike ride.”

Freewheelin’
freewheelinwaytogo.com

“Freewheelin’ is a unique bike sharing program that incorporates the ideals of health, environmental conservation and community. The embodiment of sustainability, Freewheelin’ allows you to track your bicycle usage so you know how your health and the environment benefits from your ride. What was your carbon offset? How many calories did you burn?”

Bikes Belong
1920 13th Street, Suite A
Boulder, CO, 80302
BikesBelong.org
303/449-4893

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BICYCLE PROMOTION and LOBBYING ORGANIZATIONS

Bicycle Colorado
1525 Market Street, Suite 100
Denver, CO 80202
303-417-1544
info@bicyclecolorado.org

Bike Denver
1536 Wynkoop Street Suite 801
Denver, CO 80202
BikeDenver.org

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BIKE SHOPS catering to the commuter:

The Cherry Creek Bike Rack
171 Detroit Street
Denver, CO 80206
303-388-1630

Campus Cycles
2102 S Washington St
Denver, CO 80210
(303) 698-2811
Campuscycles.com

Mind of a Champion

Back in the 1960’s my swim coach told me, “Everyone has the will to win; it is the will to work to win that makes the difference.” Those who have an athlete’s work ethic have been competing on the world stage since Hercules. The Olympic motto, “Faster, higher, stronger,” exemplifies the effort, focus, and determination that elevates Olympians from those of us who will be cheering them from our sofas.

Physical ability properly melded with good training and coaching, is a large part of getting a shot at “the gold.” But those who make it to the Olympics--and other national and world venues-- need mental training as well. “The Olympics is a unique environment to test mental and physical skills,” explains Peter Haberl, Ed.D., Senior Sports Psychologist for the US Olympic Committee. “It takes a great deal of ability and skill to stay focused on the task at hand.”

Because each athlete’s needs are both individual and specific, Haberl works with athletes at all stages of their training. Sport psychology offers a number of techniques athletes can use to hone their mental game. Two important ones are goal setting and mindfulness.

According to Haberl, all athletes set goals, some more consciously than others. A natural goal is winning the competition. This ‘outcome goal’ provides tremendous motivation during the months and years of training, but can get in the way of actually performing your best on the day of competition. Therefore, the closer the athlete is to actual competition, the more the attention should be drawn to the ‘performance goals’ (improving racing time) and the ‘process goals’ (technique). “The difference is that these types of goals are much more under the control of the athlete,” explains Haberl. “The ‘process goal,’ in particular, directs attention to the here and now, which allows the athlete to totally focus on the doing of the activity; this is key to performing well.”

Athletes benefit from understanding and accepting that, while the goal often is winning, that this is not necessarily in their control. Performance goals are the driving force in the core of every champion, helping to set their personal standards of excellence. Because athletic events are inherently wild cards, control of the outcome is never possible.

“The process goal has to do with being focused on technique and mechanics,” says Haberl. “The process goal (as opposed to the outcome goal) is in their control.” Haberl explains that the outcome goal of winning gold can actually distract the athlete from winning gold as it diverts attention from the present moment. But, by staying totally in the moment, concentrating on technique, narrowing the vision to each individual movement, and on every breath the mind is narrowed directly onto the task at hand. “This sounds simple but it really is quite difficult because the mind takes you to the past and the future all the time, particularly in the Olympic environment with it’s plethora of distractions and enticing rewards.”

A good example of staying focused on the process is gymnast Paul Hamm at the 2004 games in Athens. He came from 12th place in the individual overall competition after a disastrous fall to win the gold medal, winning by .012 of a point! Throughout the last round there were numerous delays caused by scoring disputes as well as squabbles over protocol, yet he managed to stay in the moment and perform his last routine on the high bar to win.

Learning to become aware of your mind’s focus and what distracts you are two key skills for athletes. Once there is this awareness, a plan can be made and tools developed to bring concentration back to the process. Haberl teaches the athletes to be mindful of their focus at every moment. “With that knowledge and awareness,” says Haberl, “you have the freedom to put your mind where you want it to be.”

Haberl suggests that we can all use these techniques to better our own exercise routines. Lets say you have a plan to walk every morning for 30-minutes before going to work. “There is a good chance that the mind will say negative things about getting up every morning to do your walk and at times prevent you from getting out the door because it doesn’t feel good in the moment. Being aware of such distracting thoughts is the first step to counteract them. Then the next step is to clearly identify your true values. If you value your health you can trump the initial discomfort generated by the thinking mind, recognize these thoughts as simply thoughts and get up to do the walk anyway--irrespective of what the mind says in the moment--knowing you will feel better afterwards.”

Watching elite athletes perform and compete for high honors can be an inspiring starting (or re-starting) point for the rest of us. While we can wish to become fitter, sometimes vicariously through the efforts of others, our own efforts are all that count. Using the same steps-- establishing goals, accepting various outcomes, designing a plan to achieve the goal, and working to stay in the moment--works for us regular folks as well, whether it is improving diet or engaging in more exercise.

Changing the diet or developing better exercise habits do not materialize out of the ether—conscious decisions and plans of action are key.

First, without judgment or excuses, take a personal and honest assessment of where you are today. Are you overweight, slacking on exercise, into a fast-food habit? Whatever is going on is now in the past and this moment is your new beginning.

Second, write down your goals; don’t just let them float around in the mind. Make note of your weight and/or time currently spent exercising and decide where you want to be in that regard in one week; one month; three-months; six-months; one year. Be as specific--and as real--as possible. For example, it is unrealistic to lose 20 pounds in a month. It is just as unrealistic to set yourself up to run five miles a day if you either hate running or have never run even one mile.

Third, figure out your motivations and values. Looking better for a high school reunion for the short term, for example, is an easy set-up for disappointment because physical changes like reduced body fat and increased muscle mass take a lot of time and effort. Look to other benefits that come with better eating and more exercise such as stress relief, better health, and an improved social life through physical activities with friends.

Fourth, choose activities or sports that you enjoy and that fit your time and financial budget. “Exercise” does not equal “treadmill.” It is fun to learn new things and to meet others doing the same.

Finally, be mindful of what has tripped you up in the past and prepare for the inevitable. Good habits are hard to make and easy to break. Being aware of your personal human potholes allows you to confront the diversion and get back on track more quickly.

***********

RESOURCES

“Head Games: Life’s Greatest Challenge,” Charles Austin, Turnkey Press, 2007, $13.95

“Understanding Psychological Preparation for Sports,” Hardy, Jones, and Gould, John Wiley and Sons, 1996, $60.00 (can be found for less at Amazon.com)

“Applied Sports Psychology: Personal Growth to Peak Performance,” Jean Williams, Editor, Mayfield Publishing, 1997, $70.00 (can be found for less at Amazon.com)

********

Interviews with Olympians:

Jane Katz, EdD, was a member of the U.S. Synchronized Swimming Performance team at the 1964 Tokyo Olympics. She is currently a professor at John Jay College of City University of New York and the author of five books with special emphasis on fitness through aquatics. (Globalaquatics.com)

Alan Culpepper is a long distance runner (10,000 meters and marathon) who represented the USA in the 2000 and 2004 Olympics.

- Is there an Olympic mindset -- a way to concentrate and stay focused on your goals that separates you from other athletes?

Jane: “Staying focused on your goals is key. First you plan, you prepare, then you take the plunge. Work hard but have fun with it.”

Allen: “Physical ability can be trumped by fuzzy mental abilities because of the intense pressure that comes with high-level competition. You learn to stay in the moment and to ‘think simple’ or you do not survive the grind.”

- Are there moments during training or competition when you just want to quit; how do you work through that?

Jane: “It is important to have really great friends and confidants who will be with you during the low times as well as the victories. You must have people with whom you can trust your feelings and who can help you visualize your event.”

Allen: “Anticipation of what is ahead of you is worse than the action to get through it. You just pretend; fake it until you make it. Expect those thoughts to come, know it is going to happen, then refocus.”

- Who is your mentor/motivator and is there something they've told you that you always recall: the words of a coach, a parent, a friend?

Jane: “My parents were my rock growing up, especially my father. He always told me, ‘Yes, you can do it.’ A female athlete in the 1940’s was a rare thing so support like this for my endeavors was a great gift.”

Allen: “My first coach taught me to write down my goals in order to own them, to be ready when it counts, to make yourself breathe, and to get through the task in front of you before taking on the next.”

- What's your favorite healthy food to eat, and a guilty pleasure when competition's over?

Jane: “I love oatmeal and plenty of water. My guilty pleasures are a really good cup of coffee with ice cream or peanut butter cheesecake.”

Allen: “Long distance runners can pretty much eat what we want but I love a good salad and will occasionally crave a doughnut.”

June 23, 2008
Wheelchair Exercising

[Note: This feature will focus on paraplegics (loss of use of the lower extremities).]

The vagaries of life can rock our world and find some of us rolling instead of walking. Finding yourself in a wheelchair will present myriad challenges because, in order to maintain flexibility, mobility, muscle tone, heart health, strength, and weight control, exercise is an important part of this new reality. Exercise will not only help to maintain the physical strength needed to transfer to and from the chair but also help with mood, self-esteem, quality of life, and aid in both digestion and elimination.

Sports of all kinds are available for the disabled--skiing, basketball, hockey, tennis, rugby, and cycling, just to name just a few. Regardless of whether you want to get into a sport--or just want to enjoy going to restaurants, theater, and ball games--your muscle strength, flexibility, and stability are important factors. Strength training (the use of resistance bands, free weights, and fitness machines) for building and maintaining muscle is the bedrock that supports an independent lifestyle.

Terry Chase, ND, RN, and Patient and Family Education Coordinator for Craig Hospital (3425 S. Clarkson, Englewood, CO), stresses that everyone comes to activity levels in their own way, tapping into their strengths and feelings about their health. “’How would you like to get healthy and be healthy?’ is the question we ask our patients,” says Chase. “We provide resources and encouragement with activities that are more sedentary, like going to ball games and barbeques, to more active endeavors like tennis, sailing, and skiing. And we do not make people wait until they are in perfect shape. We offer activities and outings right away.”

Certified Strength and Conditioning coach, Micah Zackroff, has been working at Craig Hospital as a rehabilitation aide for two and a half years. Rehabilitation Aides serve as a bridge between early rehabilitation, when patients learn how to deal with both the medical aspects of their disability as well as the basics on how to transfer to and from their chair, to the point where people are ready to get more active. “The biggest challenge is getting people with new injuries to physically deal with their new reality since the last thing they want to think about is performing sports and activities from a chair,” says Zackroff. “I see them when they are ready to get back to activity; we show them how to adapt to their favorite activity as a paraplegic.”

Activity helps disabled people to find their own strengths. Rehabilitation Aides like Zackroff help people in wheelchairs figure out their goals regarding the activities they want to do and design programs to facilitate that goal. “It is a good idea to get back into activity and sports within six months to a year after basic rehabilitation and therapy,” recommends Zackroff. “Don’t wait too long because muscle tone, function, flexibility, and stability will suffer.” Zackroff also points out that with many paraplegics, the core (abdominal, gluteus and back muscles) is often jeopardized from the injury. Getting to work to maximize the core muscles that are functional is very important.

Cheryl Wilson, 26, ended up in a wheelchair because of a car accident while on duty with the Air Force. After eight years in a chair, she has rekindled her love of sports and got into Sled Hockey, which is played on the ice. “I tried sled hockey about three months after my injury but decided it was not the same. So I took the attitude that ‘wheelchair sports are lame’ and did nothing physical until recently.” Corey Fairbanks, President of the Colorado Sled Hockey Association, knows that enough people understand that life is not over because you are in a wheelchair. “There are more opportunities than ever, especially in Colorado,” points out Fairbanks. “If you want to do it, we have it here.”

For the past six months Wilson has been training with Zackroff, at the Fitness Station (475 W. 12th, Denver, CO) in order to improve her ability for Sled Hockey. “Working with weights, bands, and performing other strength and flexibility exercises has benefited me in all areas but particularly in strength and endurance,” says Wilson. “I can now push myself in my chair much longer without a break.” It took Wilson a while to get back her independence but a rekindled passion for sports and regular workouts has also created a new focus for her other talents. “I was part of the Air force Security Forces (police force) and am now studying criminal justice.”

Mortgage banker and US Paralympic Cycling Team member Matt Updike, 36, was an avid skier and cyclist prior to an auto accident that left him paralyzed and in a wheel chair. Eleven years ago he began a new athletic life in a wheel chair. “I knew nothing about sports in a chair but Craig (Hospital) has a great recreation department and I got into handcycling,” says Updike. “Eight months after my accident I did Ride the Rockies.” Hand cycling, where a hand crank instead of foot peddles powers the bike, started becoming popular in the mid-1990’s. Updike began racing in 2000 and qualified for the US Paralympic Team in 2002. That year he won the bronze medal in the time trials at the world championships in Germany. On Friday, June 6, 2008, Updike learned he had made the Paralympic Cycling Team for the upcoming summer games in Beijing.

“Handcycling improves the quality of life because you can get outside and enjoy the parks, bike paths, roads, and ride along with “able-bodied” friends easily,” says Updike. “It is safe for the shoulder and good for weight control and overall fitness.” Updike works with weights in the winter, pointing out that most gyms have plenty of equipment that paraplegics can use. “Any upper body work on machines, dumbbells, and resistance bands is good as well as cable equipment like FreeMotion and Technogym.”

The Technogym equipment is installed at Qi Kinesis Athletic Club (3121 E. Colfax, Denver). Owner, Chris Lindley, designed the Athletic Club to accommodate all ages and capabilities. “Our goal is fitness for everyone,” says Lindley. “Every move can be done with this equipment whether you require a wheelchair or a walker for mobility.”

Maintaining a healthy lifestyle and remaining active is important for everyone. But for those who depend on a wheelchair, the more functional activities perform, the more functional and full your life can be. Retired teacher, Linda McCurdy, was injured 20 years ago and is a paraplegic. After three months of rehabilitation she resumed teaching and did some exercising on an irregular basis with weights and resistance bands. “As I aged I realized how important it was to maintain strength,” says McCurdy. “You can’t remain independent without that.” She now works with a trainer twice a week specifically to improve strength, flexibility and bone density and uses an upper body cardiovascular machine for heart health and weight control.

Exercises recommended by Micah Zackroff, CSCS:

Back/Lats: Lat Pulldowns with FreeMotion machine or similar. Have athlete keep back against the back of the chair and face the machine. Pull straight down through the shoulders, while keeping shoulders and head upright.

Chest: Cable Crossovers with FreeMotion machine or similar. Have athlete face away from the machine and keep chest up and back against the chair. Pull the cables together out in front of the chest, while keeping chest upright.

Biceps: Hammer Curls with free weights. Hold weights upright while extending and contracting the arm. Alternate arms if core/stability cannot tolerate both arms simultaneously.

Triceps: Rope Extensions with rope pulley or cable. Hold pulley overhead and extend the arm out and over the head. Keep back against the chair while alternating arms.

Shoulders: I, Y, T's with free weights. Keep arm extended and bring the weight straight in front of the body (I), to a 45' angle from the body (Y), and straight out to the side of the body (T).

Core/Stability: Side-to-Side with medicine ball. Hold weighted ball overhead while rotating body from side to side. For more advanced, hold ball with one hand overhead or out at a 90' angle.

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*The premier resource for activities for people with disabilities:

National Center on Physical Activity and Disability, NCPAD.org, 800-900-8086

*********

*Local Resources:

Denver Parks and Recreation Special Needs Program,
Special Needs Division: (720) 865-0820

Boulder Expand Program,
Contact: Maura Holden, holdenm@ci.boulder.co.us, 303 413-7217

Winter Park National Sports Center for the Disabled
NSCD.org, 303-293-5711

Breckenridge Outdoor Education Center
boec@boec.org, 970-453-6422

Challenge Aspen
Challengeaspen.com, 970-923-0578

*National Sports Organizations:

U.S. Handcycling, UShandcycling.org, 303-459-4159

U.S. Sled Hockey Association
Denver Team contact: Corey Fairbanks, CFWheels@comcast.net

Paralympic Games
Paralympic.org, 719-866-2035

Colorado Wheelchair Sports, coloradowheelchairsports.org,

*Rehabilitation and Fitness Facilities:

Craig Hospital
(Specializes in rehabilitation for people with spinal cord and brain injury)
3425 S. Clarkson
Englewood, CO 80113
303-789-8000

Qi Kinesis Athletic Club of Denver
3121 E. Colfax
Denver, CO 80206
303-993-4041
Contact: Neil Almond, ACSM

Fitness Station
475 W. 12th Avenue
Denver, CO 80204
720-956-1580
Contact: Micah Zackroff, CSCS

*Equipment

Access to Recreation, accesstr.com, 800-634-4351

FreeMotion, FreeMotion.com, 877-363-8449

Technogym USA, technogymusa.com, 303-374-8857

“I’m still hot…but now it comes in flashes.” “These aren’t hot flashes, they’re power surges.” “The Seven Dwarves of Menopause: Itchy, Bitchy, Sweaty, Sleepy, Bloated, Forgetful, & Psycho.” ”Menopause: Where every day feels like summer.” According to the North American Menopause Society, two million American women enter menopause every year (about 6,000 a day). And the T-shirt and bumper sticker industry is going gangbusters. There is even a hit musical called (duh) “Menopause, The Musical.” Surely, “Menopause, The Mini Series” is not far off.

Menopause is confirmed by the cessation of the menstrual cycle for one continuous year, causing a huge disruption in the female body’s status quo. The sex hormones--estrogen and progesterone—affect over 300 different tissues as well as cholesterol levels, bone health, the nervous system, urinary tract, liver, and fat distribution.

Because the estrogens are now at a very low level, a whole different kind of experience kicks in. The reduced estrogen levels put the body into a state of withdrawal, thus the hot flashes, night sweats, dryness, mood swings, and changes in the metabolism. Every woman goes through this differently. Some breeze through it with barely a bead of sweat; others suffer for several years and require extensive medical involvement.

It is not just the hot flashes that cause consternation; it is also the “settling of the contents.” One day you fit into your clothes just fine. The next day your midsection looks like a muffin top and it is rolling out over the only pants that fit—the ones in size “elastic.” The good news is that this weight gain is not all in your head or some myth dreamed up by the diet industry.

Scientifically, weight gain is consistent with menopausal women. Wendy Kohrt, Ph.D., Professor of Medicine, Division of Geriatrics, at the University of Colorado Denver, Anschutz Medical Campus has been studying the interactive effects of exercise and estrogen on bone loss and body fat on post-menopausal women for 15 years, starting in 1993 at the Washington University School of Medicine in St. Louis.

“Body composition changes around the time of the menopause,” confirms Kohrt. “Loss of estrogen during the transition through menopause results in a metabolic transition that causes fat to increase around the waist rather than the hips and thighs,” she explains. “Some of these changes start subtly before women even know their estrogen is dropping. Studies show that this drop in estrogen actually lowers the Resting Metabolic Rate (RMR) by about 70 Kcal a day.” (In other words, start monitoring weigh gain in your early 40’s in order to stay ahead of the inevitable metabolic slowdown. More on this later.)

Current research by Kohrt, which involves studying the relationship between the stress hormone, cortisol, and estrogen, is ongoing and still in the theoretical stages. “In the estrogen-deficient state, women may have an exaggerated cortisol response to stress,” says Kohrt. “We suspect that it is the increased cortisol that directs fat to the waist.” She also pointed out that in animal studies, where the females were put into “menopause” through the removal of the ovaries, food consumption went up and physical activity went down. “This suggests that the loss of sex hormones changes the underlying biology in a manner that increases food intake and simultaneously reduces energy expenditure—just the opposite of what you want.”

FIGHTING BACK WITH EXERCISE

It is frustrating to be confronted with the seeming inevitability of the “menopot” hanging off the belly. But this does not give anyone permission to just throw the proverbial hands into the air and whimper, “What’s the use?” We may not fit into our high school prom dresses (like we would really want to!) but we need daily physical activity to protect us against the potential for cardiovascular disease, diabetes, osteoporosis, and other disorders associated not only with a sedentary lifestyle, but also with the onset of menopause.

With the reduction of heart and bone-protecting estrogen, heart disease and osteoporosis rise dramatically among postmenopausal women. Consistent physical activity and exercise becomes crucial. Good bone health is supported by resistance training (in the form of lifting weights, taking power yoga, and/or Pilates) two to three times per week, and by weight-bearing aerobic activity (walking, jogging, and dancing) most days of the week.

The heart responds to aerobic activity in general and, according to Bryan L. Haddock, Ph.D. who has done research at the Cooper Institute for Aerobics Research in Dallas, Texas, “Cardiorespiratory fitness can significantly reduce the risk of cardiovascular disease in postmenopausal women regardless of whether they used hormone replacement therapy (HRT).” It was noted that the combination of HRT and exercise was the best combination but for women who cannot or do not want to use HRT, this is indeed good news.

“Strong Women, Strong Bones” is a researched-based program from Tufts University specifically designed for perimenopausal, menopausal, and post-menopausal women. Ellen Martin, Living Well coordinator for South Suburban Parks and Recreation (SSPR.org, 303-798-5131. “Participants are in a comfortable environment, even if they have not exercised before,” says Martin. Classes are Tuesday/Thursday for eight weeks from 1:00-2:00 PM and involve a warm up, 12 progressive exercises using hand-held dumbbells and ankle weights, balance work, and a cool down with stretching. “Every participant is given six assessment tests on the first and last day of the program,” explains Martin. “Even though we do not really work that much on flexibility or cardiovascular, participants have shown remarkable improvements not only in the expected area of strength but also in flexibility and cardiovascular conditioning.”

Judy Regensteiner, Ph.D., Professor of Medicine and Director of the Center for Women’s Health Research at the University of Colorado Denver, Anschutz Medical Campus, who works in the field of diabetes and cardiovascular research, stresses that the power of regular exercise and increased physical activity is enormous but it is not a quick fix.

She points out that inactivity and a sedentary lifestyle are associated with increased heart disease, diabetes, poor cholesterol ratios, and the dangerous increase of abdominal obesity (the “apple” shape as opposed to the “pear”). “If you treat your body poorly throughout your life, eventually your body may pay you back,” says Regensteiner. “You do not have to be a triathlete, just be consistent and keep moving.” She encourages everyone to get started with physical activity regardless of past abuses or sedentary habits. “It is never too late.”

Nutrition

Beth Jauquet, Registered Dietitian and spokesperson for the Colorado Dietetic Association, stresses the importance of self-monitoring to prevent any weigh gain that is the annoying by-product of the slowing metabolism associated with menopause. “Weigh yourself once or twice a week at the same time of the day and then evaluate,” suggests Jauquet. “The best way to get your calories and nutritional needs realigned is to see a registered dietitian for a nutrition prescription.”

Because of the two major areas of risk to menopausal women—heart disease and osteoporosis—nutritional requirements shift to foods that protect both heart and bones. For heart health, foods that contain Omega-3 Fatty Acids are good options. This includes consuming fatty fishes, such as tuna, halibut, and salmon, twice a week; and nuts such as walnuts, pine nuts, and flaxseed, three to five times a week.

Bone health is supported nutritionally by calcium and vitamin D. “Menopausal and post-menopausal women should consume 1200 milligrams (mg) of calcium-rich food each day, or about three servings,” says Jauquet. “This includes non-fat milk, low-fat yogurt and cottage cheese, reduced and low fat cheeses like Swiss or mozzarella, and calcium fortified soy milk.”

Vitamin D is necessary for the body to absorb calcium. “Fortunately,” Jauquet points out, “there is a lot of overlap between essential foods. Fatty fish and dairy foods all have vitamin D as well as fortified whole grains.” Jauquet also stresses two other areas of concern when it comes to food choices: caffeine and vitamin B-12. “High levels of caffeine contribute to bone loss, and vitamin B-12 levels (essential for maintaining healthy nerve and red blood cells) decline as we age.” Caffeine is found in sodas, coffee and tea. Jauquet recommends no more than three cups a day of any caffeinated beverage. “If you drink one Starbuck’s Venti (large) latte, you are maxed out on caffeine because they contain three shots of espresso.”

As for vitamin B-12, animal proteins (meat, eggs, dairy) are the only natural sources. “Most people should get plenty of this vitamin if they eat animal protein and take a multivitamin,” says Jauquet. For vegetarians, supplementation is a must.

“By eating properly and being vigilant, you can be protective of your health instead of treating problems later,” advises Jaunquet.

(From the American College of Sports Medicine, “Guidelines for Exercise Testing and Prescription,” Lippincott, Williams, & Wilkins, 2000)

Sample Aerobic Workout (Menopausal, New to exercise)

Warm-up
-Five to 10 minutes
Aerobic exercise
-Progress to 20 minutes continuous walking on a treadmill-vary grades and speeds. Rate of Perceived Exertion should be at 12-14 on a scale of 20 (where 20 is very intense).

Cool down
-10-15 minutes

Sample Strength Workout (Menopausal, New to Exercise)

Warm-up
-Five to 10 minutes on treadmill

Resistance Exercise
Intensity:
-One set of 10-15 repetitions to start, progressing to two-three sets of eight to ten repetitions

Exercises:
-Squats (body weight or leg press machine)
-Seated Row machine
-Chest Press (machine; progress to free weights), or pushups (body weight)
-Overhead shoulder press (machine, progress to free weights)
-Abdominal crunches (body weight)
-Prone back extension (body weight)

Cool-down
-Fifteen minutes of static stretching for the whole body with deep breathing

Stretch:
-Hamstrings, quadriceps, hip flexors, pectoralis (chest), back, and triceps

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Strong Women Strong Bones Assessment Tests

1. “Chair sit and stand” (Number of sit and stands performed in 30-seconds)
2. “Biceps curl” (Number of curls in 30 seconds)
3. “Two-minute step” (Number of steps in two minutes)
4. “Chair sit and reach” (To the nearest ½ inch, sit in a chair and reach for your toes as far as you can)
5. “Back scratch” (To the nearest ½ inch, reach behind the back)
6. Eight foot up and go (For reaction time, from sitting in a chair, around a cone that is eight-feet away and back to a seated position)

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Food Portions: Omega-3 Fatty Acid-Rich Foods

Fatty fish = three to four ounces
Walnuts = Six nuts
Flaxseed and Pine nuts = two tablespoons

Food Portions: Calcium-Rich Foods

Milk = one cup
Cottage Cheese = one cup
Cheese = one ounce
Yogurt = eight ounces

Recommended Dietary Allowances

Calcium: 600 to 1200 milligrams (mg) per day
Vitamin D: 400 International Units (IU) per day
Vitamin B-12: 2.4 micrograms (mcg) per day

RESOURCES:

“The Pause,” Lonnie Barbach, Ph.D., Penguin, 1995, $13.95

“Fight Fat After Forty,” Pamela Peeke, M.D., 2000, $14.00

“Strong Women, Strong Bones,” and “Strong Women Eat Well,” Miriam Nelson, Ph.D., Perigee, 2000/2001, $13.95

“Menopause for Dummies,” Marcia Jones, Ph.D., Theresa Eichenwald, M.D., Wiley Publishing, 2003, $21.99

“Juicy Tomatoes,” Susan Swartz, New Harbinger, 2000, $13.95

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Female Biology 101

How does menopause happen? It is all thanks to changes with the same hormonal signals that kicked in our menstrual cycles in the first place: estrogen, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH). When we enter puberty, the pituitary glad begins producing FSH, which encourages the ovaries to ripen an egg, which secretes estrogen. This causes the lining of the uterus to thicken with blood in preparation for a fertilized egg. At about day fourteen, the pituitary gland stops producing FSH and starts putting out LH; the egg is released and ovulation begins.

If the egg is fertilized, the egg secretes its own hormones; if it is not fertilized, the estrogen and progesterone start to fizzle and finally crash completely, hence the dreaded “PMS”. The uterus is now starved for estrogen and progesterone; it spasms; you get a “visit from Aunt Flow.” And then it starts all over again, until you get to the age where the body is just about out of eggs and decides it is time to stop. The pituitary glad continues to send out FSH but the ovaries, which now have fewer eggs (follicles), ignores the signal or accepts it when it feels like it, causing a withdrawal of estrogen and erratic periods, among other symptoms. When the ovaries ignore the signals all together the cycle stops completely.