Posts Tagged exercise

Physical Activity for Cardiovascular Health

Physical inactivity is an important risk factor for the development of cardiovascular disease (i.e. heart attack or stroke). Given that the average Canadian is sedentary for approximately 70% of the waking day, many Canadians are at risk of having a heart attack or stroke. Being physically active can help to regulate blood pressure, blood sugar, cholesterol and obesity, all of which impact heart health.

Please join us to learn more about how physical activity can benefit cardiovascular health.

Topics of this seminar will include:
-Types of physical activity and their cardiovascular benefits.
-How physical activity benefits blood pressure, cholesterol and blood sugar.
-What steps you can take to reduce your risk of cardiovascular disease by being more physically active.

Graham Beaton, BHSc, ND
Doctor of Naturopathic Medicine
Ottawa Collaborative Care Centres

Date and Time:
Thursday February 6th 2014 at 7 pm.

To register for this free event, please contact the Sunnyside Public Library or call 613-290-6115.

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Exercise for the Control of Blood Sugar and Diabetes

Diabetes is a disorder that is characterized by high levels of blood sugar which occurs due to changes in insulin production, insulin sensitivity, or both. This long term elevation in blood sugar levels has serious health effects. Specifically, long term elevations of blood sugar can damage small blood vessels. This damage may then affect vision, kidney and nerve function, bone health, and lead to increased risk of heart attack and stroke, etc.

The prevalence of diabetes is increasing worldwide. In 1985 it was estimated that 30 million people were diagnosed with the disease. Last year, the number of people diagnosed with diabetes was estimated at 371 million people, more than a tenfold increase. This trend for increasing rates of diagnosis is even greater in Canada, where it is estimated that the number of Canadians diagnosed between 1998 and 2009 increased by 230%. It is currently estimated that 2.4 million Canadians have diabetes, and that the incidence will continue to grow1.

One of the most important ways to manage diabetes is through physical activity. It is currently recommended that people with diabetes participate in both regular aerobic and resistance exercise. The participation in these forms of exercise has been shown to be effective in improving blood sugar regulation, reducing insulin resistance, substantially lowering the mortality risk in people with diabetes, and decreasing the risk of several other diabetes related complications (bone and muscle loss, foot ulcers, nerve damage, etc).

Insulin, Blood Sugar Regulation, and the Effects of Exercise
Insulin is a hormone produced in the pancreas that regulates carbohydrate (sugar) and fat metabolism in the body. When eating a meal, insulin is release from the pancreas, entering into the blood stream where it stimulates cells of the body (liver, muscles, fat cells) to take up sugar that was absorbed from food. The cells of the body then use sugar for energy or store it for future use.

In diabetes, the control of blood sugar is impaired. In type 1 diabetes, the cells of the pancreas that produce insulin are destroyed and insulin is not produced. This lack of insulin impairs body tissues to take up sugar. Furthermore, blood sugar levels cannot be properly regulated, remaining elevated. In type 2 diabetes, cells of the body become resistant to the effects of insulin, again leading to elevated levels of blood sugar. Moreover, as type 2 diabetes progresses, the pancreas can lose the ability to produce enough insulin, so there may be both a lack of insulin in addition to the loss of insulin sensitivity.

Exercise has been shown to be very effective in helping regulate blood sugar levels and improving the long term health of diabetics. Exercise has been shown to be effective in regulating blood sugar levels by stimulating active muscles to take up blood sugar without the need for insulin, effectively lowering blood sugar for at least 24 hours following exercise2. In addition to the non-insulin mediated absorption of sugar, exercise has been shown to lower the insulin resistance found in type 2 diabetes1.

To achieve blood sugar regulation benefits, people with diabetes should take part in both aerobic and resistance exercise. A minimum of 30 minutes per day for 5 days of the week should be allotted for aerobic exercise (e.g. brisk walking, swimming, jogging, bicycling, aerobics, dancing, etc) and at least two sessions per week of resistance exercise (weights and other forms of strength training) is recommended1.

Safety considerations with exercise and diabetes
For the majority of individuals with diabetes, participation at a moderate level (i.e. brisk walking) of physical activity is safe. However, individuals with certain pre-existing health concerns (autonomic or peripheral neuropathy, unstable angina, vision problems, or with presence of foot/leg ulcers), should speak to a health professional for further evaluation prior to starting a new exercise plan.

It is important to be aware that resistance training and vigorous aerobic activity (i.e. aerobics, jogging, brisk walking up an incline, etc.) can lead to an unsafe level of blood sugar in diabetics both during and post exercise. For example, vigorous exercise can cause low blood sugar (hypoglycemia) in diabetics who are on insulin or insulin secreting medications1-2. Thus it is important to first speak to a health care professional about how to safely monitor and regulate blood sugar before, during and after exercise.

Exercise is an essential component for the prevention and management of diabetes. It can help to regulate blood sugar levels, reduce risk of cardiovascular disease, and can reduce the risk of complications associated with diabetes.

If you have diabetes, or if you are at risk of developing diabetes, it is important that you ensure that your blood glucose levels are monitored and properly controlled. Diabetes treatment and blood glucose control should include a personalized diet and exercise plan that is tailored to one’s specific situation. In practice I help patients who are at risk of developing diabetes, or who have diabetes, to improve their blood sugar control through diet and exercise. If you have questions about diabetes, exercise, how to exercise safely with diabetes, or how Naturopathic Medicine can help you, please call 613-290-6115.

Graham Beaton is a Naturopathic Doctor practicing in Ottawa at the Ottawa Collaborative Care Centres.

1. Sigal, R.J. et al. Physical Activity and Diabetes – Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. Can J Diabetes 37;2013:S40-44.
2. 2. Colberg, S. R. et al. Exercise and Type 2 Diabetes: the American College of Sports Medicine and the American Diabetes Association join position statement. Diabetes Care 2010;33(12):e147-e167.

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Exercise During Pregnancy and Infant Brain Development

Exercise and physical activity have been found to be important to improving one’s general health and in reducing risk of developing different diseases. Recently, there has been an increased amount of research looking into the effects of exercise during pregnancy on newborns. Two such studies were presented at the 2013 Society of Neuroscience’s annual conference in San Diego. Specifically, they looked to determine the effect of exercise during pregnancy on infant brain development. Taken together, results suggest that physical activity has a beneficial impact on brain development for children.

Study 1 – Maternal exercise during pregnancy improves object recognition memory in adult male offspring

Researchers from Dartmouth College in New Hampshire used Long Evans rats as subjects to examine the effects of maternal exercise on memory in their adult male offspring. In particular, pregnant female rats were divided into two groups following conception. In one group, exercise wheels were placed in their cages and the pregnant rats were free to exercise. In the second group, the pregnant rats were placed in cages that did not contain an exercise wheel. After the offspring were born, the wheels were removed from the cages of the “exercise” group and the rats in both groups remained with their mothers until they were weaned.

At 60 days post birth the ability of the male offspring to recognize objects from memory over a period of 24 hours was assessed. Findings revealed that rats whose mothers exercised during pregnancy, were better at recognizing objects, demonstrating improved memory, compared to rats whose mothers did not exercise during pregnancy. Moreover, rats whose mothers exercised were better able to recognize objects two weeks later, demonstrating improved long term memory capabilities.

Study 2 – Foetal brain development is influenced by maternal exercise during pregnancy
In this study, researchers at the University of Montreal recruited women who were in their first trimester of pregnancy and randomly assigned them to either an active (minimum 20 minutes of low intensity exercise 3 days per week throughout their pregnancy) or to a sedentary group, who did not exercise.

A short time after the children were born (e.g. 8-12 days), the electrical activity of the children’s brains in response to auditory cues were examined using EEG (i.e. electroencephalography – which uses electrodes placed on the scalp to measure underlying brain activity). Results of the study showed that exercise had a beneficial effect on the brain of the newborns such that infants born to active mothers had brainwave patterns that indicated that their brains were more mature compared to infants born to inactive mothers.

In conclusion, physical activity during pregnancy has been shown to benefit the brain development of newborns. These studies further reinforce the importance of physical activity and the role it plays in promoting and maintaining health.

Graham Beaton is a Naturopathic Doctor practicing in Ottawa. If you have questions about how Naturopathic Medicine can help during pregnancy, about prenatal health or for an appointment, please call 613-290-6115.

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Does walking affect the risk of developing breast cancer?

Graham Beaton BHSc, ND
Doctor of Naturopathic Medicine

Several studies have shown that the risk of developing postmenopausal breast cancer is lower in women who are physically active (1). To show this, studies typically compare breast cancer rates in women who participate in regular vigorous physical activity (jogging/running, tennis, racketball) to women who are physically inactive. While these studies clearly show why physical activity is important and suggest that postmenopausal women should participate in vigorous physical activity, many women will not participate in “vigorous” physical activity due to health concerns (for instance osteoporosis) or lack of interest. Thus a question that arises, is if a woman is unable or unwilling to participate in vigorous physical activity, can their risk of breast cancer be lowered with regular moderate physical activity (i.e. walking)? A recent study published in the journal Cancer Epidemiology, Biomarkers and Prevention looked to answer this question (2).

To explore the link between breast cancer and moderate physical activity, the researchers looked at cancer rates amongst postmenopausal women who participated in the CPS-II Nutrition Cohort (a prospective study of cancer incidence established by the American Cancer institute). The researchers collected information regarding levels of weekly physical activity (walking was the predominant form of physical activity) and categorized women into 3 separate groups: those who participated in moderate physical activity less than 3 hours per week, those active for 4 to 6 hours per week, and those who were active more than 7 hours per week.

Results of the study showed that women who were moderately physically active for more than 7 hours per week had a 14% lower risk of developing breast cancer compared to those who were moderately active for less than 3 hours per week. In accordance with previous results, results also confirmed that women who participated in vigorous activity had the greatest benefits, a 25% reduction in breast cancer risk.

These results provide evidence that physical activity even at a moderate level of intensity can have a large impact on one’s risk of developing breast cancer risk and overall health.

1. Friedenreich, CM. The role of physical activity in breast cancer etiology. Semin Oncol. 2010 Jun;37(3):297-302.

2. Hildebrand, J. S. et al. Recreational Physical Activity and Leisure-Time Sitting in Relation to Postmenopausal Breast Cancer Risk. Cancer Epidemiol Biomarkers Prev. 2013 Oct;22(10):1906-12

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Physical Activity vs Prescription Medications – Which is Better for Health?

It is well documented that physical activity has many positive effects on health (reference). In general, people who are physically active have a higher quality of life and are at a reduced risk of developing many chronic diseases (such as arthritis, cancer, diabetes, heart disease, respiratory illnesses) compared to individuals who are sedentary.

A question that now arises, is does physical activity have a greater effect on health compared to medications? A recent journal article in BMJ (published on October 1st, 2013) looked to address this question.

What did the researchers do?
To determine if physical activity had a greater impact on health compared to taking medications, the researchers pooled the results of 16 separate meta-analyses (four of which were on exercise and 12 on medications), where a meta-analysis is a statistical method of combining the results of similar studies to increase the number of participants who received an intervention. Health was examined by determining mortality rates associated with 4 diseases:

  • Coronary heart disease
  • Diabetes
  • Stroke
  • Heart failure

What did they find?

  • Coronary heart disease: Physical activity and medications were equally effective in reducing mortality.
  • Diabetes: Physical activity and medications were equally ineffective in reducing mortality.
  • Stroke: Physical activity was more effective than medications for reducing mortality risk.
  • Heart failure: Certain medications (diuretics) were superior to physical activity in reducing occurrences of heart failure.

Are there limitations to this study?
Yes, unfortunately there were a number of limitations to this study, making it difficult to reach a definitive conclusion.

  • There are a limited number of randomized clinical trials (RCT) looking at the effectiveness of exercise/physical activity on mortality. The majority of studies looking at the health effects of physical activity are observational, which are not as strong in predicting cause and effect as an RCT
  • The authors correctly commented that they had relied on information from previously completed meta-analyses, and that several larger RCTs had been completed but were not “pooled” in with their data. It is possible that these new RCTs could have affected the results.
  • It is unclear if the appropriate amount/type of physical activity was chosen in the original studies to reach a conclusion. This is important issue as some studies underestimate the amount of activity required to reach a desired outcome. An example of this would be how much exercise is required to lose weight? If a study has selected 30 minutes as the amount of time one is required to exercise in order to lose weight, it might be insufficient (more time might be required). As well, the study may not account for what an individual is doing for the remainder of the day with regards to being physically active. So, if a person is exercising 30 minutes per day, and he/she is sedentary for the rest of the day, the 30 minutes spent exercising would be insufficient to have an impact on weight loss or on other possible health outcomes.
  • In addition to the above point, while it is known what direct effect a medication has on an outcome (e.g. dose x will result in x% decrease of blood pressure), the same is not always known for exercise (e.g. how much and what type of exercise should be done to achieve a certain outcome, etc).

What is the take home message?
The take home message is that physical activity has equivalent or better outcomes in the treatment of certain health conditions. Specifically, being physically active will reduce the mortality risk of coronary heart disease, diabetes, and stroke. Does this mean that if you suffer from certain conditions you should stop using your prescribed medications? Absolutely not. The findings from this article reinforce the fact that physical activity is vital to health, and being physically active can reduce one’s risk of mortality from certain diseases.

If you suffer from a chronic disease, or if you are at risk of developing a chronic disease, can physical activity help you? Yes. But before starting on a new exercise routine, talk to your health care provider about what type of activity is both safe and effective for you.

In practice, I council my patients on increasing their level of physical activity, taking into account their health condition(s), possible medications and level of physical fitness. If you have questions about a chronic health concern, physical activity or how Naturopathic Medicine can help you, please give me a call at 613-290-6115.

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Breast Cancer and Promoting Breast Health

Each year 5000 Canadian women will die because of breast cancer and another 24000 women will be diagnosed with breast cancer1. Breast cancer is a significant health concern for Canadian women. This article will discuss what breast cancer is, risk factors for the development of breast cancer, and steps that can be taken to attempt to minimize one’s risk of developing breast cancer.

The Normal Breast and Breast Cancer
The breast is composed of several different types of tissues, including fat and connective tissue, blood and lymph vessels, specialized glands (called lobules) that produce milk after a woman has given birth and ducts that transport milk. The tissues of the breast are controlled by various hormones and other growth factors that allow the breast to mature (during puberty), produce milk, and that allow for the normal repair and replacement of cells of the breast. Like all cells of the body, the cells of the breast have a normal life cycle, where they grow, die and are replaced with new cells, and this process occurs in a regulated manner. In cancer, this normal regulated cell growth is lost, and abnormal cells are allowed to continue to replicate, resulting in cancer. Specifically, breast cancer arises when there is abnormal growth in the cells of the lobules and their associated ducts.

Why Does Breast Cancer Occur?
Unfortunately it is not known why breast cancer occurs. While there are several risk factors for the development of breast cancer, it appears as though the onset of cancer might be influenced by a combination of risk factors occurring at once. For instance, one common risk factor is a genetic mutation in a specific gene, the BRCA1 gene. Normally, the BRCA1 gene works to produce proteins that fix errors in DNA synthesis during the production of new cells. When the genetic mutation exists, the DNA repair proteins are not produced, allowing cancerous cells to arise. Now, amongst women who carry the gene, approximately 55 to 65% go on to develop breast cancer by the age of 70 – which indicates that additional cancer promoting factors might need to be present for a woman to develop breast cancer2.

Additional risk factors for the development of breast cancer include: a woman’s age, personal and family history of breast cancer, early menstruation and late menopause, exposure to hormones (birth control pills, hormone replacement therapy), pregnancy and breast feeding, etc. Three additional modifiable risk factors include obesity, physical activity and alcohol use, which are discussed below.

Obesity and Physical Activity
Obesity is an established risk factor for the development of postmenopausal breast cancer. One reason for this is that fat tissue, especially fat around the waist, produces estrogen. The estrogen produced enters into circulation, where it may stimulate the cells of the breast, increasing both the risk that abnormal cancerous cells can arise, and/or stimulates the growth of breast cancer that is already present3.

Obesity has also been shown to influence several other cellular mechanisms that can increase the risk of developing breast cancer. These include increasing inflammatory factors present in the breast (which can cause damage to cellular DNA of the breast, potentially leading to the presence of abnormal/cancerous cells) and increasing the production of other cellular growth factors (e.g. insulin-like growth factor 1 (IGF-1)), which would increase the chance that abnormal (cancerous) cells are produced and/or stimulate existing cancer cells to grow/reproduce2-3.

In addition to one’s weight influencing her risk of developing breast cancer, one’s level of physical activity has also been linked to breast cancer2. Specifically, it has been shown that amongst postmenopausal women, those who are physically inactive have higher levels of estrogen in circulation. Again, this can increase the risk of cancer cells arising and can promote the growth of existing cancer of the breast. As well, physical activity has been shown to influence one’s level of the cellular growth factors, including IGF-1, such that a lack of physical activity is associated with higher levels of IGF-1 in circulation, and a subsequent increased risk of developing cancer4.

Alcohol and Breast Cancer Risk
Alcohol has consistently been shown to be associated with an increased risk of developing breast cancer. It was previously believed that alcohol contributed to breast cancer risk by increasing the levels of estrogen in circulation5. It appears now that this might not be the case as several studies have shown that alcohol ingestion does not have an effect on estrogen levels. Newer studies are now focusing on how alcohol may initiate the formation of cancerous cells by altering how DNA is replicated, how alcohol might affect the invasiveness of breast cancer cells and how alcohol might affect other hormones that can then be converted in to estrogen within breast tissue5.

In summary, while it is currently unknown why certain women will develop breast cancer, it is possible to reduce the risk of developing breast cancer by maintaining a healthy weight, being physically active and moderating alcohol use.
Graham Beaton is a Naturopathic Doctor in practice at Ottawa Collaborative Care Centres. If you are concerned about developing breast cancer, or if you have breast cancer and you would like to know how naturopathic medicine can help, please contact Graham at 613-290-6115.
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