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When I was a little girl in the 1960s, pregnant women wore loose billowing clothes in futile efforts to hide their pregnancies. The round silhouette of the pregnant belly was considered too suggestive for public presentation. Pregnant women were encouraged to stay home out of sight and rest.
Fast forward to 2015 and not only are women wearing yoga pants in public, but pregnant women are too, complete with body conscious form fitting exercise tops in bright colors. They are out and about flying that pregnancy flag and getting fit. I love it. Do you exercise ? Would you continue your exercise in pregnancy? Review the facts on the subject here on my page on Exercise and Pregnancy.
This blog post reflects two of my biggest health priorities: exercise and good food. It also reflects one of my favorite hobbies: getting more done in the day.
Have you ever balanced the checkbook while waiting for laundry to dry ? How about unloading the dishwasher while listening to an online class ? I call this nesting. This just means you put one chore inside another. It is not the same as multitasking, which is so last decade.
In that spirit, I like to workout and prepare dinner when I get home from work. To accomplish both I need recipes which can go untended for the length of a workout. I call these workout recipes.
I have noticed that many of my patients do not get the recommended amount of cardio. I have advised such patients starting out to take it easy at first, and go for a manageable length of time, like about 20 minutes. What kind of recipe might work ? Meatloaf ? Nope. It takes too long. But what if you hacked the recipe and instead of making one big lump that took an hour to cook, you divided it into muffin tins ? Voila. You may have heard of this on Pinterest, but my husband is sure he made it up. OK. Here is our version. I suspect you can do it with any meatloaf recipe.
Preheat to 350 degrees
Thoroughly Mix:
1 pound thawed drained ground red meat
1/2 to 1 minced onion, 1 Tablespoon minced garlic, or once bunch minced green onions
1 Tablespoon mixed Italian spices or Herbes de Provence, a few grinds of pepper, 1/2 teaspoon kosher salt
1 Tablespoon mustard, and some say also of ketchup, some say a dash of Worcestershire sauce
One whole wheat piece of bread, made into fine crumbs
One egg
If you want to sneak some veggies in, add a couple grated carrots.
Mixture should be moist but able to be formed. Adjust with crumbs or olive oil.
Scoop into papered muffin tins and bake until crusty and done to 160 degrees internal temp ( Takes between 20-30 minutes ) You may add a sauce on top but this may make it too sweet and also it will be prone to burning before the meat is even done. You can always add a sauce later.
Do your workout.
Toss a big fresh salad, pour some water and serve.
Yoga became popular when I was a child in the 1970s. Since then it has taken on more the luster of fad than fitness. Learn what the evidence says here.
Ever wonder how to get dinner done and a workout accomplished all at the same time ? Try this technique to get it all done.
Read MoreHigh Intensity Interval Training is a time efficient effective way of getting gains in fitness and weight loss. Learn more about this new school way of getting fit.
Read MoreNeed motivation to exercise ? Here's a comprehensive list of tips to help.
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Gina at the summit of the " Dish" run at Stanford, after her 20th reunion. http://web.stanford.edu/group/runningclub/Runs/Dish.htm
There is a great deal one could say about exercise. However, talking or writing about exercise is only useful if it leads to people actually doing it. So, since I am committing the Wednesday column to the topic of exercise, I decided to reach out and ask about your interests and needs on the subject of exercise. I would like to tailor the column to meet these needs. Here is a link to a short survey that will be fun and illuminating to take.
Gina with Zumba Royalty Acea Theroux Zes and Nancy Mehring
I have really decided to give exercise some serious focus because I really feel it is at the center of optimal mental and physical health. If you have mediocre exercise and excellent nutrition you are probably moderately healthy. However if you have mediocre nutrition and excellent exercise you are probably very healthy. Plus, good nutrition seems to follow in the wake of good exercise, but not as much the other way around. And of course, the worst attitude can be fixed better by a good workout than a good meal.
I realize there are serious and challenging obstacles to exercise, from money to peer support to childcare challenges, injury, chronic illness, social culture, motivation, depression and more. But I would like to explore and deconstruct these and look for solutions.
I am hoping this survey and its results will help pin some of these reasons down and help us solve them.
Next Wednesday I will post the results, and add a few thoughts of my own from over twenty years in medical practice and over 40 years exercising regularly.
Many thanks, Dr. Gina
Bath, England
There is a village in England called Bath. It is called this after the natural heated pools that are found there. There and in similar places around the world people have sought healing waters. Theses waters have alleviated pains in muscles and joints perhaps by virtue of their warmth and enhancement of mobility and circulation. In such places the spa was born.
I have always thought of exercise as a spa treatment from the inside out. Of course it takes more effort than simply slipping into a heated pool, but the benefits are greater. For example, the cardiovascular system is healed and strengthened. The immune system is boosted. Muscle and bone growth is stimulated and fat is burned. Arthritic joints are mobilized and balance is improved. Stress is relieved and mood is enhanced. Moreover, confidence and a sense of accomplishment are created.
All of this sounds appealing and yet exercise is so hard to sell. Once begun, seems hard for many to continue. This is one of the main challenges I face in my practice: How to inspire people to exercise, and even more, how to educate them to be consistent in perpetuity.
I am just starting to build my section of the website which deals with fitness. I have surveyed many authoritative websites having to do with exercise but my favorite so far is the American College of Sports Medicine, or ascm.org. I have looked for their answers to some fundamental questions. In the following link, I will share a few of them with you. I plan to devote the Wednesday Wellness blog post exclusively to exercise. Join me as we learn from the ground up.
Did you realize the concept of wellness wasn't always around ? According to an article in the November issue of Real Simple, the term did not appear in the English language until the 16th century. Until then we simply thought of the absence of disease.
After World War Two, the World Health Organization ( WHO ) explicitly defined health as not simply the absence of disease, but rather a state of " complete physical mental and social well-being ". The concept of " High Level Wellness" was defined in a book of the same name in 1961. And finally the first " Wellness Center " was opened in northern California in 1975, and was catapulted to both fame and ridicule with its spot on the TV news show 60 minutes in 1979. Today the general public and the medical profession take wellness very seriously. I agree with the WHO definition of what it is. What interests me is how to attain it.
My first comment is this: that wellness is not a one time goal. Rather it is a constant work in progress. It is borne of a repetitive but dynamic rhythm of daily activities that we must consciously put into place. If I have emphasized anything about health maintenance in my practice it is this: that no one thing that will confer wellness. It is a comprehensive approach which says that every thing you do or take into your body must be for a good health promoting purpose. Whether it is a food, an exercise, or even a manner of communication, it should be for the good. If these good things are done so often as to become habits, their cumulative result is wellness. In other words, it is the summation of all the well chosen good small things and actions in the day, experienced repeatedly over time.
In this spirit I would like to introduce the concept of optimal health. Yes there is great satisfaction in curing disease. But there is even more in teaching people how to move toward optimal wellness. And with that in mind I would like to share a terrific website :
Of course it is a play on the word "greatest" and I take it to mean someone who studies and tries to embody that which is great. The site offers tips not only on nutrition and fitness, but also addresses optimal life functioning in general. So check it out, as a part of your quest for wellness.
For more information see:
This article is written in honor of my brave niece who is recovering from a ski accident.
She is very athletic and very experienced. She is not reckless, and was wearing a helmet. Nonetheless, she caught an edge, lost a ski, flew out of bounds, hit a tree, lost consciousness and went down a tree well. Luckily, a patrol just happened to be skiing right behind her and dashed down after her. She and my sister in law, who nearly passed by the single ski on the trail, hauled her out, and our awesome Alert Helicopter evacuated her. Her helmet suffered a big gash. She got a concussion and some hairline spine fractures. People keep saying she is so lucky that that she was wearing a helmet.
It wasn't luck. The data and recommendations are crystal clear and their family follows them. I have summarized them here for you. They come from a review article which was published in the Journal of Trauma and Acute Care Surgery in April of 2014. This review combined the findings of 16 prior well designed studies which examined the effects of helmet wearing on both skiers and boarders. Here are some of their key findings:
The authors concluded that helmets should be strongly recommended and that policies should be put into place to promote their usage.
My niece is going to be fine. But she has a few challenging weeks ahead of her. She will miss her finals, miss her sports, and end up with lots of physical therapy and doctor visits instead. We are just grateful she is with us and, and still moving and smiling.
I have been meaning to write a post about how routine is the basis of all health maintenance. It has to do with how small simple tasks repeated over and over in time, create health. Or wealth, for that matter. Everyone knows that small consistent contributions to a savings account make large gains over time. One could also argue that consistent routine is the basis of most work or creative productivity.
But health is our wealth, and what I want to emphasize is the regularity of just a couple things: nutrition in three healthy meals and snacks, and regular 6 days per week of exercise. If these could be done simply, moderately, and consistently, without a lot of stress or fanfare, it would be awesome.
However, it is the holiday season. Holidays can be disruptive, to health, wealth, nutrition, exercise and work. And as you have seen, I am a bit off schedule in certain things. For example, I took some time off from the blog due to sheer merriment and kids being home from college. But I have been thinking about you all, and how you are faring, during this festive and sometimes disruptive season.
Here are my simple suggestions for keeping the happy in the holidays. Try to keep to your exercise above all, especially since you're perhaps eating richer food this season. Even if you eat treats, such as those on this holiday table, don't fret. Sample them in moderation, by all means, but be sure to include healthy holiday food in the menu.
And since it is the holiday season, I feel I can ask for a few more things. Have ice water or plain club soda on every table, and ladies, no more than one 8 ounce glass of beer, wine, or champagne per day. Try to sleep at least 7 hours per night. Finally, develop a holiday month plan, right down to gifts, wrapping, invitations, and meals. I am a big advocate of plotting all this on a calendar, and refining what works bests year after year.
Routines, large and small, will help you keep the holidays merry and bright.
I don't know about other professions, but in medicine there is an old intern's tale that things come in threes. It can be ectopics, miscarriages, twins, or this last week : pyelonephritis. Pyelonephritis is infection in the kidneys. It's awful. But good news: it's easy to diagnose and treat. I might add, it's easy to prevent.
What is it and how can it be prevented ? To start thinking about kidney infections, think first about bladder infections. They are very common. Women get them because their urethra is all of about 3 cm long and the bacteria in the area can ascend quite easily. Whenever there is irritation or dehydration, infection has a chance to set up.
An undiagnosed or neglected bladder infection simply ascends up the urethra to the kidney, and if the patient is dehydrated, run down, or otherwise compromised in some other way, she can develop a kidney infection. Forms of " other compromise" include, but are not limited to, kidney stones, other illnesses or pregnancy.
Bladder infections have the symptoms of burning, urgency, or difficulty voiding. They are diagnosed by symptoms and a dip test. They are easy to treat with tablets taken by mouth and generous hydration with water.
Kidney infection symptoms are more systemic, including fever aches, nausea, and backache. These infections are deep within the body and have gotten through several defenses. They require IV antibiotics or shots, and good hydration. If a pregnant woman gets a kidney infection, she must be admitted to the hospital, usually for a few days. Pyelonephritis is linked with preterm labor.
How can we prevent kidney and bladder infections ? First and foremost, hydrate well. Women need 2 liters of water a day, and pregnant women need 3 liters per day. A good rule of thumb is to keep your urine looking nearly clear. Urinate after sex. Keep yourself well rested and in a good general state of health. Finally, don't wait to call in if you think you might have a bladder infection. If you wait too long, you could get pyelonephritis.
You all know that I am all about fitness, nutrition and productivity. In today's post I am going to reveal the Secret behind having all of these : bags. Yes bags, and to a lesser extent boxes and other containers.
I think it is entirely possible that love of bags, boxes and containers can be taken to the level of obsession. I mean, they're not even a thing. They are a thing that hold other things. And yet, they can be so appealing and so useful. I chose to write about them today because they can make a number of aspects of your life better.
Take nutrition. When you shop, you want to be mindful of what you buy. One way to do that is to bring your bags. Most grocery stores have their version of a reusable bag. Places like Pier One have cheap but beautiful ones. Natural Grocers has a sturdy version in burlap. At any rate, you are thinking green when you bring those, and so by association you are thinking healthy, and so you are NOT going to fill one of those up with white bread and soda pop. That just isn't going to happen.
Once home, you have to plan for tomorrow's lunch and snacks so you can avoid eating unhealthy, eating out, or going without. A nice lunch bag makes this so much easier. It gets you excited for packing your lunch. You can also include a wide mouth or a drink thermos. Think about what you would want in your dream lunch bag, and then go find it. I saw some good ones at Target the other day. Pack it all with a lunch and two snacks while you're cleaning up from dinner.
Then there's the ski bag, the lake bag, the picnic or go-to-a-potluck rigid basket, and so on. Fix some of these up and things will start Happening.
I would like to highlight two more: the gym bag, and the office bag.
Regarding your gym bag, yours will not stink. The gym bag is inspiring. You have an outfit in which you feel comfortable, the right shoes, a coordinated water bottle, and your ear buds. Sometimes you need changes of clothes, and shower stuff, depending. Trick yours out and you will get to the gym more than ever.
Finally the office bag. In order to ready your office bag, which people used to call a briefcase, you have to clean it out, look at your schedule for the next week and the next day, then pack it back up with the necessary files and items to get those things done. You make sure all your electronics are charging, and that you have enclosed your favorite things like glasses, lipgloss, etc. Doing this will of course, tremendously lower your stress and cause you to feel confident about the week.
See how bags have great health benefits ?
As the years go by, I have become increasingly regimented in my life. The reason for this is that I like things to be easy. If I simply decide what I need to do, and pick a time for it to be done, then I all have to do is stick with the schedule and things happen as they should without much additional thought. This is the case even with things most people find challenging…like exercise.
I have read widely on the subject of habit formation and it appears that it takes considerable longer to form a habit than most people realize. Instead of the usual three weeks that most people hear quoted, it is actually more like three months. So this is relevant because it helps people have realistic plans and expectations.
I tell people that after a time, working in regular exercise begins to feel natural. The act of beginning to get ready to exercise does not feel like a chore. The internal debate about whether to actually do it eventually ceases. In fact, you begin to feel psychologically uncomfortable if it does not happen at the proper time. This comes after the three month mark. Before that, you must persist by discipline and device.
What devices can you use to get yourself through those first three months?
1. Get an exercise buddy for accountability. Pick someone your same gender and fitness level if you can.
2. Keep written or electronic calendar and schedule your workout as though it were a meeting or an appointment.
3. Restrict your time to somewhere between 15 to 30 minutes. The most important number at this stage is not minutes per session. It is sessions per week. It is possible that once you are a seasoned exerciser, you can get what you need for an hour four times per week. But to establish your habit well, begin with one short session six times per week.
4. Vary your workouts, but not too much. You may and should be using some DVDs at home in addition to walk-jogging or gym workouts. Any routines which you may be learning need to be done often enough so that they become second nature. It will not be helpful to have you struggling through a routine.
5. Be realistic in your choice of workout. Take into consideration the weather, your present fitness level and factors like cost. Set yourself up for success.
6. Make your first three months of exercise very manageable and pleasant, perhaps even less vigorous than you could be doing.
7. Finally I suggest reading about personal performance. The book “ The Power of Habit “ would be a good start. Concepts contained in such books can be inspiring and useful in many areas of life.
Enjoy your workout !
This is a fantastic funny article from Greatist about beginning down the path of fitness.
" The Surprising Benefit About Being Bad at Yoga "
I am always encouraging my patients who do not exercise to explore it. I tell them that what they do does not matter so much as just doing it. I ask them to start slowly, and to quit before they are overly tired. I have explained that their muscles, ligaments and joints need weeks to adjust to the new routine.
Some people like to go three or four days a week for a hour or more. This can be appropriate for seasoned athletes, but for those still establishing a solid routine, I prefer 6 days a week of at least two or three different workouts, for only about 20-30 minutes. With this high of a weekly frequency, a habit can be established. With such a low duration, it won't be too hard. Nor will it be allowed to interfere with the daily schedule. In short, it should be sustainable.
Here's a funny thing I hear at the office. " I can't go to the gym until I get in better shape. " This leads me back to the point of this article. When I was taught yoga back in my groovy Southern California high school , we were told to begin by observing and accepting our present state. In doing the poses, we were cautioned to listen to our body, and lean into them only insofar as it felt healthy. This was part of what is now called " mindfulness " or being " present". One of my best high school friends said it best : " Be here now."
Yoga has never been about others. It is a gentle practice wherein we gain the physical skills of strength, stamina, relaxation and flexibility, and the mental skills of self calming and focus. Any exercise or sport can achieve similar goals but it must be a properly crafted regimen with a warm up, a cool down and sensible sequence. Those who are just beginning in fitness do best with some form of guidance. Ideally this is with a class and a teacher, but it can also take place with a DVD at home . That way the truly self conscious can get a taste of the benefits of yoga and similar workouts.
I blogged about this article because I think it did a great job of showing the transformation from disliking exercise to loving it, something I wish all my patients could experience.
