Authors: Ksenia Power, M.S., Sara Kovacs, Ph.D., Lois Butcher-Poffley, Ph.D., Jingwei Wu, Ph.D., and David Sarwer, Ph.D.

Corresponding Author: Ksenia Power, PhD Candidate 1800 N. Broad Street, Pearson Hall, 242 Philadelphia PA, 19122 tug82764@temple.edu 267-766-8938

Ksenia Power is a Doctoral Candidate and an Instructor of Record in the Department of Kinesiology at Temple University, majoring in Psychology of Human Movement. She is also a Volunteer Assistant Womens Tennis Coach at Temple University.

ABSTRACT

Over the last three decades, a large body of research has examined the issue of eating disorders, both formal diagnoses and subclinical features, as well as compensatory behaviors in National Collegiate Athletic Association (NCAA) athletes. In general, this literature suggests that large numbers of student-athletes engage in disordered eating and compensatory behaviors; smaller percentages have symptoms that reach the threshold of formal diagnoses. Increased symptoms are associated with reduced athletic and academic performance, both of which may impact psychosocial functioning later in adulthood. Unfortunately, a number of methodological shortcomings across this body of research (e.g., studies with insufficient sample sizes, inappropriate comparison groups, and suboptimal or biased psychometric measures) limit the confidence that can be placed in these findings, underscoring the need for a new generation of studies. This paper provides an overview of this literature, focusing on issues of gender differences, sport type, and age. It also highlights the relationship between disordered eating and compulsive exercise, a compensatory behavior that is highly prevalent among collegiate athletes. The health and athletic performance consequences of eating disorders in conjunction with compulsive exercise are also discussed. In addition, a focus on more recently recognized eating disorders, such as binge eating disorder and the night eating syndrome is underscored. Future work in this area needs to include the most methodologically rigorous measures available in order to aid most appropriately coaches and athletic trainers in promptly identifying at-risk athletes and to inform future prevention and treatment efforts.

Key words: eating disorder, disordered eating, compulsive exercise

INTRODUCTION

Over the past decade, a number of studies have examined the symptoms of disordered eating among National Collegiate Athletic Association (NCAA) athletes (9,12,13,24,30). Up to 84% of collegiate athletesreported engaging in maladaptive eating and weight control behaviors, such as binge eating, excessive exercise, strict dieting, fasting, self-induced vomiting, and the use of weight loss supplements (12,13,24). Subclinical symptoms or those that reach diagnostic criteria may contribute to poor physical and mental health, as well as suboptimal athletic and academic performance (29).

The substantial physical demands of being a student-athlete are believed to contribute to the development of eating pathology and compensatory behaviors (32). In season, student-athletes are restricted to 20 hours of weekly on-and-off the court/field physical workload, including the time spent in competition (1).However, the 20-hour rule if frequently violated, which results in excessive hours of physical activity and subsequent overtraining (39). For instance, Division I football, baseball, and basketball players reported the highest weekly in-season athletic commitments, averaging nearly 40 hours per week (39). In all other sports, the weekly times spent in training and competition averaged 32 hours (39). The combination of disordered eating and physical overtraining may further produce significant health impairments, such as low energy availability, muscle weakness, acquisition of overuse injuries, mineral bone deficiency, cardiac complications, impaired immune function, malnutrition, dehydration, fatigue, amenorrhea, and osteoporosis (5,15). Some of these conditions are sustained after the athlete has moved on from organized competition (29,44). Physical overtraining and inadequate nutrition can also negatively impact an athletes mood, contributing to poor academic and athletic performance (29,44,45).

Some collegiate athletes suffering from disordered eating are known to engage in compulsive exercise as a strategy to compensate for excessive caloric intake (33). Compulsive exercise, beyond sport-required training, places student-athletes at a high-risk for physical overtraining, overuse injuries, and subsequent diminished performance (12, 53). In addition, this compensatory behavior often occurs as a symptom of eating psychopathology (21, 33). Particularly worrisome is the finding that maladaptive eating with simultaneous engagement in compulsive exercise can often remain undetected in athletes and contribute to the progression of an eating disorder (36, 45). Like subclinical eating disorders, formal eating disorders can endure into adulthood and have a continued, negative impact on physical and psychosocial health (56). Unfortunately, most of these athletes experience eating disorder symptoms in isolation, as these behaviors often are missed by the coaching and athletic training staff (62,63). Thus, further studies are necessary for identifying eating disordered athletes (9,25,29).

Disordered Eating Symptoms and Eating Disorder Diagnoses

According to the Diagnostic and Statistical Manual (DSM-V) of the American Psychiatric Association (2013), eating disorders are characterized by severe alterations in an individuals eating habits that are linked to physiological changes.Individuals with eating disorders become pre-occupied with food, body weight, and physical appearance. Common eating disorders that occur in collegiate athletes are Anorexia Nervosa (AN) and Bulimia Nervosa (BN) (4,10,12, 24, 42). For instance, in a mixed-sport sample of Division I collegiate athletes, 5.1% of all women scored in the clinical range for either Anorexia Nervosa or Bulimia Nervosa (49). Similar rates of clinical eating disorders were reported in a sample of 414 NCAA Division I athletes (6.3%), with Bulimia Nervosa being the most frequent one (4).

According to the American Psychiatric Association (2013), Anorexia Nervosa (AN)is characterized by persistent restriction of caloric intake, resulting in significantly low body weight (below the minimal norm considering an individuals age, height, weight, and developmental trajectory). It also manifests through an intense fear of gaining weight and severe disturbances in ones perceptions of his or her own body weight and shape (i.e., refusal to recognize the seriousness of ones low body weight). Bulimia Nervosa (BN) is characterized by the following symptoms: (a) recurrent episodes of binge eating; (b) recurrent engagement in detrimental compensatory behaviors in order to prevent weight gain; (c) the binge eating and compensatory behaviors must occur at least once a week for three consecutive months; and (d) an individuals body and shape become vital parts in his or her self-evaluation (3). Binge Eating Disorder (BED)includes the following symptoms: (a) recurrent engagement in episodes of binge eating; (b) occurrence of binge eating episodes, on average, at least once a week for three consecutive months; (c) manifestation of distress related to binge eating; and (d) disassociation with the recurrent use of compensatory behaviors as in Bulimia Nervosa or Anorexia Nervosa (3). Other Specified Feeding or Eating Disorder (OSFED) can be applied to cases, when a person engages in eating behaviors that cause clinically significant distress or impaired functioning, but does not meet full criteria for an eating disorder (3). Lastly, Night Eating Syndrome is characterized by recurring episodes of eating after awakening from sleep or by immoderate food consumption following the evening meal (3).

The Prevalence of Eating Disorders in Athletes

Although disordered eating and exercise behaviors have been highlighted as significant issues among collegiate athletes, the percentage of athletes who meet full diagnostic criteria for clinical or subclinical eating disorders vary greatly, from 1.1% to 49.2% across studies (4,10,12,24,30,42). For instance, Greenleaf et al. (2009) found that, in a group of female collegiate athletes, 2% met the criteria for an eating disorder diagnosis and another 25.5% exhibited subclinical symptoms of an eating disorder (e.g., binge eating, self-induced vomiting, and excessive dieting). Similarly, in Petrie et al.s (2008) study, 19.2% of collegiate athletes reported maladaptive eating behaviors. Sanford-Martens et al. (2005) detected slightly lower rates of subclinical eating problems (14.5%).

In Anderson and Petries (2012) study among female collegiate athletes, 26.8% of women reported disordered eating behaviors. Approximately 40% of the athletes engaged in at least two hours of daily physical activity, suggesting that many may be using this high level of activity as a compensatory strategy in response to binge eating. Up to 28% of athletes reported dieting or fasting at least two times over the past year (4). Kato and colleagues (2011) reported the highest rates of disordered eating in a sample of NCAA Division I and III athletes, ranging from 40.4% to 49.2%. In addition, 30.7% of all athletes reported body dissatisfaction, weight preoccupation, and bulimic tendencies. Wide-ranging rates of clinical and subclinical eating disorders in collegiate athletes call for additional research on eating disorders and associated symptoms, including compulsive exercise (9,29). Although previous studies provided useful prevalence data (4,12,24,30,42), new studies could potentially yield more accurate and consistent results of unhealthy eating and weight control behaviors in collegiate athletes.

Health Consequences of Eating Disorders

While each eating disorder has its distinct signs, symptoms, and health effects, the most frequent signs and symptoms of disordered eating and compensatory behaviors include: sudden weight loss, gain, or fluctuation; hypothermia (i.e., a dangerously low body temperature); and fatigue (29). Oral and dental problems caused by pathogenic weight control behaviors are dental erosion or caries, perimolysis (i.e., a dental condition linked to frequent regurgitation), and recurrent sore throats (64). Dermatological issues, such as hair loss, brittle nails, skin discoloration, and poor skin healing; also arise in individuals suffering from an eating disorder (54). Disordered eating behaviors also severely affect an individuals endocrine system by resulting in irregular menstrual cycles or a complete absence of menstruation (i.e., amenorrhea), which could potentially lead to infertility (55). Furthermore, prolonged misuse of laxatives, diuretics, enemas, and diet pills, as well as self-induced vomiting lead to various gastrointestinal problems, such as abdominal pain, early satiety and delayed gastric emptying, constipation, hematemesis (i.e., the vomiting of blood), and hemorrhoids (40). The resulting damages of disordered eating on the cardiorespiratory system include, but are not limited to, chest pains, hypotension (i.e., low blood pressure), arrhythmia (i.e., irregular heart beat), bradycardia (i.e., an extremely low heart rate), and shortness of breath (11).

Another consequence of maladaptive eating and compensatory behaviors is the Female Athlete Triad, which is characterized by energy deficiency, menstrual irregularities, and low bone mass that occur as a consequence of malnutrition and disordered eating (40). Low bone mineral density can result in injuries, stress fractures, and potential osteoporosis (55). This may be especially hazardous for competitive athletes who are generally at higher risks for overuse injuries due to their continuous engagement in high amounts of intense physical training (61). For instance, disordered eating, amenorrhea, and low bone mineral density were associated with musculoskeletal injuries in interscholastic female athletes (46). Finally, neuropsychiatric symptoms, including memory loss or lack of concentration, insomnia, increased anxiety, depression, seizures, obsessive-compulsive behavior, and suicidal ideation can be seen in persons with eating disorders (50). Up to a third of athletes at-risk for an eating disorder tend to engage in multiple pathogenic behaviors, as opposed to a single behavior such as restrictive eating (41).

Consequences of Eating Disorders on Athletic Performance

Disordered eating can have an effect on athletic performance (18). In aesthetic (e.g., gymnastics, swimming, diving), endurance (e.g., cross-country), and weight-classsports (e.g., wrestling, rowing), it is believed that leanness leads to enhanced performance (9). However, many athletes achieve low weight through disordered eating and compensatory behaviors, which can significantly decrease athletic performance (18,29). Specifically, long-term disordered eating impairs the main components of muscular fitness (i.e., aerobic fitness, musculoskeletal fitness, motor fitness, and flexibility), thus resulting in poor athletic performance (18). In addition, the health consequences of restricted caloric intake, such as loss of fat, lean body mass, electrolyte imbalances, and dehydration, can contribute to diminished performance (29). In a study among junior elite female swimmers, Van Heest and colleagues (2014) found that female athletes who restricted caloric intake and increased energy expenditure in training frequently suffered from ovarian suppression (i.e., lack of estrogen production). Female athletes who trained in the presence of low energy availability and ovarian suppression exhibited significant declines in their swim velocity (59).

A similar study of high school athletes found a negative relationship between disordered eating and athletic performance (56). Among a large sample of high school athletes, 35.4% were found to suffer from disordered eating, 18.8% reported menstrual irregularities, while 65.6% reported suffering a sports-related musculoskeletal injury during the ongoing season. Athletes exhibiting disordered eating behaviors were twice as likely to sustain a sports-related injury during a competitive season, as compared to the athletes reporting healthy eating behaviors. Moreover, the inability to train and compete due to an injury further results in decreased athlete performance upon the athletes return to play (56).

In addition to physical consequences on sport performance, disordered eating may contribute to other psychosocial issues (18). In particular, obsessive concern about weight and body image, as well as continuous eating restriction have been associated with mood disorders, which may impact athletic but also academic performance (27). Furthermore, overvaluation of shape, weight and eating control, anxiety, and depression that often coexist in athletes at-risk for an eating disorder, are capable of decreasing athletes motivation to train and compete. The resulting poor performance may further increase the pressure experienced by athletes to train more intensely and adhere to even more rigid dieting for weight loss (18). Disordered eating behaviors in competitive athletes may not only severely undermine an athletes health, but may also produce deterioration in sport performance (18).

Eating Disorders by Gender

A number of studies have found higher rates of maladaptive eating habits in female athletes compared to male athletes (9,10,24,31). For example, in a sample of 800 NCAA Division I student-athletes, 19% of women and 12% of men reported unhealthy eating habits (10). Krebs et al. (2019) also found a higher rate of eating disorders in collegiate female athletes than males. Specifically, three times as many female distance runners screened positively for an eating disorder as compared to male (46% and 14%, respectively). In another study, 26% of student-athletes scored in the clinical range for an eating disorder, with five times more females (84%) than males (16%) reporting disordered eating behaviors (37).

The main explanation for this tendency is that female athletes are more subjected to socio-cultural pressure to diet and be thin, while male athletes tend to be more concerned with physical fitness and masculinity (51). Thus, fewer male athletes contemplate dieting as compared to female athletes, which represents a risk factor for the development of eating disordered in females (51). Nevertheless, disordered eating has been significantly increasing among male athletes (22,12,42,52). For instance, certain male athletes, specifically wrestlers, rowers, and long-distance runners, are more likely to engage in pathogenic weight control behaviors than female athletes in general due to an increased focus on physical appearance and weight (22,26).

Hinton and colleagues (2004) examined dietary intake and eating behaviors in 345 NCAA Division I student-athletes. They found that more male athletes than female athletes exhibited having inadequate nutrient intake. Specifically, only 10% of male athletes, as compared to 19% of female athletes, consumed the recommended minimum of carbohydrates per each kilogram of their body weight, while 19% of males and 32% of females consumed the minimum recommended amount of protein. Moreover, male athletes were more likely to exceed the Dietary Guidelines for fat, saturated fat, sodium, and cholesterol intakes, as compared to female athletes (26).

In contrast to female athletes, who indicated restricting their nutrient intakes for weight gain prevention, male athletes reported using dietary supplements (other than vitamins) for weight reduction (26). Also, approximately 6% of male athletes indicated restricting their fluid intake. These findings can potentially be understood in the context of mens preoccupation with muscularity, resulting in a focus on diet, nutritional supplements, and excessive exercise (10). Hinton et al.s (2004) study findings suggest that male athletes, just as female athletes, undergo psychological problems of body dissatisfaction and low self-esteem, which leads to the onset of eating pathologies. In regards to sport-specific factors, male athletes are equally pressured to diet and exercise compulsively in order to maintain low body weight and produce successful athletic results (14).

In summary, a substantial body of literature shows that rates of eating disorders and disordered eating symptoms among collegiate athletes range widely, 0-19% in male athletes and 6-45% in female athletes (9,29,31,34). While the occurrence of clinical eating disorders is more prevalent in female athletes than male athletes, male athletes, in sports such as wrestling, rowing, and cross country, are at greater risk for pathological weight control behaviors (26,49,52). Such findings highlight inconsistencies in the eating disorder area and emphasize the need for additional research on the prevalence of eating disorders among both male and female athletes.

Eating Disorders by Sport

A number of studies have determined that the sport type in which an athlete participates can serve as a risk-factor for the development of disordered eating (4,22,48,52). In eating disorder research, sports have been categorized according to the level of pressure an athlete faces to maintain a low body weight for aesthetic reasons and/or performance enhancement (14). Across several studies (4,22,29,42),the following categories have been described: aesthetic or lean sports (e.g., gymnastics, figure skating, swimming, diving, track and field), endurance sports (e.g., cross country, cycling), technical sports (e.g., tennis, golf, baseball, softball), ball game sports (e.g., soccer, volleyball, basketball, football), weight-class sports (e.g., wrestling, rowing), and anti-gravitational sports (e.g., skiing, pole vault jumping).

Higher rates of eating disorders in aesthetic, endurance, and weight-class sports have been consistently reported (9,29,57). For example, Thiemann et al. (2015) found a greater frequency of maladaptive eating in aesthetic sports (17%) than in ball-game sports (3%). In Sundgot-Borgen and Torstveits (2004) study on elite athletes, 42% of women in aesthetic sports had subclinical and clinical eating disorders (e.g., gymnastics, figure skating, diving), 24% in endurance sports (e.g., long-distance running, cycling, swimming), 17% in technical sports (e.g., golf, tennis), and 16% in ball game sports (e.g., soccer, volleyball, basketball). Among male athletes, 9% of eating disorders were seen in men participating in endurance sports and 5% in ball-game sports (52). There are three possible explanations of higher rates of eating disorders in aesthetic, endurance, and weight-class sports. First, in endurance sports, such as cross-country, weight higher than an athletes optimum performance weight is linked to decreased performance (14). Second, in weight category sports, such as wrestling, athletes are pressured to meet a specific weight requirement just to qualify for a competition (9). Third, in aesthetic sports, such as gymnastics, athletes physical appearance is a part of an aesthetic evaluation, which pressures athletes to attain a certain body composition (14).

While the prevalence of disordered eating in sports that emphasize leanness is high, the reported rates of eating disorders vary by sport (48,53,57). For instance, in a sample of 414 NCAA Division I female athletes competing in gymnastics and swimming/diving, 108 (26%) scored in the subclinical range for an eating disorder (4). In addition, 26 athletes (6.1% of gymnasts and 6.7% of swimmers/divers) were classified as having an eating disorder. Out of 26 athletes in the eating disorder group, 20 athletes were identified as having subthreshold Bulimia Nervosa, 4 with Non-bingeing Bulimia, and 2 with Binge Eating Disorder (4).

In contrast to Anderson and Petries (2012) findings, Carter and Rudd (2005) detected lower rates of disordered eating considering the sport type. In a mixed-gender sample of 800 NCAA Division I athletes, Carter and Rudd (2005) found 9.2% of non-lean sport athletes and 17.5% of lean-sport athletes exhibiting subclinical features for an eating disorder. Additionally, 6.1% of athletes in lean sports suffered from chronic dieting, as compared to 2.5% of athletes in non-lean sports. Such high rates of disordered eating in gymnasts and swimmers/divers support the notion that athletes competing in lean and aesthetic sports are pressured to possess ideal body weight for reaching optimal performance. Thus, lean- and aesthetic-sport athletes are exposed to higher risks for developing an eating disorder than athletes competing in sports that do not overly emphasize body weight and physical appearance (4,10). Furthermore, Glazer (2008) found that athletes participating in lean sports averaged significantly higher on the Eating Attitudes Test (EAT) and the Social Physique Anxiety Scale (SPAS), suggesting greater disordered eating and physique anxiety, as compared to athletes participating in non-physique-salient sports. Glazers (2008) findings support the notion of increased prevalence of eating disorders in sports that emphasize leanness (e.g., gymnastics, long distance running). Participation in non physique-salient sports (e.g., basketball, softball, soccer) may be a protective factor for the development of disordered eating (22).

Although some studies have linked the sport team classification to disordered eating levels (4,10,48), other studies found no support for this relationship (24,42,49). For example, despite the high frequency of pathogenic eating in a sample of collegiate athletes (19.2%), no association was found between sport team classification and eating disorder status in Petrie et al.s (2008) study. Similarly, Greenleaf et al. (2009) found no differences in the frequency of maladaptive eating behaviors across sport type. These results corroborated previous findings from Sanford-Martens and colleagues (2005) study, which also found no differences in eating disorder symptoms across sport types. These findings suggest that sport type may not be an influential factor in the development of maladaptive eating habits in competitive athletes (49).

To conclude, some studies suggested that lean-sport athletes (such as gymnasts, runners, swimmers, cyclists, and wrestlers) are more prone to developing an eating disorder than non-lean sport athletes, who do not overly emphasize body weight and physical appearance as part of their sport (4,10). However, other studies failed to establish the relationship between athletes sport classification and their propensity for unhealthy eating behaviors (24, 42). This observation calls for the need to broaden researchers perspectives on identification of at-risk athletes (9). Future studies may provide a clearer pattern between the sport type and disordered eating in collegiate athletes.

Eating Disorders and Age

While a great number of studies on the prevalence of eating disorders among athletes have reported their ages as a demographic variable (22,34,36,47,52), only a few studies assessed the direct link between disordered eating and college athletes age (23,24,42). For instance, in Petrie et al.s (2008) study, disordered eating group status (symptomatic vs. asymptomatic) was not related to age, indicating that symptomatic athletes may be found among all different ages (42). Similarly, Greenleaf et al. (2009) found no differences in athletes eating disorder status (i.e., symptomatic vs. eating disordered) based on their age. These findings suggest that the age variable may not be an influential factor on collegiate athletes disordered eating symptomology (24). Similarly, in a sample of 290 elite athletes between 14 and 30 years of age, Gomes et al. (2011) assessed the relationship between unhealthy eating behaviors and age. No association was found between athletes age and each subscale of the Eating Disorder Examination Questionnaire (EDE-Q, 20). Thus, the findings indicate that athletes across different ages may be equally at-risk for developing maladaptive eating habits (23, 42).

Pettersen et al. (2016) further examined the prevalence of disordered eating in 225 Norwegian athletes in the age groups of 17, 18, and 19+ years old. In total, 18.7% of the athletes exhibited symptoms of disordered eating. Age was not a significant predictor of athletes maladaptive eating patterns. As Pettersen et al. (2016) explain, the peak risk for the development of an eating disorder occurs between childhood and early adolescence. However, the majority of the sample athletes were in their later adolescence and early adulthood, which may explain why age was unrelated to disordered eating symptoms. Specifically, adult athletes have acquired higher levels of confidence and self-esteem than athletes in their early adolescence, which could serve as a protective mechanism against the development of eating pathologies (43).

In summary, some studies suggest that the prevalence of maladaptive eating behaviors (e.g., fasting, self-induced vomiting, using laxatives and diuretics, binging followed by exercise, etc.) is higher in the college-aged athletes, as compared to competitive adolescent athletes (29, 30, 43). Nevertheless, a substantial body of literature indicates that competitive adolescent athletes experience severe eating disorder symptoms as do collegiate athletes (9, 29, 43). Additionally, the studies focusing specifically on the impact of age, failed to establish a significant association between age and athletes eating disorder status (24, 42 ,43). Thus, additional studies are necessary to establish a clearer association between athletes age and pathogenic eating.

CONCLUSIONS

Collegiate student-athletes represent a unique population of young adults who, because of the demands on their time associated with their sport, may be at particular risk for disordered eating and compulsive exercise (32). Specifically, many collegiate athletes appear to use excessive exercise as a compensatory behavior to control their body weight (4, 12, 36, 42, 48). Compulsive exercise, in combination with the sport-required training, place student-athletes at a high-risk for overuse injuries, and physical exhaustion, which can further impede athletic performance (12, 53). Therefore, there is a need to further examine disordered eating and compulsive exercise patterns among collegiate student-athletes in order to draw athletic staffs, coaches, and athletes attention to the deleterious health effects of these disordered behaviors.

APPLICATIONS IN SPORT

The roles of athletic trainers, administration, and coaches are paramount in recognizing detrimental eating and exercise patterns in athletes and providing them with the necessary professional assistance (14). First, expanding athletes knowledge about proper nutrition habits, maladaptive eating behaviors and their health consequences, and learning how to address the issue of disordered eating, are pivotal steps in primary prevention (40). There is a need to inform athletes that dietary restriction and purging behaviors for attainment of the desired body weight may lead to decreased athletic performance and adverse health consequences. Structured educational programs have shown to reduce the impact of risk factors of disordered eating (6, 17, 19). For instance, Becker et al. (2012) observed a significant reduction in bulimic symptoms just after 1 year following a peer-led educational intervention for athletes. In addition, the researchers found an increase in the number of athletes seeking medical assistance due to the concern that they may suffer from the Female Athlete Triad symptoms (6). Through educational programs, athletes, parents, and coaches can also learn that menstrual dysfunction occurs as a result of low energy availability due to deliberate dietary restriction, rather than a positive adaptation to high-intensity sport participation (17).

Changing perspectives on competitive sport participation for athletes and coaches could be another strategy for eating disorder prevention. Specifically, the way in which athletes evaluate their maladaptive eating and exercise habits can foster maintenance of an eating disorder (44,58). For instance, Thompson and Sherman (2010) found that athletes tend to underreport their eating disorder symptoms due to the misconception that dietary restriction and excessive exercise will result in enhanced sport performance. Athletes and coaches often reinforce maladaptive behaviors (i.e., dietary restriction, excessive exercise) because they believe that certain aspects of sport participation, such as mental toughness and continuous engagement in intense training, are pivotal in reaching optimal performance (44). As a result, athletes may perceive compulsive exercise as a demonstration of high commitment to their sport, rather than a symptom of an eating disorder (16,28). In addition, athletes and coaches falsely believe that weight loss achieved through food restriction and excessive exercise will imminently lead to increased performance (16). Thus, due to perfectionistic and result-oriented views of athletic participation, eating disorder symptoms are often overlooked and underreported (28). Consequently, an emphasis of educational programs should be placed on prompt recognition of maladaptive eating and exercise habits to prevent the development of a clinical eating disorder.

Furthermore, despite the availability of various eating disorder prevention strategies, Vaughan et al. (2004) found that only 1 in 4 (27%) of athletic trainers feel confident in identifying an athlete with an eating disorder. In addition, only 38% of athletic trainers feel confident in asking an athlete about disordered eating behavior (60). Although educational programs and counseling services have been created for collegiate student-athletes, proactive steps on behalf of the university athletic staff are necessary for early identification and prevention of eating disorders (8,35). Prompt detection of unhealthy eating behaviors through screening protocols has been associated with more effective treatment outcomes (8,57).

For instance, the Preparticipation Physical Examination (PPE) monograph, created by the American Medical Society for Sports Medicine (AMSSM) and the American College of Sports Medicine (ACSM), can serve as an effective screening tool for identification of disordered eating behaviors in athletes (7). This instrument assesses whether athletes suffer from body weight pre-occupation, restrict their caloric intake, use nutritional supplements for weight loss, and undergo pressure to lose weight by outside sources (7). The Female Athlete Triad Coalition developed an 11-question screening tool that could be successfully employed as a part of the Pre-participation Physical Examination (17). This measure evaluates a female athletes pre-occupation with body weight, dietary restriction, menstrual dysfunction, bone injuries, and low bone mineral density. Consequently, simultaneous use of these screening tools could play a key role in identifying at-risk athletes and providing immediate treatment prior to competitive season. By utilizing screening protocols, coaches and athletic trainers can ensure that student-athletes have rewarding collegiate experiences. In addition, this method can protect athletes against the development of eating disorders that otherwise may endure into adulthood, impacting their physical and psychosocial health long-term (18,27).

Directions for Future Research

Further studies investigating the patterns of disordered eating in conjunction with compulsive exercise in collegiate athletes are necessary for several reasons. First, it is pivotal to provide athletes, coaches, athletic trainers, and athletic administrators with accurate information about the severity of maladaptive eating and exercise in collegiate athletes. Second, various socio-cultural and sport-specific pressures have been identified as potential risk factors for the onset of eating disorders in athletes, which allows researchers to examine the links between these risk factors and the development of disordered eating behaviors (14,18,51). While numerous studies have investigated these issues in great depth, wide gaps still exist in the literature due to inconsistent prevalence rates of eating disorders based on athletes gender, age, and sport type (9,29). In addition, certain studies yielded contradictory results and failed to establish the relationships among athletes sport classification, age, and their propensity for unhealthy eating behaviors (23,24,42).

To date, there is a scarcity of literature focusing on more recently recognized eating disorders, such as Binge Eating Disorder and the Night Eating Syndrome (4,12). Studies investigating the prevalence of clinical eating disorders in collegiate athletes reported rare instances of BED and the NES, ranging from 0 to 0.5% (4,10,12,24,42). The low rates of BEDs can be explained by the difficulty to disassociate the recurrent use of compensatory behaviors, which are distinct symptoms of AN and BN only (3). In the majority of clinical cases, athletes disordered eating occurs in conjunction with pathogenic weight control behaviors (12), which results in higher rates of AN and BN, and significantly lower rates of BED diagnoses.

In addition, a great number of studies in eating disorder research used the Questionnaire for Eating Disorder Diagnoses (Q-EDD; 38) due to its high psychometric properties (4,10,12,24,42,49). Based on the DSM-IV (2) diagnostic criteria for eating disorders, the Q-EDD mainly assesses the symptoms of AN, BN, and BED, thus omitting questions related to the symptoms of the NES, an eating disorder that was later added the DSM-V (3). Consequently, questions exploring the NED symptoms, such as the frequency of recurring episodes of eating after awakening from sleep and the episodes of immoderate food consumption following the evening meal, should be added to the more recent eating disorder measures.

Considering limitations of the previously discussed studies of eating disorders in athletes, the following methodological recommendations could help future researchers to gain a better understanding of the nature and distribution of eating disorders. First, samples should include a large number of NCAA athletes to provide more reliable and valid results, and to ensure generalizability of the study findings. Second, athlete samples representative of each sport should be selected for accurate and valid comparisons by sport type. One way to achieve this goal is to categorize sports by their types (e.g., lean vs. non-lean, weight-class vs. non-weight-class) and recruit approximately an equal number of athletes for each sport category.

In regards to gender comparison, sufficient samples of both female and male athletes competing at the collegiate level need to be recruited to more accurately address the issue of gender differences in eating disorders. Although male athletes generally have a lower prevalence of eating disorders than female athletes, an increasingly large body of literature indicates that disordered eating among male athletes is on the rise (12,22,42,52). Moreover, male athletes in certain sports are more likely to engage in compensatory behaviors than female athletes (26). This conclusion could not be drawn if the study focused solely on one gender. Thus, excluding one gender from the investigation may result in biased reporting of the disordered eating problem and inaccurate conclusions about its prevalence rates across both genders.

Lastly, the conditions under which athletes report their eating behaviors must be assessed prior to data collection. Athletes tend to underreport their maladaptive eating and compulsive exercise habits due to the fear that their eating disorder may be discovered by their coaches and potentially affect their athletic careers (52). Consequently, athletes must be provided with confidentiality and a pressure-free environment in which they can answer instrument questions candidly. In addition, researchers need to choose appropriate measures that have been previously validated in athlete samples to successfully discriminate between eating disordered and healthy athletes.

ACKNOWLEDGMENTS

None

REFERENCES

The rest is here:
Disordered Eating and Compulsive Exercise in Collegiate Athletes: Applications for Sport and Research - United States Sports Academy Sports Journal

Start (Dec. 31): 447 lbs.

Two weeks ago: 433 lbs.

This week: 437 lbs.

Total lost in 2020: 10 lbs.

Shortly after writing these words two weeks ago, I began to struggle: Although I have not yet struggled with any major issues so far this year, I know that eventually life will knock me down again, and Ill have to work hard to get back up.

Yup, I got knocked down, and now Im back up again.

It all started with my new work schedule and a special project that required a lot of long days, extra attention to detail and creativity. Needless to say, it took a lot of energy out of me, and when I dont have the energy, I dont have the will power to behave. Ill start making excuses as to why I cant exercise and justifications as to why its OK to eat that junk food or drink that beer.

When things get busy at work, sometimes the dishes dont get done in a timely manner, and after a long day, the last thing I want to do is wash dishes so I can cook a healthy meal. I end up choosing the quicker option of picking up food, such as frozen pizza, that I can just pop in the oven. The next day, its something else, then something else, and before I know it, Im out of control.

A little extra sleep helps. So does exercise, especially when you are forced to get the exercise.

After the snowstorm last Friday, for example, I had to shovel about 18 inches of snow out of the driveway so we could get the cars out. On Friday night, I moved all the snow from my wifes side of the driveway to my side of the driveway in front, behind and on top of my 2012 Ford Focus. You couldnt see my car at all.

On Saturday, I was busy announcing the Gala Parade in front of the town hall for the Saranac Lake Winter Carnival and was too tired afterward to shovel.

On Sunday, I spent three hours shoveling my car out, taking breaks by sitting on the front steps of my house and listening to the blue jays make all kinds of noise. It had warmed up, too, so it was pleasant. I actually enjoyed it. It was meditative, if that makes any sense. I was at peace while I was out there. It helped me recharge and get back on track.

Even with two weeks of questionable behavior eating junk food, meat and drinking a six pack of beer Im still 10 pounds down for the year.

I have a feeling my struggles will continue in the coming months, as I feel cabin fever setting in, and spring isnt coming anytime soon. Thats usual this time of year. With almost four months of winter weather, its getting me down, and I feel the need more than ever to reach for comfort food.

In April 2014, when I was down 60 pounds on the first round of the Lake Placid Diet, I wrote about cabin fever and how I was self-medicating:

I keep placing sunshine on my daily list of positives when the sun is out. Even then, I continue to find myself in a dark place this time of year.

With the long winter almost over, tax day reminds me of finances, which always give me stress, especially after learning last week that its going to cost $700 to fix my car. I hate money problems.

I also hate this time of year. Ive been suffering from cabin fever for almost three months, and its getting worse. There is no spring break in my world, so theres no hope Ill get better any time soon. My spirits could be lifted if I took a small break, but where would I go? I cant afford to travel. And spring break in the Adirondacks doesnt cure cabin fever, not with fresh snow on the ground this week. So Im stuck with the urge to self-medicate with food.

I go through short periods of depression once in awhile. Thats normal, isnt it? I even find myself enjoying the melancholy. Its a good time to reflect on whats important in life. But the depression is always deeper in March and April.

Before starting this column, I shut the blinds in my office, closed the door and turned off all the lights except for a warm antique desk lamp my mother gave me. Its just me, the light, and the computer, and Im doing what I like best writing. Its therapeutic.

Foods always been my answer to depression, not alcohol, illegal drugs, medication, therapy or religion. I keep rubbing my eyes, searching for answers and not finding any. I just find more questions and the uneasy craving for food, knowing all the time that stuffing my gut wont solve a thing.

Still, it makes me feel better in the short term. Over and over, one day after another, giving myself a high with food, kept me going for years. But its an addiction I want to break, one that the Lake Placid Diet was designed for.

I spent years looking forward to dinner as the highlight of my day, and on weekends, it would be breakfast, lunch and dinner. I would just eat and eat and eat. It was a time to enjoy food behind closed doors, leaving the stresses of everyday life for a short time while I indulged in the guilty pleasures on my plate, feeding myself well past the feeling of being full. I dont drink a lot of alcohol, and I dont smoke or do drugs. Food is my addiction.

I cant promise that when I see you next Ill be out of this funk, but I will promise to try not to self-medicate with food. And Ill still be seeking that sunshine until I finally feel better.

See the original post:
Gearing up for my annual battle with cabin fever - Lake Placid Diet by Andy Flynn - LakePlacidNews.com | News and information on the Lake Placid and...

The disruption to shift workers natural bodily rhythms may play a part in their increased risk of disease, according to a new study.

Every human body runs on a 24-hour clock. This system, known as the circadian rhythm, uses factors such as daylight to determine when a person sleeps and wake.

It also has an effect on bodily functions such as metabolism and cognition. However, in the modern age, technology and varying working hours can disrupt this delicate balance.

Conflict between a persons natural bodily rhythm and the way they live can have a number of detrimental effects, including hormonal changes.

These alterations can lead to metabolic syndrome. This is a condition that increases a persons risk of stroke, type 2 diabetes, and heart disease.

Night shift workers, who make up almost around a fifth of the United States workforce, are more likely to experience these effects than others. Not only are they more likely to develop sleep disorders, they are also at a higher risk of cardiovascular disease and type 2 diabetes than other workers.

Also, people who work irregular or rotating shifts may face an even greater risk of sleep problems and metabolic syndrome.

Previously, researchers believed that the lifestyle habits that tend to go hand-in-hand with shift work was responsible for this increased risk. However, no solid evidence exists to back up this belief.

Researchers are therefore beginning to dig deeper into the relationship between shift patterns and metabolic syndrome.

A new review in the Journal of the American Osteopathic Association did exactly that, focusing on the circadian rhythm.

Examining a number of studies and clinical trials from 2018, the review authors used the findings to propose ways of reducing the circadian impact of shift work, such as optimizing sleep and diet.

Its true that getting enough sleep, eating right, and exercising are critical to everyones health, says lead study author Kshma Kulkarni, from the Touro University College of Osteopathic Medicine in California.

However, the nature of shift work is so disorienting and discordant with those principles, we really need to help people in those jobs strategize ways to get what they need.

It is not only individual workers who can help. Employers and healthcare professionals also have a responsibility to make changes.

Good quality sleep is one of the simplest ways to prevent detrimental health effects. Shift workers themselves should try to sleep for 78 hours at the same time every day, suggests Kulkarni.

In order to aid the bodys natural cycle, workers should try to sleep in the evening, or as close to the evening as possible. They can take naps earlier on, and these should last between 20 and 120 minutes.

Moving away from rotating shift patterns is one way employers can help in this area. Kulkarni also suggests that employers should ensure that shifts begin before midnight and last for no longer than 11 hours.

Nutrition is another element to tackle. Research has shown that shift workers tend to miss meals and opt for sugary snacks instead.

Eating three meals per day is vital, says Kulkarni. These meals, along with any snacks a person has, should include a good amount of protein and vegetables.

Consuming more calories earlier in a persons day is also a beneficial step to take. Employers should therefore try to schedule breaks earlier in a shift and offer more healthful snack options.

Shift workers should also try to take exercise levels into account. Kulkarni recommends working out around the same time each day, at least 5 hours before bedtime.

It may be best to prioritize aerobic exercise, such as running and dancing, as this may boost the quality of a persons sleep.

These three factors are not the only lifestyle choices that may benefit shift workers.

Sufficient light exposure may also help. Certain light sources can alter a persons circadian rhythm to their advantage.

Night workers should try to increase their exposure to light before shifts and throughout. Installing high intensity lights in workplaces can also help employees feel more awake.

It is also important to avoid blue light 23 hours before going to sleep.

Kulkarni and colleagues also believe that medical treatment is of interest.

Medications that help control the sleep cycle, such as certain benzodiazepines and antidepressants, may benefit people at risk of metabolic syndrome.

Similarly, a physical technique called osteopathic manipulative treatment can reduce the amount of time shift workers spend trying to fall asleep.

It is critical we address the health issues facing people in this line of work, Kulkarni explains, particularly because the strength of our economy and safety of our society depend heavily on night shift workers.

To prevent metabolic syndrome, healthcare professionals should check workers especially those in sectors including hospitality and the emergency services for signs of a disrupted circadian rhythm.

With early detection, a person can successfully implement lifestyle modifications and treatment regimens.

However, further research is necessary to determine the most effective strategies.

Original post:
Using the bodys natural cycle to improve shift workers health - Medical News Today

Its been said that a thousand-mile journey begins with one step. Similarly, a journey to a healthier you begins with just one consultation.

There are an endless number of reasons why our health starts to slip away from us as we get older. A demanding career, family commitments, age and injury all these things can impact our ability to adhere to a program focussed on healthy living.

But the good news is that there are people here to help.

Live Well Exercise Clinic is a state-of-the-art exercise facility that provides professional fitness training and healthy lifestyle coaching to members of any age, shape or size. By using exercise as medicine, the expertly trained and educated staff at Live Well coach members on developing healthy habits that lead to sustained lifestyle change and improved quality of life.

Live Well Exercise Clinic in Lynn Valley has been open just over a year now and has already helped dozens of clients on their journey to find their way back to a healthier self.

Take Live Well member Tanja for example. Fed up with the constant guessing game of which diet and which gym would serve her best, Tanja decided to seek professional help to finally find a long-term solution to her health concerns.

Like many others, I have been yo-yo dieting for the majority of my adult life and stuck on the weight loss and weight gain cycle for years. I have tried every diet program and joined just about every gym, says Tanja.

Thats when she found Live Well.

Live Well fosters a friendly and welcoming community, and this motivates me to keep coming to exercise classes. Sessions are structured so that there is a different educational and inspirational component with each visit. Also, if something is not quite working for me, staff is always on hand to answer my questions and help me adjust my own personal program to suit my needs, says Tanja.

I have learned to incorporate (and even enjoy) regular exercise in my life again. Along with gaining more muscle strength and stamina, I also noticed that after a few months of doing the Live Well program I had less knee and joint pain! I feel physically stronger and more confident, and I am enjoying exercising my body and treating it well.

Unlike Tanja, Live Well member Tory had apprehensions about exercising for years due to her fear of injury, anxiety and lack of preparedness but after years of stagnant living she soon found that she couldnt delay her health journey any longer.

I spent years trying to get fit and lose weight, trying all sorts of things but nothing worked until Live Well. My balance was bad, my strength was minimal and I was scared. My whole life Ive taken horrible falls, many with serious injury, says Tory.

Since Ive been with Live Well, I have not fallen at all. The trainers are so amazing, if something doesnt work for you or you feel unwell they find an exercise you can do. Everyone has a different program with exercises just for them. There is no competition, the gym feels more like a sanctuary than a gym.

Some members have found inspiration to seek out and sustain healthier habits together like married Live Well couple Irene and Lloyd.

Lloyd and I both realized we needed to have some structured exercises as we age and we wanted it to be in a safe and supervised environment so that we could maintain and build strength, flexibility and stamina, said Irene.

Lloyd saw an ad for Live Well, looked into it and suggested we go. It has been a very positive and enjoyable experience. The groups are small, the exercises are designed for each individual and we work and advance at our own pace. It isnt a competitive environment and everyone in each session is at a different level.

Whatever the reason for seeking out Live Well, each member is able to find the safe and secure environment that they need to flourish. With just one consultation, the journey to a healthier you begins. Come visit us today and let us show you the path to a lifestyle youll be happy to have.

Go here to read the rest:
Start your Health Journey with Live Well Exercise Clinic - North Shore News

A vast body of evidence demonstrates that exercising regularly offers a bulwark against life-threatening complications, such as heart disease. The case for exercise could not be clearer but when it comes to how much you need to do to extend your lifespan, the jury is often out. Research is increasingly shedding light on this area, however, and one study shows that even a little exercise can go a long way.

The NHS recommends adults should do at least 150 minutes (two hours and 30 minutes) of moderate-intensity aerobic activity, such as cycling or fast walking, every week to reap the health benefits.

While the more exercise you do the better, according to findings published in the British Journal of Sports Medicine, even partaking in 10 minutes of exercise a week a day can reduce your risk of developing life-threatening complications.

The study was based on data from more than 88,000 U.S. adults who participated in the National Health Interview Survey between 1997 and 2008. All of the participants were ages 40 to 85 and did not have any chronic diseases when they took the survey.

They also provided demographic and health information, and were tracked by researchers for about nine years.

READ MORE:How to live longer: This simple activity may increase your life expectancy

About 8,000 people died during the follow-up period, and the researchers found virtually any amount of exercise reduced the risk of dying of cardiovascular disease, cancer or any other cause.

What was particularly noteworthy is the study found participants who did just 10 to 59 minutes of light-to-moderate intensity physical activity each week had an 18 percent lower risk of early death than people who were sedentary.

The findings also revealed they also had a 12 percent lower risk of dying from cardiovascular issues during the study and a 14 percent lower risk of dying from cancer.

Whats more, these reductions in risk increased the more people exercised.

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People who got 60 to 149 minutes of light-to-moderate exercise per week had a 22 percent lower risk of early death than sedentary people, and those who got 150 to 299 minutes had a 31 percent reduced risk.

In addition, those who engaged in 300 to 449 minutes of light-to-moderate physical activity per week was linked to a three percent lower risk of dying during the study period.

Out of all of the exercises available, aerobic exercise comes out on top for its myriad health benefits.

One of the primary health benefits of doing aerobic exercise is it helps keep visceral fat at bay.

Visceral fat is a harmful form of belly fat that lies close to internal organs and can trigger a range of deadly mechanisms in the body.

Emphasising the effectiveness of aerobic activity to attack visceral fat, many studies have shown that aerobic exercise can help you lose visceral fat, even without dieting.

For example, an analysis of 15 studies in 852 people compared how well different types of exercise reduced visceral fat without dieting.

They found moderate and high-intensity aerobic exercises were most effective at reducing visceral fat without dieting.

Aerobic exercise generally refers to any activity that gets your heart pumping and makes you breath faster than you normally would when resting.

Walking, jogging, biking, dancing, and swimming are popular examples of aerobic activity.

Of course, it is also important to compliment an exercise regime with a healthy, balanced diet too.

The NHS advises eating a low-fat, high-fibre diet, which should include plenty of fresh fruit and vegetables (five portions a day) and whole grains.

Go here to read the rest:
How to live longer: Do this much exercise each week to increase your life expectancy - Express

Springfield Hospital will likely cut ties with nine health clinics throughout the region as part of its bankruptcy plan.

The clinics in Springfield, Londonderry, Ludlow, Chester, Rockingham and in Charlestown, New Hampshire are currently part of Springfield Medical Care Systems, and they are tied to Springfield Hospital.

But Springfield Hospital is working to become part of a three-hospital system with Mt. Ascutney Hospital and Health Center in Windsor and with Valley Regional Hospital in Claremont, New Hampshire. Dartmouth-Hitchcock Medical Center would likely oversee the new organization.

More from VPR: Vermont's Springfield Hospital Files For Bankruptcy [June 27, 2019]

Springfield Medical Care Systems CEO Josh Dufresne said the clinics cannot remain tied to Springfield Hospital under the proposed three-hospital partnership.

As were looking to split these two companies apart and be completely independent, we have to make sure that the right services stay within the right company, Dufresne said.

Neil Mallan, 50, lives in Saxtons River and goes to the Rockingham Health Center in Bellows Falls. His doctor there got Mallan enrolled in the lifestyle medicine program, which is run out of the Springfield Health Center, one of the clinics in the system.

The lifestyle medicine program stresses diet, exercise and mental health to address chronic health issues, and Mallan said the connection between the clinics led to dramatic improvements in his health.

It has changed my life in a sense that I have a little bit more self-esteem. I feel better, Mallan said. I have big plans to see my grandchildren grow up and to be able to be active during that period of time. And its just been great for not only me but for the whole family.

More from VPR: Green Mountain Care Board Pushes Sustainability As Rural Hospitals Struggle [Oct. 15, 2019]

Since April, Mallan has lost 50 pounds, and hes no longer taking diabetes or cholesterol medication.

Dr. Scott Durgin leads the wellness program at the Springfield clinics and he said healthcare services in small rural towns have to be aligned within a larger system to better serve people who live far from population centers.

When Im working in Ludlow, there are certainly patients that I see there that cant go anywhere else, theyre just going to be able to see a provider in Ludlow," Durgin said. "And I think the same goes for Springfield, and Londonderry and Charlestown. And I think that provides a much better service for those that need it the most."

'It's uncertain right now'

This model, of having a hospital coordinate healthcare services in rural communities, has been happening more frequently as primary doctors struggle to keep their practices open.

Dufresne, the Springfield Medical Care Systems CEO, said the clinics lost $2.5 million in 2018 and will have to submit a separate plan to the bankruptcy court. And that could mean consolidation, or closure, among the many services the clinics now offer.

And what were doing right now is meeting internally with each one of the departments," he said. "We do feel its key that those department folks know whats going on prior to having community dialogue or press releases or those type of activities."

The medical offices offer dental, and eye care, mental health support, general medicine, and even child care at two sites. And Dufresne said in a sparsely populated region like southern Vermont, the models just not working.

More from VPR: As Losses Mount, Some Hospitals Request Steep Rate Increases [Aug. 1, 2019]

Where we went astray a bit is we started to become everything to everyone, he said. And we started to do services, maybe broader services, than what we probably should have focused on. And do we continue that? Its uncertain right now.

Once the bankruptcy plan is finished for the medical care system, community meetings will be held to discuss how the changes might affect the region.

Springfield Hospital will submit its bankruptcy plan to the court in early spring.

See more here:
Springfield Hospital Looks To Sever Ties With Clinics In Bankruptcy Plan - Vermont Public Radio

By Shirley Bose If its your birthday today Planetary positions are auspicious for travel, particularly for work/business. Visiting several new destinations is exciting and negotiations being successful is also revealed. Planning career/business moves for the next one year is important, keeping long term goals in mind. Income/profits increase. The relationship with your spouse/partner is good, but sometimes you feel there is less emotional connection. Follow diet/exercise plans.

Capricorn: Dont complicate life with an avoidable relationship. News from overseas is quite unexpected. Karmic undercurrents advise being on guard though some work related issues have been logically resolved. Colours: lime green/white.

Virgo: Focus on one task at atime instead of multi-tasking. Getting enough sleep is important. Karmic undercurrents reveal an unexpected surprise is thrilling and just what youve wanted. Colours: bronze/grey.

Aquarius: A wholesome and balanced life is what you aim for. Anxious feelings disappear unexpectedly. Karmic undercurrents advise gradually changing a traditional approach to a more modern way of thinking. Colours: lavender/brown.

Gemini: Just do your duty, letting go of what is not important. Business/career move ahead rapidly. Karmic undercurrents advise taking assertive action since you are in an advantageous position. Colours: maroon/gold.

Libra: Work runs according to schedule and two deadlines are met without any major delays. Resolving a misunderstanding immediately is better. Karmic undercurrents advise being sensitive to a friends moods. Colours: rust/yellow.

Pisces: The present karmic cycle favours enhancing work-related knowledge. Some sign up for a seminar. Karmic undercurrents advise not spending inordinate amounts of time alone. Dont become a recluse. Colours: turquoise/red.

Cancer: Dont worry about circumstances that are karmic in origin. Just do your best to systematically work through them. Karmic undercurrents advise living in the moment peacefully and with faith. Colours: khaki/mustard.

Scorpio: Social life sets a good pace once more and friends make plans. Money owed to you by someone is returned. Karmic undercurrents advise not procrastinating. Do the work immediately. Colours: white/scarlet.

Leo: Stay away from people who regularly play mind games. Karmic undercurrents reveal receiving karmic justice in a job done well feels good (someone else had taken credit for it). Colours: purple/red.

Go here to read the rest:
Horoscope today: Here are the astrological predictions for February 14 - Mumbai Mirror

Its cold, its dark, and youve got zero motivation. Well, one trainer has good news for you: you only need to commit to seven minutes, three to four times a week. Not only could you lose weight and build muscle something thats essential for everyone over the age of 30 but it builds up bone density and targets belly fat, a common midlifer problem. Sounds do-able, right?

HIIT is nothing new you see people doing it in their local park every weekend. But Zana Morris, personal trainer and founder of The Clock gyms in London, has a unique take: we need to do it much harder and for a much shorter time. "You should be totally exhausted after six reps, Morris says, then you move on to the next exercise.

"The key is to think of it like sprint training: you wouldnt sprint for 45 minutes, you run all out for a few minutes. Its the same with HIIT when youre doing it right its about short, sharp bursts.

When I join Morris well-heeled, mainly middle-aged clients at her luxe Marleybone gym for a month in December, I do a different circuit on each visit, either legs and bum, shoulders and arms or back and chest, and am out the door in under 10 minutes. Its a get in, get on, get the job done approach, Morris laughs.

Her approach, which she has been honing for more than 20 years, is backed up by a plethora of research, including a recent study in The American College of Sports Medicine (ACSM) Journal which found that seven minutes was enough to get the fitness benefits. You really can see a difference fast when you do seven minute really intense sessions, Morris says. On average, when you team it with the right nutrition, we see clients lose around 6-7lbs of fat and gain 2-3lbs of muscle.

The reason, Morris explains, is down to our hormones, particularly insulin levels. Any weight around our middle is insulin related, she says. Put simply, insulin, the hormone that regulates the levels of glucose in the blood, can cause weight gain when the cells absorb too much glucose or blood sugar and convert it into fat. Not only can it make you fatter, but in a catch-22 situation, increased body weight can also lead to higher insulin levels. Sleep affects your insulin levels, as does eating carb-heavy or sugary foods and stress all midlifer concerns.

But micro HIIT sessions can reverse that a study published in the journal Frontiers found that a ten-week HIIT training programme in sedentary adult women at risk for type-2 diabetes had positive effects on their insulin levels, while a separate Brazilian study confirmed the same thing, looking at sleep-deprived men and the effect that HIIT had on their insulin levels.

Theres an added benefit to performing HIIT, according to Pamela Peeke, assistant professor of medicine at the University of Maryland and Equinox Health Advisory Board member: The healthy stress your body undergoes during HIIT triggers autophagy, which rids your body of cellular debris and stimulates the production of stem cells, the primary regenerative cells in the body. The more stem cells you have, the better you are able to induce super autophagyits a cycle. Think of it as a spring-clean for your cells.

Peeke recommends HIIT training three times per week plus find every opportunity to add one, two, three minutes of HIIT to your day." Such as doing as many squats as you can in a minute while you wait for the kettle to boil or racing for the bus at a full-out pelt.

But for added benefit, as Morris has found with herself (she has roughly the same body composition now shes in her mid-forties as she did as a 20-year-old) and her clients, is to add in weights. After the age of thirty, we lose between 3-5pcof muscle per decade in a process called sarcopenia (most men will lose about 30pcof their muscle mass during their lifetimes). Its problematic because it not only leads to diminished strength as we get older, but makes us more prone to breakages, according to a study from the American Society for Bone and Mineral Research.

More pressingly, the amount of muscle you have has affects on your weight. Its estimated that 1lb of muscle burns about 50-100 calories per day, Morris explains. So, by the time youre 40, if youve already lost around 5lbs of muscle due to natural age-related wastage, you would need 500 calories less per day. But not many of us reduce our calorific intake in fact, we often increase it. The antidote is to try to rebuild that muscle.

When I train with Morris for four weeks over December, I build up my strength surprisingly quickly. In four weeks I am able to lift 110 kgs on the bench press machine, up from 80kgs at the start. In a month I gain 2.5 lbs of muscle taking me back to my twenty-something levels.

While having a trainer on hand to set your weights up is a luxury, the exercises are easy to replicate at home or in your own gym. You can do 60 squats in a minute, or as many as you can do, or swimming sprints in your pool. You can do it with almost any exercise, Morris says. But dont in the zeal of January restarts think that more is better. In fact, going over the 30-minute mark has negative effects on our ability to build muscle because we start to produce cortisol, which can lead to muscle atrophy. Morris shudders when she thinks of midlifers doing marathons and triathlons (I darent tell her Im one of them).

At the same time nutritionist Mackenzie Dumas looks at my diet. She points out that theres little point training if Im going to continue with my nightly Maltesers/ half a bottle of wine habit. For the first 12 days Im on a high fat, low carbohydrate diet which comprises of a lot of avocado and eggs, and almost zero carbs. During this period, I lose eight pounds of fat, according to Dumas callipers. Then she moves me onto a more sustainable high protein, low carbohydrate diet, which is broadly what the surgeon Dr Andrew Jenkinson author of Why We Eat (Too Much), recently recommended in The Telegraph.

The month under Morris's guidance has been a huge re-education in fitness. Out goes the half-hearted Sunday morning boot campbootcamp in the park, replaced by seven-minute power sessions with my kettlebell.

See the rest here:
Get ready for micro HIIT: the seven-minute workout that could transform your body, and your life - Telegraph.co.uk

Thirty years ago, fat was the main diet demon and carbs fuelled the day with toast or cereal the standard breakfast, a simple sandwich at lunchtime. Back then, dinner wasn't dinner unless a potato or some rice or pasta graced the plate.

Now there are few food groups as tainted as the humble carbohydrate, especially when it comes to weight loss. So while many an extreme diet bans carbs completely, are they really that bad for us? Are some better than others? And how can you strike the right balance for you?

Carbohydrates are one of the three macro-nutrientsthat give the body energy (the other two are protein and fat). Carbs are primarily found in plant-based foods, including bread, rice, breakfast cereal, fruits, starchy vegetables and sugars and offer 17kJ (4 calories) of energy per gram.

The simplest form of carbohydrate is glucose, and carbohydrates range from mixes of simple sugars to hundreds of individual sugars that form more complex carbohydrates, such as breads and cereals.

Carbohydrates can also be grouped according to their glycaemic index. The glycaemic index refers to how quickly or how slowly a carbohydrate releases glucose into the bloodstream. Low GI foods such as wholegrains release the glucose relatively slowly, compared to higher GI foods such as white bread and rice.

Generally speaking, natural sources of carbohydrate, as found in whole, natural foods like fruit, starchy vegetables, and legumes, and wholegrains such as oats, barley and quinoa, are the best carbs to include in the diet on a daily basis.

When carbs are consumed as wholefoods, we get the added benefit other key nutrients, including fibre, vitamins and minerals. Wholegrain and low GI natural sources of carbohydrate are also far less likely to be overconsumed the way refined carbohydrates found in processed cereals, white breads, snack food, biscuits, juices and sugars are.

The amount of carb you need will depend largely on how active you are. If you spend all day on your feet and are already quite slim, you will need more than someone who sits all day does minimal exercise. And similarly, on days you train for an hour or more, you will need more than on a sedentary day when you barely leave the house.

Without shifting to a complete 'low carb' or keto approach, where carbs equate to less than 20 per cent of total calories or just 50-80g of total carbohydrates per day, the average adult will require 30-50 per cent of their daily calories from carbohydrates (you can see this is a wide range), equating to roughly 80-200g of carbohydrates each day, or 1-3 half cup serves at each meal.

As carbohydrate is the primary fuel for the muscles, it is a common belief that eating fewer carbs means that you automatically burn a greater amount of fat. While this is somewhat true, as the body prefers to burn carbs in the form of glucose as its primary energy source, if carbs are restricted to a great enough extent, even though the body will shift to burning fat it will also slow metabolic rate over time. This means that initially you will get good results from a strict low-carb approach, but over time metabolic rate will reduce and the body will begin burning fewer calories as a result. This effect can be observed in individuals who have great success initially using a low-carb diet but who find it difficult to maintain once they return to their usual carbohydrate intake.

The strongest sign that you're eating too much carbohydrate is if you're gaining weight, or not losing weight despite making a concerted effort to eat less and exercise. The easiest way to count your own carbs is to use an online monitoring app such as 'myfitnesspal'.

While extremely low-carb diets, or less than 50g of total carbs a day will support ketosis and rapid weight loss, for those not in keto, it is possible to eat too few carbs for the amount of activity you are doing.

Signs your carbs may be a little on the low side include constant sugar cravings and hunger and an inability to lose weight despite eating less and exercising more. This may suggest you need a little more carbs to successfully burn body fat. The minimum amount of carbs someone not in keto will require is roughly 80-100g plus another 20-30g for every hour of exercise.

Naturally every food that contains carbohydrates has a different amount and generally larger serves for example, larger slices of bread have more than smaller slices. As a general rule of thumb, cup of carbohydrate or one piece of fruit has about 20g of carbs per serve. For a more accurate analysis, simply check 'carbs per serve' on nutrition panels or use a monitoring program such as 'myfitnesspal'.

So carbs are not bad for us, rather it tends to be the types of carbs we commonly choose or are served. Large slices of sourdough or Turkish bread, the white rice in sushi and large serves of noodles and fries at night are when we get our carbs wrong.

On the other hand, fruit, vegetables and controlled portions of wholegrains have plenty to offer the key is to stick to natural, whole unprocessed carbs when you can. And if your goal is weight loss, keep a close eye on how much total carbohydrate you are consuming each day.

Susie Burrell is a leading Australian dietitian and nutritionist, founder of Shape Me, and prominent media spokesperson, with regular appearances in both print and television media commenting on all areas of diet, weight loss and nutrition.

Auto News:Kia's Australian Open Fleet hits the road -caradvice.com.au

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Everything you need to know about carbs - 9Honey

February 11, 2020 Looking at recent media articles about the California wildfires, I continue to see people banter about the electrical utility companies liability due to wildfire ignition starts and the Public Safety Power Shutoffs (PSPS). Seems that a large majority believes that if the utility companies did not contribute to the start of wildfires, our state and nation would not have the current wildfire problem.

Are they right?

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Public comments express that utility companies may put shareholder interests above general public safety by deferring system maintenance for years. But just think if we did not witness the recent influx of devastating wildfires associated with utility companies, would the politicians and others change their priorities and aggressively address/fund wildfire issues?

This thought is not unlike you and I who may know that we need to lose weight, exercise and change some lifestyle habits so we dont suffer a heart attack, but we dont make the hard lifestyle choices until a major traumatic event hits us. While I dont want to thank the utility companies for their liability or the damages and tragedies that resulted, the overall wildfire situation has disclosed a range of topical issues such as infrastructure maintenance, antiquated technology, social media generational differences, insurance coverage/rate issues, population growth outpacing first-responder system growth, and the publics role in emergency preparation.

Here in California, the issues may not be different from elsewhere, but the scale of impact is perhaps nearing a tipping point as the impacts of fire touch nearly every sector, including:

Whether you acknowledge climate change impacts or not, if you are not happy with PSPS actions by utility companies, just recognize that the last three years of devastating wildfires have created an opportunity to aggressively address the wildfire problem.

The National Wildland Fire Cohesive Strategy clearly identifies that as a nation we must learn to live with wildfires by restoring our landscapes, building fire adapted-communities, and having a robust response system. We need to restore our landscapes by various means and the amount of acres burned over three years could never be accomplished by current fuel treatment practices due to bureaucratic and social-acceptance hurdles. We need to build fire-adapted communities, but this community effort has to be contiguous/continuous and not the checkerboard approach that is being done today. Our response system needs advanced technology that is available today and emergency response resources must be bolstered to meet the publics performance expectations.

As noted by a Headwaters Economics report Full Community Costs of Wildfire as a country, we need to decide if we will ever address and sizably invest in the wildfire problem before a fire, or will we simply pay for damages and subsequent post fire issues (i.e. flooding, loss of water sources, etc.) (https://headwaterseconomics.org/wildfire/homes-risk/full-community-costs-of-wildfire/).

In other words, when it comes to wildland fire we must go on a diet, exercise and change lifestyle habits before our heart attack because someday we may not be there to pay for damages. The recent history of devastating wildfires should be the traumatic event that wakes us up to effectively address todays wildfire problem.

And in a strange way, we should acknowledge that those fires and subsequent PSPS issues have helped to focus political efforts. Yet political will and action relies on social will, which is ultimately an individual decision.

Have you seen the fires? Have you tried to adapt to smoke and lived without power? Are we ready, as individuals and communities, to get fire-fit?

Bob Roperspent 40 years in the fire service focusing on wildland fire topics. He is the retired Fire Chief from Ventura County, CA, retired State Forester of Nevada, and currently Western Fire Chiefs Association Policy Advisor. He served as the FIRESCOPE Chair and participated in the development of the National Cohesive Wildland Fire Strategy development. He was a member of Governor Schwarzeneggers Blue Ribbon Commission following the CA 2003 Firestorms. He wroteWildfire The Answer,a reflection and call to action after the 2017 California fire season, in February 2018 Wildfire.

Reprinted with permission from Wildfire Magazine (www.wildfiremagazine.org), published bythe International Association of Wildland Fire (www.iawfonline.org).

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Bob Roper | The fires of California: Past the tipping point? - YubaNet