Benefits of Walking

walk, path, walking
Fotorech (CC0), Pixabay

Evidence of Benefit

We monitor the evidence base for the benefits and harms of walking and funded two comprehensive reviews which are reproduced below. In 2012 William Buckland, the Director of the National Campaign for Walking produced a report for Public Health England and the Ramblers which reinforced the strength of the evidence base – the evidence is very strong that the benefits are considerable and the risks negligible

HEALTH BENEFITS OF WALKING – THE EVIDENCE BASE Prepared by Nick Cavill and Charlie Foster

For the National Campaign for Walking funded by the Department of Health, NHS London and Knowledge Into Action
Version Author Date  Comment
1.0 Charlie Foster & Nick Cavill 25/6/2008  
2.0 Charlie Foster & Nick Cavill 21/2/2009 2 papers by Allender added
       

HEALTH BENEFITS OF WALKING – THE EVIDENCE BASE                                                                     “Walking is the nearest activity to perfect exercise”. Professor J Morris and Dr Adrianne Hardman, 1997[i] 

 1. Introduction

There is now overwhelming evidence about the associations between regular physical activity and a reduction in risk of death, and risk of major diseases like CVD, stroke and diabetes. It contributes to well being and is essential for good health. The considerable evidence base for the links between physical activity and health were reported in the Chief Medical Officer’s (CMO) report[ii].

In many studies, walking is merged with other activities to generate an overall composite measure of physical activity. As walking is one of the most common types of physical activity, we could refer to the evidence that links total physical activity to health outcomes assume that it can be extrapolated to walking. However, there is now sufficient evidence on the independent benefits of walking to health outcomes.

In this report we therefore do not rely solely on evidence about the relationship between physical activity and health and apply that to walking. Wherever possible, we rely on evidence that specifically links walking and health outcomes.

2. The impact of walking on fitness, strength, flexibility and stability of joints

Walking gently stresses the body’s key systems (heart and lungs, muscles, joints and circulation). This stress leads to the body adapting to accommodate the increased demands on it – i.e. becoming fitter. Walking stresses the body at a level that is considered very beneficial to overall health and fitness but is within the reach and ability of all adults and children.

It is important to remember that walking at 3 mph uses up only 30% of the maximum energy consumption of a person aged 25. But, as this decreases by 10% a decade, a person aged 75 walking at the same speed uses up 60% of his / her maximum energy. This principle is central to walking advice or prescription.

Brisk walking can improve cardiovascular fitness[iii]. Even 10-minute brisk walks can increase fitness. One study reported that women walking continuously for 30 minutes on 5 days a week had almost identical increases in fitness as women who split their 30 minutes into three 10-minute walks[iv]. Some younger men and most other adults would improve their fitness if they took up regular brisk walking[v].

We have estimated that encouraging the adult population to walk at 3 mph instead of their slower usual pace would be sufficient to improve their levels of cardiovascular fitness. This message would be appropriate for approximately 6.3 million English adults or 23% of all adults aged 16-74 years (using data from the 1990 National Fitness Survey[vi]. Figure 6 illustrates this.

Figure 6: Average levels of fitness for both genders at different age groups with the reach of brisk walking and its potential impact on improving fitness

Brisk walking would improve fitness for these adults

As muscle strength declines with aging, regular brisk walking can maintain functional capacity and muscle strength. For both men and women there is a strong relationship between stronger muscle strength and brisker preferred walking speed[vii].

Walking and other physical activities can increase joint range of motion, particularly for older adults. Stronger muscles, joints and general flexibility developed and maintained by walking can reduce the likelihood of fallsii. The risks of injury by participating in walking are extremely small[viii].

 3. Mortality and walking

Walking more can bring substantial benefit to health. This benefit is quantified by comparing the risk of specific diseases between people who walk with people who don’t walk. There is a clear dose-response relationship between walking and all-cause mortality[ix]. A physical activity energy expenditure of 500-1,000 kcals per week (about 6-12 miles of walking for an average-weight individual, compatible with the current physical activity recommendations for adults) reduces the risk of premature death by 20-30%ii.

From a public health perspective, helping people to move from a low level of walking to increasing walking levels will produce the greatest reduction in risk. These considerable health benefits hold for both women and men and are evident even up to the age of 80 years. The reduction in relative risk of mortality for adults walking more than 12.4 miles per week compared to adults who walked less than 3 miles per week is 16%[x].

Regular walking across the life course (from childhood to old age) will reduce risk of disease and pre-mature deathi. Figure 7 shows the difference in risk between an active / regular walker and less active / non-walker. The top line (unhealthy non-walker) shows the negative and cumulative effects of inactivity, low fitness and a higher risk of premature illness across the life course.

 

4. Prevention of diseases and risk factors for disease

Walking reduces the risk of many diseases.

The benefits of physical activity can be gained from activities that can be incorporated into everyday life, such as regular brisk walking…Physical activity does not need to be vigorous to confer protectioniv

 

Figure 8: Schematic representation of the dose-response relationship between walking and physical activity level and risk of diseaseii

Walking and recovery from illness

Walking is now commonly recommended by doctors as part of recovery from illness or post operative. For example using walking as an exercise therapy can improve long term conditions such as for people with peripheral vascular disease[xi].

 5. Long-term conditions

There are 15 million people in England with a long-term condition[xii]. These conditions account for 80% of the NHS Budget, 80% of GP workload and 60% of hospital inpatient activity. Those over 75 years of age make up 7.6% of the population. 75% of these have a long-term condition.

The main long-term conditions seen in primary care respond to physical activity both in prevention and treatment. These are outlined below:

Coronary Heart Disease

  • CHD causes over 101,000 deaths per year, one in five deaths in men and one in six deaths in women. It causes 20% and 11% of premature deaths in men and women respectively.
  • There are 2.6 million people living with CHD (i.e. angina, MI) in the UK.
  • The total cost of CHD to the economy is £7.9 billion, with 45% due to direct healthcare costs, 40% in productivity losses and 16% due to the costs of informal care.[xiii]

The cost of ischaemic heart disease to the NHS due to physical inactivity has been estimated at 23% of a total spend of £2.3 billion[xiv]. The Foresight report [xv] estimates direct NHS costs of CHD in 2007 to be £3.9 billion, suggesting the total NHS cost of CHD due to physical inactivity to be just over £1 billion.

The effect of walking on CHD is as follows[xvi]:

  • Increased maximal oxygen consumption
  • Relief of angina symptoms
  • Increased heart rate variability
  • Reduces Blood Pressure
  • Reduces body fat
  • Increases fibrinolysis
  • Increases levels of HDL
  • Improves glucose-insulin dynamics.
  • Improved psychological wellbeing
  • Protection from triggering an MI from vigorous activity >6 METS

For a healthy, young or middle-aged person, walking at a ‘normal’ to ‘brisk’ walking pace is enough to reduce the risk of cardiovascular disease and to improve risk factors for cardiovascular diseaseii.

Walking more than four hours per week reduces the risk of hospitalisation for cardiovascular disease by 30% compared to walking less than one hour per week[xvii]. The incidence of CHD is halved by walking over 1.5 miles a day in men compared to men who walked less distance per day[xviii]. Women who walked for exercise for about hours per week enjoyed a 35% reduction in their risk of CHD events compared to women who walked infrequently[xix].

Brisk walking of more than 3.5 hours a week may slow an atheroma, and walking five hours a week may slowly reverse its formation[xx].

Regular brisk risk walking reduces diastolic blood pressure but appears to have no effect on systolic blood pressureii.

Brisk walking for 8-15 miles per week for 6-9 months can increase good cholesterol levels (HDL) and reduce triglyceride levels in the blood[xxi]. Regular stair climbing has been reported to cause increases in HDL cholesterol, and a reduced ratio of total cholesterol to HDL cholesterol[xxii].

Heart Failure

  • There are about 900,000 people with heart failure in the UK, with a steep increase in age from 1% in those under 65 to 15% of those over 85[xxiii].
  • The total cost of treating heart failure in the NHS is £628.6 million, with the 86,000 hospital admissions accounting for over 60% of these costs[xxiv].
  • There are over 7.6 million GP consultations every year for heart failure, costing £103 million[xxv].

Most of the symptoms of heart failure are due to poor perfusion in the peripheral muscles secondary to limited cardiac output. Exercise limitation is usually from leg weakness due to lactate accumulation, leading to shortness of breath because of resulting acidosis. Regular walking therefore improves the peripheral muscle metabolism more than it affects the cardiac output. Regular walking as part of a rehabilitation programme significantly enhances quality of life, helps to retain independence and reduces hospital admissions.

Stroke

  • There are 68,400 strokes each year in the UK, causing 55,000 deaths and costing the NHS £1.36 billion.
  • Patients who have had a stroke are usually highly de-conditioned, with half the average VO2 maximum.

After a stroke regular walking can increase self-selected walking speed, reduce dependence on external aids (so maintaining independence), and reduce fatigue.

One study reported a decreased risk for stroke across increasing categories of walking pace in women[xxvi].

Most patients who have had a stroke will be encouraged to walk through their physiotherapy-led rehabilitation. There appears to be less structured walking programme for stroke patients. NICE will publish guidelines on stroke rehabilitation in 2009

Diabetes

  • There are 2.2 million people with diabetes in England (4.48% of the population) [xxvii]
  • This will increase to 3.6 million by 2025 (64% increase)
  • Half this increase is from the rise in obesity.

The effects of walking on diabetes include:

  • Improvement in blood sugar control
  • Improved insulin sensitivity
  • Reduction in body fat
  • Cardiovascular protection
  • Stress reduction (Stress can disrupt diabetes control by increasing counter-regulatory hormones, ketones and free fatty acids)
  • Prevention of diabetes in those at high risk[xxviii].

Walking and cycling levels are also associated with reduced risk of type 2 diabetes: those who walk or cycle more are less likely to get type 2 diabetes[xxix]. Walking and other changes can be a better option for helping to manage diabetes in some patients than drugs. The lifestyle changes in diet and increases in daily walking were found to be more effective in reducing the incidence of type 2 diabetes than treatment with the drug metformin (58% versus 31% reduction in risk)[xxx].

Chronic Obstructive Pulmonary Disease (COPD)

  • 900,000 people have a diagnosis of COPD, with half as many again living with COPD without a diagnosis.[xxxi]
  • There are 109,000 COPD admissions, contributing to one million bed days costing the NHS £600 million, with a total cost to the NHS of about £1 billion.
  • COPD causes 24 million lost working days per year.

COPD patients who undertake more walking halve their risk of being admitted as an emergency admission.[xxxii] NICE guidance requires that all COPD patients who can walk attend Pulmonary Rehabilitation (PR). Patients in PR are recommended to walk regularly but there are only isolated schemes that link with organised walking groups. Regular exercise in groups reduces breathlessness and anxiety and increases confidence and independence.

Depression and Anxiety

  • Every day, 25,000 people see their GP with a psychological problem.
  • 7% of the population suffer from Depression and Anxiety at any one time.
  • In 2005, 27.7 million antidepressant prescriptions were written in England, costing £338 million.
  • The cost of depression in lost economic output is £12 billion a year[xxxiii].
  • There is doubt whether most anti depressants are any better than Placebo.[xxxiv]

The Chief Medical Officer states that ‘Physical activity is effective in the treatment of clinical depression and can be as successful as psychotherapy or medication’ii.

NICE recommends that patients with mild depression follow a structured and supervised exercise programme of up to three sessions per week of moderate duration (45 minutes to one hour) for between 10 and 12 weeks. Walking might contribute to this type of regime[xxxv].

Walking can improve self-esteem, relieve symptoms of depression and anxiety, and improve mood[xxxvi]. There is an inverse relationship between daily walking and the reporting of depressive symptoms[xxxvii]. Shorter bouts (10-15 minutes) of brisk walking can induce significant positive changes in mood.

Osteoarthritis

  • Osteoarthritis of the knee and hip is the single most important cause of disability in retirement years, affecting up to 25% of those over 65.
  • The annual cost of treatment to the NHS is £675 million.
  • There are 36 million days lost due to osteoarthritis, costing the economy £3.2 billion in lost earnings.

Regular walking to build up the quadriceps muscles and help reduce weight is the cornerstone of both preventing and reducing symptoms of osteoarthritis of the hip and knee. Three 40-minute walks a week may help to halt the progression of knee osteoarthritis[xxxviii]. Regular walking and other moderate physical activities may be associated with a lower risk of subsequent osteoarthritis, especially among women.[xxxix]

Ironically, most GPs we spoke to said that the most frequent reason why overweight patients with osteoarthritis of the knee could not walk more was because of pain.

Obesity

  • 24% of the population is obese and by 2050 60% of males and 50% of females will be obese.
  • In men, 18% of social class I and 28% in social class V are obese.
  • In women 10% of social class I and 25% in social class V are obese.
  • The current NHS cost is £1 billion with a projection of £6.5 billion in 2050.
  • The wider cost of obesity is £7 billion, rising to £45.5 billion in 2050.

Obesity is associated with diabetes, hypertension, asthma, osteoarthritis, depression and hyperlipidaemia. All of these are independently improved by regular walking.

Walking uses up about 100kCal per mile regardless of pace. Abdominal weight gain has been reported to be less than peripheral gain for women who walked >4 hours a week than women who walk less than 2 hours.

Below two hours a week walking there appears to be no weight loss.

Walking one hour a day for five days a week at 50-70% VO2 max can promote regional fat loss in the abdominal sites[xl]. This is critical in reducing the risk of diabetes and coronary heart disease. Overall weight may change little as lean body mass increases with exercise. Brisk walking reduces BMI and body weight,and also reduces body compositionii.

Any walking will help children and young adults to maintain energy balance[xli]. Any consistent movement of body weight by regular walking or stair-climbing will contribute to energy expenditure and may help with weight management.

Obesity is the single most common reason for GPs to refer patients for walking schemes and exercise referral schemes.

Walking and Cancer

Fewer studies have examined this relationship compared to other diseases, and the majority has only looked at physical activity rather than walking alone. However there is evidence that physical inactivity is associated with increased risk of colonic, breast (postmenopausal) and endometrium cancer. A faster reported walking pace was associated with a reduced risk of colorectal cancer in men compared to men with a slower walking pace than others[xlii].

6. Walking and children’s health

The Chief Medical Officer has pointed out that there is a strong justification for encouraging young people to be physically active. Physical activity provides an important vehicle for play and recreation, learning physical and social skills,

developing creative intelligence and stimulating growth and fitness.

However, there is relatively little direct evidence (compared with adults) linking physical inactivity in children with childhood health outcomes. The chronic diseases described above require long incubation periods, and children and adolescents very rarely have lifestyle-related diseases such as hypertension, diabetes, osteoporosis or cardiovascular disease.

Promotion of physical activity and walking in childhood does have strong justification however. It:

  • Promotes healthy growth and development of the musculoskeletal and cardio-respiratory systems
  • Helps maintain energy balance and hence healthy weight
  • Lowers risk of hypertension and high cholesterol
  • Generates opportunities for social interaction, achievement and mental well-being.

Walking is an excellent activity for all of these benefits. In addition, it may be that walking patterns track better into adulthood than do sport and leisure pursuits.

7. Economic value of walking

There is currently no economic evaluation of walking.

WHO has recently published guidance on including health effects in economic appraisals of transport interventions[xliii]. This was designed primarily to help transport economists estimate the mortality (and therefore economic) benefits of interventions that increased walking and cycling (such as new footpaths, policies or programmes). The rationale for this work is that 35% of all energy demand is from transport and 80% of this is in road transport. The transport sector is projected to be responsible for 90% of the increase in CO2 emissions until 2010.

The WHO guidance covered walking and cycling but the subsequent Excel model focused only on cycling. WHO is now proposing to extend this model to include walking to provide a practical tool that can be used at local, national and international level to make the case for walking.

This represents an opportunity to strengthen the approach taken to provide an economic appraisal and provide a strong, evidence-based arguments to advocate walking to key policy-makers.

[i] Hardman AE, Morris JN. Walking to health. British Journal of Sports Medicine 1998 Jun;32(2):184

[ii] Department of Health (2004). At least five a week: a report from the Chief Medical Officer. London, Department of Health.

[iii] Murphy MH, Nevill AM, Murtagh EM, Holder RL. The effect of walking on fitness, fatness and resting blood pressure: a meta-analysis of randomized, controlled trials. Preventive Medicine 2007; 44:377-385.

[iv] M Murphy and A E Hardman 1998, ‘Training effects of short and long bouts of brisk walking in sedentary women’ in Medicine and Science in Sports and Exercise 30:1:152-7

[v] Killoran AJ, Fentem P, Caspersen C. Moving on: an international perspectives on promoting physical activity. London: Health Education Authority, 1994.

[vi] Sports Council, Health Education Authority, 1992. Allied Dunbar national fitness survey. Health Education Authority, London.

[vii] American College of Sports Medicine. Exercise and Physical Activity for Older Adults. Medicine & Science in Sports & Exercise 1998. http://www.acsm.org/Content/NavigationMenu/Research/Roundtables_Specialty_Conf/PastRoundtables/Exercise_for_Older_Adults.htm

[viii] Sandolin J, Santavirta, Lattila R, Vuolle P, Sarna S. Sport injuries in a large urban population: Occurrence and epidemiological aspects. International Journal of Sports Medicine 1988; 9:61-66.

[ix] Lee IM, Skerrett PJ. Physical activity and all cause mortality: what is the dose-response relation? Medicine and Science in Sports and Exercise 2001; 33: S459-S471; discussion S493-S494.

[x] Lee I, Paffenbarger R. Physical activity and stroke incidence: the Harvard Alumni Health Study. Stroke 1998;29:2049-54.

[xi] Gardner AW, Poehlman ET. Exercise rehabilitation programs for the treatment of claudication pain. A meta-analysis. Journal of the American Medical Association 1995; 274: 975-980.

[xii] Our Health, Our Care, Our Say (2006) Department of Health

[xiii] Allender S, Peto V, Scarborough P,  Kaur A, Rayner M. Coronary heart disease statistics 2008. London: British Heart Foundation, 2008.

[xiv]Allender S, Foster C, Scarborough P, Rayner M. The burden of physical activity related ill health in the UK. Journal of Epidemiology and Community Health 2007; 61:344-348.

[xv] Tackling Obesities: Future Choices – Modelling Future trends in obesity & their impact on Health. A Foresight report for Government Office for Science.

[xvi] ACSM’s Exercise management for persons with chronic diseases and disabilities. Durstine JL Moore GE 2002.

[xvii] LaCroix AZ, Leveille SG, hecht JA, Grothaus LC, Wagner EH. Does walking decrease the risk of cardiovascular disease hospitalizations and death in older adults? Journal of American Geriatric Society 1996; 44: 113-120.

[xviii] Hakim AA, Curb JD, Petrovitch H, Rodriguez BL, Yano K, Ross GW, White LR, Abbott RD. Effects of walking on cornary heart disease in elderly men: The Honolulu Hart Program. Circulation 1999;100:9-13.

[xix] Manson JE, Hu FB, Rich-Edwards JW, Colditz GA, Stampfer MJ, Willet WC, Speizer FE, Hennekens CH. A prospective study of walking as compared with vigorous exercise in the prevention of coronary heart disease in women. New England Journal of Medicine 1999; 341:650-658.

[xx] Hambrecht R, Niebauer J, Marburger C, Grunze M, Kalberer B, Hauer K, Schlierf G, Kubler W, Schuler G. (1993) Various intensities of leisure time physical activity in patients with coronary artery disease: effects on cardiorespiratory fitness and progression of coronary atherosclerotic lesions. J Am Coll Cardiol; 22 (2):478-9.

[xxi] Dishman RK, Washburn RA, Heath GW. Physical activity epidemiology. Champaign, Human Kinetics 2004.

[xxii] Boreham CA, Wallace WF, Nevill A. Training effects of accumulated daily stair-climbing exercise in previously sedentary young women. Preventive Medicine 2000; 30: 277- 281.

[xxiii] Ellis C, Gnani S and Majeed A (2001) Prevalence and management of heart failure in general Practice in England and Wales 1994-1998. Health Statistics Quarterly 11: 17-24.

[xxiv] DH (2002) Hospital Episode Statistics 2000-2001

[xxv] Gnani S et al (2001) Health Statistics Quarterly; Netten et al (1999) PSSRU, University of Kent.

[xxvi] Hu FB, Stampfer MJ, Colditz GA, Ascherio A, Rexrode KM, Willett WC, et al. Physical activity and risk of stroke in women. Journal of the American Medical Association 2000; 283: 2961-2967.

[xxvii] Yorkshire and Humber PHO. Diabetes – key facts, Yorkshire and Humber PHO, 2005.

[xxviii] ACSM’s Exercise Management for persons with Chronic Diseases and disabilities. Human Kinetics 2002.

[xxix] Hu FB, Sigal RJ, Rich-Edwards JW, Colditz GA, Solomon CG, Willett WC, et al. Walking compared with vigorous physical activity and risk of type 2 diabetes in women. Journal of the American Medical Association 1999; 282: 1433-1439.

[xxx] Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention of metformin. New England Journal of Medicine 2002; 346: 393- 403.

[xxxi] NICE Guidelines on COPD management. Thorax 2004;59(suppl 1); 1-232.

[xxxii] Garcia-Aymerich J, Farrer E, et al Risk factors of readmission to hospital for a COPD exacerbation: A Prospective Study. Thorax 2003;58:100-105.

[xxxiii] LSE The Depression Report The Centre for Economic Performance’s Mental Health Policy Group June 2006

[xxxiv] Moncrieff J, Kirsch I Efficacy of antidepressants in adults. BMJ 2005, 331 155-9

[xxxv] NICE. Depression, NICE Guideline, Second Consultation. London: NHS, 2003, p19, 21.

[xxxvi] See MIND at http://www.mind.org.uk/Information/Booklets/Mind+guide+to/Mindguidetophysicalactivity.htm

[xxxvii] Mobily, K. E., L. M. Rubenstein, J. H. Lemke, M. W. O’Hara, and R. B. WALLACE. Walking and depression in a cohort of older adults: the Iowa 65+ rural health study. J. Aging Physiol. Activ. 4:119-135, 1996

[xxxviii] Ettinger Jr WH, Burns R, Messier SP, Applegate W, Rejeski WJ, Morgan T, et al. A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST). Journal of the American Medical Association 1997; 277: 25-31.

[xxxix] Rogers LQ, Macera CA, Hootman JM, Ainsworth BE, Blair SN. The association between joint stress from physical activity and self-reported osteoarthritis: an analysis of the Cooper Clinic data. Osteoarthritis and Cartilage 2002; 10: 617-622.

[xl] ACSM Exercise Management for persons with chronic diseases and disabilities Ch 23

[xli] The Health of Children and Young People 2003. Chapter 4: Physical Activity

[xlii] Davey Smith G, Shipley M, Batty G et al. Physical activity and cause-specific mortality in the Whitehall study. Public Health 2000;114:308-315.

[xliii] Cavill N, Kahlmeier S, Rutter H, Racioppi F, Oja P. (2008) Economic assessment of Transport Infrastructure and Policies: Methodological guidance on the economic appraisal of Health effects related to Walking and cycling. Rome. World health organization. Http://www.euro.who.int/transport/policy/20070503_1

 

Do you have memory loss?

Alexas_Fotos (CC0), Pixabay

Dear Diana I am in my early 60’s and am annoyed with myself because I often don’t remember people’s names or what I am out shopping for and sometimes I even forget what I did yesterday! My family get cross with me is there anything I can do to help myself?
Elaine Wright… Huddersfield

Dear Elaine it’s normal to become a bit forgetful as we get older. But memory loss (amnesia) is unusual forgetfulness which happens when we can’t remember information of new events, or past events which we would normally be able to recall. Memory loss can start suddenly and get worse over some time, or the loss may be for a short time (transient) and then resolve.

Some memory loss may be caused by anxiety stress or depression. It’s a distressing situation for both the person affected and their family with relatives sometimes fearing the worst. They assume its dementia, but this often isn’t the case, 40% of people over 65 have some type of memory problem, but only 15% will develop dementia each year.

Simple tips to cope with poor memory are keeping things like car keys in the same place, and writing important events and dates down. If you are worried it could more serious talk to your doctor who will do an initial assessment, ask questions about symptoms, your family history and lifestyle. A GP may arrange a blood test or if a more serious underlying condition is suspected, like brain damage, refer you to a specialist. But hopefully you jotting things down will do the trick!

Bone Strengthening Exercises & Tips For Those Who Suffer From Osteoporosis

Source

You’re never too old to improve bone and muscle strength, even if you actually suffer from osteoporosis. Before-and-after research with very elderly people has demonstrated the benefit of bone-loading exercise and also shown how mobility and muscle power enhance even simple activities like getting up from a chair, lifting parcels or going up stairs. Of course these benefits also reduce the risk of falling and suffering a fracture. Should you have the bad luck to fall, you’re less likely to suffer serious consequences.

One study showed that 30 exercising women with an average age of 84 showed bone gains of over 2% compared to an inactive group who lost over 3% of bone thickness when monitored by researchers for three years.  What makes this study remarkable is that they did it sitting down! Their routine included knee lifts, toe taps, arm lifts, sideways bends, leg spreads.  The exercisers worked out for 30 minutes a day, 3 days a week.

Thin old people are more likely to fracture their hips when they call than their plumper contemporaries. Some researchers suspect that the fat acts as a kind of shock absorber. Hence the arrival of the energy-absorbent hi-protector, a padded device developed in Denmark that can be worn by anyone frail and elderly and at risk of damaging falls.

An 8-week programme of ‘high resistance’ training followed by 10 elderly people in an American residential home resulted in spectacular gains in muscle strength.  Muscles were more flexible afterwards too, another vital  weapon in the fight against falling.

Improvements in muscle strength can come within weeks of doing regular daily exercise, but bone-building takes longer. There may even be an initial period when bone gets slightly thinner, but after a year, improvement should be discernible.

If you already suffer from osteoporosis, there’s no need for us to remind you of the discomfort and pain you experience.

If you have the disease in your spine, particularly in your lower-middle back below the ribs, you may be permanently bent over and unable to hear weight through your spine.  In this case, we know, exercises are difficult and in some cases impossible to perform.

The best treatment for sever sufferers is pain-relieving drugs prescribed by the doctor and rest in bed with a pillow under the head for support. One pillow if possible  though we know some people can only find relief with more. Add a pillow under the knees and relax with legs straight if you find that more comfortable.

Most people, however, can benefit from some exercise, and I have designed our Osteo-Relief Bone Strengthening specifically for osteoporosis sufferers. Do them on a regular basis for at least 3 months before you expect to see any improvement. Don’t be discouraged if you feel initial discomfort. After a fall or operation, it is often difficult to overcome the pain barrier – the fear of pain, in fact. But remember the rewards in terms of regaining mobility, strength and independence, and try to stick it out.

If you have any doubts, show the exercises to your doctor or consult a trained physiotherapist. The extra stress on bones during exercise is not appropriate for people with advanced osteoporosis and could result in fracture.  Seek medical advice if you think you are  at risk before attempting Osteo-Relief Bone Strengtheners.

People without osteoporosis who have been actively exercising during their middle years can, and indeed do, continue at a high level of physical activity through out life, but late-starters need to take it nice and easy, putting the emphasis on walking, swimming, dancing and low-key routines like the one we suggest here.

A brisk daily walk is healthy and beneficial for anyone and everyone.  Not only does it increase our stamina, strengthen our heart, improve circulation and tone up our muscles, but it’s a Bone Booster too. A simple walk costs nothing and gives excellent results – so off your bottom and get those boots walking.  Keep to a brisk pace and walk for at least 20 minutes.  You should puff a bit!

THE EXERCISE PROGRAMME

The following 5 exercises are particularly beneficial if you already suffer from osteoporosis. They will help strengthen your spine and correct your posture

  1. NECK RETRACTION

Lie on your bed with your knees bent and a small pillow to support your head. Fix your eyes on a spot above you, and simply push with your neck and stick your chin up and out. Retract your chin and pull it down into your chest as far as you can. Continue with this ‘chicken neck’ exercise for 1 minute. As you progress over the weeks, remove the pillow but keep your knees bent and continue the exercise for 1 minute. Aim eventually to lie out on the floor without the pillow and with legs straight to do the exercise.

  1. SPINAL ROLL

Lie on your bed, preferably without a pillow, with both knees bent and arms out to your sides, opalms down. Keep your feet in contact with the bed and roll both knees together over to your right side as far as comfortable. Try to look over to your left hand. Hold 2-4 seconds. Slowly bring your knees back to the centre, and carefully roll them over to your left side and try to look right. Hold 2-4 seconds. Keep your upper back, shoulders and arms in contact with the bed throughout the exercise. Aim to do 4 rolls to each side, and eventually to do the exercise on the floor.

  1. FORWARD LIFT

To strengthen your tummy muscles like on your bed with your head supported by a small pillow. Bend your knees up, feet down flat on the bed. Place your left hand behind your head (or neck), and extend your right hand on to your right thigh. Breathe out and lift your head and shoulders up, sliding your hand up to your knee. Breathe in and relax back down. Continue 4 times, then change hands and repeat 4 more lifts with your left hand on your left thigh. Aim eventually to do this exercise on the floor without a pillow, but always with your knees bent.

  1. BOTTOM LIFT

Lie on your bed without a pillow, with your knees bent and feet flat down. Place yur hands up on your thighs. Clench your bottom and lift it up off the bed. Hold for 2-4 seconds and carefully relax back down. Repeat 8 times, and try eventually to do this exercise on the floor.

  1. PRESS BACK

This exercise is best performed on the floor. Lie out on your tummy, chin to floor. Place your hands under your shoulders with your fingers turned slightly inwards.  Breathe out and push yourself back to lift your shoulders and chest up off the floor. Breathe in and relax back down. (Keep your chin facing down as you lift up,) Repeat this exercise 8 times.

When you first start this exercise you may need several pillows under your tummy in order to get comfortable and completely straight before attempting to bend backwards.

  1. RELAX

Lie on your back with your head supported by one pillow, (more may be necessary in severe cases). Place another pillow behind your knees and thighs to help relieve pain. Place your hands comfortably on your rtummy. Breathe deeply, taking the breath into your abdomen, and feel the rise and fall of your tummy with your fingers.  Close your eyes and relax.

It is often difficult for those who have vertebral factures, with painful, tender spines and limited mobility, to lie on their backs.  You may find it easier to try an alternative starting position for some of the exercises, such as sitting, from which you can do head and upper back exercises.

People who have already fractured their vertebrae can also benefit from exercise, to strengthen the muscles around the hips and knees – strong muscles in the legs help to prevent falls, which may well lead to fractures.

For information and further specific illustrated exercises for osteoporosis sufferers, contact the National Osteoporosis Society for their booklet Exercise and Physiotherapy in the Prevention and Treatment of Osteoporosis.

DAILY LIVING  MAKING IT EASIER

Walk tall is tough advice if you suffer from a curved upper spine, but, nevertheless, it’s exactly what you need. Get into he habit of checking that your shoulders are down and back, your chin pulled in and your weight evenly distributed. Hold your abdomen in if you can. Check your posture by standing against a wall:heels touching it, no hollow back. If you can’t get your head straight against the wall at first, keep practising.

Don’t slump when you sit, get your bottom well back into the chair. A soft, low armchair may seem like luxury, but if it makes you sink too low and rounds your back, change to something more upright with a high, firm back. A rolled towel at he back of your neck and another supporting the small of your back will enhance comfort and remind you to sit upright when reading. Make sure your feet are resting easily on he floor, and when you get up, resist bending forward. Keep as upright as possible and then stand up straight. You may find that at first you need to hold on to something as you get up, but gradually you’ll be able to do it without the help.

A supporting mattress doesn’t have to be iron-hard, and you don’t need special orthopaedic types. On the other hand, it shouldn’t sag. Buy a new one if yours shows signs of wear, and if it feels a bit on the hard side after that comforting sag, put a quilt over it and sleep on that to soften the blow.

Practise getting up and down from the floor once a day. It will help lessen the impact should you accidentally fall.

Start by standing beside a steady, upright chair, holding the back with the left hand. Get down on your left knee, keeping your back straight, then take the right knee down, letting go of the chair and go down on all fours.  Swing your bottom over to the floor on the right and sit down, Stand up in your own time, using the chair as support.

Guard your back when lifting anything heavy. Get as close to the object as possible, go down on one knee to pick it up, hug the load to your abdomen and lift with the strength from your legs by pushing down firmly with both feet. Don’t try to take on too-heavy loads.

Remember, calcium helps reduce bone loss in older women. Recommended daily allowances are give on page… and calcium supplements have been shown to have a protective effect.

Poor diet not only leads to malnutrition and muscle weakness, it can also mean shrunken jaws and loose-fitting false teeth. Cooking for one doesn’t have to be a chore. Even if someone else does the shopping for you, when it’s cold and wintry outside, make sure you give them a shopping list that includes daily helpings of fresh fruit and vegetables, fish and dairy produce, and not too much fried food.

How to prevent falls

Osteoporosis – Bone Booster Exercises

Photo by Pixabay on Pexels.com

HOW MY EXERCISE PROGRAMME CAN HELP YOU

My Bone Boosters programme consists of a set of easy movements designed specifically to strengthen and preserve bone thickness.  They are exercises you can do in your everyday life, around your home or workplace or in the garden. You need no more than 20-30 minutes a day, for three days a week, though we do ask that you build up to this slowly to avoid possible injury or over-tiring.

Bone Boosters are intended especially for women of 40-plus who are approaching the menopause, but the earlier you start incorporating them into your life, the better.  There is also a special Osteo-Relief section of exercises for those who already suffer from osteoporosis.

But before you start this or any exercise programme, please check with your doctor if you suffer from heart disease, have high blood-pressure, joint problems, back problems, if you are very overweight, have any serious illness, or are convalescing.

If you already have osteoporosis, do not attempt the main Bone Boosters section and, check with your doctor before starting on the special Osteo-Relief.

It is essential that you check the support and equipment you will be using before performing any of the following exercises in your home or even out in the garden, to make sure they are strong enough to take your weight.

How much exercise should we do?

To be effective exercise must be done on a regular basis.   Some physical activity should be undertaken for an hour at least once a week, but preferably more often, up to 5 times a week.  Ideally a generally more active lifestyle must be aimed for, because all exercise and activity is good for us – but inactivity isn’t.

Why is weight bearing exercise so beneficial?

We know that it’s a natural process for women (and men) to lose some density from bone after about the age of 35.  Research over the past 10 years or so has shown that through regular, weight-bearing exercise it is possible to prevent some of the dramatic loss which often occurs in women over 50.   This is largely due to the fall in levels of the female hormone oestrogen at the time of the menopause (or earlier if there has been a premature menopause brought about by hysterectomy).  Genetic inheritance and other factors can also contribute to bone loss.

Weight-bearing exercises or movements that use the bodies own weight will help preserve and even build bone, but the effect only occurs when the weight is repeatedly exerted. Muscles that are attached to either end of the bone force it to twist and bend in response to strike action and jarring movements.  This stress-strengthening effect on bone is boosted if sufficient calcium and Vitamin D are available in the diet – more on this in our chapter on nutrition……

Simple brisk walking, skipping or running all use a hard, vibrating strike action with the weight of the upper body borne by the spine hips, legs and feet.  A push up uses whole body weight and can strengthen shoulders arms and wrists.  Studies by Dr Joan Bassey at the University of Nottingham Medical School Nottingham showed that pre-menopausal women who were encouraged to do a series of little jumps for a controlled period of time on a regular basis, significantly increased the bone density of their ankles, knees and femoral head.

Can you target specific bones?

Introducing additional weights can target specific bones still further.  For example, exercising with dumb-bells puts extra demand on the arms and wrists.  So too does carrying heavy bags of shopping (as long as you keep a straight back and don’t stoop).  Lifting household objects, like heavy cooking pots or the vacuum cleaner, has a similar Bone-Boosting effect.   However care must be taken when carrying awkward and heavy objects to avoid a falls that might cause a fracture.  Twisting off the tight lid of a jar helps wrists and forearms too.

Once you’ve followed my bone boosting exercise programme you will be able to adapt other everyday objects and activities and turn them into your own Bone Boosters.

My Bone Boosters programme targets hips, wrists, and spine particularly, these being most vulnerable to the painful, crippling and sometimes fatal fractures caused as a result of osteoporosis.  So go ahead, enjoy the sessions and make them part of your life.   And may the power they bring be with you.

BONE BOOSTERS EXERCISE PLAN

Before you begin my special Bone Boosters exercise plan it is essential to warm-up by putting your major joints through their natural range of movement.  This will help to maintain mobility, warm up major muscles and raise the pulse.  By adding some stretches to your warm up you will be ready and prepared to continue exercising without the risk of injury.  But the less fit you are, the longer your warm-up needs to be.  An average warm-up should take 5-10 minutes.

WARM-UP

So, let’s make a start.  You need to be wearing loose, comfortable clothes and sports shoes if possible.  Clear enough space and use furniture and fittings around the house, like tables, chairs, banisters and the kitchen sink, for support.  Or better still you could exercise outside in the fresh air.  But before performing any exercises in your home or garden, it is essential to check that the support is secure and strong enough to take your weight, and that the ground surface you are working on isn’t wet or slippery.  Don’t exercise until at least an hour after meals, and keep drinking water near at hand to avoid becoming dehydrated.

1.  STAND TALL

Check your posture by standing with your feet comfortably apart, your shoulders back but down and relaxed.  (Don’t poke your head forward.) Pull in your tummy muscles, tighten your bottom and tuck your tail under.  This will tilt your pelvis forward.  Your knees should be soft (relaxed).

2.  WRIST CIRCLE

To mobilise wrists sit in your chair or stand up.  Tuck your elbows into your waist or place them on a table for support and simply circle your hands, working the wrists first 8 times in one direction, then 8 times in the other direction.

3.      WINDMILL

To mobilise shoulders and release tension, place your fingertips on your shoulders.  Bring your elbows together in front of you, then take them up, and back, and draw imaginary circles with your elbows, pulling your shoulder blades apart.   8 times clockwise then 8 times anti-clockwise.

4.      HEAD ROLL

To mobilise neck and release tension, look over your right shoulder with chin parallel to floor.  Slowly drop your chin to your chest and roll it on around to look over your left shoulder.  Return your chin to your chest and roll back up to the right side.  Continue with control, 8 times. Do not roll your head backwards.

5.      ANKLE  CIRCLE

To mobilise ankles and toes, stand with your feet comfortably apart, hands on your hips or hold on to a table unit or chair back for support.  Place the toes of your right foot on the ground.  Keep them in place, heel up.  Circle your ankle 8 times clockwise, then 8 times anti-clockwise.  Repeat with your left foot.

6.      SIDE TWIST

To mobilise your upper body, stand with your feet apart, lift your arms up to shoulder level.  Bend your elbows and bring your fingertips together.  Keep your hips facing forward and twist your upper body and head around to the right side only.  Come back to face centre, then take your upper body around and look to the left.  Repeat 8 times.

7.      SIDE REACH

To mobilise the sides of your body, stand with your feet apart and knees relaxed.  With your right arm, reach up and over your head, bending your left knee.  Bring your arm down and transfer your weight on to your right leg and reach up and over with your left hand.   (As if you are climbing up a rope.)  Repeat 8 times to alternate sides.

Diana Moran – Artist

Diana says: – 

“Ever since I was a little West Country girl I’ve enjoyed drawing and painting. At my Bristol Grammar school I proved to be a competent artist and later obtained entry into the West of England College of Art with the intention of becoming a full time student. However my very strict father would not consent to my being an Art Student!  I had to get what he called – a “proper job”!

Subsequently, in the following years, as and when my work allowed, I regularly attended Evening Art Classes. I thoroughly enjoyed the experience and viewed painting as my hobby and relaxation.  I mostly painted in oils, on a board or canvas.  Later on, and as a result of my BBC TV and media work, I was fortunate enough to be invited as a regular Guest Speaker on major cruise lines. Whilst at sea and when not speaking, I had the time and opportunity to attend painting classes aboard.  I was introduced to watercolours, this medium being convenient to both pack and paint with whilst travelling. However, 4 years ago out painting landscape with a local group of amateur artists, here in Surrey, I was introduced to Acrylics and discovered the convenience of quick drying! Acrylics are now my preferred medium.  I enjoy the intensity of colour, ease of handling and the ability to “correct” things immediately – when they don’t go according to plan! 

 

Covid has been a miserable experience for most of us, but personally I have found that with extra time on my hands I‘ve had more opportunity

 to devote to painting. My conservatory has become my studio with its excellent natural light.

Having spent much of my time in the past painting still life, flowers and landscapes I have now broadened my horizons to painting birds, animals, fish and….people!”

I’ve put up some examples of my work at http://www.goddessart.co.uk – let me know what you think?

KFACO Part one intro and warning

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Some exercises are not suitable for seniors with limited abilities

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Diana Moran – My paintings of animals

I have not been taught to paint animals but maybe my natural love of all creatures great and small helps me depict them.  Ella, a dear horse adored by her owner Lucy, one of my granddaughters, was my first nervous attempt.  I was very pleased with the result which spurred me on to paint my own cat Maisie and other people’s pets.

If you’d like to know more – head over to http://www.goddessart.co.uk and sign up [free] for more of my paintings and let me know what you think of them!

Granddaughter Lucy with painting of her horse
Ella Oils on Canvas 16 x 20

summertime should be about fun in the sun

Photo by Emma Bauso on Pexels.com

Mention summer and I immediately think bikinis, swim suits, short shorts and skimpy clothes. Like most of you I want to look good in the sunshine – summertime should be about fun in the sun! The “hazy, lazy, crazy days of summer” include picnics and barbeques and this I find a bit challenging when it comes to maintaining healthy eating habits. I prefer fish and other seafood, and when the weather is hot I like to eat smaller meals, but more frequently. The more often I eat, the higher my metabolic rate – and a higher metabolism burns more calories. If you prefer meat for your picnic or barbeque, make sure its lean cut meat like steak, chicken and turkey.

I get outdoors whenever possible and include recreational activities as my exercise, because doing something is better than doing nothing.  I certainly don’t take a summer break from fitness! But exercise doesn’t have to be the recommended 30 minutes a day, just ten minutes of exercise/activity a few times a day is beneficial and soon adds up.

When it’s really hot I avoid exercise in high midday temperatures and if I’ve been brisk walking I do my stretching when finished in the shade of trees and bushes. And talking of bushes – at this time of year I like to forage, it can yield delicious results! Hedgerows are full of blackberries, elderberries, damsons, apples, sloes and rose hips, all wild fruits which are extremely good for us. Back home I use the berries to make jams, crumble or freeze to use during the winter months.

If I’m outside for some time I cover up and always wear sun cream to avoid over exposure to the sun’s damaging rays. I sometimes wear a hat but prefer a visor, and have collected sun visors from around the world in all colours. Visors are strangely stylish, help tame my unruly hair and protect my eyes as well as skin. Over exposure to the sun’s ultraviolet rays, the wind and rain cause havoc to coloured hair, so if this is your problem cover up!  And talking of covering up I like to wear a good fitting, flattering 1-piece swimsuit in a stunning colour to boost my confidence, plus a sarong to compliment it. I feel chic and ready to go, but nowadays leave the bikinis to the slim and the very young!