Inspiration to Exercise!

Although it seems that summer has all too rapidly come to a close in western Canada, race season is still in full swing. I competed in the bike leg of a team triathlon in Banff on Saturday (a personal first), and I spent Sunday as the physician on call for the Dinosaur Valley Half Marathon in Drumheller, AB (www.dinosaurhalf.com). During the weekend, I had the opportunity to observe and be inspired by the athletes, and to think about the variety of ways in which people motivate themselves to exercise and stay active.

One key theme was that people were often found to be competing in groups. At the marathon, I met mothers and daughters, friends, and neighbors who had banded together to train up for race day. Although triathlons are traditionally a solo sport, there were many groups who enrolled as a three person team, with one person assigned to each of the swimming, cycling, and running legs of the race. For myself, it was a great opportunity to enrol as a family and cheer each other on at our respective sports. For all of these groups, the important message that shone through each time was that having the common goal of the race in mind provided an excellent opportunity to support each other through the months of training before the race. It's true - exercise programs are often more successful in a group support setting than when a person tries to go it alone. Consider planning workouts with a group of at least 3 people, such that if one person cancels, the other two can still provide mutual motivation to burn some calories!

Another theme was the sense of accomplishment that arose from participation in these events. At the Dinosaur Valley marathon, I had the great joy of watching contestants of all ages and abilities walk or run anywhere from 5km to a full half marathon (26km). I was equally inspired by every individual who competed, because I knew that each person was challenging themselves personally to accomplish their goal. Aspiring towards a personal best provided sufficient motivation for many an athlete to train towards their goal in the preceding months. I came across a number of athletes this weekend who were going it solo, and felt that the drive to succeed was motivation enough!

One interesting theme I heard time and time again, was that people who were racing were doing it to set a good example for their children. Childhood overweight has become a serious problem, and although there are many contributory factors, a key contributor is the increase in sendentary behavior that has been noted (TV watching, internet, etc). At the Banff Triathlon, there was many a child cheering on their parents as they crossed the finish line. At the marathon, I was thrilled to see whole families running the 5km race together!

These are just a few ideas to consider to increase motivation and adherence to exercise. To all this weekend's competitors - hats off to you!

Dr. Sue Pedersen © 2010 www.drsue.ca drsuetalks@gmail.com

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Normal Weight Obesity Part II

Thanks to all of my readers who provided feedback, comments, and questions regarding last week's blog on Normal Weight Obesity. The questions generated were important, and I'd like to share some of these key issues with you this week!

One of my readers enquired as to whether everyone in the normal BMI range (18.5-25) is at risk of Normal Weight Obesity (NWO). The answer is that the higher your BMI is within the normal range, the higher the risk of NWO. In other words, an individual with a BMI of 19 is extremely unlikely to have NWO, whereas an individual with a BMI of 24 has a higher likelihood of NWO. (Stay tuned for a little more detail on this one - I've just submitted a research article for publication along with my colleague Dr. Arne Astrup in Copenhagen, looking at our own DEXA scan data and BMI misclassification rates.) Women are also at higher risk of NWO than men.

Another important issue to point out is that the opposite classification problem can occur as well: that is, that some people are classified as being overweight by BMI, but do not have excess body fat. Men are at higher risk of this type of misclassification than women (though it can happen in women as well). Picture, for example, a male hockey player with lots of lean muscle mass, and a BMI of 27. This individual is overweight by BMI criteria, but his fat mass may be only15%, well under the 25% fat mass cutoff that defines excess body fat in men. It would be entirely inappropriate to recommend to this hockey player to lose weight!

This example highlights the importance of having other estimates of body fat than just BMI. Waist circumference can be helpful as well: you could imagine that the ultra-fit hockey player would have a trim waist, whereas a sedentary man with a BMI of 27 may be collecting a little extra around his midline. Our ideal upper limits for waist circumference are:

• Caucasian, Middle Eastern, Africans: men 94cm, women 80 cm
• South Asians, First Nations, Chinese, and Japanese: men 90 cm, women 80 cm

This discussion also highlights another important issue with regards to weight struggles, and that is to remember to take pride in a change in body composition that you might be making by stepping up your exercise routine, even if you are not seeing a change in weight. Building muscle in place of fat is beneficial in terms of decreasing your risk of complications of excess body fat (cardiovascular disease, high blood pressure, and many others), and will likely also provide you with an improved sense of general well being and overall health. Changing your body composition in favor of less body fat is a victory in itself!

Dr. Sue © 2010 www.drsue.ca drsuetalks@gmail.com

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Canadians have become More Overweight and Less Fit!

It comes as no surprise that Canadians have become more obese and less sendentary over the last 25 years. However, statistics from the Canadian Health Measures Survey have now put some numbers on the scope of the problem, and the results aren't pretty.

In the 1970's and 80's in Canada, there was a period of time where fitness was taken more seriously, at least in part due to the governmental ParticipACTION campaign. In 1981, the Canadian Fitness Survey reported that 56% of Canadian adults were active in their leisure time.
In 2008, that number has dropped to only 33%. Even worse - only 13% of Canadian children meet guidlines for recommended amounts of physical activity. Muscular strength and flexibility have fallen in Canadian adults, and the proportion of young adults with a waistline that puts them at risk of cardiovascular and metabolic health problems has more than quadrupled.

The need for more action from the government is clear. Comparisons to Canadian anti-smoking campaigns are often made; while the stop smoking campaigns have been comprehensive and strong, the committment by our government to promote active living has waxed and waned over the past decades. ParticipACTION lots its federal funding in the early 2000s, but was resurrected in 2007.

An easy way that we can all engage in active living is simply to incorporate activity into our daily ttransport routines. Taking the stairs instead of the elevator to get to your office or apartment is an easy one (if this is difficult at the start, try taking just one flight of stairs, and hop on the elevator for the remainder; you can build it up over time!). Park your car blocks away from your office and walk the rest (you may even save on parking this way!).

I learned a lot from the year I spent working at the University of Copenhagen, Denmark last year, with regards to active transportation. In Copenhagen, there are more bikes than there are cars, and rush hour bike traffic is a way of life. I rode my bike to work every day, which was only 5km away - but by the end of the year, this amounted to 2,000 km of cycling! Clearly, the Canadian climate is not always conducive to cycling to work, but even doing this for 8 months of the year would be an important contribution to an active lifestyle. Interestingly, even back in 1973 when Canadian dedication to an active lifestyle was stronger, the fitness of our 30 year olds was comparable to the fitness of a 60 year old Swede, which is at least partly attributable to this active transport lifestyle.

Dr. Sue © 2010 www.drsue.ca drsuetalks@gmail.com

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