Healthy for a Happy Life

A good night’s sleep is an essential component of a healthy, happy life.  Known as “sleep hygiene,” there are several behaviors we can follow to get better sleep.

1. Maintain a regular sleep routine. Go to bed and get up around the same time every day of the week.  Ideally, you should try not to deviate by more than 20 minutes. 
2. Avoid naps if possible. When we nap, it decreases the amount of sleep at night.  This can lead to difficulty falling asleep and may cause sleep fragmentation. 
3. Don’t lay awake in bed for more than ten minutes. The American Sleep Association (ASA) recommends getting out of bed and sitting in a chair in the dark if you find your mind racing or worrying about not being able to sleep.  “Do your mind racing in the chair until you are sleepy, then return to bed,” the ASA suggests.  Definitely do not turn on the TV or pick up your phone during these periods.  They will just stimulate your brain and make it even more difficult to get to sleep.  Consider keeping a notepad nearby so you can jot down any random thoughts.  This might help clear your mind and make it easier to fall asleep.
4. Try to reserve your bed for two things only, with sleep being one of them.
5. Be careful with caffeine. Try not to drink any coffee, black tea or caffeinated sodas after noon. 
6. Try to limit alcohol, cigarettes and over the counter medications that may cause sleep fragmentation – especially two hours or so before you go to bed.
7. Get regular exercise early in the day and try to avoid rigorous exercise before bedtime. Strenuous exercise stimulates your endorphins, which may make it difficult to fall asleep if conducted late in the day.
8. Make sure your bedroom is quiet and comfortable. Turn off your TV, phone, and other extraneous items that may disrupt your sleep.  Consider adding some white noise, like a fan or nature noises.  Free apps including Calm and Beltone offer soothing nature sounds that can promote sleep.  Turn off lights.  Even blue lights can disrupt sleep, so consider turning them off, moving them, or covering them up.  Hide your clock.  Make sure you have a comfortable mattress and pillows.  Most of us will spend a third of our life in our bed, so it is important that is comfortable.
9. Implement a soothing pre-bedtime routine. Consider meditation, a warm bath or a shower.

Make yourself a checklist, or just print this article to help remind you of the steps to take for a better night’s sleep.  If you slip up or have a bad night, don’t worry.  By following most of these recommendations most of the time, you will be well on your way to making your dreams of better sleep come true.

If you had a choice, would you exercise really hard for a few minutes or moderately for 45 minutes?  Pressed for time, you would probably select the former.  According to a recent study, the two options - high-intensity interval training (HIIT) and endurance training - yield some of the same health and fitness benefits.

Now you may be wondering if the rise of HIIT signals the demise of endurance training.  Rest assured, both approaches are here to stay.  For a recent article in the Washington Post, lifelong mind-body fitness enthusiast Gabriella Boston explored the health and fitness benefits associated with HIIT and endurance training, whether or not HIIT training is appropriate for everyone, and if there is an ideal weekly ratio of HIIT-to-endurance training.

When she consulted fitness professionals and a sports medicine doctor, she was directed to a study by researchers at McMaster University in Ontario.  The study looked at sedentary individuals, not athletes with sport-specific goals, and focused on health indicators such as insulin sensitivity and cardiorespiratory fitness (the body's ability to supply oxygen-rich blood to the muscles and for the muscles to use that blood for movement). "The study focused on health intervention. How can we get [sedentary] people into a regular exercise routine?" said Pete McCall, spokesperson for the American Council on Exercise.

As Boston highlighted, lack of time is often cited as a reason that so many of us (about 60 percent) fail to get regular exercise.  Therefore, for the majority of Americans, a shorter, more efficient routine could be an attractive solution. 

The study concluded that 30 minutes of interval training, consisting of 10 minutes to warm-up, 10 minutes of high-intensity intervals, and 10 minutes of cool-down, had the same health benefits as 150 minutes of moderate endurance activity for individuals who are just starting out on a fitness regime.  It is important to note that those who are sedentary and just starting a fitness program are the most vulnerable to cardiac events, which can be brought on by high-intensity interval training.  Therefore, members of this population should definitely see their doctor for an evaluation before starting a new fitness routine.

Next, Boston explored the benefits of HIIT for those who are already engaged in a fitness routine.  "With athletes, like everyone else, it improves VO2 max and lactate threshold," says Dave Hryvniak, a doctor with University of Virginia sports teams. VO2 max is a measure of the maximum volume of oxygen that an athlete can use per minute while lactate threshold is the point at which lactate, a waste product resulting from the body’s conversion of nutrients to energy, builds up faster than it can be removed from the blood.  "The best athletes have the highest VO2 max," he says.

However, when it comes to HIIT vs. endurance training, it is never an either/or situation.  The ration depends on the athletic activity and it’s specific demands.  Most runners, for example, will do high-intensity interval training, working at more than 90 percent of their max heart rate, to increase power and speed, but they obviously also do long runs too, says Hryvniak.

The type and length of intervals is sport-specific. For example, a football player might need to do 10-second intervals (short but very intense bursts of power), while a tennis player might train with 30- to 45-second intervals, says Ben Fidler, fitness director at Sport&Health on Capitol Hill in Washington.

Fidler, who does high-intensity intervals as part of his own routine, says it is important to remember that the body needs lots of time to recover after high-intensity intervals. "You can only do HIIT 15 to 20 minutes a few times a week," Fidler says. "It's really hard on the body."

High intensity training creates significant stress on muscles and demands sufficient nutrition, sleep and recovery to heal muscles and avoid overtraining syndrome.  Overtraining syndrome is an imbalance that can be illustrated in a simple equation: Training = Workout + Recovery. The full spectrum of overtraining syndrome includes hormonal, nutritional, mental, emotional, muscular, and neurological imbalances.

Unlike HIIT, you can train aerobically for endurance, at a lower heart rate, every day of the week.  "Endurance days can also help you recover from the high-intensity days," Hryvniak says. As with any training program, though, you should start at an easy to moderate level, training at 40 percent to 60 percent of your maximum heart rate, and then, as you get fitter, move into a moderate-to-challenging range at about 70 percent of your max heart rate.  If you would like to learn more about finding your target heart rate, see my article, “Finding Your Target Heart Rate.”  (insert link here).

It is also important to be sport- and goal-specific when figuring out your training routine.  If you are training for a 10-miler, you will have to put the time in. For example, if you figure the race will take you 90 minutes, you need to be on your feet for that amount of time during training.  "The body is an adaptive machine," Fidler says. "It will respond to whatever you put it through."

In other words, if you put it through 15 to 20 minutes of high-intensity intervals, that is what it becomes good at - not 90 minutes of steady-state endurance work.  "Your body won't know what to do after the 15 to 20 minutes of HIIT," he says. "But when you are working on steady-state cardio for a longer period of time, the body adapts to that."

The aerobic/endurance training zone is also called “the fat-burning zone,” which means that the body is using fat for fuel, Hryvniak says. Therefore, it is clear that endurance training can be beneficial for weight loss.  Studies also show that HIIT is useful for weight loss, as the post-exercise metabolic rate is higher after HIIT than after endurance training.  In other words, HIIT and endurance training are complimentary and that the ideal ratio is really sport and goal specific.

Fitness experts recommend not just doing these two but also adding strength, balance, mobility and stability into your routine.  For example, add resistance training for strength and stability as well as yoga for mobility, core, mind and balance.

Boston’s fitness experts all suggest varying your routine at least every few months if you want to continue to see improvement.  "There is no one way of doing it," McCall says. "But we do know that doing nothing at all - no regular exercise at all - will take years off your life."

Recent studies indicate that motivation to exercise may be inherited.  This indicates that perhaps some of us are born with a strong desire to exercise while others struggle to find an exercise routine that makes us happy.   

In “Are You Programmed to Enjoy Exercise?,” Gretchen Reynolds writes:

“It’s possible that some of us are born not to run. According to an eye-opening new genetics study of lab rats, published in The Journal of Physiology, the motivation to exercise — or not — may be at least partly inherited.”

For years, scientists have been perplexed by the question of why so many of us fail to exercise on a regular basis when we know we should.  There are many obvious reasons, such as busy schedules and worrisome health complications, but researchers have recently speculated that genetics may play a key role.  In one recent study, sets of adult twins wore activity monitors to track their movements. The results indicated that the twins were more alike in their exercise habits than a shared upbringing alone would explain. The willingness to exercise or not depended a lot on genetics, these studies concluded.  But the specifics on the genes involved and their role in the individuals’ activity remained a mystery.  As a result, scientists at the University of Missouri delved into these issues and created their own groups of exercise and sedentary enthusiasts.  .

They concluded that it is possible that some of us are born not to run. According to this recent study of lab rats, published in The Journal of Physiology, the motivation to exercise or not to exercise may be genetic.  

The researchers accomplished this task by inter-breeding normal rats that had voluntarily run on wheels in the lab. Rats that enjoyed running were bred while those who were more sedentary were bred.  This process continued through several generations, until the researchers had two distinct groups of rats – one group that would happily run for hours on their wheels and others that were content to sit and think about whatever rats think about in their spare time. 

During early stages of the experiments, researchers found some interesting differences in brain activity.  In most situations, the genes create proteins that tell young cells to grow up and join the working world. However, if the genes do not function this way, the cells do not receive the necessary chemical messages and remain in a protracted, stagnant state. These undeveloped cells do not join the cognitive network and do not contribute to healthy brain function.

In general, these genes worked normally in the brains of the rats that are bred to run. However, their expression was quite different in the non-runners’ brains, particularly in a portion of the brain called the nucleus accumbens, which is involved in reward processing. In many animals, including humans, the nucleus accumbens is illuminated when we engage in activities that we enjoy.

As a result, when the scientists closely examined the brains of the two types of rats, they found that the animals bred to run had more mature neurons in the nucleus accumbus than did the non-runners, even if neither group had actually done much running. In practical terms, that finding indicates that the brains of those born to the running line are innately primed to find running rewarding as the more mature neurons in the reward center of the brain could be expected to fire robustly in response to exercise.

Conversely, the rats from the line that is more reluctant to running, with their sparse complement of mature neurons, would probably have a weaker motivation to exercise.

These results may appear to be dispiriting, but the study showed that the brains of those who were less inclined to exercise were changing.  Compared to others in their family that had remained sedentary, those who were involved in the study were responding to exercise in ways that would seem likely to make it more rewarding.

According to Dr. Booth, a leader in the study, that data suggests that “humans may have genes for motivation to exercise and other genes for motivation to sit on the couch.” Over generations, one set of genes could predominate within a family.

The bottom line is that people can decide to exercise, regardless of genetic inheritance.  If you’re not excited to exercise, do what makes you happy and try to “rewrite” your brain so that exercise becomes a pleasurable experience. 

Many of us are counting our steps every day, but did you ever wonder where the goal of 10,000 steps a day came from?  Joe Cannon, a consumer advocate dedicated to educating fitness trainers and the public on exercise, health and wellness, did some digging and found that the number actually dates back to the 1960s.  “Back then, there was a company in Japan making a pedometer called –wait for it... – The 10,000 steps meter.”

While all the talk about how we all should aim for taking 10,000 steps a day may look like an arbitrary number, 10,000 steps a day is still a healthy goal for many people.  However, we are all unique individuals with different health profiles and fitness objectives.  While studies show that the average American gets in about 5000 steps a day, this objective can vary by our age, education level and other demographics.  The appropriate goal depends on your current fitness level and other unique health considerations.  For someone just starting out on a fitness regime with their new Fitbit, for example, suddenly going from a low level of daily activity to 10,000 steps a day will likely lead to overuse injuries, like tendinitis and shin splints.  For someone with arthritis, a quick jump to 10,000 steps a day could cause arthritic flair ups.

As a general rule, taking 3000 steps a day provides about 30 minutes of physical activity.  This meets the minimum requirement for good health by the Centers for Disease Control and Prevention, which recommends at least 150 minutes of exercise per week.  If you do not find yourself with a solid block of 30 minutes or more for exercise, you can break it up into smaller chunks.  Walk 10 minutes in the morning, 10 minutes during the day and 10 minutes in the evening. 

In Joe’s review, which you can review here, he outlined a simple way to build up to 10,000 steps or whatever is right for you.  Rather than focusing on a specific number of steps per day, the most important point is to get regular exercise on a consistent basis.  As Joe reminds us, “a body in motion stays in motion. A body at rest stays at rest.”

Ideally, adults should exercise at least 30 minutes a day, five days a week.  This doesn’t necessarily mean you need to be running or lifting weights every day.  One of the most important tenants of a successful fitness plan is to do something you enjoy.  If you are finding it hard to squeeze in some daily exercise, consider your daily activities and take them up a notch.  There is even a scientific acronym for this principle:  Non-Exercise Activity Thermogenesis or NEAT.  It’s the energy we use for everyday activities, from walking up stairs to grocery shopping, that turn mundane activities into calorie burning opportunities—no gym required. 

We might not work up a sweat while shopping or doing housework, but every minute we’re not lounging on the couch is another step closer to a healthy lifestyle.   

For many years, it was suggested that we had to be active for at least 10 minutes at a time for the activity to count toward physical activity.  However, recent studies published in the American Journal of Health Promotion are causing some people to reconsider these dated beliefs.  Researchers looked at physical activity in adults between the ages of 18 and 64 and found that both long and short bouts of higher-intensity exercise were associated with lower body mass index (BMI) and reduced risk of obesity.

These findings suggest that we should take advantage of our daily activities to get exercise.   By tackling everyday tasks with a little creativity, the tedious to-do list can turn into a resourceful fitness plan. 

• Shop around. Whether it’s shopping for groceries or clothing, shopping includes walking, and walking burns calories (an estimated 120 to 150 per half hour).  Ready to take it to the next level?  Park as far away from the store’s entrance as possible and just say “no” to elevators and escalators.  
• Take the stairs.  Whether you’re at work, shopping, or traveling, embrace the stairs.  Taking the stairs burns more calories per minute than jogging.  In addition, it is a great workout for legs and glutes.

• Clean house. Vacuuming, sweeping, or dusting earns burns around 150 calories an hour and it is more enjoyable with good music in the background.  Get creative and add some moves to get a little added benefit like adding some isometrics by contracting your glutes while you dust.   

• Sit tight. Sitting in class, meetings, or at a desk doesn’t burn many calories, but add some isometrics by tightening the core and butt, hold, release, and repeat. 

• Stop hop. Get off the bus or metro one stop early and get in some extra mileage.  Walking burns around 135 calories every half hour. 

• Wax on, wax off. Washing the car burns 135 calories in 30 minutes. Add some calf raises to reach the roof of the car, along with a few sets of squats to wash the tires and the legs get a workout, too.

While traditional aerobic activity and strength training are the keys to physical fitness, taking these everyday activities to the next level will augment your fitness routine and help you maintain a healthy lifestyle. 

When you work out, are you doing too much or not enough? There is a simple way to find out by calculating your target heart rate, and the American Heart Association has some tips for your training.  “We don’t want people to over-exercise, and the other extreme is not getting enough exercise,” says Gerald Fletcher, M.D., a cardiologist and professor in the Mayo Clinic College of Medicine in Jacksonville, Fla.

Before you learn how to calculate and monitor your target training heart rate, you have to know your resting heart rate. Your resting heart rate is the number of times your heart beats per minute while it is at rest. You can check it in the morning after you have had a full night’s sleep (hopefully), before you get out of bed.

According to the National Institute of Health, the average resting heart rate is 60-100 beats per minute for adults, including seniors, as well as for children ten years and older.  For well-trained athletes, the resting heart rate is between 40 - 60 beats per minute.

Once you know your resting heart rate, you can determine your target training heart rate. As you exercise, follow these tips on a periodic basis:

• Take your pulse on the inside of your wrist, on the thumb side.
• Use the tips of your first two fingers (not your thumb) to press lightly over the blood vessels in your wrist.
• Count your pulse for 10 seconds and multiply by 6 to find your beats per minute.
• As you work out, stay between 50 percent to 85 percent of your maximum heart rate. This range is your target heart rate. 

This table below illustrates the estimated target heart rates for various age groups.  The maximum heart rate is calculated by taking the number 220 and subtracting your age.  For example, if you are 40 years old, your maximum heart rate is 180.

In the age category closest to yours, read across to find your target heart rate. Heart rate during moderately intense activities is about 50-69% of your maximum heart rate, whereas heart rate during hard physical activity is about 70% to less than 90% of the maximum heart rate.

These figures are averages, so use them as general guidelines.

Age	Target HR Zone 50-85%	Average Maximum Heart Rate, 100%
20 years	100-170 beats per minute	200 beats per minute
30 years	95-162 beats per minute	190 beats per minute
35 years	93-157 beats per minute	185 beats per minute
40 years	90-153 beats per minute	180 beats per minute
45 years	88-149 beats per minute	175 beats per minute
50 years	85-145 beats per minute	170 beats per minute
55 years	83-140 beats per minute	165 beats per minute
60 years	80-136 beats per minute	160 beats per minute
65 years	78-132 beats per minute	155 beats per minute
70 years	75-128 beats per minute	150 beats per minute

The American Heart Association cautions that a few high blood pressure medications lower the maximum heart rate and thus the target zone rate. Therefore, if you are taking medication for high blood pressure, check with your physician to determine if you should be using a lower target heart rate.

Those who have a heart condition or are in cardiac rehab should talk to your doctor about what exercises are best, the appropriate target heart rate, and whether or not monitoring the heartrate during exercise is appropriate. 

If your heart rate is too high, you are straining your heart and need to slow down. If it is too low, and the intensity feels “light” or “moderate/brisk,” you may want to push yourself to exercise a little harder.

During the first few weeks of working out, aim for the lower ranger of your target zone (50 percent) and gradually build up to the higher range (85 percent). After six months or more, you may be able to exercise comfortably at up to 85 percent of your maximum heart rate.

If all this math is making your head hurt, here is a great rule of thumb to remember:  If you are working out and are unable to carry on a conversation, you may be overexerting yourself and should slow down until you can converse easily.