With the push to get individuals to become more active and follow a well-balanced diet, the role that sleep plays in attaining better health seems to have gotten buried under the covers. The results of the 2009 Sleep in America Poll, a telephone survey of 1,000 adults conducted by the National Sleep Foundation, found that the number of Americans who get less than 6 hours of sleep per night has increased from 13% to 20% since 2001, while those Americans getting more than 8 hours of sleep per night decreased from 38% to 28%. Furthermore, a 13% increase in the number of adults reporting sleep problems was noted.

An adequate amount of sleep is essential for your optimal well-being, as is quality sleep. Getting the proper quantity and quality of sleep, about 8-8.5 hours of uninterrupted, deep sleep per night for the average healthy adult, is associated with improved learning, memory, concentration, productivity, and enhanced mood states. Chronic sleep deprivation is associated with weight gain, a greater likelihood for getting into a car accident (from falling asleep at the wheel), and an increased risk for developing diabetes, hypertension, cardiovascular disease, depression, and other illnesses.

Sleep and Body Weight

Because obesity (and the diseases to which it contributes) is a great health concern, it is important for you to understand the impact sleep has on body weight. Individuals who get around 5-6 hours or less of sleep per night are more likely to become overweight and obese. A lack of sleep can influence your dietary choices. The results of the 2009 Sleep in America Poll revealed that 22% of those surveyed who did not get adequate sleep reported that they were less likely to eat healthy. Other studies have found that a lack of sleep is associated with a greater preference for foods that are higher in calories and sugar content. Consuming these foods in excess can lead to weight gain.

Adequate sleep helps to regulate your appetite. While you sleep, your body's levels of leptin, an appetite suppressor, are increased. Conversely, your body's levels of grehlin, an appetite stimulant, are decreased during sleep. A lack of sleep can interfere with the balance of these hormones.

Sleep deprivation can decrease your energy levels, interfering with your motivation to exercise. According to the 2009 Sleep in America Poll, of those individuals who did not get sufficient sleep, 30% stated they were too tired to exercise compared to 10% of those polled who got adequate sleep.

Tips to a Better Night's Sleep

• Stick to regular wake and bedtimes, even on weekends.
• Establish a bedtime ritual to signal to your body that it is time to relax and go to sleep.
• Exercise - regular exercise improves sleep. However, avoid exercising right before bedtime because it can reenergize you, making it difficult to fall asleep. It also increases your body temperature which can interfere with sleep quality. For optimal sleep, the best time to exercise is late afternoon.
• Avoid nicotine, caffeine and alcohol which can make it harder for you to fall asleep as well as hinder the quality of your sleep.
• Stop eating and drinking about 2-3 hours before your bedtime. A full stomach and heartburn can make lying down uncomfortable and interfere with the quality of your sleep.
• Create a sleep-friendly environment. The room should be dark, quiet, cool, and free of allergens.
• Choose a comfortable mattress, pillow, and bedding.
• Consider using sleep aid devices such as ear plugs, eye shades, "white noise", and blackout curtains.

If, after trying the above tips, you are still having difficulty falling and/or staying asleep, make an appointment with your physician to discuss the problem. Many disorders, such as sleep apnea and restless leg syndrome, can be the cause. Documenting your troubles and symptoms in a "sleep diary" that you can then share with your physician will help him/her determine the cause and proper course of treatment.

Resources

National Sleep Foundation website, www.sleepfoundation.org

The next time you need a break from desk work, but do not have enough time to go to the gym for a full workout, try these lower body exercises that can be performed at your chair. These exercises are also great for older adults who do not have a gym membership, but wish to incorporate some strengthening exercises into their routine at home. Commercially made ankle weights may be used for the activities pictured below or you can make your own "weight" by filling a sock with dried beans or rice and then tying it around your ankle. An example of a homemade sock weight is found in the photos below.

To reduce the risk of injury, use a sturdy chair to perform these exercises. It should be able to support your weight for both the seated and upright activities. For added safety, your chair should be pushed securely against a wall. To reduce muscle soreness and/or injury, perform a light warm-up (e.g., walking in the halls at work) prior to starting these strengthening exercises. Remember to breath when doing the exercises. You should exhale while you lift the weight or exert the force.

Seated Leg Extension - strengthens quadriceps muscles (the front of your thigh)

Step One: Secure an ankle weight around one of your ankles. Sit comfortably with your back against the backrest of the chair. Your feet should should be about shoulder width apart.

Step Two: In a controlled motion, slowly lift your weighted lower leg by extending your knee. Hold for a count of two. Slowly return to the starting position. Repeat. Perform 2-3 sets of 8- 12 repetitions per leg. Note: you may lightly grasp the seat of your chair for support, but if you need to hold it tightly and strain to lift your lower leg, then the weight is too heavy and you need to choose a lighter one. Also, you may find performing this exercise is more comfortable in a chair with a cushion. You can also place a towel under your thigh for added comfort if you do not have a cushioned chair.

One-legged Squat - strengthens the buttocks, quadriceps, and hamstrings muscles (the back of your thigh)

Step One: Stand behind your chair with your feet shoulder width apart and your hands holding onto the chair's backrest.

Step Two: Lift your left foot up off of the floor by bending your left knee. While supporting yourself on the chair, lower your body toward the floor by bending your right knee to about 45 degrees. Hold for a count of two. Slowly return to the starting position. Repeat. Perform 2-3 sets of 8-12 repetitions per leg. If you find that performing the one-legged squat is too difficult, you can perform a traditional squat instead. Step one will remain the same. In step two, both feet would remain planted on the floor while you slowly lower your body by bending your knees to about 45 degrees.

Hamstring Curls - strengthens the buttocks and hamstrings muscles

Step One: Secure a weight around your left ankle. Stand behind your chair with your feet shoulder width apart and your hands holding the backrest.

Step Two: While bracing yourself on the back of the chair, lift your left foot up off of the floor toward your buttocks by bending at your knee. Hold for a count of two. Slowly return to the starting position. Repeat. Perform 2-3 sets of 8-12 repetitions per leg.

Heel Raises - strengthens calf muscles

Step One: Stand behind your chair with your feet shoulder width apart and your hands holding onto the backrest.

Step Two: While bracing yourself on the back of the chair, raise your heels a few inches up off of the floor until you are on your tiptoes. Hold for a count of two. Slowly return to the starting position. Repeat. Perform 2-3 sets of 8-12 repetitions. Note: to make this exercise more challenging, use ankle weights.

Side Leg Lifts - strengthens hip abductors, quadriceps, and buttocks muscles

Step One (pictured above in first heel raises photo): Secure a weight around your left ankle. Stand behind your chair with your feet shoulder width apart and your hands holding onto the backrest.

Step Two: While bracing yourself on the back of the chair, extend your left leg out to your side. Hold for a count of two. Slowly return to the starting position. Repeat. Perform 2-3 sets of 8-12 repetitions per leg.

Chair Squat - strengthens core stabilizers and quadriceps muscles

Step One: Sit at the edge of your chair with your hands on your hips and feet flat on the floor shoulder width apart.

Step Two: With your hands remaining on your hips, tighten your abdominal muscles and stand up until your buttocks is off of the chair and you have a slight bend in your knees. Do not fully extend your knees. Hold for a count of two. Slowly return to the starting position. Repeat. Perform 2-3 sets of 8-12 repetitions.

Chair Raises- strengthens core stabilizers, shoulder, and triceps muscles.

Step One: Sit on the edge of a chair with your feet shoulder width apart. Place your hands on the chair's arms with your elbows slightly bent.

Step Two: With your feet firmly planted on the floor, tighten your abdominal muscles and extend your arms to push your buttocks up off of the chair. Hold for a count of two. Slowly return to the starting position. Repeat. Perform 2-3 sets of 8-12 repetitions.

Note: Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

The North Country Trail - Kalkaska County, Michigan.

Trail Head to National Huron Forest - National City, Michigan

Whether you choose to trek the trails of your local community park or follow nature's corridors in the backcountry, hiking is a great way to improve your health. From weight loss to improving your aerobic capacity, trekking will help you meet your fitness goals. The mere "nature" of the sport offers a total body workout, improving your muscular coordination, strength, balance, and stability as you navigate the varying terrains and changes in elevation on your path.

Mental health benefits can be reaped as well as you travel nature's obstacle course. Trekking through grassy fields and over babbling brooks into the woodlands is a great way to relieve your stress and to get refreshed. Choose to wander the forests and wetlands in solitude or with the family. Either way, your inner spirit will be invigorated.

To ensure that your hiking experience is both fun and safe, Svea Gordon, sales associate at Nordic Sports in East Tawas, Michigan recommends the following:

• Good pair of hiking shoes/boots - the style you choose should match your activity. For hikes on well-maintained or smooth terrain paths, "day hikers" would be suitable. These lightweight hiking shoes are cut low at the ankle and have a footbed that offers more flexibility than boots designed for more rugged terrain. If you will be tackling a tougher trail that consists of rocky, uneven terrain, then you will want more ankle support (to prevent rolling) than what the day hiker will provide. A hiking boot that is cut high to protect the ankles and that has a stiff shank (footbed) will be sturdier and provide you with better support on the more challenging trails.
• Day/backpack - this is needed to carry your supplies. Like the hiking shoes/boots, the pack you choose will depend on your activity. Pack manufacturers number the bags. The bigger the number, the larger the pack, and the longer the hiking trip for which they are intended. If you will be going on a one-day outing, a daypack, which is small, should be all that you need. Backpacks designed for overnight excursions have straps to fasten tents and other equipment needed for extended trekking expeditions.
• Hydration system - this is essential to prevent dehydration. For short hikes, this can be as simple as carrying a water bottle (many have tops that are designed to be clipped onto your backpack with a carabiner for ease of transportation). Longer, overnight treks require carrying some type of a water filtration system. Mechanisms by which the hiker can purify creek and river water run the gamut in sophistication from iodine and chlorine dioxide tablets that chemically remove harmful organisms to hand and gravity pumps that physically trap the particles in filters.
• Food/energy source - the type/form of food items chosen is also based on the length of your trek. For day hikes, snacks in the form of commercial sport/granola bars and protein shakes or homemade trail mixes and dried or fresh fruit and vegetables should be enough to keep you going. Weekend and/or weeklong treks require you to bring along nourishment for mealtimes. Packing dry food that you can add boiling water to later will be lighter to transport and will take up less space in your backpack. For both short and long hikes, bringing along commercially prepared gel shots to provide immediate energy is a good idea, as is stashing a few single packs of dry sports drink mix that can be added to your water to replace electrolytes lost through sweat.
• Maps/compass/navigation systems - these items decrease your chances of getting lost in the wilderness. Although modern technology is great, you never know when the batteries will fail or when a signal will be lost. Therefore, always carry a waterproof map of the area in which you will be hiking. Or, carry your map in a waterproof bag.
• First aid kit - kits vary in items but should at least contain gloves, anti-septic wipes, adhesive bandages, gauze pads, tweezers, scissors, anti-acids, and non-steroidal anti-inflammatory medicine.
• Sunscreen/bugspray - these will protect you from the elements
• Whistle - it is essential that everyone going on a hike carry a whistle in the event you get lost in the woods or a member of the trekking party gets separated from the group.

Other items to consider bringing on your outing include a pocket knife, waterproof matches, flashlight, extra batteries, a watch, and a cell phone. Overnight excursions will require camping gear such as tents, sleeping bags, a portable stove and fuel, "mess" kits, plastic bags for storing left over food, and trash bags. Dressing appropriately for the weather is always important. Dress in layers so that clothes can be removed and added as needed.

Trekking poles are another good item to bring along for either a short or extended hike. Hiking poles aid in maintaining your balance as you navigate uneven terrain. They also absorb the shock placed on your body (especially in your arms) and they decrease the strain placed on your back and legs as you trek up and down hills. Some poles are adjustable and can be collapsed to attach to your backpack when not in use.

The extent to which you invest in gear and equipment is dependent upon the length of your trek. Your safety is of the utmost importance. Wearing appropriate clothes, socks, and footwear will protect you from illness and injury. Always make sure you have a means to get "clean" water and food to refuel while out on your hike. Plan ahead. Check the weather reports to avoid getting stuck in bad weather. Let someone know where you will be going and when you plan on returning. Ensure you have a means by which to alert others if there is an emergency or if you get lost (such as a whistle and cell phone). Following the above tips will increase your chances of a safe and enjoyable hiking experience.

For more information about hiking, backpacking, and camping or to purchase related items, contact the Nordic Sports store in East Tawas, Michigan at (989) 362-2001 or nordsport@gmail.com.

Note: Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

Resources

Svea Gordon, sales associate at Nordic Sports, 218 West Bay Street, East Tawas, Michigan 48730 (owner Gary Nelkie); http://www.n-sport.com/

Water Filtration Systems - http://www.rei.com/

Hiking Shoes/Boots - http://www.abc-of-hiking.com/

Research supports the safety and benefits of participation in a regular resistance training program for adults over the age of 65. Overall body strength can lead to great gains in everyday function, from getting out of a chair and climbing the stairs to playing with your grandchildren. Enhanced strength leads to greater independence.

If you have been sedentary up until this point, you may not know where or how to begin. Getting started with a strength training program doesn't require expensive equipment or a gym membership. Items found around your house will suffice nicely. A tennis ball can be used for handgrip exercises. Soup cans and milk jugs can subsitute for free weights, as can sacks of sugar or flour. Strength training exercises that incorporate use of these items are found below. Do not feel that you have to be limited to using items around your house; if you prefer, these exercises can be performed with free weights or equipment at a fitness center. The exercises are demonstrated in the seated position, however, they can be performed in the upright position based on your fitness level.

Before beginning a strength training program, consult your physician first to ensure that you do not have any underlying medical issues that have to be addressed before you can safely start. Based on your current condition, you may need to begin with a light load to avoid excessive muscular discomfort and injury. You should feel that it is a challenge to lift the weight 8-12 times per set. However, you should not perceive the load to be unbearable to lift near the end of the set. Once you are consistently and comfortably lifting the weight 12 times per set, you can increase the weight you lift for that exercise. If this is your first experience with resistance training, you may further reduce your risk of musculoskeletal injury by choosing a light weight that you can lift 10-15 times per set. Some mild muscular discomfort is to be expected. However, if you experience severe discomfort that does not subside in a few days, you should seek medical attention.

Prior to performing your strength training exercises, make sure you do a 5-10 minute warm-up to increase the blood flow to the working muscles. This can involve performing calisthenics and/or slow walking. As you lift the weight, make sure to breath. Exhale as you lift the weight or exert the force. Do not work the same muscle groups 2 days in a row. For example, if you performed upper body strengthening exercises on Monday, Tuesday should be devoted to performing lower body resistance activities. This will give your muscles a chance to recover before they are exercised again.

Handgrip Exercise - strength developed from this exercise will make opening jars and picking up items easier.

Step One: Hold a tennis ball in your right hand.

Step Two: Squeeze the ball as hard as you can. Hold for a count of five. Slowly relax your grip to the starting position. Repeat. Perform 2-3 sets of 8-12 repetitions per hand.

Wrist Curls - strength developed from this exercise will aid in lifting and carrying grocery bags as well as the activities listed for the handgrip exercise.

Step One: Rest your arm on the arm of a chair or the edge of a table with your hand hanging over the end. Hold the weight with your palm facing up.

Step Two: Slowly lift the weight by bending your wrist toward your elbow. Gradually lower the weight to the starting position. Repeat. Perform 2-3 sets of 8-12 repetitions per wrist.

Seated Overhead Arm Raises - strength developed from this exercise will help with lifting and carrying grandchildren and baskets of laundry.

Step One: Sit (or stand) with your feet shoulder width apart. If you are standing, your knees should have a slight bend and your back should be kept straight. Your arms should be extended out to your sides at shoulder level. Your elbows should be bent 90 degrees. The weight should be held with your palms facing away from you.

Step Two: Slowly extend your arms above your head. Hold for a count of two. Gradually bring your arms back to the starting position. Repeat. Perform 2-3 sets of 8-12 repetitions.

Seated Biceps Curls - strength developed from this exercise will aid with lifting and pouring from water pitchers and milk jugs. It will also help with lifting and carrying trash bags.

Step One: Sit (or stand) with your feet shoulder width apart. If you are standing, your knees should be slightly bent with your back straight. Your arms should be down at your sides. Hold the weight with your palms facing toward your body.

Step Two: Slowly lift the weight toward your chest by bending at your elbow (you can lift both arms at the same time or you may choose to alternate arms, lifting with one, then the next). Hold for a count of two. Gradually lower the weight to the starting position. Repeat. Perform 2-3 sets of 8-12 repetitions.

Seated Triceps Extensions - strength developed from this exercise will help with pulling down window blinds and shades.

Step One: Sit (or stand) with your feet shoulder width apart. If you are standing, your knees should be slightly flexed and your back should remain straight. Your shoulder should be extended with your elbow bent at 90 degrees and the weight held behind your head, level with the top of your ear. Use your opposite hand to support your elbow of the hand that is holding the weight.

Step Two: Slowly extend your elbow toward the front of your body. Hold for a count of two. Gradually return to the starting position. Repeat. Perform 2-3 sets of 8-12 repetitions per side.

Note: Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

Does your walking routine need a little boost? Re-energize your walks with these ideas that will keep boredom at bay and your heart pumping.

Change the Terrain

Head to the beach - walking in the sand almost doubles the energy you expend when compared to walking the same distance on pavement. This is because your body has to work harder to stabilize itself against the shifting sand.

Go to the hills - strengthen your quadriceps and buttocks muscles by adding a hill workout once or twice a week. Trekking up a hill will help you to burn more calories than if you were to remain on level ground.

Go with the flow at the pool - walking in water up to your underarms provides resistance that challenges your muscles and cardiovascular system. Some research even suggests that walking in water can help to improve your balance on land.

Change the Pace

Interval train - add 2 0r 3 segments of faster paced walking into your workout. You can use landmarks to designate faster periods throughout your route or rely on time intervals (e.g., 5 minutes of moderate-intensity walking followed by 3 minutes of vigorous-intensity walking).

Add a slow jog - substitute your walk with a jog once or twice a week.

Seek New Scenery

Visit state or national parks - stimulate your senses by heading to the trails. Smelling the sweetness of the woods and catching glimpses of wildlife will be a welcome distraction from the mundane for your mind.

Go to the city - the hustle and bustle of a downtown can energize your walk.

Incorporate Mini Exercise Stations

Park benches aren't just for sitting - break up your walk by stopping to use a park bench to perform triceps dips or push-ups.

You won't be barking up the wrong tree if you stop to do chin-ups from one of its strong limbs; or, if you use its trunk to build lower body strength and core stabilizers as you transform the traditional "wall sit" to a "tree sit" exercise.

Take Along the Toys

Use a handheld GPS to explore a new path.

Keep tabs on your heart rate by investing in a heart rate monitor.

Count your steps with a pedometer.

Burn more calories by walking with handheld weights or trekking poles (Nordic Walking).

Note: Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

A quick drive to the grocery store takes me past high school teams of various sports involved in pre-season training from runners to football players. Although participation in high school sports offers many physical advantages to the adolescent athlete (such as enhanced motor skills, muscle control and coordination, reflexes, strength, and aerobic capacity), it also presents unique challenges to the growing and developing body that need to be addressed for optimal health and performance. Just to sustain the nutritional needs of growth alone during this rapid period of development places great demands on the teen's body. Combine these needs with the nutritional requirements of physical activity and you create a unique situation that puts the adolescent child at risk for developing nutritional deficiencies and related health disorders.

Specific care needs to be taken to ensure that the teen athlete's diet not only contains enough calories to meet these extra demands, but that it provides nutrient-dense foods. This can prove to be a challenge when you factor in that teens as a whole are not the most compliant group when it comes to proper personal health care practices. Parents and coaches may opt to explain the importance of proper nutrition from a sport's performance perspective to help the adolescent athlete understand the need for adequate nutrition and to motivate them to make healthier food choices.

Consequences of a Poor Diet

• Stunted growth
• Impaired development of organ systems
• Poor bone development which increases risk for developing osteoporosis as an adult
• Increased risk of developing iron-deficiency anemia
• Increased risk of illness and injury
• Increased risk of bone fracture from low calcium intake
• Fatigue/lack of energy
• Greater risk for becoming dehydrated which, in turn, increases susceptibility to succumbing to a heat illness
• Decreased performance in sports and in school

Who is at the Greatest Risk?

• Female athletes who have the added pressure from society to be thin and so restrict calories to obtain that image.
• Athletes who participate in sports that place an emphasis on appearance, small body size, and involve subjective scoring (e.g, gymnastics, figure skating, and diving).
• Male wrestlers who have the pressure of meeting weight regulations and, therefore, go to extreme measures such as severely restricting caloric intake to make their weight class.

Diet Considerations for the Adolescent Athlete

• Because of the enormous energy requirements for this population, less of an emphasis should be placed on the distribution of the calories from carbohydrates, protein, and fat sources in comparison to the diet of adult athletes. Since fat offers the greatest concentration of energy (9 calories/gram compared to 4 calories/gram for protein and carbohydrate), consuming slightly greater amounts of fat can help the teen athlete meet his/her energy needs. The focus should be on the source of fat, ensuring that it mostly comes from mono-and poly-unsaturated fat sources as opposed to coming from saturated and transfatty foods. It is recommended that the fat intake be equal to about 30-35% of the total daily calories for the adolescent athlete. Because protein is needed for tissue repair and maintenance, it should account for approximately 15 % of the daily calories consumed by the young athlete, or 1.5 grams/kilogram of body weight.
• Adequate amounts of calcium are necessary to promote bone health. Males and females ages 14-18 years need 1,300 mg/day.
• Adequate amounts of iron are needed to prevent iron-deficiency anemia. Males ages 14-18 years need 11 mg/day. Females ages 14-18 years need 15 mg/day.
• The adolescent athlete should have frequent meals, occurring about every three hours.
• Because teen athletes have a tendency to under-consume fluids, allowing them to drink sports beverages, which have flavor and sweetness making them more appealing, is acceptable to prevent dehydration.

Meal Suggestions for the Adolescent Athlete

Breakfast:

• Yogurt smoothie
• Hard boiled egg and english muffin
• String cheese and nuts
• Whole grain bagel with peanut butter (if nut allergies are present try sunflower seed butter or cream cheese)
• Fresh fruit and vegetables

Lunch

• Tuna fish salad on whole wheat pita bread
• Whole grain rice and beans
• Whole grain pasta with tomato sauce and parmesan cheese
• Lean turkey and cheese wrap
• Fresh fruit and vegetables

Dinner

• Mixed greens salad with grilled chicken
• Bean soup and whole grain crackers
• Homemade pizza with low-fat cheese on a whole grain crust
• Lean beef stir-fry
• Fresh fruit and vegetables

Snack

• Hummus dip with pita chips
• Low-fat greek style yogurt and fruit
• Cheese and whole wheat crackers
• Carrots or celery with peanut butter

To ensure proper growth and development, the adolescent athlete should be assessed by a physician on a yearly basis (more often if warranted).

Resources

The Coaches Guide to Sports Nutrition, 2007; pp. 200-206; Benardot, D. and Thompson, W.R.

Food for Fitness - Eat Right to Train Right, 2004; pp. 215-233; Carmichael, C.

Office of Dietary Supplements of the National Institutes of Health; Fact Sheet on Calcium; Fact Sheet on Iron

A medicine ball is a great tool to use to improve muscular control and coordination. It also helps to improve balance and dynamic flexibility, two attributes that are important in preventing injury if you have to "catch yourself" from a potential trip-and-fall situation. Furthermore, medicine ball training is a great option for those individuals who want to build strength but have physical limitations/conditions, such as rheumatoid arthritis, that make it difficult to grasp hand held weights or resistance bands. Below are some exercises that will help you to build upper body strength and overall core stability. The weight of the ball that you choose should be heavy enough to challenge your muscles, but not so heavy that form and technique are compromised.

Overhead Lunge - works shoulder, triceps, abdominal, back, hip, buttocks, and thigh muscles

Step One: Stand with feet shoulder width apart and ball level with your navel.

Step Two: Lunge forward with your right leg, making sure to keep your abdominal muscles tight. At the same time, extend your arms above your head. Hold for a count of two. Slowly return to the starting position. Repeat. Perform 2-3 sets of 10 repetitions per side.

Reverse Wood Chop - works shoulder, obliques, abdominal, hip, thigh, buttocks, and back muscles

Step One: Stand with feet shoulder width apart, knees bent, and torso twisted to the left with the ball slightly behind your left hip.

Step Two: In a quick, but controlled, motion raise the ball diagonally upward toward the right while extending the legs to assume an upright position. The motion should end with your arms extended over your right shoulder. Hold for a count of two. Slowly return to the starting position. Repeat. Perform 2-3 sets of 10 repetitions per side.

Lateral Raises - works shoulder and triceps muscles; challenges core muscles

Step One: Stand with feet shoulder width apart, knees slightly bent, and ball slightly below your navel.

Step Two: While keeping your abdominal muscles tight and your back straight, extend your arms until you have raised the ball to shoulder level. Hold for a count of two. Slowly return to the starting position. Repeat. Perform 2-3 sets of 10 repetitions.

Triceps Extension - works triceps muscles; challenges core muscles

Step One: Stand with feet shoulder width apart, knees slightly bent, and the ball held behind your head.

Step Two: While keeping your abdominal muscles tight and your back straight, extend your arms upward until the ball is above your head. Hold for a count of two. Slowly return to the starting position. Repeat. Perform 2-3 sets of 10 repetitions.

Helpful Hints

• The reverse wood chop, lateral raise and triceps extension exercises can be performed while in the seated position.
• Remember to breathe when performing the exercises, exhaling as you lift the ball.

Note: Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

The use of medicine balls (weighted balls) originated in Europe where they were used to improve muscular function in older rehabilitation patients. Their use in the United States became prevalent when Admiral Joel Boone, the White House physician for President Hoover, developed a game known as Hoover Ball to maintain the President's fitness. The medicine ball lost some of its popularity as interest in weight training with machine and free weights increased. In recent years, medicine ball training has made a come back in school, home, rehabilitation, and fitness center settings due to its versatility and adaptability. A countless number of exercises of varying degrees of difficulty can be performed by individuals of all ages and fitness/skill levels. Medicine balls come in different sizes (baseball to basketball) and weights (1-30 pounds). They can be "lifted" to improve strength and stability or thrown to improve power.

Benefits of Medicine Ball Training

• Develops functional fitness, muscle coordination, and core strength. To perform the exercises, your body must perform as a unit. Therefore, the effects of this type of training can be carried over to improve performance of activities of daily living.
• Increases muscular strength and endurance.
• Improves balance.
• Improves flexibility and range of motion.
• In the athletic setting, drills can be performed that mimic movements during a particular sport to help increase power and agility. For example, a drill that involves chest passes with a weighted ball can increase the force with which the athlete passes the basketball during a game.
• Exercises can be designed to be performed alone (e.g., walking lunge) or with a partner (e.g., chest pass).
• Exercises can be modified to account for functional capacity of the individual (e.g., performed seated in a chair rather than in an upright position).

For a change of pace in your workout, try these medicine ball exercises:

Walking Lunge - develops abdominal, thigh, hip, back, shoulder, and triceps muscles

Step One: Stand with your feet shoulder width apart and the ball level with your navel.

Step Two: Lunge forward with your right leg while twisting your upper body to the right, bringing the ball to the right and slightly behind your right hip. Hold for a count of two. Slowly return to the starting position. Repeat. Perform 2-3 sets of 10 repetitions per side.

Lateral Flexion - targets obliques and works lower back and shoulder muscles

Step One: Stand with feet shoulder width apart. Hold ball above your head.

Step Two: Slightly bend at your waist to the left while keeping the ball above your head. Hold for a count of two. Slowly return to the starting position. Repeat. Perform 2-3 sets of 10 repetitions per side.

Squats - works entire core, thigh and upper arm muscles

Step One: Stand with your feet shoulder width apart and knees slightly flexed. Your arms should be bent with the ball at chest level.

Step Two: While tightening your abdominal muscles and keeping your back straight, bend at the knees to assume a squatting position. At the same time, push the ball out in front of you. Hold for a count of two. Slowly return to the starting position. Repeat. Perform 2-3 sets of 10 repetitions.

Russian Twist - works entire core

Step One: Stand with feet shoulder width apart. Hold the ball at waist level, slightly behind your left hip.

Step Two: Swing the ball across your body to just behind your right hip. Then, swing back to the left side. Perform 2-3 sets of 10 repetitions (one full repetition includes swinging to the left and right). Your abdominal muscles should be tight throughout the exercise. Rotating your back foot will increase your range of motion.

Helpful Hints

• Lateral flexion and russian twists can be performed in a seated position.
• Do a 5 minute warm-up prior to training with a medicine ball.
• Start with a lightweight ball. As fitness improves heavier balls can be used.
• Perform medicine ball exercises on 2-3 nonconsecutive days of the week.
• Focus on technique while performing the movements in a slow controlled manner.

Note: Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

Resources:

ACSM's Health & Fitness Journal, Vol. 12, No. 3; pp.7-12. "Medicine Ball Training For Kids: Benefits, Concerns, and Program Design Considerations," Faigenbaum, A.D. and Mediate, P.

Have you been feeling tired lately? Are you lacking the energy to tackle your daily activities? Or, have you noticed a recent inability to keep up with the others in your Zumba class? Some obvious causes of your fatigue could be an insufficient amount of sleep at night or maybe you are putting in extra hours at work. But, your fatigue could be the result of something more than that.

A trip to your physician for a complete evaluation may reveal that you are suffering from iron-deficiency anemia, a condition characterized by a reduced oxygen-carrying capacity of the blood. Iron deficiency is a common nutritional deficiency, especially among active females of childbearing age. Iron is needed by your body to form hemoglobin and myoglobin, essential oxygen-carrying proteins in the blood and muscles, respectively. It is also needed to make enzymes that play a role in energy production. If your body is using more iron than what it is taking in, red blood cell formation and hemoglobin production are impaired.

Low iron levels reduce the oxygen carrying capacity of your blood. If there is not enough oxygen transported to your muscles, fatigue sets in, reducing your endurance capacity during exercise and leading to a general feeling of tiredness throughout the day. Low iron levels can also effect the functioning of your brain, which relies on an adequate supply of oxygen, causing such symptoms as irritability, poor concentration, decreased attention span, and impaired learning. Other symptoms of iron deficiency include a sensitivity to cold, weakness, and impaired immune function.

Who is at Risk?

• Females, particularly active/athletic women of childbearing age, due to iron loss through menstruation.
• Pregnant women who need more iron due to the increased blood volume associated with pregnancy.
• Active individuals/athletes, especially those engaging in endurance exercises. The need for iron in these individuals is increased by approximately 70%. Iron is lost through sweat, therefore heavy sweating could contribute to lower iron levels. Runners can also experience what is called "heel strike" hemolysis in which the red blood cells are damaged as the feet make contact with the ground, thus effecting iron status.
• Children experiencing growth "spurts" which involve quick increases in blood volume and red blood cell formation.
• Vegetarians/vegans because iron consumed from plant-based sources is not as readily absorbed by the body as it is from animal sources.
• Those who consume a diet that is deficient in iron.
• Regular blood donors

What is the Recommended Daily Intake?

• Women ages 19-50 years - 18 mg/day
• Women ages 51+ - 8 mg/day
• Pregnant women - 27 mg/day
• Men ages 19-50+ years - 8 mg/day

Best Food Sources of Iron

• Lean red meat
• Fish
• Poultry
• Liver

Other Food Sources of Iron

• Iron-fortified cereals
• Legumes
• Beans
• Dark-green leafy vegetables (e.g., spinach)
• Blackstrap molasses
• Dried fruit (e.g., raisins)

Factors Effecting Iron Absorption

• Iron found in animal sources is better absorbed by the body because it is in the heme form (myoglobin and hemoglobin, like in our bodies) and, therefore, treated like a protein.
• Iron found in plant sources is in the nonheme form which has to be released by digestive enzymes from the plant structures. Various factors decrease its absorption.
• Consuming Vitamin C (approximately 25-75 mg of Vitamin C) can enhance your body's absorption of iron.
• Cooking foods in a cast iron skillet increases absorbable iron, especially when cooking acidic foods such as tomatoes.
• Caffeine, calcium, zinc, tannins (in tea), polyphenols, and phytates can interfere with the body's ability to absorb iron.

Reversing iron-deficiency anemia can take 3-6 months and may require taking iron supplements. However, you should consult your physician before taking iron supplements because iron toxicity can result. Under normal circumstances, very little iron is lost from the body and so taking an excess can lead to an accumulation in your body's tissues and organs. Abnormally high levels of iron are associated with an increased risk for Parkinsons' disease, cancer, and heart disease. Excessively high levels of iron can also cause congestive heart failure and irreversible liver damage.

If you suspect that you may have iron-deficiency anemia schedule an appointment with your physician. There may be causes of the anemia, other than dietary intake, that need medical attention.

Resources

Vegetarian Sports Nutrition - food choices and eating plans for fitness and performance, 2007; Larson-Meyer, D.E.

The Coaches Guide to Sports Nutrition, 2007; Benardot, D. and Thompson, W.R.

Office of Dietary Supplements of the National Institutes of Health, "Dietary Supplement Fact Sheet - Iron."

ACSM's Health & Fitness Journal, Vol. 9/Issue 2, "Avoiding Exercise-Related Fatigue," pp. 30-32, Rush, S.

Aetrex's iStep Digital Foot Analysis system at the Running Fit store in Novi, Michigan. Employees at the store use this tool to help them identify your foot type and pressure points. This information is then used to help determine the right running shoe for you.

Rachel Ingle, store manager at the Running Fit store, Novi location, explains my results from the Aetrex iStep Digital Foot Analysis system.

The red zones on the monitor of the Aetrex iStep Digital Foot Analysis system indicate the pressure points on the feet.

Buying a pair of running shoes can seem like a daunting task in light of all of the different possible brands and models available on the market from which to choose. Your training needs, foot type, and strike pattern play a role in determining which shoe is best for you. To get the best fit, you should visit a store that specializes in selling running shoes. Here you will find individuals with experience in analyzing your gait and foot type and who have the knowledge of what the various shoe brands have to offer to meet your specific needs. Some stores will even have computer analysis systems like the one pictured above to aid in the shoe fitting process.

While at the store, be prepared to try on several different pairs of running shoes from various shoe manufacturers. Rachel Ingle, store manager of the Running Fit store in Novi, Michigan, recommends that you try on at least 4 different pairs of shoes to ensure you get a proper fit. She also states that you should keep an open mind about shoe brand. Your past favorite running shoe may have been updated and redesigned by the manufacturer; therefore, it may no longer be the best fit for you. Before you head out to the store, review the following key points on foot type and shoe construction and write down any questions you may have so that you are ready to discuss your needs with the shoe sales associate.

Foot Type - Your foot type effects your running pattern.

• Flat Feet - If you have flat feet, you have no, or a very low, arch.
• High-Arched Feet - The opposite of flat feet, high-arched feet have an unmistakable arch between the heel and the ball of the foot.
• Neutral/"Normal" Feet - If you have neutral/"normal" feet you tend to have a medium arch (neither flat-footed nor high-arched).

Use the "Wet Test" to Determine your Foot Type

• Wet your foot with water.
• Step onto a solid, flat surface such as a cement driveway.
• You have flat feet if your foot leaves a complete or near complete impression.
• You have high-arched feet if your foot leaves an imprint with a very narrow band connecting the heel to the ball of your foot.
• You have neutral/"normal" feet if your foot leaves an imprint that shows a wide band connecting the heel to the ball of your foot.

Strike/Running Pattern

• Neutral/Normal - Occurs when your foot strikes the ground on the outside of your heel and then slightly rolls inward.
• Overpronate - Occurs when your foot strikes the ground on the outside of your heel and then excessively rolls inward. People with flat feet have a tendency to overpronate.
• Oversupinate - Occurs when your foot strikes the ground on the outside of your heel but doesn't roll inward enough. Individuals with high arches have a tendency to oversupinate.

Shoe Type

• Motion Control - These shoes are made for individuals who have flat feet. They have a control-oriented design. They tend to be more rigid than other running shoe types. Ingle describes these shoes to have a flat, straight bottom that is wider through the arch. These shoes have a denser/firmer material at the inner side of the arch (called the medial post) to provide stability and to prevent overpronating.
• Stability - These shoes are designed for individuals who have a medium arch and tend to be neutral in their stride pattern. Stability shoes offer a good combination of cushioning and support. Ingle describes these shoes as being less firm than motion control shoes. She also notes that they have a smaller medial post and are narrower through the arch. When you look at the bottom of the shoe it will have a slight curve to it.
• Neutral - These shoes are similar in construction to stability shoes in that, upon looking at the bottom, you will notice a slight curve to the shoe. However, these shoes do not have the dense material on the inner side of the arch. Ingle states that these shoes tend to be more comfortable for individuals with a higher arch.

How Should the Shoe Fit on your Foot?

Expect that your running shoe will be about a 1/2 size larger than your street shoes. According to Ingle, there are 4 points of fit that you and the salesperson should consider.

• Your foot should sit all the way back into the heel counter (the back part of the shoe that cups around your heel). You should not feel your heel slip when you walk.
• Through the lacing it should be snug, but not tight. Your foot shouldn't slip back and forth and you shouldn't feel the edge of the shoe along your foot.
• The toe box (the area between your big and little toe joints) should be loose enough that you are able to grab a little bit of material on the top when you stand.
• At the very front of the shoe, there should be a thumb's width between your toe and the tip of the shoe.

When to Buy New Shoes

• Ingle recommends that your running shoes be replaced every 300-500 miles. "That would be about every 6-8 months if you run 3-5 miles, 3-5 days/week," she states.

Other Points to Consider

• To care for your shoes, do not put them in the washing machine or dryer. This tends to warp the shoes, according to Ingle. If your shoes get wet, she recommends that you take out the insoles and stuff the shoes with newspaper while they air dry.
• Before you run in your new shoes outdoors, Ingle recommends that you do a test run of 3-5 miles on the treadmill. She says this is a good way to tell if the shoes will cause problems with your feet. If you experience problems during this test run, it is likely that the shoes aren't a good fit and that they will continue to cause problems. If this happens during your trial run, then you should take your shoes back to the store and get a different pair (make sure you do not wear them outdoors first, you will not be able to return them if a problem arises).

Keep in mind that the time and money that you invest into getting a well-fitting pair of running shoes is an investment in your health. By wearing old, worn shoes or shoes that fit improperly, you increase your risk for injury. Properly fitted shoes will help to make your journey toward better health more comfortable, increasing the likelihood that it will become a lifelong commitment.

Note: Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

Resources

Rachel Ingle, store manager at Running Fit in Novi, Michigan; 43280 11 Mile Road, Novi, MI 48375; (248) 347-4949; www.runningfit.net

University of Michigan Health System, Sports Medicine Advisor 2009. 1: "Running Shoes: Finding the Right Fit."

Stretching is a good form of relaxation from life's stresses. It promotes circulation, reduces muscular tension, and helps to develop body awareness. The next time you feel that life has taken you one step forward only to push you two steps back, take a few minutes to perform the following stretches to clear your mind and relax your body.

Crescent Lunge - stretches muscles of the abdomen, hip, lower back, front thigh, chest, shoulders, and upper arms

Step One: Kneel on the ground. Lift and bend your right knee, placing your right foot flat on the ground in front of you.

Step Two: While gently tightening your abdomen, lift your arms straight above your head making sure to keep your shoulders down and back. At the same time slightly lean into your right leg at the hips. Hold for a count of 15. Return to the starting position. Repeat. Perform 1 set of 3-5 stretches per side.

Knee to Chest - Stretches muscles of the buttocks and lower back

Step One: Stand with your feet shoulder width apart and your arms to your sides.

Step Two: Lift your left knee toward your chest with your hands. If needed, you may perform this stretch against a wall for balance. Hold for a count of 15. Slowly return to the starting position. Repeat. Perform 1 set of 3-5 stretches per side.

Warrior - Stretches muscles of the abdomen, hip, back, front thigh, lower leg, ankles, chest, shoulders, and upper arms

Step One: Step forward with your right leg. Toes of your right foot should be pointing straight ahead. Toes of your left foot should be pointing slightly in.

Step Two: Bend the knee of your right leg to 90 degrees. Keep a slight bend in your left knee. Slightly lean into your right leg at the hips. At the same time, lift your arms straight above your head. Hold for a count of 15. Slowly return to the starting position. Repeat. Perform 1 set of 3-5 stretches per side.

Extended Triangle - Stretches muscles of the groin, hip, thigh (back), lower leg, ankles, and arches of the feet

Step One: Stand with your feet separated greater than shoulder width apart. Point the toes of your right foot out to the right. The toes of your left foot should be pointing slightly in.

Step Two: From your hip, bend to the right while extending your right arm toward your right foot. At the same time, raise your left hand toward the sky. Do not bend at the knees. Hold for a count of 15. Slowly return to the starting position. Repeat. Perform 1 set of 3-5 stretches per side.

Extended Side Angle - Stretches muscles of the groin, hip, thigh (back), lower leg, and ankles

Step One: Stand with your feet greater than shoulder width apart. Point the toes of your right foot to the right. Toes of your left foot should be pointed slightly in.

Step Two: Bend your right knee to a 90 degree angle. At the same time, extend your right arm down toward your right ankle while reaching with your left arm over your left ear. Hold for a count of 15. Slowly return to the starting position. Repeat. Perform 1 set of 3-5 stretches per side.

Stretching Tips

• Perform a warm-up of at least 5 minutes before beginning stretches (e.g., walking)
• Perform stretches in a slow, controlled, and gentle motion
• Do not bounce while performing the stretches
• Stretch only to the point of tension, you should not feel pain while performing the stretch
• Do not hold your breath while stretching; breathing should be slow and steady
• Do not perform these stretching exercises if you have any musculoskeletal condition that may be exacerbated by the stretches

Note: Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

My son and me before the 4th Annual Kayla O'Mara Memorial Road Race in Goodrich, Michigan.

My son crossing the finish line of his first official road race.

My son and me after the race.

I think many people would agree that, as a parent, there is a little part of you that desires to have your offspring follow in your footsteps. I had the pleasure of experiencing this joy yesterday. My son is on his middle school's cross country team. Their first event of the preseason, and my son's first race ever, was the 4th Annual Kayla O'Mara Memorial Road Race in Goodrich, Michigan. I was given the opportunity to run the race with him, which I eagerly took. I have helped him make his way through many of his "firsts" so far and was excited to be able to be present for a "first" that is so dear to my heart - running.

I strongly believe that all children should be engaged in some type of physical activity, whether it is through a team sport or just riding their bikes for fun around the block. A child that participates in regular physical activity doesn't just develop fitness, but learns the value of such virtues as patience, perseverance, self-discipline, and resilience. My son became a step closer to understanding these concepts from participation in yesterday's race.

Although I ran the race with my son for moral support, I used this opportunity to teach him the strategy for running a race, of which the above virtues all play a role. It was my chance to "pass on the torch" to my son. The most important lesson that he learned from yesterday's race was perseverance. It was the longest distance he has run to date. He started the race apprehensive, but I coaxed him along giving him tips such as "lean into the hill as you run up" and "gravity is your friend running down hill, relax and let it bring you down, this is where you can get an advantage on time." His apprehension subsided but fatigue and muscular discomfort started to set in. He made comments such as "I can't do this, my feet hurt" and "I'm not running cross country again next year!". With these comments I was concerned that the light of the torch would be extinguished. I continued to encourage and reassure him.

In the midst of his misery I pointed out that we were not far from the finish line. As we entered the last leg of the race, and with the finish line in sight, my son got his second wind, "kicking it" in the last few yards to the end. He was handed a medal as he crossed the finish line. His negative thoughts about running were soon replaced with self-satisfaction. He did it and he was proud. So proud that he wanted to get a shadow box to display his medal and race number, and we did. So proud that there was talk about what he would do with medals from future races. Perseverance prevailed and the torch was passed.