Tag Archives: exercise therapy

Are You Sure You (and Your Kids) are Living an Active Lifestyle?

Toronto Naturopathic Doctor

Here’s the content of an article I wrote that was published in EcoParent

They haven’t posted it Online, but have a lot of other great content. Check them out. In the meantime, enjoy!

– Jonah Lusis, ND

THE SCENE: A DOCTOR’S OFFICE (The late afternoon sun shines in through a dusty window, illuminating dog-eared copies of Time Magazine).

DOCTOR: Are you getting enough exercise?

PATIENT: Oh yeah. I walk my dog for 15 minutes every day.

DOCTOR: Let’s talk more about physical activity.

This is a not unusual conversation in my practice as a naturopathic doctor (except for the dirty windows and old magazines). Many, even those of us committed to living a healthy lifestyle are not active enough, not for lack of effort, but for lack of knowledge.

The first step in setting and meeting any goal, including active living, is a clear understanding of the goal itself.

Many having an active lifestyle do not have a clear idea whether they are as active as they ought to be, and many wanting to begin a physical activity regimen do not necessarily know where to begin.

Exercise: seems like a good idea, tell me more!

Although most people are on board with the fact that exercise is good for health as a means of preventing illness, many, including many healthcare professionals, are not aware of how dramatically healthful exercise is.

Certainly, preventing illness is reason enough to exercise, but as a review of research in the British Journal of Sports Medicine demonstrates, the value of exercise goes far beyond preventing illness.

Exercise is an effective therapeutic intervention for a wide range of health conditions, effectively reducing symptoms and mortality rate; and increasing function in patients having osteo- and rheumatoid arthritis, low back pain, fibromyalgia, chronic fatigue syndrome, heart disease (e.g., heart failure, stroke), diabetes mellitus, obstructive lung diseases, Parkinson’s disease, multiple sclerosis, dementia, depression, urinary incontinence and cancer recovery1.

For children, the immediate benefits of exercise relevant to many parents can be seen in academic performance. Active children have lower rates of anxiety and depression2, and higher mathematics and language scores3. Physical activity is a recognized supportive therapy in management of the symptoms of attention-deficit hyperactivity disorder (ADHD)4, helping children with attention and behavioural control.

It’s basically an miracle drug.

An overlooked value of fostering a activity children is the normalization of an active lifestyle. Like almost all behaviours, if children are socialized to consider an active lifestyle as a “normal” way of living, they are much more likely to be physically active (and therefore, healthy) as adults.

And if that doesn’t sell you on getting active. Are your kids taking forever to fall asleep, cutting into your Netflix time? Research demonstrates that every hour spent in sedentary activity delays bedtime by over three minutes5!

More Netflix time? I’m on board – how much exercise is enough?

Good to hear, and I’m glad you asked.

The recommended amount of weekly exercise for adults is:

  • 75 minutes of “vigorous” activity6, or
  • 150 minutes of “moderate” activity6, 7,
  • in sessions of 10 minutes or greater7, including
  • at least two sessions of muscle- and bone-building activity7.

In an interesting review of research, this amount of activity was confirmed to provide a nearly maximal benefit, reducing risk of death by 31 percent when compared to non-exercisers6.

A 39 percent decrease in risk of death was the best possible outcome identified, but required three times the investment to achieve: 450 weekly minutes of moderate exercise6.

And in case you were wondering, there is no upper limit for how much exercise is beneficial – all levels of activity are more healthful than no activity.

How about my kids?

Unfortunately, only 9 percent of Canadian school-aged children participate in the recommended amount of daily physical activity8 as defined by the guidelines determined by the Canadian Society for Exercise Physiology (CSEP).

According to CSEP research, every day, children ages 5 to 17 years of age should be engaged in:

  • 60 minutes of moderate to vigorous physical activity8
  • Several hours of “light” activity8
  • No more than two hours of recreational screen time8
  • Including at least three days of muscle- and bone-building activity8 weekly

Is watching TV considered “moderate”-level activity?

No, but thank you for asking.

The descriptors used in research and exercise guidelines are frustratingly vague.

Exercise intensity is measured in units called metabolic equivalents (METs).

“Moderate” activity is activity requiring 3.0 to 6.0 METs (in itself, not useful information, but read on), for example:

  • Brisk walking (4 miles per hour)
  • Light-effort bicycling (12 miles per hour)
  • Doubles tennis
  • “Involved” house work (e.g., window washing)
  • “Involved” yard work (e.g., lawn mowing using a push mower)

Basically, activity that requires mild, but clear effort.

“Vigorous” activity (greater than 6.0 METs) is not as challenging as many assume. Examples include:

  • Hiking or jogging (6 miles per hour)
  • Effortful bicycling (14 to 16 miles per hour)
  • Cross-country skiing
  • Singles tennis
  • Team sports games (e.g., soccer, basketball)

Not necessarily “full on” activity, but activity that is definitely challenging, and results in a sweat.

“Light” activity (fewer than 3.0 METs) is to important to recognize, because many do not value walking in the course of daily life as having particular value, but from a physical activity level perspective, it is clearly of greater value than screen time. Examples of light activity include:

  • Leisurely walking
  • Leisurely house work

And “bone-building” and aerobic activity?

Muscle and bone development, in general, are stimulated by the same types of activity: “resistance training”9. Both muscles and bones “grow” in response to stress. Using muscles (e.g., lifting a weight) stresses them: because muscles are attached to bones, when muscles are contracted (“flexed”), tension is placed on bones, which in turn stresses the bones.

Common examples of activities that challenge the muscles (and therefore bones) include weight lifting, push-ups, chin-ups, “plank”, lunges, squats, triceps dips; and in the case of children, climbing a play structure.

Aerobic activity is defined as activity that exercises the heart, technically activity at an intensity of 65 to 85 percent of maximal heart rate10 (again, not super useful, but bear with me). One of the most useful pieces of information I gained in my kinesiology undergraduate degree was that this corresponds to, at 65 percent, having to mouth-breathe (i.e., lower exertion does not challenge the heart); and 85 percent, not being able to carry a conversation (i.e., if you are gasping for air, slow down).

Examples of aerobic activity include brisk walking, jogging, cross-country skiing and swimming (although, importantly, swimming is not bone-building).

That’s a lot of info – what’s the bottom line?

For persons having an exercise routine or involved in recreational sport, meeting the recommended guidelines for activity for adults is not particularly difficult: a couple of vigorous workouts at the gym can do it; a weekly basketball game or two can do it; twice daily bicycle commutes to work can do it .

Many however, do not have time for a regular fitness or sporting routine. For this group, 150 minutes weekly can be broken down into shorter (but at least 10 minutes long), several times daily activity sessions, and a couple of sessions of resistance exercise weekly.

This may accomplished, for example, by:

  • Briskly walking to and from a transit stop 10 minutes from home every work day (totaling 100 minutes), or
  • 15 minutes of “involved” house and/or yard work daily

Plus 50 minutes of muscle- and bone-building activity:

  • two to three, 15 to 25 minute sessions of exercises at home involving body-weight exercises (e.g., push-ups, squats, etc. – search YouTube for “scientific seven minute work-out” for a range of exercises requiring only a chair and a wall as equipment), or
  • two 30 minute Pilates or yoga classes, or
  • three, 15 minute sessions of “sun salutation” (again, visit YouTube for instructions, including a version at our office page, Toronto Centre for Naturopathic Medicine), or
  • 50 minutes of lifting/jarring outdoor activity such as wood chopping and stacking

My kids aren’t really into Pilates.

That’s okay.

Most children, assuming (in the case of older children) they do not have an electronic device they use at school breaks, will be engaging in about half their daily activity requirement during school breaks.

In my experience, the primary reason children do not engage in physical activity as a form of leisure and in their daily routines is obstacles that we parents create:

  • Over-scheduling of extra-curricular activities that result in free time that can be used being active being spent in sedentary activities (e.g., as a car passenger, then in a non-physical activity)
  • Over-protective parenting that discourages outdoor play in less-than-ideal weather, or absolute safety (whatever that is)
  • Access to “screens” that children will default to, rather than engaging in physical play
  • Driving rather than walking to school

Children do not require gymnastics classes or a rock climbing gym membership to be active. They can play.

Most activities children playing in a park or school yard will engage in (e.g., running, climbing, jumping) are moderate to vigorous in intensity, and are muscle and bone stressing.

Playing, particularly for younger children is an excellent use of their time. Play helps children develop cognitive skills such as organization, planning, behavioural regulation, task initiation and ability to transition between activities; vital to academic performance, social development and correlated to future success. In my opinion, an excellent value for a free activity, and as an “adults hands-off” activity, an opportunity for parents to have some much needed time to themselves as well.

Ultimately, spending 30 minutes of after-school time, and using at least part of the week end engaged in physical activity (e.g., a family hike, sledding) will help your children, and you, meet your weekly activity goals.

Tweet it to me doc.

Here’s the Twitter version:

  • On a daily basis, execute more of your daily activities at a “mouth breathing” pace, accumulating exercise time in sessions of 10 minutes or more
  • Supplement your routine brisk activity with a sessions of muscle- and bone-building activity
  • Let your children walk to school
  • Let your children play in the school yard for 30 minutes after school
  • Include some form of physical activity in your week end plans (e.g., family hike or trip to a park)

And now it’s time, as a shoe marketing executive once said, to “Just do it!”

Good luck.

References

  1. Kujala Evidence on the effects of exercise therapy in the treatment of chronic disease. Br J Sports Med. 2009;43:550-555. doi:10.1136/bjsm.2009.059808.
  2. Larun L, Nordheim LV, Ekeland E, Hagen KB, Heian F. Exercise in prevention and treatment of anxiety and depression among children and young people. Cochrane Database Syst Rev. 2006;(3):CD004691.
  3. McIsaac JD, Kirk SF, Kuhle S. The association between health behaviours and academic performance in Canadian elementary school students: a cross-sectional study. Int J Environ Res Public Health. 2015;12(11):14857-14871.
  4. Gapin JI, Labban JD, Etnier JL. The effects of physical activity on attention deficit hyperactivity disorder symptoms: the evidence. Prev Med. 2011 Jun;52 Suppl 1:S70-4. doi: 10.1016/j.ypmed.2011.01.022. Epub 2011 Jan 31.
  5. Nixon GM, Thompson JM, Han DY, Becroft DM, Clark PM, Robinson E, Waldie KE, Wild CJ, Black PN, Mitchell EA. Falling asleep: the determinants of sleep latency. Arch Dis Child. 2009;94(9):686-689.
  6. Arem H, Moore SC, Patel A, et al. Leisure Time Physical Activity and Mortality: A Detailed Pooled Analysis of the Dose-Response Relationship. JAMA internal medicine. 2015;175(6):959-967. doi:10.1001/jamainternmed.2015.0533.
  7. Canadian Society for Exercise Physiology [Internet]. Canadian physical activity guidelines. [cited 2016 Nov 22]. Available at: http://www.csep.ca/CMFIles/Guidelines/CSEP_PAGuidelines_adults_en.pdf.
  8. ParticipACTION [Internet]. 2016 The ParticipACTION Report Card on Physical Activity for Children and Youth. [cited 2016 Nov 22]. Available at: https://www.participaction.com/sites/default/files/downloads/2016%20ParticipACTION%20Report%20Card%20-%20Full%20Report.pdf
  9. Layne JE, Nelson ME. The effects of progressive resistance training on bone density: a review. Med Sci Sports Exerc. 1999 Jan;31(1):25-30.
  10. S. Department of Energy [Internet]. Aerobic exercise intensity and target heart rate. [cited 2016 Nov 22]. Available at: http://www.hanford.gov/health/?page=112.

 

Posted: 2017 May 24