In Australia 67% of adults are overweight according to the AIHW, the Australian Government agency for health and welfare data. To repeat the significance in this statement, that is 2 out of 3 adults in Australia who have a BMI classed as overweight or obese. This factor alone has in the last decade been ranked as the number one cause of disease burden in Australia. Not only that the World Health Organisation has estimated that of all non-communicable diseases those related to overweight and obese populations make up around 90% of Australia’s deaths annually. If these aren’t immediately significant enough for you, I want to outline within this write up the importance of all the measurements you complete with an Exercise Physiologist and other health professionals, and a summary of some of the changes you can make to positively affect your physical health and wellbeing.

What are the measurements you will have taken by an Exercise Physiologist?

Body Mass 
“The weight of a person or thing is how heavy they are, measured in units such as kilograms, pounds, or tons.”

BMI
“Body Mass Index is a measure of body fat, that is the ratio of the weight of the body in kilograms to the square of its height in metres.”

Body Composition
“The different components (or "compartments") of a human body. The selection of compartments varies by model but may include fat, bone, water, and muscle.”

Waist Circumference
“The measurement around the narrowest point of the abdomen, or the midpoint between the lower border of the rib cage and the iliac crest. Used as an indicator for abdominal obesity.”

What are the outcomes of each of these measurements?  

Body mass and BMI go hand in hand and as you can imagine, as the weight increases or decreases so does the number in the BMI score. The current trend for Australians is that we each gain an average of 300grams to 500grams with every year. Those increases yearly align with the rapid increases we’ve seen in our country the last 2 decades of overweight and obese individuals, again these have seen an increase of between 14% to 27% across different age brackets as recorded by AIHW.

​Having an overweight or obese BMI attributes to 30 diseases, including 17 types of cancers, 4 cardiovascular diseases, 3 musculoskeletal conditions, type 2 diabetes, dementia, asthma and chronic kidney disease. Here is a table of the classes of BMI for reference, with the healthy range being <25kg/m2.

​When recording body composition in our clinic the results measured include fat mass (both total fat mass and visceral fat), muscle mass, bone density, and body water to name a few. If your goal is weight loss than the figure you want to decrease is your fat mass. The other components such as muscle mass, bone density and body water can help flag and monitor other conditions such as osteoporosis, muscular atrophy, and more.
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When considering body fat here is a representation of what ranges are considered healthy:

​Within this component, there is increasingly more evidence supporting that the visceral body fat represents higher risks of cardiovascular and metabolic risks. This is the fat that is deposited around the organs. Independent of otherwise healthy organs, visceral body fat continues to present cardiovascular risk and metabolic risk when it makes up for >10% of the total body fat count. Here’s a guide on where these numbers should sit on the scale 0-59:

When measuring waist circumference, the aim is to guide health professionals on risk levels associated with abdominal fat and total body fat that may be increased. The evidence surrounding measuring waist circumference for these risks is increasingly more valid for quantifying health risks; the current guidelines for these are below:

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​In the previous decade in Australia, the trend for our waist circumference as we age is accelerating by 0.42cm every year, not dissimilar to the increase in weight discussed earlier. This makes for a compelling correlation. When looking at reliability of these measures, waist measurements applied with other data such as waist to hip ratio, waist to height ratio or coupled with a BMI score, these demonstrate a good strength of correlation coefficient of at least 0.82 across the board. The correlation being how strongly linked the result is to cardiovascular and metabolic risk factors, and scored from -1.00 to +1.00.

What can be done to reduce your risk of illness if you are outside these healthy ranges?

At the risk of repeating everything you’ve heard from your doctors, family, friends, or out in society; increase your physical activity and change some of your eating habits. Specifically try meet these guidelines:

1. 300-420mins/weekly of moderate intensity exercise.
2. Educate yourself on the Australian Healthy Eating Guidelines. Reduce your energy expenditure to -500kcal/day.
3. Sit for less than 8 hours a day, or less than 4 hours is the gold standard.
4. Seek out the help of an Exercise Physiologist or other health professional for any other guidance.

Thomas Harrison
Accredited Exercise Physiolgist

How does exercising turn the alarm down? 
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We here at Optimum EP advocate strongly for exercise because we know the huge amount of benefit someone can see in all aspects of their health. And you guessed it, Exercise can be a helpful mechanism for perisitent pain also. 

This proces is called exercise hypoalgesia which simply means engaging in exercise can help alleviate or decrease painful symptoms. This happen several different ways including:  

• Natural Painkillers: The release of endorphins during exercise.
• Natural Anti inflammatory: Regular physical activity can reduce inflammation, thereby decreasing pain.
• Improved Blood Flow: Improved blood flow can help reduce muscle tension, alleviate stiffness, and increase the delivery of nutrients to affected areas, all of which can contribute to pain relief.
• Turns down the pain radio: Exercise can alter the way the central nervous system processes pain signals. Imagine being able to turn down the radio when it is to loud. 
• Makes you happy and you focus on something different: Engaging in exercise often shifts a person's focus away from their pain and toward the activity at hand and can enhance mood and reduce stress, which can indirectly impact pain.
• Enhance ability to change: By engaging in regular physical activity, the brain may become more adaptable, allowing it to rewire its responses to danger signals.

Tips for starting!

The key to successfully starting an exercise program with persistent pain is to: 

• Start gradually and with a clear plan in mind. 

 

• Set achievable goals, whether they're related to pain relief, improved mobility, or enhanced well-being. 

 

• Acknowledge flare ups. Flare ups are normal in persistent pain and sometimes cant be explained. With the knowledge you now have you can be confident that even though the pain you experience may be more, this doesn't always relate to further injury.

 

• Focus on progress not perfection. Some exercise is better than none and just because you may have to take a step back or go sideways for the time being doesn't mean you are failing or it's not worth it. 

The journey is unique for each person, so there's no need to rush. In fact, taking the time to build a solid foundation is often the path to long-term success. Seek the guidance of one of our Accredited Exercise Physiologist to tailor your exercise plan to your specific needs and limitations.

​Remember, the most important thing is to start, keep moving forward at your own pace, and celebrate the small victories along the way.

Izaac Boylan 
Accredited Exercise Physiologist 

Is 10,000 steps per day enough to achieve any health benefits?
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Research recently has shown that people taking 10,000-steps or more a day have a 46% lower risk of early death.   Other studies have also shown that people who took more than 5,000 steps a day had a much lower risk of heart disease and stroke than those who took less than 5,000 steps.  And, each 1,000-step increase per day reduced the risk of dying prematurely of any cause by 6%.
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Activity classifications from steps alone

A study by Catrine Tudor-Locke & David R. Bassett Jr have suggested a classification for pedometer-determined physical activity in healthy adults: 

<5000 steps/day - may be used as a ‘sedentary lifestyle index

5000–7499 steps/day - is low active

7500–9999 - likely includes some intentional activities  - somewhat active
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≥10 000 steps/day indicates the point that should be used to classify individuals as ‘active’.

>12 500 steps/day are likely to be classified as ‘highly active’.
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​​Lisa Parkinson
Accredited Exercise Physiologist, Diabetes Educator

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Mental health is a critical aspect of our overall well-being, but it is often overlooked or stigmatized. According to the Australian Bureau of Statistics, one in five Australians experiences a mental health condition in any given year. People living with mental health illness have a 15-20 year reduced life expectancy compared to the rest of the population primarily due to an increase in cardiovascular disease. 

Fortunately, there is growing evidence that exercise can have a significant positive impact on mental health. Regular physical activity has been linked to a reduction in stress, anxiety, and depression symptoms, as well as an improvement in mood and cognitive function. In fact, the 2018 HUNT study showed that 12% of cases of depression could have been prevented with just 1 hour of exercise per week. Further research found physical activity can reduce the odds of depression development by 17%. Furthermore, Studies have found exercise can be just as if not more effective than some medications in treating Depressive symptoms. 

The COVID-19 pandemic has also exacerbated mental health challenges, with many people experiencing increased stress, anxiety, and depression due to social isolation, economic uncertainty, and health concerns. 

Exercise plays a critical role and below will give some insight into exercise and mental health. ​

Exercise is believed to work through several mechanisms including:

• The release of endorphins, the body's natural painkillers and mood enhancers.
• The release of other neurotransmitters such as dopamine and serotonin, plays a critical role in regulating mood, reward, and motivation
• The reduction of inflammation and oxidative stress, are two processes that contribute to the development of mental health conditions.  
• The promotion of neuroplasticity (the brain's ability to change and learn) and neurogenesis (neuron creation) in the brain. They are improving cognitive function and protect against age-related cognitive decline.
• Social interaction and support allow the ability to forge connections and prevent social isolation and loneliness. 

These biological and psychological effects can have powerful and lasting impacts on mental health, making exercise a valuable tool for preventing and managing mental health disorders.
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Incorporating exercise into your mental health routine can be challenging, but it's worth the effort. Here are some tips to help you get started:

1. Start small: If you're new to exercise, start with a small, manageable routine, such as a 10-minute walk around the block or a gentle yoga practice. Gradually increase the duration and intensity of your workouts as your fitness level improves.
   
2. Choose activities you enjoy: Exercise doesn't have to be a chore. Choose activities you enjoy, whether it's dancing, hiking, or playing a team sport. When you enjoy the activity, you're more likely to stick with it.
3. Make it social: Exercise can be a great way to connect with others and build a support network. Join a fitness class, find a workout buddy, or participate in a team sport to add a social component to your routine.
4. Be consistent: Consistency is key when it comes to reaping the mental health benefits of exercise. Try to exercise at the same time each day or week, and make it a non-negotiable part of your routine.
5. Set realistic goals: Setting realistic goals can help you stay motivated and track your progress. Whether it's running a 5K or mastering a new yoga pose, having a goal to work toward can keep you focused and engaged.
6. Monitor your progress: Keep track of your workouts and monitor how you're feeling before and after exercise. This can help you see the positive impact of exercise on your mental health and keep you motivated to continue.

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​In conclusion, exercise is a powerful tool for improving mental health and well-being. Through a combination of aerobic exercise, resistance training, and mindfulness practices, exercise has been shown to reduce symptoms of depression, anxiety, and stress, improve cognitive function, and boost self-esteem. Incorporating exercise into your mental health routine may take some effort, but the benefits are well worth it. By starting small, choosing activities you enjoy, and being consistent, you can create a routine that supports your mental and physical health. So next time you're feeling stressed or down, try incorporating some exercise into your day - your mind and body will thank you.

Izaac Boylan
Accredited Exercise Physiologist
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It’s the happiest time of the year…. And definitely the busiest for most of us too. With Christmas, School Holidays, Harvest, Frantic present shopping, busy work lives and all the day to day chores, it is easy for other things in life to slip by the wayside over this period. One of the most common includes exercise and our daily movement! It is easier to convince ourselves that we don’t have time to fit it in, than to make it work. BUT… today I am going to let you in on 4 fun and easy ways to get your movement in without even having to try. ​

What exercise can you do, and at what intensity??

Aerobic exercise
Examples of aerobic exercise are:  ​walking, running, swimming, cycling

Intensity recommendations

• BMI >26 - Moderate intensity, that is 60-90%  of age predicted heart rate maximum
• BMI >26 - training intensity should commence at 20-30% of age predicted maximum heart rate.
• Interval training can be undertaken by women who have previously been active, and for those requiring increased glucose control.

Duration

• 30-45 minutes of self paced exercise

Frequency

• No  more than 2 consecutive days without exercise, but most days are great!

BMI=body mass index

Resistance training
Examples include:  multi-joint exercises, large muscle groups using dumbbells, resistance bands and body weight.  Modified push ups or chest press, squats, resisted row, hip exercises, bicep curls, tricep pulldowns

Intensity recommendations

• Moderate, 50% of 1 repetition maximum, aiming for 5-10 exercises, 1-2 sets of 8-15 repetitions.

Duration

• 60 minutes

Frequency

• 2-3 times per week.

Precautions for Exercising with GDM
Pregnant women with GDM who are taking insulin also need to be cautious of hypoglycaemia (low blood glucose levels).  It is best to talk to your Exercise Physiologist or Credentialed Diabetes Educator to work out an exercise action plan that is tailored for you.  Be mindful that the glucose lowering effect of exercise lasts for days, and that a hypoglycemic even (low blood glucose levels) is possible up to 24 hours post exercise.



The bottom line …
All pregnant women should participate in exercise during pregnancy, whether they have gestational diabetes mellitus, type 2 diabetes or no diabetes, unless they have a health condition that excludes them from doing so.  Exercise has benefits for mother and unborn child and for ladies with GDM exercise is an integral part of your diabetes treatment, and health and wellbeing during your pregnancy.  For specific advice in tailoring an exercise program for you, speak to our resident Accredited Exercise Physiologist and Credentialled Diabetes Educator, Lisa, to ensure you are exercising safely, and get the most from your exercise program.

Lisa Parkinson
Accredited Exercise Physiologist & Credentialled Diabetes Educator.

​Here in the clinic we don't have gas analysis so, to find out someone's aerobic capacity (Vo2 max) we use a treadmill/bike test where a subject will walk/run/ride while increasing the intensity every 1-3 minutes. During the test we monitor heart rate, rate of perceived exertion and the given workload. The test can be completed to a maximal effort or to a sub maximal effort depending on the subject. From the data we receive we can accurately measure Vo2 max using data driven equations from the American College of Sports Medicine.
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From this method we can then individualise our aerobic programs to suit exactly the level of the subject which then helps to directly improve their health.

If you have any questions pop up throughout this blog please don't hesitate to ask. 

Izaac Boylan 
Accredited Exercise Physiologist