Physical Activity Alone Doesn't Prevent Weight Gain for Most Women

I am often asked by my patients if it is possible to prevent weight gain by maintaining high activity levels, without giving special consideration towards food intake. An important study from the Journal of the American Medical Association tells us that physical activity is not enough to prevent weight gain for most women.

The study by I-M Lee and colleagues surveyed over 34,000 American women over a 16 year period, and asked them to report their weight and physical activity levels. They were classified into one of three levels of activity:

• less than 150 minutes of moderate intensity exercise per week
• 150-420 minutes of moderate intensity exercise per week
• 420 or more minutes of moderate intensity exercise per week (at least 1 hour per day)
  

The study found that for women who were overweight, there was no difference in weight gain over time between each activity group. It did not seem to matter how much exercise overweight women engaged in; weight gain was the same regardless.

Interestingly, they found that physical activity was helpful to prevent weight gain in some women who were not overweight (ie, with a Body Mass Index of ≤ 25; you can calculate your own BMI here, in the right hand column). It is no cake walk, though (so to speak) - in order for normal weight women to prevent weight gain with exercise, they had to engage in at least one hour of exercise per day.

The take home messages, as I see them, are:

1. For most women, exercise alone is not enough to prevent weight gain. Weight management is more about watching what you eat, rather than how much you exercise.

2. Regardless of whether or not exercise will prevent further weight gain, it is still very important to exercise for its other health benefits!  Exercising for 150 minutes per week has been clearly shown to lower the risk of chronic diseases, so it remains of crucial importance to continue to exercise for the benefit of your overall health.  (Before engaging in, or stepping up, an exercise program, be sure to speak with your doctor to make sure you are making changes safely.)


3. For normal weight women, at least an hour a day of moderate activity is necessary for exercise alone to prevent weight gain over the long haul.

You can read about the Canadian Physical Activity guidelines here to find out how much exercise is recommended.   Check out Health Canada's website for further details, and some great ideas as to how you can work exercise into your daily life!

Dr. Sue © 2011 www.drsue.ca drsuetalks@gmail.com

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The Trials and Tribulations of Urban Transport

In last week's post, I blogged about the sad state of some rural Canadian roads - the shoulders being too narrow and covered in rumble strips, with no option for a cyclist to safely enjoy a day on the road.  This week, allow me to rant about the problems that plague urban North America, making it difficult, and sometimes impossible, to get around on our own steam!

For the first time since I started working at my current clinic location (and that's a year and a half!), I decided to brave the roads and cycle to work one day last week.  I live 5km from my office, so it would seem on the surface that it would actually be very convenient to cycle there.  Well, let me tell you... I am not sure how many lives I'm going to get, but I think I used up about a dozen of them during that 10 km round-trip adventure.  Although Calgary is known as a city with one of the best cycling path systems in Canada, this system is only useful for daily transport if you are so lucky to both live and work somewhere along its length.  Most of us are not so geographically lucky to have both work and home on the system, so we're exposed to the elements of regular traffic if we want to ride.

 Obstacles/health hazards encountered on my adventure to and from work included:

• no cycling lanes 
• drivers who did not show any interest in yielding to, or even minding, the cyclist; 
• sidewalks did not have graded curbs on the corners (making these areas highly inaccessible to people in wheelchairs, never mind bikes)
• many through roads were blocked off by industrial companies with fences around their properties, necessitating back tracking and finding curcuitous routes
• random hubcaps, broken glass
• the same train track had to be crossed three times before reaching my destination

So for me, some big changes would have to be made before I would consider riding my bike to work again.  Our new mayor has made it a priority to improve cycling access and safety, so let's see what happens.  Contrast this with the year I spent working at the University of Copenhagen, where the society is so geared towards bike travel that it actually dissuades one from wanting a car.  Coincidentally, I lived the exact same distance from work in Denmark that I do here in Calgary (5km), and when I calculated the calorie burn over a year of cycling to work - it equated to 18 pounds of body fat!  This focus on self powered transport is one contributor to the lower obesity rates seen in Denmark (11%, compared to 25% in Canada, and 34% in USA).

This week's biggest hats off goes to the people of the Netherlands, who are turning to cycle powered school buses to help their children stay active and safe (pictured above)!  I love it.  It appears that the company that makes these buses, De Caferacer, also makes these buses for adults (if there are any Dutch speakers out there who can help me out with the website, please feel free to comment on this post - my Danish is not saving me here!). 

For those of us back in North America - we'd sure love to incorporate these self powered buses as transport, but the reality is that our entire society will require an infrastructural overhaul before that would even be possible.  Fair enough to say that our climate is not as permissive of this form of travel, but for half the year, it would still be a blessing!



Thanks to my friend Brian at marketinghits.ca for the heads' up on the great photo!


Dr Sue


www.drsue.ca © 2011 drsuetalks@gmail.com


Follow me on Twitter for daily tips! @drsuepedersen

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Ready to RUMBLE??

North America suffers some of the highest rates of overweight in the world, with 66% of American adults and 59% of Canadian adults affected. Although the list of contributing factors is long and complex, there is no doubt that an infrastructure and attitude that promotes sedentary living is clearly a major issue.

I took the above photo at last year's meeting of the American Diabetes Association in Orlando, FL, USA. This is one of the largest gatherings of health care providers interested in the treatment and prevention of diabetes on earth, and yet, when offered the option, the escalator was usually preferred to the stairs. Part of the problem here was the construction of the conference centre: while an escalator is certainly important for accessibility for people unable to take the stairs, are two sets side by side really necessary?

For people who try to engage in more healthy leisure activity, golf has really taken off as a popular activity. Golf can provide fantastic exercise; within the space of an afternoon, several kilometres can be walked and enjoyed with friends or colleagues. Sadly, many golf courses now don't allow patrons to walk the course, insisting that they use a buggy so that more players can be moved through! While golf courses were previously built to walk, many are now developed with the goal of maximizing real estate property on the course, which results in an enormous golf course which may not even be practical to walk.

The tipping point which stimulated me to write this blog on this particular week was a recent experience I had on the rural highways in Southern Alberta. I was out for a fantastic ride on my road bike on a fairly quiet highway, with beautiful views and great weather to accompany me on my journey. The shoulder was narrow, but I felt comfortable.... until I came upon a long stretch of rumble strips that had been planted in the middle of it! Unfortunately, there was no cycle path alongside for cyclists to move to; the choices were to brave the traffic, or turn around. This is in stark contrast to many other countries around the world, where there is a priority on accessible and safe self-powered transport, which not only helps to keep people active, but also saves on CO2 emissions and keeps road traffic more manageable. I certainly understand the need to alert drivers with rumble strips if they get distracted and are edging towards the side of the road, but this should not be at the sacrifice of others who are trying to enjoy the road under their own steam.

As North Americans, it is upon each of us to work exceptionally hard to find ways to stay active in our environment. Maybe it's time to rumble with policy makers to make our infrastructure more conducive to physical activity.

Dr Sue Pedersen www.drsue.ca © 2011 drsuetalks@gmail.com

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Are We Getting Our 10,000 Steps Per Day?

As part of living a healthy lifestyle, it's important to make a point of being active on a daily basis.   Though this used to come naturally to our ancestors, we have to make a purposeful point of moving these days, as our society is built to promote a sedentary lifestyle where we can get most of our daily tasks accomplished without moving much at all.   Thus, one piece of counseling that health care providers often give (including myself!) is to take 10,000 steps a day.  To confirm that I am practicing what I preach, I donned a pedometer a couple of weeks ago to check out my own daily steps.

I must admit to you that prior to this little self-experiment, I was confident that I was well over my requisite 10,000 steps.  I rush around all day long in a whirlwind of activity as many of you do as well - there was no doubt in my mind that I was making the cuts!

Well....was I wrong!

In a crazy day in my clinic, running literally up and down the halls all day, it turns out that I bag only 2,000 steps.  This was a disappointing realization! The first day I discovered this, I thought, no matter, I still have errands to run at the grocery store... those laps up and down the aisles will be sure to get me there.  Nope - just 600 steps more.  (I even took a couple of extra trips down the veggie aisle to buff this up a bit.)  A walk to the gym and back (from the parking lot) gets me another 1,200 steps... and then there's about another 500-1000 steps around the house between the start and end of the day.

My grand total for a typical, very busy day, ranges between 3,000-4,500 steps.  Not even half! 

This is why we all need to have a purposeful focus on activity on a daily basis.   Other than those lucky few of us who truly engage in physical exercise at the workplace (manual labor, or a self-propelled transport/delivery job such as newspaper delivery), we simply do not get enough exercise in our day. 

There are two ways to solve this dilemma:
1.  Focused physical activity (workouts at the gym, running, cycling, skiing, etc)
or
2. Modification of daily life to accomplish those 10,000 steps! 

The science behind the 10,000 steps is that walking this distance (about 8km or 5 miles) is equivalent to about a 500 calorie burn (though this amount will vary depending on how much you weigh).  If you have a 500 calorie deficit per day, this would result in one pound of weight loss per week - but remember that this has to be 500 calories above and beyond what you take in.  Also remember that if your weight is stable, you'd have to walk an additional 10,000 steps above and beyond what you already do, without eating anything extra, in order to lose weight at that rate.  Sound difficult? - It is!! This is why the studies show overall that exercise alone does not result in weight loss - unless it is accompanied by a calorie reduced diet.  However, exercise remains crucially important as it has many health benefits, and is very important for weight maintenance as well.

Modification of daily life to increase your daily steps can include any number of things:

• park at the far end of the parking lot (it is interesting to observe people circling the lot at the gym to get the spot closest to the door!)
• walk into the the store instead of using the drive-thru
• go to the mall instead of shopping online
• take the dog for a longer walk
• get off the bus one or two stops earlier
• and the list goes on!

Wearing a pedometer is a great way to monitor and motivate yourself - studies show that it is those of us who walk the least, who benefit the most from this wonderful little tool.


For me, I'll keep up my workouts at the gym to make sure I top my 10,000 steps worth of activity each day....and I'll take our dog for a few more trips around the block!

I'd love to hear about your experiences with your pedometer, and how you've modified your life to increase your steps!


Dr. Sue © 2011   www.drsue.ca     drsuetalks@gmail.com

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Canadian Physical Activity Guidelines - Are You Getting Enough?

In today's society, most of us do not exert ourselves physically unless we make a conscious effort to set aside special time dedicated towards physical activity.  As such, it is important that we are all making sure that we do get enough exercise, and Canada now has brand new guidelines.  Are you getting enough?


On January 24th, the Canadian Society for Exercise Physiology published the 2011 Canadian Physical Activity Guidelines, which are easily downloadable for free online.  There are four sets of guidelines for different age groups, each on an easy-to-read one page summary sheet.  Here is a summary of what is currently recommended:

Children aged 5-17 years:

• at least 60 minutes of moderate to vigorous intensity physical activity per day:
• this should include vigorous activity at least 3 days per week;
• this should include activity that strengthens muscle and bone at least 3 days per week

Adults:

• at least 150 minutes of moderate to vigorous intensity aerobic physical activity per week, in bouts of 10 minutes or more
  
• add muscle strengthening activities using major muscle groups, at least twice a week
• for adults aged 65 and older, those with poor mobility should perform physical activities to enhance balance and prevent falls
  

It is noted for all age groups that more daily physical activity (above what is recommended) provides greater health benefits.  Specific helpful suggestions are also provided for the different age groups for possible activities to engage in. 


Take a moment and review these guidelines with your family - are you and your loved ones getting enough exercise?  If not, think about how you can work some extra activity into your daily life.  Remember that before you engage in any new exercise program, it is important to speak with your doctor to review the safety of any planned changes in physical activity in the context of your personal health; in some cases, a heart checkup (possibly with additional testing) is important before engaging in any new exercise.  No different that getting your bike checked after some time in storage, before you take it for a ride!


Have fun!!



Dr Sue Pedersen www.drsue.ca © 2011 drsuetalks@gmail.com

Follow me on Twitter for daily tips! @drsuepedersen

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