Category: Staying Motivated

Being a Change Agent

For most of us, change happens slowly, if at all. But as the recent holiday season fades into the distance, many of us wish to be increasingly proactive this year and take real action on the numerous New Year’s resolutions that we made in regard to our health and well-being.

Back in December, many of us formulated resolutions such as “I’ll start going to the gym” or “I’ll lose weight” or “I’ll go for a walk every day”. Although these are worthy aspirations, in order for us to actually make progress in the areas of health and wellness, quantifiable and measurable goals are required. By declaring what we intend to accomplish and by when, we are providing instructions to our internal goal-accomplishing mechanism that will make all the difference.

By creating specific targets such as “By February 1st, I will begin a strength-training program and workout at the gym for three 45-minutes sessions each week” or “By February 1st, I will begin a daily 2,000-calorie weight optimization program including consuming five servings of fresh fruits and vegetables a day” we provide our subconscious mind with specific goals. Just as an automobile driver needs to know precise directions in order to reach the destination safely, our internal steering mechanism will assist us in fulfilling our goals, based on specific directions and instructions.

For example, once oriented toward accomplishing good health, our subconscious mind may bring to our conscious attention the healthy opportunities around us. We begin to recognize and focus on matters of importance regarding health and wellness such as new offerings at your local fitness center or specials at your nearby organic market. Without being an agent of change, this information would have never penetrated our selective perception and awareness.

As well, our renewed focus on overall health may point us in the direction of obtaining regular chiropractic care. Regular chiropractic care helps us achieve and maintain optimal functioning of our spinal column and other major components of our musculoskeletal system. By focusing on spinal wellness and optimizing performance of the nerve system, our body’s master system, regular chiropractic care helps ensure that we are reaching maximal levels of health. In this way, regular chiropractic care supports and reinforces our intentions of achieving increased health and wellness for our families and ourselves.

Sources:

1. Jackson PA, et al: Promoting brain health through exercise and diet in older adults: a physiological perspective. J Physiol 594(16):4485-4498, 2016
2. Jakicic JM, et al: Role of Physical Activity and Exercise in Treating Patients with Overweight and Obesity. Clin Chem. 2017 Nov 20. pii: clinchem.2017.272443. doi: 10.1373/clinchem.2017.272443. [Epub ahead of print]
3. Kim: Effects of yogic exercise on nonspecific neck pain in university students. Complement Ther Clin Pract. 2017 Oct 14. pii: S1744-3881(17)30374-2. doi: 10.1016/j.ctcp.2017.10.003. [Epub ahead of print]

How do you determine whether your life is going well? Whether you’re happy and fulfilled vs. merely going through the paces? Whether you’re growing and developing as a person vs. merely expressing more of the same old, same old? In short, when the alarm goes off in the morning does the prospect of a new day cause you to be filled with excited anticipation and a sense of being actively engaged? Or do you wish you could bury yourself beneath the blankets and put off your daily routine for as long as possible?

“Flourishing” is a term long-used by philosophers to describe a state of ongoing positive engagement with life.^1,2,3 When a person is flourishing she is not only interested and participating, but also widening and expanding her range and her scope. Most of us are familiar with the concept of flourishing as it relates to our plants and gardens. A flourishing tree sports many new branches, many new twigs, and many shiny new leaves. The bark of a flourishing tree has deeper and richer shades of brown. The greens of such a tree’s leaves are moister and wetter, reflecting the aqua tones of the rivers, streams, and sky. All the flourishing tree’s semi-moving parts are joyously turned toward the sun.

A flourishing human being expresses many similar phenomena. When describing the characteristics of well-balanced individuals, psychologists and sociologists have historically used the term “happiness”. But “being happy” seems a fairly passive state of affairs. It’s good to be happy, certainly, but what’s being referred to is more of an emotional, subjective state of being. You’re happy in response to a circumstance or series of events. In contrast, when you’re flourishing you’re actively taking part. You are the initiator rather than the responder. You’re in the driver’s seat. You get to say how things are going to go.

How do you achieve a state of flourishing? As always, it’s the journey, not the destination, that provides the biggest payoff – in this case, a joyous, fulfilling life. Flourishing as such is not an endpoint – it’s a moving target. We need to be proactive to replenish, reinvigorate, and revivify our continuing cycle of 24-hour allotments. We want to live, rather than merely exist. Living requires imagination, invention, interest, and action. Flourishing is an outcome of playing full out, of active participation in life.

¹Menk OL, et al: Exploring measures of whole person wellness: integrative well-being and psychological flourishing. Explore (NY) 6(6):364-370, 2010

²Bunkers SS: A focus on human flourishing. Nurs Sci Q 23(4):290-295, 2010

³Fosha D: Positive affects and the transformation of suffering into flourishing. Ann NY Acad Sci 1172:256-262, 2009

Whether you live in the United States, Canada, or Western Europe, your health care decision-making is impacted by the type of health insurance available. In the United States, a fee-for-service system implies that you will be paying for some or all of the costs of every service used on your behalf. In Canada patients receive health care through a publicly funded system. Costs are funded via income taxes, so Canadian patients pay indirectly for their care. The majority of Western European countries have national health care systems in place. In France, for example, the national insurance program pays 70% of costs and much of the remaining 30% is paid by supplemental private insurance (most of this is paid by the patient’s employer). Regardless, for any given person, more health problems mean more costs. Thus, preventing health problems in the first place is a strategy that will save families stress, anxiety, and financial resources in the long run. In health care it can be said that the best defense is a good offense.

What constitutes a “good offense” in health care? Being proactive in terms of lifestyle choices helps you put together a health care program that works. Your health care “offense” includes a healthful diet supported by sound nutritional principles, regular vigorous exercise, getting sufficient rest, and regular chiropractic care. All these elements are needed to enjoy long-term health and well-being. Each element provides critical value and helps support the benefits you get from the others. Good food helps you build strong muscle in response to regular vigorous exercise. Doing regular exercise helps you sleep better at night. More sleep helps you have more energy, so you have more strength and endurance when you’re exercising. Regular chiropractic care helps your nerve system function at peak level, helping all your body systems work well together.

Such a lifestyle program goes very far toward restoring good health and reducing the costs of using the health care system. For example, regular vigorous exercise is an important part of all lifestyle programs aimed at lowering blood pressure and reducing the risk of cardiovascular disease and stroke.¹ A healthful diet and regular exercise help lower the incidence of type 2 diabetes and assist overweight and obese individuals, children as well as adults, in returning to more optimal levels of health.^2,3

Many self-help books, DVDs, and television infomercials target those who wish to improve their overall health status. These materials and programs may have some use, but professional advice and guidance is the key to developing long-term, successful health strategies. Your chiropractor is experienced in nutrition, exercise, and health maintenance and can help you design a “good offense” for health care that works for you and your family.

¹Williams PT, Thompson PD: Walking versus running for hypertension, cholesterol, and diabetes mellitus risk reduction. Arterioscler Thromb Vasc Biol 33(5):1085-1091, 2013

²Clark JE: An overview of the contribution of fatness and fitness factors, and the role of exercise, in the formation of health status for individuals who are overweight. J Diabetes Metab Disord 11(1):19, 2012

³Wilson V: Type 2 diabetes: an epidemic in children. Nurs Child Young People 25(2):14-17, 2013

Everyone knows he or she “should” be doing regular exercise, but most people have not exercised in so many years that they don’t know where to begin. As a result, people start and stop various training programs and routines. They join gyms, buy workout clothes, spend hard-earned income, and ultimately fail to follow-through because they don’t have a clear idea of how to exercise effectively.

One of the issues relates to the many choices available. You can lift weights, swim, ride a bicycle, run, take Pilates classes, take yoga classes, or play tennis. But the challenge lies in selecting the form of exercise that’s best for you, and then having the specific knowledge to begin training in a way that will be beneficial and not harmful.

It’s actually easy to hurt yourself if you’re returning to exercise after an absence of many years or, for some people, of decades. Doing too much too soon is a typical cause of an exercise-related injury. Doing the wrong type of exercise for your level of preparation is another major cause of these injuries. Getting hurt doing exercise is a real deal-breaker for people who didn’t really want to exercise in the first place. If you haven’t exercised in years, finally work up the motivation to start doing something, and hurt yourself after a few days or weeks of your new program, quitting and never going back becomes a very attractive option.

But exercise is a key factor in maintaining overall health and wellness. If you’re committed to the long-term health and well-being of yourself and your family, regular vigorous exercise is critical. The solution, at least in the initial phases of returning to fitness, is walking for exercise. Walking avoids the vast majority of pitfalls associated with other types of exercise. Walking is low-impact, requires minimal equipment, and no gym memberships are needed. Walking is done outside in fresh air and sunshine, providing many additional benefits beyond those gained by exercise as such.

Walking is excellent exercise,¹ and yet it’s important to follow some basic guidelines. Starting slowly is the main consideration. If you haven’t done any vigorous physical activity for months or years, 10 minutes of walking at a modest pace should be sufficient for your first day of walking. Five minutes out and five minutes back. Make 10 minutes your limit even if that amount feels like too little. It’s always better to do a little less exercise than a little too much. Add approximately a minute a day, until you’re doing a 30-minute walk at a modest pace. With this quantity of comfortable walking, you can now begin to increase your pace. Ultimately, 30 minutes of walking at a brisk pace will provide sufficient health benefits for most people, based on the principle of five or six vigorous exercise sessions per week.

The long-term results of such a program are profound.^2,3 Consistent vigorous exercise helps to lower blood pressure, prevent heart disease, reduce the incidence of stroke, reduce the incidence of diabetes and obesity, and improve outcomes in patients with cancer. Walking for exercise is an efficient, enjoyable, and easy way to enable you and your family to begin obtaining these long-term health benefits.

¹Centers for Disease Control and Prevention: Vital signs: walking among adults – United States, 2005 and 2010. MMWR Morbid Mortal Wkly Rep 61:595-601, 2012

²Lima LG, et al: Effect of a single session of aerobic walking exercise on arterial pressure in community-living elderly individuals. Hypertens Res 35(4):457-462, 2012

³Subramanian H, et al: Non-pharmacological Interventions in Hypertension: A Community-based Cross-over Randomized Controlled Trial. Indian J Community Med 36(3):191-196, 2011

What does the future hold in store? None of us can know with certainty, although some predictions are possible. Stock market indexes will rise. Then they’ll fall. Then everyone will hope that the indexes will rise again. Hemlines will fall. Then they’ll rise. Then in two or three years they’ll fall again.

The French have a saying for all this – plus ça change, plus c’est la même chose. The more things change, the more they stay the same. In fact, things have changed a lot in 10 years. The Internet exploded. Cell phones are everywhere. In the United States an African-American man was elected president. Longstanding dictatorships were toppled in the Middle East.

The next ten years have the possibility of being even more gloriously impactful.^1,2,3 Things do not necessarily remain the same. The actress Betty White has reinvigorated her career at age 89. Jeff Bridges won a Best Actor Academy Award at age 61, highlighting a 40-year career. The 2010 Best Original Screenplay Academy Award went to the 73-year-old first-time winner David Seidler. Leon Russell, the beloved musician/songwriter, was recently inducted into the Rock and Roll Hall of Fame. Well into his 60s, Russell observed that he had been “lying in a ditch on the side of the highway of life” when he his career was suddenly, unexpectedly resurrected by Elton John.

In the next ten years, for us, anything is possible. But in order to move beyond the “same old, same old” we are required to make a choice. Another old saying, “if it’s going to be, it’s up to me”, remains true today. We need to make choices on our own behalf, choices that will further our growth and development and the growth and development of our loved ones. We can create a spectacular next ten years.

¹Fosha D: Positive affects and the transformation of suffering into flourishing. Ann NY Acad Sci 1172:252-262, 20093

²Bunkers SS: A focus on human flourishing. Nurs Sci Q 23(4):290-295, 2010

³Culbertson SS, et al: Feeling good and doing great: the relationship between psychological capital and well-being. J Occup Health Psychol 15(4):412-433, 2010

In general most people pay close attention to auto maintenance. Whether the concern is tires, brakes, transmission, or windshield status, people make sure that their cars do what they need them to do. People count on their cars to perform effectively. No one wants a surprise, especially in a critical situation. But in stark contrast, people often give much less consideration to their own physical functioning and capacity than they do to several critical performance factors related to their own automobiles.

The metaphor of machine upkeep standing in for health maintenance is commonplace but apt. To prove the point, most of us allow our physical conditioning to deteriorate far beyond that which we would ever tolerate relative to our cars or even our power lawnmowers. The immediate consequences of such neglect are the developed world epidemic in diabetes, the United States–based epidemic in obesity, and the ongoing high levels of cardiovascular disease worldwide.

What redress is required with respect to our physical health and welfare? As with our cars, the long view is needed. If we lease a new car every year, upkeep is not an issue beyond an oil and filter change or two. But if we want our car to continue to perform reliably for three, five, or ten years, regularly scheduled service is necessary. Our cars need check-ups every 12 months or so. As flesh-and-blood organisms, we require a similar schedule of maintenance.

Importantly, feeling fine is not necessarily a good guide to how we’re doing from a health perspective. High blood pressure, for example, is known as the “silent killer.” There are no fully recognizable signs and symptoms of hypertension, until it’s too late.¹ By the time a person has had a debilitating heart attack or stroke, high blood pressure has probably been in place for years. Similarly, the early symptoms and signs of diabetes are subtle and seemingly harmless. Fatigue and an inability to focus may be ignored or interpreted as mere symptoms of an overly stressed lifestyle. Frequent thirst and frequent urination might be conveniently explained away as side effects of poor eating habits. Again, serious damage may be done, possibly involving one’s kidneys and one’s vision, as a result of undiagnosed and untreated diabetes.²

The solution to helping prevent such potentially serious health problems is to make sure you have regular check-ups. Operating on the long view, rather than operating as the proverbial ostrich (with his head buried in the sand) or the proverbial grasshopper (who fiddled all day), we will have annual or biannual blood pressure readings and blood tests. Appropriate scheduling for such check-ups will be specific to the individual, based upon age, past medical history, and family history. The critical takeaway is to practice preventive health care based on the long view.³ Perform personal maintenance and service checks as needed.

¹Kumar N, et al: Management of patients with resistant hypertension: current treatment options. Integr Blood Press Control 6:139-151, 20132
²Adebayo O, Willis GC: Changing Face of Diabetes in America. Emerg Med Clin North Am 32(2):319-327, 2014
³Lynch EB, et al: A self-management intervention for african americans with comorbid diabetes and hypertension: a pilot randomized controlled trial. Prev Chronic Dis 2014 May 29;11:E90. doi: 10.5888/pcd11.130349

Driving fast is not necessarily a good thing. We want to get where we’re going as quickly as possible, but we also want to arrive safely. If we drive too fast, we may encounter all sorts of problems. If we drive too slow, we’re wasting time and may be causing traffic problems behind us. These competing considerations will both be fulfilled by maintaining an average velocity that is at or close to the posted speed limit. We want to find the “sweet spot,” the happy medium that both saves time and helps keep us safe.

The same principles may also be applied when we’re exercising. We want to improve, get stronger, and build more endurance as soon as we can, while simultaneously avoiding injury and staying healthy. Very often, these goals may conflict. It’s important to ensure that we’re exercising efficiently and making certain we’re deriving the greatest benefit from our exercise time. These benefits are obtained by a steady approach, one that focuses on incremental gains accomplished over time.¹

It’s natural to want to arrive at a desired outcome quickly. But as with any other form of training, whether learning to play the piano or becoming a competent chess player, substantial time is required to produce long lasting results. In the case of exercise, trying to hurry the process will usually cause an injury. You’ll be set back at least weeks, if not months, and you’ll have to start over, pretty much from the beginning.

For almost all of us the “tortoise” approach, rather than that of the “hare” in the well-known fable, will produce the health benefits we’re hoping to achieve from our daily exercise. If you’ve never walked before and want to incorporate this aerobic activity as part of your exercise routine, start with a 10-minute walk. This doesn’t sound like much, but that is precisely the point. Start by doing a little and build up gradually and consistently. Within 6 or 8 weeks you’ll be doing 30-40 minute brisk walks several times a week, which will represent a very good aerobic exercise program. Incorporating strength training into your routine will employ a similar method. For each of your exercises (such as bench press, one-arm row, squat, toe raise, shoulder press, biceps curl, and lying triceps press), begin with a weight with which you can comfortably do 10 repetitions. If you can’t do 10 reps, the weight is too heavy. Start with that weight and do 3 sets per exercise. Build up gradually by increasing the weight by 5%, if possible, each week or every 2 weeks. After 10 to 12 weeks you’ll be noticeably stronger and your metabolism will begin to be more efficient.^2,3

By progressing slowly and steadily, you will build a solid base and make consistent and possibly substantial gains in your exercise routine. You will get where you want to get safely and effectively. The long-term outcome will be enhanced health, wellness, and well-being.

¹Marongiu E, Crisafulli A: Cardioprotection acquired through exercise: the role of ischemic preconditioning. Curr Cardiol Rev 10(4):336-348, 2014
²Huxel Bliven KC, Anderson BE: Core stability training for injury prevention. Sports Health 5(6):514-522, 2013
³Granacher U, et al: The importance of trunk muscle strength for balance, functional performance, and fall prevention in seniors: a systematic review. Sports Med 43(7):627-641, 2013

Even experienced exercisers sometimes find it difficult to know how much to do. For the beginner this uncertainty represents a significant stumbling block. Fortunately well-established guidelines and protocols exist to provide assistance to all exercisers, regardless of your skill level.

In general, the beginning exerciser requires the most instruction. The key is to build up strength and endurance slowly and not do too much too soon. In terms of strength training, the best plan is to determine at what weight you can comfortably perform three sets of eight repetitions. If you can’t do three sets of eight reps at the weight you’ve selected, it’s too heavy. If doing three sets of eight reps with the weight you’ve chosen doesn’t feel like anything at all, then the weight is too light. Overall, of course, too light is better than too heavy. The majority of strength training injuries occur when you’re attempting to train with an inappropriately heavy weight.

For example, you’ve selected 15-pound dumbbells with which to perform your bench press routine. You can comfortably do three sets of eight reps. Fifteen pounds is not too light and not too heavy. During the course of your next several weight training sessions, build up to three sets of 12 reps using the 15-pound dumbbells. When you can do three sets of 12 reps successfully, the next time you do your bench press routine you’ll increase the weight by approximately 10%. In other words, you’ll use the next heaviest weight, which is usually 17.5 pounds in a well-equipped gym. Begin with three sets of eight reps with the 17.5-pound dumbbells, and progress over the next several sessions to three sets of 12 reps. Then you’ll repeat the sequence with 20-pound dumbbells, starting at three sets of eight reps and building up to three sets of 12 reps. You’ll follow this formula with all of your strength training exercises. In this way, using a safe, smart, and graduated program, you’ll consistently build lean muscle mass, gain improved strength and efficiency of your cardiovascular system, and most likely lose several pounds as stored fat is converted to muscle.¹

The same principles apply to cardiovascular exercises such as walking, running, biking, and swimming. If you haven’t exercised in a very long time, walking is a good method with which to begin.^2,3 On your first day, go for a normally paced 10- or 15-minute walk. Don’t be concerned that your walk feels like it’s over only a few minutes after it’s begun. Your main focus should be on getting started, not on how much or how little you’re doing in the first few sessions. Over the course of four to six weeks, build up a minute or two each session until you’re able to comfortably walk for 30 minutes at a moderate pace. At this point you can begin to increase your pace gradually, building up to a 30- or 40-minute walk at a brisk pace. At this level, you’re going a very good, vigorous cardiovascular workout and your heart, lungs, and other components of your cardiorespiratory system are becoming stronger, healthier, and more efficient.

In this gradual, steady, measured way, all exercisers, of whatever age, prior experience, and skill level, can gain a lifetime of benefit from their fitness programs and minimize the likelihood of setbacks or injury.

¹Hawkins M, et al: Impact of an exercise intervention on physical activity during pregnancy: the behaviors affecting baby and you study. Am J Public Health 2014 Oct;104(10):e74-81. doi: 10.2105/AJPH.2014.302072. Epub 2014 Aug 14
²Hanson S, Jones A: Is there evidence that walking groups have health benefits? A systematic review and meta-analysis. Br J Sports Med 2015 Jan 19. pii: bjsports-2014-094157. doi: 10.1136/bjsports-2014-094157. [Epub ahead of print]
³Varma VR, et al: Low-intensity daily walking activity is associated with hippocampal volume in older adults. Hippocampus 2014 Dec 7. doi: 10.1002/hipo.22397. [Epub ahead of print]

Everyone knows what he or she “should” do to obtain good health. But the mere knowledge of what we should be doing is never enough. If we’ve not been in good shape for some time, if we can’t remember the last time we did any meaningful exercise on a consistent basis, and if we’ve added more pounds over the years than we care to admit, then the task of getting back in shape seems an impossible mission. But like the Mission Impossible team in the fabled television series and the hugely successful film adaptations, we too can turn the task of regaining high levels of fitness into “mission possible”.

The primary requirement for your personal restoration project is establishing a new mindset. No one wants to do what other people think they “should” do. Having your spouse tell you that you should lose weight or having your doctor tell you that you need to do more exercise is never pleasant. These admonitions never really work and only serve to create stressful encounters and interactions. Even though the people close to you have good intentions and want the best for you, they usually don’t realize the willingness to change is never sourced from outside a person. The only way you’re going to take on the time and effort of implementing new lifestyle activities is if you yourself choose to do so. Making the active choice to exercise and making the active choice to eat healthy foods will create the powerful difference by which you begin to actually accomplish the action steps necessary to change the quality and characteristics of your health and well-being.^1,2

Thus, your own personal choice is what’s required to get you started. Importantly, making such a choice is not a one-time event. Circumstances always intervene and your choice to exercise and eat nutritious foods will need to be reinforced frequently. There may come a time when you choose to sleep late and skip your exercise session for that day. Or you may choose to eat a whole pint of ice cream in the middle of the week. It will be helpful to recall that such deviations from your main plan are always your choice, and returning quickly to your regular exercise routine and regular food program will also be your choice.

None of this needs to be dull, boring, or onerous. Remember that if you think you “have” to do your exercise and “have” to eat fresh fruits and vegetables, then you probably won’t do these things for very long. But if you remind yourself that you have actively made a personal choice to engage in healthy activities, then you will recreate your opportunity for powerfully participating in the ongoing restoration of your own vibrant health and well-being.³

¹Sardinha LB, et al: Criterion-referenced fitness standards for predicting physical independence into later life. Exp Gerontol 61:142-146, 2015
²Hafstad AD, et al: How exercise may amend metabolic disturbances in diabetic cardiomyopathy. Antioxid Redox Signal 2015 Mar 4. [Epub ahead of print]
³Crous-Bou M, et al: Mediterranean diet and telomere length in Nurses’ Health Study: population based cohort study. Brit Med J 2014 Dec 2;349:g6674. doi: 10.1136/bmj.g6674

Simon and Garfunkel [and later, The Bangles] had it right. Winter light is hazy – it’s more diffuse. The sun is lower in the sky and the sun’s rays reach the Earth at an angle, losing much of their power. And of course, there’s less sunlight during each 24-hour day of winter than during the rest of the year.

All these facts make it more important during winter to ensure you’re getting your daily dose of sunlight. Humans depend on sun exposure to satisfy daily requirements of vitamin D.¹ Vitamin D deficiency is classically associated with loss of bone mass, and is also associated with rheumatoid arthritis, cardiovascular disease, cancer, and type 1 diabetes.²

Humans need sunshine. It’s not just a matter of aesthetics or a personality quirk like being a sun-worshipper. In Southern California and the rest of the Southwest there’s plenty of sunshine all year round. Everywhere else in the United States, though, direct sunlight is much harder to find.

Humans also need exercise. And, as time is a precious commodity for all of us, it makes sense during winter to exercise and get your daily dose of sunlight at the same time.

Doing aerobic exercise outdoors perfectly fulfills our requirements. Walking, running, and cycling get us out into the fresh air and sunshine. If you’re used to riding a stationary bike or walking or running on a treadmill at home or at the gym, winter is the time to take it outside.

Your bones will benefit greatly by increased contact with direct sunlight. And, interestingly, your entire body will benefit from your new outdoors focus. Machines such as treadmills and stationary bikes are great – they make it easy to exercise. But there’s a big difference in terms of overall benefit when you’re actually riding a real bike up a real hill or running on a real surface that changes configuration on almost every step.

The difference relates to proprioception³ – your body’s response to physical changes in three-dimensional space. Bottom line – the more overall use you make of your body, the more you’ll benefit. Exercising outdoors provides whole-body training in ways machines never can.

The need to actively seek out sunshine during winter creates a wonderful opportunity to broaden our exercise horizons. Make sure to dress appropriately and to wear UV-protecting sunglasses.

Many affordable brands of high-performance sportswear are available that wick moisture away from your skin and provide good insulation. Layering is the way to go. You can remove layers as you get warmer. Wicking-and-insulating caps and gloves are also available. It’s better to be a little too warm than a little too cold.

Be sure to consult with your chiropractor about the most effective forms of exercise for you. She will be able to help you design a customized exercise program that works for you.

¹Holick MF: Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr 80(6):1678S-1688S, 2004
²Mohr SB, et al:The association between ultraviolet B irradiance, vitamin D status and incidence rates of type 1 diabetes in 51 regions worldwide. Diabetologia 51(8):1391-1398, 2008
³Buccello-Stout RR, et al: Effects of sensorimotor adaptation training on functional mobility in older adults. J Gerontol B Psychol Sci Soc Sci 63(5):P295-300, 2008