To hibernate or get some winter exercise?

It’s officially the start of the “meteorological winter” in the UK.  Watching the weather news while sipping my morning coffee, I’m mentally preparing myself for the onset of the inevitable ‘cold snap’ we are to expect and its made me realise:

1. We are actually in December so it should be cold right?  We have been lucky to enjoy the luxury of the mild weather leading up to now 
2. How the hell is it December already and what happened to the rest of this year 
3. Errrr – did we have summer?  I don’t remember it? 
4. Eeeek! – its nearly Christmas!

Of course as the cold is approaching and the dark mornings/eves are already here, I’ve started to remember that feeling when you wake up and can’t even stick one foot out from under the duvet because it’s too cold and dark for getting up early, for doing all those things you needed today, and under the duvet, not out of it, is of course a much better place to stay – probably until about April when the sun comes out again and spring is in the air! 

BUT NO.  Instead of hibernation mode I’m pledging to get over it and get up and embrace the cold winter months.  There are cool (excuse the pun) things to look forward to in the winter –

1. Christmas of course and 
2. New Year 
3. Nights in with Netflix (without feeling guilty)! 
4. Hot chocolate, mulled wine 
5. “comfort food” 
6. Warm cosy winter clothes 
7. (and … please insert here all the things you love about the dark cosy winter nights) 

Plus, I found this article - http://www.huffingtonpost.com/avelist/5-ways-to-motivate-yourself-to-exercise-during-the-colder-months_b_8462780.html  that got me thinking…

Ways to motivate yourself to exercise during the colder months.  The exercise part – getting out there in the cold dark mornings – didn’t cross my mind when contemplating hibernation, which goes to show how much activity is on my mind!  Then I thought about it again, that feeling when sticking your foot out from under the duvet…..imagine taking your entire body out and into the park in the dark for a run in the cold!  God forbid.  My nose will run, my chin will freeze, my ears, my lips and my fingers will hurt!  My toes in my lightweight runners won’t make it through the damp cold grass or frozen ground and I will see my own breath as I’m panting after the first 3 minutes!  No, no no. There are too many excuses not to get out and exercise during the cold months, BUT there are lots of things you can do to flip the excuses and enjoy exercise during the winter too.  Reading this article DID motivate me and that’s why I’m sharing.  In the hope it will do the same for you.  5 motivating factors that start with buy new clothes – gotta be a winner!

So the article lists the following 5 factors to motivate you to get out and exercise and I agree with them all – I also wanted to add my own.  They say:

BUY NEW CLOTHES Perfect – did we really need an excuse?  But this one solves the problem of the cold wet toes, freezing finger tips and ears etc.  Treat yourself to a new winter work out wardrobe.  Perhaps a nice long sleeved and insulated outdoor running top.  How about a hat, gloves?  Remember its dark in the winter mornings and evenings  so wear something reflective, something so you can be seen – even if running in the park – you may still need to cross roads, encounter cyclists etc so be seen and be safe.  In case you need more inspiration – check out this list of the best running shoes 2015 http://www.runnersworld.com/running-shoes/the-best-running-shoes-of-2015

PLAN FOR THE SUMMER MONTHS Basically what they are saying here is get a goal.  Goals are the best motivator in all things you are doing, whether that’s in your training and exercise, your job, your financial planning etc.  In this case a goal of perhaps a spring race, a fundraiser in the new year – 5K, 10K or even the cold runs through the winter if you fancy it (check out winter runs in support of cancer research here for example http://winterrunseries.co.uk/)

If you don’t want to or are not ready to sign up for a race / run / event yet, set your own smaller goals.  For me – I’m still aiming for my first elusive 5km and know even if I only run an extra 30 seconds faster, or longer than last week I feel good and have achieved. So over the colder months keep your goals in mind, set new ones,  push yourself as much as you can and stick with it.  Don’t stop or lose sight just cos it’s dark and damp ok!

USE THE COLD WINTER MONTHS TO OUR ADVANTAGE.  Totally get this one as in my youth I loved ice skating!  In London over the winter, up pop the festive ice rinks. 

Yes you can buy mulled wine, hot cider, hot chocolate, take a loved one on a date and fool around BUT remember skating is a great form of exercise too, so go on a date and include some activity.  Seriously – if like me you haven’t been ice skating since you were in your early teens you will feel it in your hips and your bum the day after you do it “just for fun” at almost 40 years old! (London pop up winter ice rinks are listed here http://www.timeout.com/london/things-to-do/ice-skating-in-london there are LOADS) Other than skating think about winter sports you might want to try – skiing holiday anyone?  Snowboarding with those amazingly cool (hot) guys / instructors…..?

GET NEW TUNES  Update the playlist.  You’ve got the outfit, you’ve found the sport and you are on your way to your winter goals.  What else will help motivate? A new music playlist of course. As we head to Xmas everyone is bringing out new tunes aiming for the Christmas no1.  Granted, festive melodies may not scream run tracks, but I’m sure you can find some new stuff you love and sing along to on the early morning work outs.  If you don’t find something new, then look back to the summer(?) and the summer tracks from this years holiday perhaps?  Make yourself a new playlist with your summer faves and blast it on a cold winter morning as the sun comes up.  Yep – motivating for sure.

TAKE IT ONE DAY AT A TIME.  Basically (and I love this one) If you don’t feel great, and don’t feel like exercising one morning, then don’t.  Duvet days are fine – especially in the colder months.  Everyone has days when they just don’t want to – and you know what – if you don’t want to then don’t.  You are the one imposing your own goals, you are the one motivating, you are the one who decides.  It’s totally up to you if you exercise or not.  Don’t punish yourself if you don’t feel like it.  Just don’t do it and try again tomorrow…or the next day…or start again Monday…or do it on the weekend…whenever.  As long as you do it soon/again, its ok.

ADDITIONAL NO NONSENSE MOTIVATORS:

For me, as well as agreeing with all the above, I’d add the following:

My first tip to stay motivated is doing things as a GROUP – accountability, not letting others down, moral support etc – all fabulous motivating factors.  Also if you don’t fancy running or strenuous exercise, WALKING is a great starting point and walking with others as a group really builds confidence and community.  As a fully qualified walk leader, I lead group walks with Walking for Health/Ramblers/Macmillan - you can find details of the walks starting in January on our website here http://www.nitakothari.com/no-nonsense-nutrition-news/

REWARDS.  A lot of us are reward driven.  We like to think we aren’t, but we are.  And a high percent of rewards for humans (as for dogs!) are food based.  Of course we are talking about motivators for exercise here, so let’s not fall into the trap of “been to the gym, deserve a bacon sarnie” approach.  But after a run on a cold winters morning, look forward to the hot cup of coffee on your return, or the cup of tea / hot chocolate. 

Or perhaps (like me) you will be stupidly hungry on your return – well how about rewarding yourself with a hot steaming bowl of porridge?  Or totally un food related, a hot bath if you exercise in the evening, or a foot rub / massage from your other half to ease those tired aching hard worked muscles.

As well as looking at winter sports, how about CHANGING IT UP?  Hot yoga in the summer is even hotter and often not too enjoyable.  Hot yoga in the winter is warming and something to look forward to.  Swimming is great in the summer, but the heat of the pool I actually find enticing during the winter months too (just remember your hair dryer as there is nothing worse than the headache from cold wet hair after winter swims).  Outdoor swimming can also be amazingly invigorating during the winter months.  **PLEASE NOTE** I can seriously tell you open, outdoor swimming is for fully competent swimmers only.  You need to be a good, strong, capable swimmer but nothing will wake you up and invigorate you more before a long hard winters day, than an outdoor cold swim.  

Outdoor ponds/lidos in London that are open during the months can be found herehttp://www.timeout.com/london/things-to-do/lidos-and-outdoor-swimming-pools-in-london Or try www.wildswim.com for more outdoor swimming venues around the south east (or anywhere in the UK – just use your location on opening the site).  Or how about outdoor heated pools (In London I found this  http://www.better.org.uk/leisure/london-fields-lido)

Not appealing – then no worries, you can always EXERCISE INDOORS.  As well as cold in the winter, there is also wet weather.  For me that’s so much worse.  So sometimes, when you want to hibernate and just haven’t got the motivation to get dressed and outdoors, exercise inside.  You can hit the gym and run on the treadmill, use the cross trainer or bike too for some cardio activity, or build in some strength training.  If you can’t even get out the house – that’s ok.  There are a million fitness DVD’s (and there will be more in the new year) so grab one and get into the living room and work it!  If you’re even lazier than that – YouTube.  Find a fitness channel and whack it on in the bedroom, then just creep out of bed, stretch to warm up and work out right there!

Still staying indoors - there is always SEX! Yep, it’s a great workout and an undeniable calorie burner.  And you don’t have to leave the house or even your bed or come out from under the duvet if you don’t want to.  Just so long as you have a willing partner they get to exercise with you too!  Sharing is caring. You can even work out your calorie burn here http://www.sexcalculator.co.uk/

MAGICAL MORNINGS Think about outdoor exercise again – assuming you’ve made it out from under the duvet, it’s still dark and you head out.  The streets are really quiet, but it’s almost magical.  I love this time of day.  It’s not scary or intimidating darkness as late in the evening is, but early morning darkness is hopeful.  You start running under the cover of darkness and it feels good, like no one is watching and you have a certain sense of freedom.  Then the sun slowly rises around you and all of a sudden you are running on a bright, beautiful day. 

For me, watching the sun rise is the best motivator for early morning, outdoor exercise.  On the other hand, if you prefer to exercise later in the day, time it for the sunset if possible.  It can be just as beautiful and as the sun goes down the temperature drops and you heat up, so perfect climate conditions for outdoor exercise. Then of course you can head home for the hot dinner and hot choc and hot bath and massage!

Finally, I would say look forward to the spring months and the BIG REVEAL.  Working on yourself and your body over the winter months when your body is hidden under clothing layers, leads to the spring when you finally start peeling those layers off to show off your toned arms, legs, abs etc.  Don’t let them be covered and forgotten during the winter.  Work on your winter bod, to reveal a healthy summer body, without having to crash diet or overdo it, or do any of those stupid fad diets 2 weeks before your springtime holidays.  Preparation, goals and thinking long term – believe me there are no short cuts so all this works!

So good luck in staying motivated through the colder months, by exercising at home, indoors at the gym, taking up a new sport, embracing the winter sports, rewarding yourself with hot healthy treats, getting some new tunes and of course new clothes!  Enjoy nature during the winter months and take it one day at a time.  Seeing through the winter to your spring time goals is the best motivator.  Keep going, don’t hibernate and remember a duvet day once in a while is totally OK.

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**Please remember this is advice ONLY (as is all other information contained in this blog, the website and social media related to it) None of the info or advice is intended to override any recommendation from your GP or health professional**

"Diabetes could bankrupt the NHS"

This week and next (as it’s such a large topic) I wanted to talk about the facts behind the alarming headline that was splashed all over the news and media on Monday – it was reported that Diabetes in the UK had increased by 60% in the last decade and treating this increase would basically destroy and bankrupt our entire NHS…..so I figured we should look a little more at diabetes – its types, its symptoms, those at risk, the correlations between health/weight and diabetes, worse-case scenario outcomes and then prevention vs end stage medication (and NHS spending) and of course take a look and what we can do to help ourselves avoid diabetes.

“60% rise in diabetes cases in the last decade”

As this is no nonsense let’s start with the initial report from diabetes.org.uk:

https://www.diabetes.org.uk/About_us/News/diabetes-up-60-per-cent-in-last-decade-/

And here are how a couple of the papers reported the new statistics:

The Guardian (http://www.theguardian.com/society/2015/aug/17/diabetes-bring-down-nhs-charity) have quoted a lot of the initial report, whereas the Independent (http://www.independent.co.uk/life-style/health-and-families/health-news/diabetes-could-bankrupt-the-nhs-after-60-rise-in-number-of-cases-charity-warns-10458353.html) has lead with the cost factor and used words and phrases such as “bankrupt”, “amputations”, “stroke”…. Using shock language and looking at worse-case scenarios on all counts for the health system and for people with diabetes.  Both are great reports and both give the facts and figures.  Maybe it takes sensationalism to make it to our conscious and get us talking about it, maybe with all repots just giving the facts and figures this would have passed the general population without issue, so I’m grateful for a little doom and gloom and the splashing of disaster headlines sometimes to raise awareness.

In any case and via any reporting what we can see is that there has been a 60% increase in those diagnosed with diabetes in the last 10 years in the UK.   I imagine this could be due to a number of factors including for example

1) the rate of diagnoses has increased due to better methods of diagnoses

2) the rate of awareness has increased leading to more people being tested and therefore more diagnosed 
3) even with 1 and 2, we can see the disease is on the increase

Looking more closely at number 3 I wanted to look at why diabetes is on the rise, what’s causing this rise and the correlation therefore between risk factors such as health, weight, obesity and diabetes.

Next week we will look further into these risk factors (as well at those at a higher risk due to age, ethnicity, gender), then into symptoms, outcomes, treatments and prevention and what we can do.

This week to start with I wanted to just give an overview of diabetes.

Types of diabetes:

For a start let’s break it down – there are 3 types of diabetes – TYPE 1 and TYPE 2 and Gestational Diabetes. Here is a handy video from www.diabetes.org.uk that helps explain what happens when you have diabetes in no nonsense terms that we love:

The following info is from www.nhs.uk and simply identifies each type.

Firstly: “Diabetes is a lifelong condition that causes a person's blood sugar (glucose) level to become too high. The hormone insulin – produced by the pancreas – is responsible for controlling the amount of glucose in the blood”.

Type 1 Diabetes – where the pancreas doesn't produce any insulin

Type 2 Diabetes – where the pancreas doesn't produce enough insulin or the body’s cells don't react to insulin

Gestational Diabetes - occurs in some pregnant women and tends to disappear following birth

For the purpose of this blog (and next weeks) we will only be focusing mainly on type 2 diabetes as this is on the increase, this is the type the NHS is spending the most amount of money on and this is type we may well be able to help ourselves prevent.

Type 1:

“In type 1 diabetes, the body's immune system attacks and destroys the cells that produce insulin. As no insulin is produced, your glucose levels increase, which can seriously damage the body's organs.  Type 1 diabetes is often known as insulin-dependent diabetes. It's also sometimes known as juvenile diabetes or early-onset diabetes because it usually develops before the age of 40, often during the teenage years. Type 1 diabetes is less common than type 2 diabetes. In the UK, it affects about 10% of all adults with diabetes. If you're diagnosed with type 1 diabetes, you'll need insulin injections for the rest of your life”.

It's important that type 1 diabetes is diagnosed as early as possible, so that treatment can be started as quickly as possible. Type 1 diabetes can't be cured, but treatment can blood glucose levels as normal as possible and control symptoms, to prevent more health problems developing later in life.  With type 1, your body can't produce insulin so you will need regular insulin injections to keep your glucose levels normal. With treatment, you will be shown how to do this and how to match the insulin you inject to the food you eat, taking into account your blood glucose level and how much exercise you do.

Type 2:

“Type 2 diabetes is where the body doesn't produce enough insulin, or the body's cells don't react to insulin. This is known as insulin resistance.  If you're diagnosed with type 2 diabetes, you may be able to control your symptoms simply by eating a healthy diet, exercising regularly, and monitoring your blood glucose levels.  However, as type 2 diabetes is a progressive condition, you may eventually need medication, usually in the form of tablets. Type 2 diabetes is often associated with obesity. Obesity-related diabetes is sometimes referred to as maturity-onset diabetes because it's more common in older people”.

As with type 1, there is no cure for type 2 diabetes, however if you're diagnosed, you may be referred to a diabetes care team for specialist treatment, or your GP surgery may provide first-line diabetes care as in some cases, it may be possible to control type 2 diabetes symptoms with lifestyle changes, such as eating a healthy diet and taking regular exercise (which we will focus more on next week). However, as type 2 diabetes is a progressive condition, you may eventually need to take medication to keep your blood glucose at normal levels. This may be in the form of tablets initially, but move on to injected insulin at a later stage.  This is where the cost factor to the NHS comes in as the disease is both incurable and degenerative, so preventing and managing symptoms for as long as possible with a healthy diet and lifestyle will keep us fitter, healthier and lower our risks at the same time as saving the NHS money.

NICE care processes:

You will see from the news articles and the initial report from diabetes.org.uk that there are 8 NICE (The National Institute for Health and Care Excellence) recommended care processes recommended to the NHS to use when monitoring  patients at risk or diagnosed with type 2 diabetes.  These tests are completed annually and these functions are what we can try to prevent increasing with the use of diet, exercise and lifestyle change:

 

1) Measuring the effectiveness of diabetes treatment with blood test

2) Measuring cardiovascular risk factors (such as blood pressure)

3) Monitoring cholesterol

4) Checking your BMI – Body Mass Index

5) Cutting down / out smoking

6) Monitoring early complications: eye screening and foot health

7) Checking urine serum albumin (a protein made by the liver, the main protein of blood plasma)

8) Creatinine – testing kidney function

So these are the no nonsense basics – if you are interested you can find the full audit for care process and treatment targets in the resources section here (downloadable as a PDF): http://www.hscic.gov.uk/catalogue/PUB14970

So, after establishing these basics behind the headlines, next week we will look at:

• Type 2 diabetes risk factors and those at higher risk
• Type 2 diabetes symptoms
• Treatment and worse case outcomes of type 2 diabetes
• The correlation/link to obesity
• And finally prevention vs end stage medication ie things we can do in relation to our own health, weight loss, exercise and lifestyle factors - things we can change now to prevent type 2 diabetes

I hope that’s been interesting so far and given an overview of the diabetes basics – if you want more info you can take a look at www.diabetes.org.uk ; www.diabetes.co.uk and www.nhs.uk or of course contact us at info@nitakothari.com

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**Please remember this is nutritional advice ONLY (as is all other information and advice contained in this blog and the websites and social media related to it) – none of the info or advice is intended to override any recommendation from your GP or health professional**