Exercise and Weight Loss Reduces Kidney Disease and Death
Wednesday, October 14, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
We recently found a cure for "irony deficiency disease." My near-7 foot tall husband and I were walking to a Vidocq forensic society meeting. A bake sale was set up in the building lobby - junk food, refined junk pastries, pies with artificial colorings. The sign stated "Bake Sale for Kidney Disease." I asked which items caused the most kidney disease. I was sure it was a staged joke for a commercial on nutrition awareness. The sellers were disappointed with me. Apparently, it was a real bake sale. "Bake Sale for Kidney Disease" is true, both for them and their kidneys.
Research reported in the Clinical Journal of the American Society Nephrology of pooled data from 13 studies showed found, in obese adults with kidney disease, losing weight through diet and exercise prevented additional decline in kidney function and reduced proteinuria, which is excess excretion of protein in the urine, a major characteristic of kidney damage.
Regular exercise of the recommended amount cuts risk of death in patients with chronic kidney disease by 56%, according to an analysis of National Health and Nutrition Examination Survey (NHANES) data. People who exercised, but less than recommended levels were still 42% less likely to die during follow-up than sedentary people.
1. Weight Loss Interventions in Chronic Kidney Disease: A Systematic Review and Meta-analysis. Sankar D et al. Clin. J. Am. Soc. Nephrol., September 17, 2009 as doi: 2. Physical Activity and Mortality in Chronic Kidney Disease (NHANES III). Beddhu S, et al. Clin J Am Soc Nephrol 2009; DOI: 10.2215/CJN.01970309. doi:10.2215/CJN.02250409.
Obesity is a major factor in kidney disease. A large percentage of the United States adults and children are overweight or obese, increasing their risk of kidney ailments, plus diabetes and high blood pressure, which in turn affect kidney function. More than 20 million Americans already have chronic kidney disease, with the number and severity growing.
Researchers of the Systematic Review and Meta-analysis stated,
"The health care costs that are associated with this increase are staggering. In obese adults, weight loss may offer real benefits in terms of the kidneys, in addition to the heart-related benefits of shedding excess pounds."
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
Common, Missed Cause of MusculoSkeletal Pain - Your Drugs
Wednesday, July 15, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Three years ago, I started a series of Fitness Fixer posts about the extensive phenomenon of muscle, joint, and body pain occurring from common prescription drugs. The editors at that time asked me to defer writing about it. I have been watching the medical reports grow, substantiating the numbers and secondary problems of chronic pain from common medicines. This is a short summary, with more coming this summer.
Major side effects of body and muscle pain from common prescription drugs are not rare as once thought. Misdiagnosis of this pain is common. Unnecessary treatments, surgeries, and more drugs are often given. Exercises and stretches do not stop body pain from drugs:
Statin drugs for cholesterol are a frequent cause of muscle and joint pain, and sometimes, numbness or tingling in the fingers or toes
Common prescription drugs for anxiety and depression. Even though this class of medicines may be prescribed for nerve pain, they can cause nerve and muscle pain as side effects
Ritalin (methylphenidate hydrochloride) and related drugs
Some prescription allergy medicines such as Allegra (Fexofenadine)
Prescription acid prevention medicines called PPIs - proton pump inhibitors (Nexium, Prilosec, Prevacid, Zoton, Inhibitol, and others). PPIs have also been shown to greatly increase risk of hip fracture
Erectile enhancing drugs
The calcium channel-blocker drug verapamil
The antibiotics erythromycin and clarithromycin
Some HIV medications
Prescription medicine for constipation like Zelnorm (Tegaserod), irritable bowel, and others digestive complaints.
Migraine and headache prescriptions
Medicines for fibromyalgia
Even many medicines for pain, sadly have pain both as direct side effects and rebound pain, increasing drug dependence and pain cycles
There are several more prescription drugs that cause more problems than they relieve. List your additions in the comments below.
Often the need for the original medicine can be stopped with simple healthy changes. Motivated people can address and change the original problem, making their life better and more active than before instead of paying for more medicines and the problems that come with them.
Two of my books teach how to fix pain and mention specific drugs and what to look for:
Fix Your Own Pain Without Drugs or Surgery. Each chapter on each kind of pain gives a list of drugs that are known to cause pain.
Health & Fitness THIRD ed - How to Be Healthy Happy and Fit For The Rest of Your Life. Several chapters include drug information pertinent to the condition covered, plus several chapters on general health, offering many ways to avoid needing the original medications.
--- Questions come in by hundreds. I'm bailing the ocean with a bucket. I make posts from fun mail. Before asking more, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Why not try fun stuff, then contribute! Read success stories of these methods and send your own.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy.
Fast Fitness - Quick Refreshed Perspective Every Day
Friday, May 22, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Fast Friday Fitness - strengthen appreciation. Appreciation increases happiness, lowers blood pressure and stress chemicals, and reduces resentment, an unhealthy state of mind:
When you turn on a water faucet, notice that you get water. This is more than several millions of people have. Real people, as deserving as everyone else, walk miles and pay criminally inflated prices for water that is sometimes too dirty to drink.
When you turn on an electric light, notice that you get light and have electricity. In every room. At all hours. In many part of the world, even in major cities, they do not have electricity more than a few hours and sometimes, none in non-public areas.
If you are reading this, you may have a computer or other electronics. Even if it is in a library and you waited in line, you have these luxuries to browse for life enhancing ideas.
Right now, there are people carrying loads and walking miles just to dig for food and water, or carrying all their belongings on their back and living in tent refuge cities to escape persecution, sieges, physical attacks and worse, and have been for years. Not complaining doesn't mean to not change things. Do something about it:
It is fantastic bounty to have water and electricity. Try to notice it, and be happy for it. It is also true that Western water is full of unnecessary chemicals, and destructive pharmaceuticals. We can reduce polluting and taking unnecessary drugs. Don't pollute and litter without thought. Work to change the lives of all the many without basic rights and privileges. Show children that you appreciate, and don't destroy. Lead by example.
Read success stories of these methods and send your own. Questions come in by the hundreds. I make posts from fun ones. Before asking more, see if your answers are already here by clicking labels under posts, links in posts, archives at right, or in the Fitness Fixer Index.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books. Get certified - DrBookspan.com/Academy.
Here is Fast Friday Fitness - Strengthen your breathing muscles for easier breathing.
Blow up balloons instead of using a pump this New Year's Eve and through the New Year.
Inflate some with the quickest breath you can do. Inflate others with long slow breath.
Don't overbreathe or hyperventilate to become dizzy or force breathing or strain, which can increase blood pressure and pressure in the brain and eye. Stay healthy.
Your lungs don't have muscles, but you have inspiratory and expiratory muscles in your chest and diaphragm. They are muscles like any others that improve with training and decline without regular workouts. Breathing muscle exercise is now accepted scientifically as helpful to patients with various respiratory conditions, asthmas, and allergies.
Questions come in by the hundreds. I make posts from selected ones. See if your answers are already here by clicking links and archives, and labels under posts. Read success stories of these methods and send your own.
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Fast Fitness - Strengthen and Stabilize Upper Body and Core Without Increasing Neck Tension
Friday, October 17, 2008
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - learn how to use and strengthen arm, shoulder, upper body muscles, and abdominal and back muscles without hunching, tensing, and tightening:
Have a friend stand in front of you with arms crossed over their chest. Grasp their arms or elbows, like holding a steering wheel of a car or bike
While they resist, try to "drive" and turn the wheel right and left. Both of you keep the body upright and straight.
Notice if either of you hunch shoulders, tense the neck, or strain your breathing. Practice moving strongly without clenching. Keep breathing.
This can be fun to do with kids - they can "drive" you, then you can pick them in the air and "drive" them. To try this solo, hold a doorway, sturdy pole or pipe, or other hard to move object.
It is common to tense and hunch the shoulders and neck out of bad habit while doing arm strengthening exercises, and while using arms for daily life activities like driving, hanging up clothes and putting groceries on high shelves. Tightening leads to faulty muscle use, and increased blood pressure at the moment. These habits can contribute to headaches, bad postural and breathing habits, and poor mood.
Train relaxed habits instead of tightening muscles. Transfer relaxed good posture to daily movement.
More to train arms like these in the book Healthy Martial Arts - without special equipment or supplements.
Scorn, anger, name-calling. Not good for the heart. The best warrior wins without hurting others or himself.
The Thais call it "jai yen" - cool heart. The secret is to not make anger a negative force. They keep kindness in their voice. Jai yen is central to Thai social and business interaction. It illustrates the mind and body of the experienced warrior. Jai yen is part of Muay Thai boxing training. In Thai martial arts, respecting teachers and elders is foremost. Every fight begins with the Ram Muay, a spirit dance to show respect and thanks to parents, and ask blessings from the Kruu Muay Thai - the teachers. In Japan it is "fudoshin" - unchanging heart. A person with fudoshin is more stable and light-hearted when things happen that they don't agree with.
How do you get good at being heart-healthy? Practice it like exercise. Unlikable things happen every day, so we all have the good luck to get much chance to practice. It's healthy exercise. In the novel Shogun, James Clavell, wrote:
"To think bad thoughts is really the easiest thing in the world. If you leave your mind to itself it will spiral down into ever increasing unhappiness. To think good thoughts, however, requires effort. This is one of the things that discipline - training is about."
Discipline is the mental exercise of self-control to direct your behaviors. With discipline you brush your teeth everyday, and do exercise, and refrain from bad habits, and breathe and smile when someone is rude. The other person may continue injuring their own health with negative behavior, but you won't sadden yourself and injure your body with the unhealthy chemicals generated that can hurt your health and heart. If your kindness and understanding calms and comforts the other person, that is twice healthy. Breathe. Get outside in the sunshine every day. Be happy.
We're just back from teaching the medical school elective in wilderness medicine. Each year I teach there, working over my birthday. Same food as last year. But the creek was thinly iced - good for ice swimming.
Before lecturing, I worried that my information on health - stand up straight, eat right, exercise, "and all that," would be so known and obvious to the bright young medical students that it would bore them. Instead, it was called, "Out of the box." When did health become out of the box?
I spent years of my career in a lab as a serious, intensely number-checking research scientist. I worked to ensure that we knew what truly worked, and what was hype, unrelated, or just wrong. I made certain that what I discovered and developed for patients was squarely right, practical, and in the best interest of the patient (and fun too, which is health). All I pursued was The Truth. Matt Cartmill once said, "As a youth I craved factual certainty, and I thirsted for a meaningful vision of human life. So I became a scientist. This is like becoming an archbishop so you can meet women."
Why is bypass surgery, angioplasty, stents, obesity, diabetes, and medications with uncomfortable, unhealthful side effects considered normal, while eating a vegetarian diet is labeled wacky and extreme when it is medically documented to stop and prevent heart disease, diabetes, high blood pressure, and other prevalent conditions that rob people of joy in life?
In my diving medicine lectures, I wanted students to see how the information worked and how it relates to many things in and out of diving, not just dictate lists of conditions to memorize. I showed slides, asking them to identify why an accident would happen on the way down versus up and why. I told them that if they understood, they would not have to memorize. I just wanted them to think. As my father once enlightened me, "Jolie, you're asking a lot!"
In the orthopedic lectures, I taught the same principles I tell in this Fitness Fixer blog of gaining great physical improvements without making pain and injury in the first place. After one of my lectures, students scattered for personal time, while a few stayed in the lecture hall, bent over laptops. They sat hunched, rubbing sore shoulders. Eventually one nudged the other, "Get the doc, she's right here." After some indecision, one student asked me to give him stretches to fix the pain of working at the computer. I told him you can sit and work without getting pain in the first place, and why didn't I show him that, instead of a stretch as an "antidote." He protested that the computer made his neck hurt. I agreed that the way he was sitting would do that, and repeated that you can easily sit and work in a way that doesn't cause the pain in the first place. More protests came, that as students they had to work on the computer long hours.
Medicine is not supposed to consist of allowing bad things to happen so that you can do a cool procedure to try to reverse it. Readers, do you want to try what I showed him and get a free house-call right now?
I moved his chair in close to the table where he was working. Move yours in close now.
Standing behind him with my hands on his shoulders, I gently pulled his upper body up and back to rest against the chair back. At home you can feel me guide your shoulders and upper body back.
Next, keep the chin gently in, not jutting forward.
We moved his computer back from the front edge of the table to make room to rest his forearms while using the keyboard. If you use a "below-desk" keyboard tray, it is often better to move the keyboard back to the desk. Don't crane your wrists, making a new problem. Relax and breathe.
I told them that at my own desks, I raise computer on a shelf, block, or book about 10 inches higher than desk level, and use a cheap external keyboard. Even without these helpful changes, you don't have to round forward over a laptop.
The seat back of the lecture chairs were concave - shaped to curve like the letter "C" so that you sat rounded forward. This is a common problem in many chairs, even some called ergonomic chairs. Another of the students mentioned he had a commercial lumbar roll at home. It was expensive and he didn't use it much because it was uncomfortable. I showed them how to use a small soft roll, which can be your gloves or light sweater, nothing fancy or expensive. Nestle it in the small inward curve of the lower back, then press your upper back, not lower back, against the chair back so that you can sit straight and lean back, instead of rounding forward. Pressing the lower back against the lumbar roll is a common way to make it useless and uncomfortable.
It turned out that most of the young, active, outdoorsy, academically talented medical students had muscle and joint pain. So did many of the top ranked physician faculty. Several told me they thought their pain was normal from their activities, from studying, their fallen arches, or body structure. They regularly took anti-inflammatory medicines and thought they needed special shoes.
You probably heard not to slouch since you were a child. That easy medicine hasn't changed. You heard to eat vegetables for health and an apple a day to keep the doctor away. I think only a few of the medical students I was teaching caught on, and will help others with what they learned. It can be so easy. As for the rest? Who is the one who is out of the box?
Are you doing unhealthy sitting without realizing it, during work, play, and exercise?:
All-in-one resources for healthier pain free life:
Fix Your Own Pain Without Drugs or Surgery. Chapters on fixing each kind of pain plus patient stories in every chapter tell how things work, why, and why not.
Health & Fitness THIRD ed - How to Be Healthy Happy and Fit For The Rest of Your Life. Exercise, food, health, fixing pain, functional built-in healthy life, family, mental, it's all here.
Healthy Martial Arts. Top level book for any athlete or those who would like to be.
--- Questions come in by hundreds. I make posts from fun mail. Before asking more, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Why not try fun stuff, then contribute! Read success stories of these methods and send your own. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy. ---
On Friday, a day after the shuttle Atlantis returned after 12 days at reduced gravity, one of the astronauts collapsed twice during the welcome home ceremony. The reasons are the same as what happens here on Earth.
When you stand and sit on Earth, some of your blood pools in the veins of your legs because of the pull of gravity. In space, the pull of gravity is weak so blood does not pool. Blood floats upward. Astronauts and mission control scientists refer to the upward shift of blood during space flight in a technical manner. They call it the "Fat-Face-Chicken-Legs-Effect."
Upon return to the gravity of Earth, blood is again pulled downward. More pooling than usual occurs and not enough blood may be able to get to the brain. It is not uncommon for astronauts to feel weak and dizzy.
You may notice the same venous pooling on land in several situations: Sometimes when you stand suddenly, the rush of pooling in legs briefly lowers blood supply and blood pressure to your head. You may feel light headed. When this happens you just need to bend over and get your head down. Lowering your head allows gravity to restore blood, relieving dizziness. Extreme pooling has caused occasional cases of fainting when standing suddenly, when standing long periods at attention, and when climbing out of the water, especially hot water in spas and hot tubs. Pooling has been fatal to beached whales.
In space, the human body quickly gets badly out of shape without the pull of gravity. Muscles do not have to work to pull bones and quickly weaken. Bones do not have the muscular pull they need to stay dense and lose much calcium and bone mineral. Astronauts lose bone in space no matter how much calcium they eat. The cardiovascular system does not have to work as much to pump blood. This is why astronauts must exercise so much during missions.
Here on Earth you need regular activity that contracts leg and other muscles to squeeze the vessels to keep blood moving. After sitting for long periods at work and on a plane, your feet may swell with pooling fluids. Contracting your leg muscles while sitting, and by getting up and moving around pumps blood upward, reducing pooling and your risk of clots. For daily life, you need activity to keep muscles and bones from weakening. Even if you are sick it is crucial to get up and out of bed every day to stop the huge health losses that occur. Being sedentary is so devastating to health that bed rest is used as a model in scientific studies for loss of many health benchmarks in the microgravity of space. Stand to exercise, get outside, and enjoy some fun activity every day. Smile - another way to exercise against gravity.
Gravity and activity are important for health. Thank the astronaut, Heidemarie Stefanyshyn-Piper, for reminding us.
