Hot flashes, mood swings, sleep disturbances, sexual dysfunction--menopause can place quite a toll on your body! Referred to as "the change" by many, menopause marks the end to monthly menstruation.  Approximately 37.5 million women enter menopause each year.  The average age of onset is 51.3 years, but can occur earlier or later for some.  Although a natural process, menopause can cause disruptions to daily life and put you at a greater risk for the development of certain health conditions, such as heart disease, breast cancer, and osteoporosis.  Regular exercise can help to alleviate some of the symptoms and reduce the risk of various chronic diseases associated with menopause.

What are the symptoms and body changes associated with menopause?

• Hot flashes
• Night sweats
• Sleep problems
• Bone loss
• Weight gain
• Fatigue
• Sexual dysfunction
• Mood disturbances (e.g., irritability, anger, etc.,)
• Depression
• Anxiety/nervousness

How can exercise help ease the transition into menopause?
Aerobic Exercise:

• Promotes weight management and improves body composition, particularly by helping to reduce abdominal fat which has been associated with an increased risk for cardiovascular disease.
• Enhances mood and helps to relieve anxiety.
• Improves quality of sleep.
• Increases energy levels.
• Reduces risk of, and complications from, osteoporosis. Weight-bearing exercise stimulates bone activity, resulting in stronger bones. 

Strength Training Exercise

• Promotes bone health and reduces risk of osteoporosis by stimulating bone activity which strenghtens bones.
• Decreases risk of falls and bone fractures by improving balance and bone and muscular strength.
• Helps with weight management and improves body composition.

Flexibility and Stretching Activities

• Increases range of motion and improves balance resulting in a decreased risk for falls and bone fractures.

Relaxation/Meditation-based Exercises

• There is some scientific evidence to suggest that activities, such as Yoga, may reduce hot flashes during menopause.

How much exercise is needed?

• Current exercise recommendations are to engage in at least 150 minutes of moderate-intensity aerobic physical activity per week, with a goal to increase to 300 minutes of moderate-intensity exercise weekly.  Weight-bearing activities that place demands on the skeletal system are preferable, unless an underlying health condition prevents participation.  Brisk walking, jogging, hiking, and aerobic dance are good choices.
• Strength training exercises should be performed 2-3 times per week on nonconsecutive days.  At least one set of 8 to 10 repetitions should be performed for all major muscle groups of the body.

Exercise is beneficial for everyone; however, women who are experiencing menopause may find it to be of particular benefit to help them manage symptoms and to enhance self-image.

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.

Sources for more information
ACSM Fit Society Page, Fall 2009, "Exercise Recommendations for Menopause-Aged Women," Eschbach, C.

American College of Obstetricians and Gynecologists

The North American Menopause Society

American Council on Exercise

Perhaps you remember walking to school as a kid or have heard tales from your parents depicting their treks to their alma mater "in two feet of snow for three miles up a huge hill" or a similar storyline that has been equally exaggerated about foot travels to school.  Fortunately, it turns out that walking to school offers more benefit to children later in life than just providing them with a few good tales to tell their grandchildren.  According to a study published in the August 2010 issue of Medicine & Science in Sports & Exercise, a walk to school can lower cardiovascular stress reactivity during the school day.

Why is this important?  Cardiovascular stress reactivity is the mean heart rate and blood pressure response to a given situation or stressor.  High heart rate and blood pressure responses to stressful situations in children are associated with the development of cardiovascular disease later in life.  Attenuating cardiovascular stress reactivity in children can reduce their risk. Because children are faced with many challenges throughout the school day that may evoke a stress response, such as peer pressure, exam taking, etc., finding ways to minimize their effects should be explored.

Investigators of the present study examined 40 children (20 males and 20 females) ages 10-14 years.  The children were randomly assigned to one of two testing conditions: a simulated drive to school in which the students sat in a chair and watched a slideshow of images representing a ride through the neighborhood to the school; or, a simulated walk to school in which the children walked at a self-selected pace on a treadmill while wearing a backpack containing 10% of their body weight and viewed images that represented what would be seen on a walk through the same neighborhood to the school. 

After a rest period, both groups of children answered a Stroop color-word test in which they were shown names of colors that were written in a different color than what the name described.  The children had to identify the color of the letters without reading the word.  Heart rate and blood pressure were measured and the children were asked to rate their level of stress using a Likert scale.

The results indicated that the walking group experienced a reduced perception of stress and demonstrated significanlty lower heart rate and systolic blood pressure responses to the Stroop test when compared to the group that underwent the simulated ride to school.  These findings offer one solution to reduce the cardiovascular stress reactivity of children in the school setting. The researchers concluded that walking to school can attenuate the heart rate and blood pressure responses of children to challenges faced at school which, in turn, can have a protective effect against cardiovascular disease in adulthood.

Source of Information:
Medicine & Science in Sports & Exercise, August 2010, pp. 1609-1615, "Effect of a Simulated Active Commute to School on Cardiovascular Stress Reactivity," Lambiase, M.J.

The benefits of participating in school-based sports are numerous. Not only is it a great way for your child to stay in shape, but it provides an environment in which (s)he can develop an appreciation for the importance of team work and a means by which (s)he can ascertain life skills such as conflict resolution and time management.  It also can prove to be a fun way to foster communication and social skills.

Under normal circumstances school sports offer a safe venue in which the student athlete can develop these traits.  However, some children and teens may have an underlying health condition that could put them at risk if they were to participate in physical activity without it being treated or managed.  To protect the health and safety of the student athlete, many schools require a sports physical exam, also know as a pre-participation physical exam (PPE), prior to starting the season.  Even if your child is perfectly healthy, a PPE offers the opportunity for your child to discuss personal issues, such as sexual activity and drug use, with the physician that (s)he may not want to openly share with you.

Purposes of the pre-participation exam:  

• To identify life-threatening situations.
• To assess the musculoskeletal system to rule out conditions that could cause discomfort during physical exertion (e.g., tendonitis).

The PPE basically consists of two parts: the medical history and the physical exam.

Information obtained from the medical history:

• Health conditions present at birth.
• Past illnesses and injuries (e.g., bone fractures, sprains, concussions, etc.,).
• History of surgical and non-surgical procedures.
• Current health condition (e.g., allergies, asthma, etc.,) and symptoms (e.g., shortness of breath, wheezing, etc.,) experienced.
• Current lifestyle habits (e.g., diet, exercise, sexual activity, and drug, alcohol, and tobacco use, etc.,)
• Immunization records.
• Questions regarding menstrual activity for female athletes.
• Family history of congenital (at birth) health conditions and/or chronic diseases (e.g., diabetes, heart disease, etc.,).
• List of current medications, if any.

What to expect during the physical examination:

• Height and weight measurements.
• Assessment of heart rate and blood pressure and, in some cases, an electrocardiogram (heart rhythm).
• Evaluation of visual acuity and hearing sensitivity.
• Assessment of motor reflexes.
• Palpitation of pulse points.
• Evaluation of blood and urine samples.
• Examination of the cardiovascular system (e.g., listening to the heart and lungs via the stethoscope), eyes, ears, nose, mouth, throat, abdomen, and genitalia.

Depending on the results of the PPE, your child may be referred to a specialist for further evaluation.  It is a good idea to bring a list of medications and questions with you to present to the doctor. If your child is old enough, you may want to stay in the waiting room, at least part of the time, so that your child has an opportunity to discuss any personal questions with the physician privately.  It is important that you and your child completely and honestly answer all of the physician's questions to increase the student athlete's chances of experiencing a safe sports season.

Resources:

ACSM Fit Society Page, Summer 2009, "Pre-Participation Physical Examinations," Rich, B.

As some freshmen head off to college this fall, they will be gaining more than just knowledge - they will be putting on a little extra weight.  Many factors, such as heavy class loads and longer studying periods interrupt normal sleep and eating patterns and make less time for physical activity.  And, all too often, late night studying while eating pizza is the norm.  Although some view the "Freshmen 15" as a "rites of passage," the additional pounds can have some negative health consequences later in life.

Last year, The American Council on Exercise (ACE) released these recommendations to help freshmen keep their weight, and health, in check.

• Get Active:  Instead of hitching a car ride with your roommate, walk or ride your bike to classes and other areas on campus.  Also, consider enrolling in courses that require you to be physically active during the class.  In addition, many colleges and universities have a campus recreation center which provides an opportunity to participate in intramural sports and/or group fitness classes.  The exercise will not only help you to control your body weight, but can reduce stress as well; thus, improving your overall health.
• Make Nutritious Choices:  No one is saying to completely nix the pizza and study party, but moderation is key.  Opt for one slice and fill up on fruit and veggies.  Better yet, grab a whole grain bagel and top with low-sodium tomato sauce and reduced-fat cheese to satisfy your pizza craving without the additional calories and fat.  Many dorms will allow you to have a mini refrigerator in your room and some even have microwaves located in community gathering rooms that can be accessed to make quick and easy meals and snacks.
• Eat Breakfast, Lunch, and Dinner:  Research shows that those individuals who eat a daily breakfast are more likely to maintain a healthy weight.  It is a good idea to keep non-perishable foods, such as whole-grain cereal (which can be eaten dry if need be) and meal replacement bars, stocked in your dorm room for those days that your class schedule interferes with your ability to make it to the campus dining hall.
• Choose Healthy Snacks:  Your brain needs energy to tackle long studying sessions.  However, foods high in fat and sugar will just leave you sluggish and drained a few hours later.  Choosing snacks that have a good balance between protein and carbs is the best way to go.  Yogurt and low-fat granola or a handful of nuts and dried fruit make great snacks that will give you the mental stamina you need without the "bottoming out" effect.
• Stress Be Gone:  Stress leads to an elevation in cortisol levels which can trigger appetite.  Try to manage stress through relaxation techniques and take regular study breaks.  Deep breathing exercises and walking are good ways to relieve stress.
• Don't Underestimate the Power of Sleep:  Unfortunately, "college life" can interfere with your sleep schedule.  Lack of quality sleep can lead to weight gain.  Research has shown that sleep deprivation can interfere with hunger regulation leading to an increase in appetite and cravings for fatty and sugary foods.  Ideally, you want to get 8 hours of sleep.
• Alcohol Equals Calories:  Most freshmen are not of legal drinking age anyway.  However, if you are of age, recognize that alcoholic beverages can contain high amounts of calories.  Alcohol also can stimulate the hunger center leading to consumption of unnecessary calories.  Avoid or limit alcohol consumption.

The "Freshman 15" is not inevitable.  Making adjustments that allow for adequate amounts of exercise and consuming a balanced, nutrient dense diet can help ward off weight gain.  Make your healthy lifestyle habits social - invite your roommates, fraternity brothers, sorority sisters, and other friends to join you in your efforts.

Resource:
The American  Council on Exercise