Primary Care for Low Back Pain: We Don’t Know the Half of It

Author: Frank M. Painter

Evidence-based medicine helps health care professionals and patients decide best care, drawing on research about effectiveness and safety of interventions. Systematic reviews summarise the evidence; guidelines report consensus between experts (including patients) on interpreting it for everyday practice. Although guideline recommendations are only one component of shared decisions that will vary patient-to-patient, the hoped-for outcome is health benefit for each individual. Guidelines also inform starker decisions by policymakers and health care leaders — for example, when to withdraw approval or funding for a poorly evidenced or harmful intervention. To assess whether all this research-driven activity is useful, 2 questions need answering: how well are guidelines followed in real-life practice and do patients benefit in the long-term?

In a new systematic review, Kamper et al. tackle the first question in relation to first-contact care for patients with low back pain provided by family practice and emergency department physicians. As the authors state, low back pain has major significance for the international pain community. It is the leading single cause of years lost to disability globally, and there is good evidence for what constitutes best first-contact treatment. The review selected best-quality studies of routine health care data to investigate whether first-contact physicians are putting back pain guidelines into practice (“usual care”). The results paint a bleak picture: only a minority of patients apparently receive simple positive messages to stay active and exercise, while inappropriate use of analgesia and imaging persists. The review adds to evidence that the care doctors give patients with low back pain is dominated by guideline-discordant interventions that are unnecessary, expensive, and “low-value” (ie, harm is more likely than benefit).

These findings are not entirely unexpected nor, as the authors point out, should blame be placed entirely at the door of front-line physicians. Qualitative studies reveal family practitioners agreeing with guideline conclusions but frustrated in implementing them by factors such as patients with complex needs or lack of resources for behavioural interventions and rehabilitation.

Furthermore, physicians will point to the nuances of individual patients who do not neatly fit the template for guideline recommendations. The review’s authors acknowledge this when discussing the difficulty of measuring “appropriateness” of physician requests for imaging.

The review did not study nonphysician primary care providers. Many such practitioners deliver care aligned with guidelines, such as advice about activity and exercise. More allocation of first-contact low back pain care to professionals such as physical therapists [AND chiropractors] could help to address the problem of inappropriate care. However, although some back care, such as imaging requests by physical therapists, may be more guideline-concordant, a recent systematic review indicated physical therapists have low adherence generally to guidelines for musculoskeletal pain, and a comparison of nurse practitioners and physicians in primary care revealed similar rates of unnecessary imaging requests.

It is increasingly clear that simply expecting individual clinicians to adhere more closely to guidelines is not going to close the evidence-practice gap. Recent articles have argued that effective “high-value” care for patients with low back pain (“benefit more likely than harm”) will only be achieved through large-scale top-down changes across health and social systems (“system strengthening”).

Such changes include engaging policymakers, politicians, and profession leaders to change laws and reimbursement practices; addressing counterproductive commercial pressures; creating incentives for optimal care; providing adequate resources for delivery of guideline care (including digital innovation); shifting professional education and training toward high-value care, including nonpharmacological approaches; dissolving boundaries between health care professions to create unified programmes of care; and changing culture and pain literacy among patients and populations to encourage prevention and positive health activity. The success of such innovations, however, cannot be taken for granted and will need evidence that they bring long-term patient benefit.

There is a second important issue highlighted by the authors of the review — the scarcity of relevant information to answer their question “how well are back pain guidelines implemented?” The review focused on studies reporting actual clinical care because it was recorded in health care or insurance databases. A challenge for data collection systems, particularly in family practice and emergency departments, is how to ensure such records include all aspects of care. Prescription medicines, imaging requests, and referrals to other services tend to be routinely recorded, whereas the nature and detail of patient assessment, and the content of advice and information given, often go unrecorded. Absence of data may mean either care has not been delivered — or it has been delivered but not recorded. Thirty years after randomised controlled trials reassured patients that an average low back pain episode did not require a week in bed, there is no high-quality data on what primary care physicians have been advising about bed rest.

This absence of information about relevant areas of the primary care consultation should concern us as much as the size of the evidence-practice gap or how to close it. Having the right information will itself help change policy and training and behaviour about guideline treatments, for example, by easing the path to audit as a means to improve practice. The “finely grained” information the review calls for (such as linking prescription records with the indications for prescribing) would address concerns that health care databases do not currently convey all the nuances of decision-making — not all imaging requests are wrong, not all opioid prescriptions are wrong-headed.

The authors of the review could find no high-quality studies using actual practice data from first-contact low back pain care in low- and middle-income countries (LMICs). This is of particular concern because LMIC populations are being exposed to technology and treatments for low back pain (such as opioids) that high-income countries have popularised and made profitable but that are often inappropriate and harmful. Low- and middle-income countries need appropriately strong systems to support delivery of high-value care, including guideline-concordant approaches to low back pain prevention and care that align with local practices and cultures of health and wellbeing. Achieving data collection systems and routine analysis to document low back care is a plausible investment target for LMIC populations such as Nepal that are digitally equipped even when geographically remote11 but will be hindered while pain research has no priority and remains focused on low-value items of care.

It is a strange situation to contemplate. In an information-dominated world where people’s purchasing actions are instantly known, retrievable, linked to other data, and acted upon, the [medical or “usual”] care that most people are receiving for the world’s leading cause of long-term disability is not known because it is either not recorded or the data are not accessible or reported. The challenge to digital science and modern informatics is how to record and retrieve this information without overloading already busy clinicians or saturating patients with data collection. But, along with the challenges and the risks, there is the potential for new technology to change and improve delivery of health care globally for conditions such as back pain.

The case revealed by Kamper et al. for having more accessible, better organised, well-resourced, easily collectable information about the daily content and outcomes of consultations for this most common of disabling pain conditions is clear. The international pain community, in collaboration with health care data scientists, should get behind it.

The Importance of Healthy Eating

Have you ever heard the saying you are what you eat? In some sense, this is true, because if you eat unhealthy foods you are prone to be an unhealthy person. The foods we ingest are extremely important to our ability to grow, maintain function, and prevent illness. Therefore, if you value your health, you should learn as much about healthy eating as possible.

Healthy eating is important from the day we are born. As a child, we grow quite rapidly and this is due in part to the foods we eat. Foods all contain nutrients that provide us not only with fuel to live our daily lives, but also with the very substances that build our bones, muscles, and organ tissues. Not getting enough of one nutrient or another can cause a variety of problems, including stunting our growth. For mothers who are nursing, nutrition is important because breast milk contains the nutrients a child needs to grow and develop properly. Upon growing older, these nutrients are then found in food, but don’t think that healthy eating isn’t important for growth after you’ve gone through puberty. Cells continuous break down and rebuild, so healthy eating for growth continues to be important until the day we die.

Maintaining function is also not important without healthy eating. In out daily lives, we use energy to think, walk, talk, breathe, and perform any other action. The energy it takes our body to do these things comes from two places: fat reserves in the body or our daily food intake. If you don’t eat healthy foods, you will find that you are storing more fat that necessary or that you aren’t getting enough and you feel sluggish or weak. Along with energy-providing nutrients, like fats and carbohydrates, we also need the right nutrients to allow our organs to do their jobs. Hormones and other substances in the body make sure that everything is working properly. If you don’t eat the right nutrients, your body cannot produce these hormones and, as a result, cannot function properly.

Lastly, healthy eating is important in order to prevent illness. When we do not get the right nutrients, or body’s natural defense system against diseases weakens, allowing viruses and bacteria to attack the body. It’s like a well-trained army—if the army doesn’t have enough to eat, it will not do well in battle. Without healthy foods and plenty of water, our bodies simply could not operate on a day-to-day basis. Learning how to eat healthy foods is therefore and important lesson, and one which we should begin learning as children.

The Benefits of Yoga

Yoga, as you may know, is practiced by millions of people throughout the world for several good reasons. It has been around for thousands of years now and it is continually gaining popularity for a number of benefits that it is capable of giving.

Well, speaking of benefits, one may find the benefits of yoga countless. There are too many of them to mention, but all are tailored to one particular purpose – to maintain better health and well-being through the unity of the mind and body. The benefits of yoga can be classified into three categories according to where they may occur: physical, mental and spiritual.

Physical Benefits of Yoga

Yoga is in the first place a philosophy composed of exercises that is highly capable of making the physical body as healthy as possible. Several claims have it that the exercises involved in the practice can help increase the muscle strength of a person. It strengthens the muscles and joints in the back and abdominal muscles, which are but two of the most vital elements of the spine’s muscular network which works to help the person obtain a proper posture.

The yoga can also aid relaxation. It is said to alleviate pains and stress not only in the muscles, but in the entire body. This benefit is made possible by the yoga movements that involve stretching, as well as for the breathing exercises which are done throughout the practice.

Most of all, the practice of yoga will make you aware that your body has its own limitations. Knowing this fact will help you prevent all sorts of injuries and bodily imperfections knowing that you already know what and what not to do.

Mental Benefits of Yoga

It is believed that if you are doing the yoga techniques regularly, there is a great possibility that you will be relaxed to the highest possible level. You can also handle certain situations that are stressful more easily. And, most of all, you will know exactly how to encourage yourself to think about positive thoughts. Recent researches have further revealed that the mental benefits of yoga may also include self-acceptance.

Spiritual Benefits of Yoga

In terms of spiritual benefits, yoga is deemed to be so potent for making you aware of everything about your body, as well as your emotions and the feelings of others. Many of the expert yogis even claim that practicing the yoga exercises will help promote a sense of interdependence that may involve not only the body, but also the mind and spirit. This is actually where the idea of “oneness” comes in.

20 Minute Home Work Out

Self quarantine home work-out.

1) Jog : in one place for 3 minutes

2) Jumping Jacks : 25 repeats
When landing, bend your knees slightly to reduce the impact on knee joints.

3) Crunches : 15 repeats
Lie flat on your back with your knees bent. Place your hands behind your head with elbows pointing outwards. Support your neck with your hands. Keep your neck in a straight line with your spine. Flex your waist to raise the upper torso from the mat. Lower yourself until the back of your shoulders touches the mat.
Muscle worked: rectus abdominis

4) Hip Bridges : 10 repeats
Lie on your back. With your hands at a 90 degree angle to the floor, lift your body off the floor to form a straight line, a sort of a bridge, from the shoulders to the knee. The position should resemble a table … your hands and legs as the legs of the table and your upper body to your knees as the surface. Hold this position for two seconds. Squeeze your gluteus (butt muscles) and then lower yourself.
Muscle worked: Lower back, hamstrings and gluteus.

5) Step – Up’s : 1 minute
You will need a stepper for this.
Muscle worked: hamstrings, gluteus, quards.

6) Reverse Crunches: 15 repeats
Lie on your back with your hands on your sides. Keep you knees bent. Bring your knees towards your head, till your hips come slightly off the floor. Hold this position for a second, and then lower your knees.
Muscle worked: lower abs and obliques.

7) Mountain Climbers : 1 minute
Get your hands and knees and raise your knees like a starting block sprinter. Run in that position, supporting your upper body with the palms of your hands. Keep your back straight.
Muscle worked: triceps, deltoid muscle, gluteus, quards, hamstrings, calves.

8) Push – Ups : 15 repeats
Muscle worked: triceps, deltoids, pectorals.

9) Squat Thrusts: 1 minute
Stand straight. Now, drop to a crouch position. Immediately thrust your legs out straight behind on your toes, in push up position, now jump to pull legs back to the chest, in crouching position , then stand up straight,
Muscle worked: arms, legs, chest, and lower back.

Cool down by walking around, till your heart rate starts getting back to normal, stretch.

A minutes rest is needed in between exercise. Proper form is important. Do not hold breath. Sip water during the workout. This workout targets the whole body, improves cardiovascular efficiency and tones and strengthens the body.

Tips for healthy eating with fruits and vegetables

Everyone knows the importance of a diet rich in healthy fruits and vegetables. Most people do not eat enough of these important foodstuffs, and increasing your consumption of fruits and vegetables is probably the single most effective thing you can do to improve your overall health. Eating enough fruits and vegetables does not need to be chore. After all, fruits and vegetables are delicious, easy to buy and easy to use.

In addition, fruits and vegetables are rich sources of antioxidants, which are though to play an important role in maintaining good health. Antioxidants have been studied for their effectiveness at preventing cancer, heart disease and even reversing the signs of aging. In addition, fruits and vegetables are excellent source of trace elements and other micronutrients. These important elements are not available in any vitamin pill; they must be obtained from the daily diet.

Tips for choosing the best fruits and vegetables:

  • When possible, choose fresh fruits possible. Fresh fruits and vegetables may contain more nutrients than frozen or dried varieties.
  • Even though fresh is best, frozen and canned vegetables are great for out of season varieties. When buying canned fruits, avoid those packed in syrup and opt for those packed in water or juice.
  • Choose fruits and vegetables in a variety of colors. Not only are bright, colorful fruits more attractive, but the different colors indicate different types and amounts of nutrients. For instance, yellow and orange fruits and vegetables are good sources of beta carotene, while dark green leafy vegetables are rich in vitamin C and calcium.
  • Be careful when cooking vegetables. A quick steam in the microwave with minimal water added is the best way to prevent loss of nutrients when cooking.
  • Keep your vegetables healthy by adding minimal butter, margarine and oil. Most vegetables can be flavored using a stock, a low fat yogurt or fresh fruit pieces.

Understanding portion sizes
We have all heard the government recommendations that we eat 5 to 10 servings of fruits and vegetables per day. This talk of servings and portions can sometimes be confusing, so let’s take a look at just what a serving consists of.

A serving of a fruit or vegetable can be:

  • A medium sized piece of fruit, such as an apple, banana or orange
  • One large slice of a fruit like a cantaloupe, melon or pineapple
  • Two pieces of small fruit, such as a kiwi fruit or plum
  • One cup of strawberries, raspberries or grapes
  • One half cup of fresh fruit salad
  • One half cup of stewed or canned fruit
  • One quarter cup of dried fruit
  • One half cup of 100% pure fruit juice
  • One half cup of cooked, canned or frozen vegetables
  • One side salad

Unlike with many other types of foods, more is better when it comes to fruits and vegetables. When planning and preparing meals, it is important to plan ahead and include as many servings of fruits and vegetables as possible. Proper meal planning and shopping are the best ways to meet the five a day minimum recommendation for fruit and vegetable consumption.

Some tips for healthier living:

  • Stock the fridge with healthy snacks like celery sticks and carrots
  • Keep a bowl of fruit, stocked with healthy attractive fruits like oranges, apples and bananas, on the kitchen counter and dining room table
  • Drink a glass of 100% pure apple, orange or grapefruit juice every morning
  • Warm up a cold day with a steaming bowl of vegetable soup
  • Eat at least one salad every day. Experiment with different salad additions, like broccoli, sprouts, carrots and green peppers.
  • Snack on fruits like apples and oranges. Dried fruits like apricots and raisins also make handy and nutritious snacks
  • Add sprouts, cucumbers, lettuce and tomatoes to sandwiches for extra variety
  • Garnish meals with chopped or grated carrots
  • Strive for at least two servings of vegetables at each evening meal
  • Use your creativity to create exciting vegetable stir fries for family and friends
  • Spice up the grill with vegetable and fruit kebabs
  • Use baked apples and pears as great low calorie desserts
  • Add vegetables like carrots, cabbage, onions, lentils and peas to soups, stews and casseroles.

About Vitamin C – The Wonder Vitamin?

Copyright 2006 Donovan Baldwin

Vitamin C (Ascorbic Acid) may possibly be a “wonder vitamin” in some people’s books. A lot of claims have been made for it in the past few years, not the least of which was Dr. Linus Pauling’s claims for its ability to prevent and lessen the duration and intensity of the common cold when taken in large doses.

Unfortunately, although vitamin C is anti-viral and does support the immune system, it is not necessarily a magic bullet that will defeat the common cold or even cancer! In fact, some recent studies seem to be indicating that Dr. Pauling’s claims might be a little overstated.

Vitamin C, like most other vitamins and mineral supplements primarily helps the body do its job effectively. Deficiencies of vitamin C CAN predispose the body to certain ills, and proper intake either through daily diet or vitamin supplementation can HELP prevent certain conditions and illnesses. Vitamins and mineral supplements should never be used as the only path to health, but should be part of a lifestyle that includes overall attention to nutrition, activity (okay, exercise), proper rest and sleep, and enjoyable forms of recreation and relaxation. I personally would throw in yoga and meditation, but those are MY enjoyable forms of recreation, relaxation, and exercise, I guess. You will have to find what works best for you.

SOURCES

Vitamin C is a water soluble vitamin, and, as such, is not stored in the body. This means it must be regularly replaced by diet and/or supplementation. The most commonly recognized sources of vitamin C are citrus and other fruits – oranges, tangerines, limes, guava, lemons, papayas, strawberries, black currants, grapefruit and mangoes – as well as a wide range of vegetables. Some vegetables which contain Vitamin C include collard greens, sweet and hot peppers, broccoli, tomatoes, brussel sprouts, cabbage, potatoes, kale, spinach, and watercress.

AFFECTS

Vitamin C is a nutrient valuable for tissue growth, protection of cell membranes from toxic wastes, wound healing, and, as mentioned, support of the immune system. It supports the growth of collagen and cartilage, protecting in this way against many of the effects of aging.

As an antioxidant, vitamin C helps combat free radicals, and it may help with cancer, high cholesterol, cataracts, diabetes, allergies, asthma, and periodontal disease.

The effectiveness of vitamin C is believed to be increased when taken with vitamin E.

DOSES

The recommended daily intake of Vitamin C is 60 mg per day for adults, although many people, following Dr. Pauling’s lead, take much higher doses in hopes of preventing colds and warding off the effects of aging. However, in higher doses there may be some toxicity with one of the side effects being diarrhea. In some cases, higher doses of vitamin C may cause kidney stones or anemia, due to an interference with the absorption of vitamin B12.

A reminder: vitamin C is water soluble, and unused portions will be flushed from the body, so daily intake of foods rich in vitamin C or supplementation with a multivitamin may be of value.

While there do not seem to be major problems associated with an high doses of Vitamin C, it might a good idea to stick within recommended daily allowances since the jury is still out on side effects.

DEFICIENCIES

The most well-known result of a vitamin C deficiency is scurvy, a condition characterized by weakness, anemia, gum disease, and skin lesions. Fortunately, scurvy is very rare in our modern society although still found to a greater degree in areas of poor nutrition.

Frequent infections, severe colds, nose bleeds, tiredness, and painful joints may also indicate a deficiency.

Stomach Exercises to Eliminate Belly Fat

Now that spring seems to finally be back in our lives, many people are concerned about losing those few extra pounds of chub which stand between them and a sculpted midriff. Those folks who let themselves go a little in the winter months may be working overtime now that it is March and thoughts of bikinis are dancing in their heads. The good news is that there are, of course, stomach exercises to speed along the process. Some are better than others, including these few, which are good specifically for trimming belly fat. As with any workout routine, be sure to consult a professional before beginning and always warm up properly to avoid injury.

Hip Lift
For this stomach exercise, you will need to lie on your back on a flat surface, such as the floor. Use a mat or towel to cushion your spine. Put your arms at your sides with palms facing up to the ceiling. Put your legs straight up in the air so that the soles of your feet are facing the ceiling and your legs make about a ninety degree angle with your torso. Keep your knees unbent and as straight as possible. Now, contract your ab muscles so that it feels like your belly button is being pulled toward your spine, while at the same time gently lifting your hips off the floor. Raise your hips to height of a few inches, keeping your legs extended straight upward. Hold this position, then slowly lower your hips back to the floor. Repeat for an entire set.

Seated Torso Twist
Stay on the floor for this stomach exercise, getting into a seated position. Bend your knees so that your feet are flat on the floor. Position your feet about hip width apart. Extend your arms straight out in front of you, interlocking your fingers. Contract your abdominals and lean back about forty-five degrees. Holding the contraction, rotate your torso as far to one side as you are comfortably able. Use your abdominals to control this motion so that your upper body moves at once, do not lead with your arms. Remember to keep your arms in from of you with fingers locked– pretend you are aiming an imaginary gun. Once you have rotated as far as you feel comfortable, rotate back to center, then to the other side. Repeat these steps for an entire set. Take care to go slow and keep a controlled movement. Do not allow your momentum to twist you.

Staying Motivated: An Important Factor in Weight Loss

If you are attempting to fight fat, it is simply not enough to begin an exercise program. You must also be able to stick with it. This can be challenging, especially if you have spent most of your life as a couch potato. You may find exercise to be boring or a chore. And you may be wondering whether your exercise program is really worth the effort.

It should be noted that the key to a successful exercise program is perseverance. This means that you need to commit to it for the long haul—in fact, it is best if you commit to it for the rest of your life. Certainly, it can be difficult at times. But in the end, it is well worth the effort you exert.

Staying motivated may begin with having a tangible goal. For instance, if you are basically inactive when you start your program, you should aim to burn off 500 calories a week. If you are fairly active when you start exercising, your goal should be 1,000 calories. But you must also have a long-term goal. This might be doubling the amount of calories you burn within six months of commencing your exercise program.

You might consider starting an exercise log. Here, you will record exactly what kind of aerobic, anaerobic, and stretching exercises you do each week. Be sure to include the number of repetitions you’re performing with each exercise. This way, you’ll have a concrete chart for your progress. Seeing how well you’re doing can be truly inspiring and can keep you going when you find it difficult to go on.

Another effective motivational strategy is to join a group that engages in some kind of exercise. For instance, you might become a mall-walker or you might find a local square dance club to join. Other possibilities include hiking groups, golfing groups, softball teams, or even ping-pong teams. The fact that you are part of a social network will help to keep you motivated.

You might try psyching yourself out by using a computer screensaver which says, “Get moving.” Or you might post a “get moving” sign on your refrigerator. In other words, you should be constantly reminded of the value of exercise. You might also invest in home exercise equipment such as a treadmill, elliptical trainer, or free weights. The amount of money you spend could be a powerful incentive for making sure that you use the equipment on a regular basis. You should also place the equipment in a prominent place so that you have to pass it often. After a while, you’ll find no excuse not to exercise.

You might also consider investing in exercise videos or DVDs. These allow you the convenience of exercising in the privacy of your own home. They can also give you an electronic “exercise buddy” who can help keep you inspired even on rainy days when you don’t feel like exercising at all.

Another effective idea is to place your athletic shoes near the door so that you are reminded of the need to walk rather than drive. You might also consider rewarding yourself for keeping with your exercise program. Your reward could be as elaborate as a cruise or as small as a treat from the dollar store. The idea is to make sure that your accomplishment is celebrated.

While we’re on the topic of celebration, seriously consider throwing a party once you’ve reached an exercise milestone. You can serve nutritious snacks and beverages and even encourage your guests to come in their athletic wear in order to build upon the party’s theme. Sharing your joy can help to motivate you to continue your physical activities.

It should be said that there is no right way to exercise. But you do need to make sure that whatever you do is effective and that you’re sufficiently motivated to do it. By following just a few simple tips, you can ensure that your exercise routine is not just a fad, that it will continue over the long term. Remember that you may face setbacks from time to time, but that shouldn’t stop you from continuing to try to reach your exercise goals.

Cholesterol and the effects on Men and Women

There are some people who may deny that there are differences between the sexes when it comes to cholesterol, but you should know that rather or not you are being affected from high cholesterol. You will find that many scientists will help you to determine the differences between men and women so that you can determine how cholesterol affects you. You should know that men and women have different hormones and you will find that cholesterol also works in a different way. With you do the proper research, you can learn about the differences in steroids in your body.

You will notice that men are less likely to care about what they eat, but they are less likely to exercise for the benefit of being healthier, but it’s more to look better for the other sex. They are also a lot less likely to go to the doctor for a problem that could be something serious. For these reasons men run a higher risk of having high cholesterol at an earlier age.

It may be obvious those women are more likely to be healthier with their lifestyles. However, this doesn’t mean that they are not at risk for having high cholesterol or avoiding heart disease. Did you know that women are less likely to respond quickly to a heart attack then men? Even though many women think that breast cancer is the top health risk for their gender, this is actually not true—its actually heart disease. There are so many women who believe that they need to worry about breast cancer, but they really should think about their chances of having a heart attack. This is why drastically higher numbers of women die of their first heart attack when compared to the number of male fatalities for the same reason.

Even though men and women are very different, you will find that there is one thing that both of the sexes have in common and that is being able to change the future. Yes, it’s true you can change your future by starting to become healthy and maintaining a healthy cholesterol level. You will find that if you start yourself on a diet that will limit you fat intake, you may be able to save yourself from a heart attack.

You will find that there are saturated fats, sugars, and alcohol that you are going to have to avoid in order to decrease your cholesterol, however, remember that the body does need some fats and sugars for it to perform. You will want to do everything that you can to stay active and also maintain a healthy life.

You will find that you can control your weight and with that you will be able to increase your good cholesterol, but you will also be able to decrease the cholesterol. You may also want to take some fiber supplements so that you can keep your cholesterol levels just right and you’ll be able to dispose the bad cholesterol before it enters your blood stream. There are some many things that you can do to keep your cholesterol under control, but you will want to consult your doctor about what is best for you.

When Trying to Lose Weight, Don’t Forget to Exercise

A startling statistic has been circulating over the Internet. This stat claims that half of all those who want to lose weight don’t exercise. While this might seem mind-boggling at first, it is not entirely surprising, when you stop to consider what American culture has become.

In the early days of the republic, the majority of Americans did hard labor on farms. They were used to exercise during their normal workday, so they ate large meals in order to give them the energy they needed to complete their tasks. There weren’t any Oprah Winfreys around back then to question their eating habits.

In the 19th century, Americans began moving into cities to take factory jobs. Again, they spent much of their time on their feet. Many walked to work and to school, so exercise was a part of their normal routine. They didn’t have to worry about doing Pilates or strength training, since ordinary life afforded many opportunities to exercise.

Fast-forward to today. Many people have sedentary jobs, working on computers, working at desks, working at cash registers. They have little opportunity during their work days to move, let alone get up and stretch. At home, they may spend much of their time sacked out in front of a television set, or on their home computer.

However, studies have proven that the best weight loss plan combines sensible diet with exercise. Certainly, you can reduce your calorie intake. But it is also important to boost your metabolism, and that is best done through an exercise routine. Since you must burn a phenomenal amount of calories in order to lose pounds, exercise is crucial to long-term weight loss success.

But what if you don’t enjoy exercise? How can you possibly start an exercise program?

In short, you need motivation. This can come from a variety of sources. For instance, you might want to play your favorite up-tempo music during your exercise drills. This can provide the incentive you need in order to get moving. Another motivator can be to exercise with your children in tow. This could mean doing jumping jacks with your kids, or jogging while you push a stroller. You might also consider joining a “Mommy and Me” exercise class. Another winning strategy is to employ the services of an exercise buddy. This can be your mate, a friend, or even your mother. You can encourage each other, helping each other to overcome various hurdles to regular exercise.

Another strategy is to base your exercise program on something you really enjoy. Even those of us who are not athletic usually have some physical activity that we look forward to, whether it’s volleyball or tennis, bowling or swing dancing. The type of activity isn’t as important as the fact that you are engaging in it regularly.

If at all possible, you should add strength training to your exercise regimen. Lifting weights can boost your metabolism, causing you to burn calories while also adding muscle to your frame. Strength training can also help you to guard against osteoporosis and other health problems.

You might also consider hiring a personal trainer. He or she can act as your coach, urging you on when you feel like quitting. A trainer can provide you with the inspiration necessary to achieve your weight goals. It has also been shown that those who employ a trainer reach their optimum weight faster than those who do not.

You should also prioritize exercise. You should mark it in your daily planner and stick to a regular exercise schedule. The important thing is to make exercise a regular part of your life. It should not be limited to special occasions, or those times when you are in the mood. It needs to be as regular as breathing.

In order to be a healthy person, you simply need exercise. And exercise is also beneficial to your mind as you begin your weight loss program. It can clear your head and help you to work out your frustrations. In short, it can give you a sense of accomplishment that will put you in the right frame of mind when trying to shed weight.