Archive for November, 2009

Parkinson’s Disease and Yoga: What Is Known and How to Practice Safely

by on Tuesday, November 24th, 2009

Parkinson’s disease is a condition of the nervous system that affects movement, and many people living with it look for ways to stay active. Yoga is one option. The old version of this post mixed some facts with confusing claims about specific yoga styles and breathing. This updated article sticks to what major health organizations say, and it explains how to approach yoga safely if you or someone you love has Parkinson’s.

What is Parkinson’s disease?

According to the National Institute of Neurological Disorders and Stroke (NINDS), Parkinson’s disease (PD) causes nerve cells in parts of the brain to weaken, become damaged and die. This can lead to problems with movement and balance, tremor, and stiffness. Most PD symptoms happen when brain cells in an area called the substantia nigra, which produce dopamine, are lost; NINDS says that by the time symptoms appear, most people have lost 60 to 80 percent or more of these cells. As the disease progresses, people may have difficulty walking, talking or completing everyday tasks. Some people never develop a tremor. There is no single test that can definitively diagnose PD, so doctors consider the medical history, a neurological examination and sometimes other tests.

Can it be treated?

There is no cure for PD, but medicines or surgery can help people move more easily and improve other symptoms. Levodopa is the most common medicine. NINDS also lists lifestyle changes among the ways to help: exercise, a healthy diet and supportive therapies. The older post said that early diagnosis is important and that treatment lets many people lead active lives for years, which fits with this approach. In the late stages of the disease, medicines may no longer control symptoms well, and serious effects can include choking, pneumonia and falls. The NINDS page on Parkinson’s disease has the full details.

What does the research say about yoga?

The research is limited but encouraging. The National Center for Complementary and Integrative Health reports that a 2022 review of 14 studies, with 444 participants, suggests that yoga may have benefits for mobility, balance and quality of life for people with mild-to-moderate Parkinson’s disease, and that the studies also suggest yoga is safe and acceptable for them. NINDS lists yoga with walking, dancing, cycling and swimming among the activities that can help, and says that exercise can improve flexibility, balance, strength and the ability to move. None of this means yoga treats the disease itself.

How can you practice safely?

Always check with your doctor before starting a new exercise program, as NINDS advises. Look for a teacher with experience of Parkinson’s or a class designed for it, and ask about chair-based options to lower the risk of falling. Keep movements slow, use a wall or a sturdy chair for balance, and stop if anything hurts or if you feel dizzy. The old post said that daily activity should be encouraged but not enough to cause fatigue, which is good practical advice. NCCIH also reminds beginners to avoid extreme poses and to tell the instructor about any health condition.

Can breathing exercises help?

The old post said that yoga breathing might help during “freezing” episodes, when the feet seem stuck to the floor, and might help relax the facial muscles. I could not find reliable evidence for those specific claims, so I have not repeated them. NINDS does describe start hesitation and freezing as part of the disease, and your care team can advise you on ways to cope with them. Slow breathing is a low-risk way to relax, but treat it as a complement to your medical care.

Where can you learn more?

Our guide to what yoga is and the introduction to yoga postures and styles give general background, and the article on yoga and diabetes shows how to talk to your provider before beginning a program. Whatever you choose, aim for regular, gentle movement that you enjoy.

Atkins Lifetime Maintenance: How to Keep the Weight Off for Good

by on Tuesday, November 24th, 2009

Losing weight is only half of the job. Keeping it off is the part many people find harder, and it is the purpose of the last phase of the Atkins plan. The old version of this post described Lifetime Maintenance, but much of it was unreadable. This rewrite covers the same ground in plain English and checks the advice against Atkins guidance and the best study of people who have kept weight off.

What is Lifetime Maintenance?

According to Atkins, you reach this phase once you have held your goal weight for a month. By then you should know your personal carb tolerance, which Atkins defines as the number of grams of net carbs you can eat while neither gaining nor losing weight. Atkins says most people find theirs between 40 and 120 grams of net carbs a day, depending on metabolism, age, gender and activity level, and that people who exercise regularly will probably have a higher tolerance. The old post said the same thing in different words: you use the carb count you learned in the earlier phases as a daily guide.

How can you tell if the plan is working?

The old post recommended choosing a maintenance range, for example 160 to 170 pounds if your goal was 165, and never letting your weight drift more than three to five pounds in either direction. Weighing yourself once a week was also recommended. This is practical advice, not an Atkins rule, but it fits what researchers have found. Members of the National Weight Control Registry, a group of people who have kept off at least 30 pounds for a year or more, mostly report weighing themselves regularly. Your weight can swing by a couple of pounds from day to day. The old post blamed hormones, and I could not confirm that, so the safest approach is to look at the trend over several weeks.

What do people who keep weight off actually do?

The registry paper by Hill and colleagues (2005) describes more than 4,800 participants who had, on average, lost over 70 pounds and kept it off for almost six years. Their common habits were a low-calorie, low-fat diet, eating breakfast almost every day (nearly 80 percent), about an hour a day of physical activity (walking was the most common), and regular weighing, with most weighing daily. People who kept a consistent diet on weekdays, weekends and holidays were best able to maintain their loss. It is worth noting that very few registry members followed low-carb diets, so the findings are not specific to Atkins, and the registry is not a random sample, so it cannot tell us how common success is. Even so, the habits are useful to copy. Read the paper: the National Weight Control Registry overview.

What should you do if the scale creeps up?

Atkins advises that if you gain weight or your cravings come back, you can regain control by dropping your carb intake by 10 to 20 grams. The old post suggested a similar approach: if you gain more than five pounds, buckle down and cut back. Act early. A few pounds are far easier to lose than 20, and regular weighing helps you catch the change quickly. Our post on overcoming plateaus on the Atkins diet shows how to adjust, and Atkins and sugar cravings helps if sweets are the trigger.

How do you deal with real life?

The old post said that keeping weight off means dealing with stress eating, emotional eating, holidays and restaurants. It is true that these situations are where most people slip. Plan ahead: look at a menu before you go, decide what you will order, and have a plan for the holidays. The old post also suggested donating your larger clothes and writing a list of the benefits of your new size. Those are personal motivation tricks, not research-backed methods, but they work for some people. If cost is a worry on a long-term low-carb plan, see eating low-carb on a budget.

What is the main message?

Maintenance is a long game. Keep exercising, check your weight regularly, and adjust carbs when needed. If you have a medical condition such as diabetes, kidney disease or heart disease, ask your doctor to review your plan regularly, since your medication and needs can change as your weight does. For the earlier steps in the plan, see Atkins diet basics.

A Ten-Minute Yoga Routine for Low-Energy Days: Six Simple Moves

by on Saturday, November 14th, 2009

The old version of this post was aimed at people who feel drained by Monday morning or too tired to enjoy their evenings. It promised that a “new form of yoga” would raise energy in ten minutes and even improve sexual vitality and self-discipline. No study backs those claims, so I have removed them. What remains is a sensible idea: a short, gentle routine can be a pleasant way to wake up the body. Here is how to do it safely.

Can ten minutes of yoga give you energy?

It may well help you feel a little more awake, but let’s be clear about what is known. The Physical Activity Guidelines for Americans say that Americans can benefit from small amounts of moderate-to-vigorous activity throughout the day. The guidelines say that any amount of physical activity has some health benefits, and the second edition removed the old rule that only bouts of ten minutes or more counted, so a short routine is a perfectly good way to add movement to your day. Yoga is not magic, and I could not find a study showing that ten minutes of any particular style raises energy. Think of it as light activity combined with slow breathing, both of which many people find refreshing.

What do you need?

Very little. Wear clothes you can move in and use a non-slip mat or a carpeted floor. Cleveland Clinic notes that a non-slip surface reduces the risk of slipping. Do not rush any of the moves. The old post said the same, and it is good advice: every movement should be slow enough that you can breathe steadily.

What is the routine?

This is a general-purpose sequence based on common yoga practice, not a published program, and the timings are my own suggestion. Spend about one minute on each move, and repeat the sequence once if you have time.

Start with Mountain Pose: stand with your feet hip-width apart, let your arms hang, and take five slow breaths. Next, raise both arms overhead as you breathe in and lower them as you breathe out, five times. Third, bend forward from your hips into a gentle forward fold, with knees soft and hands resting on your thighs or shins. Hold for five breaths and come up slowly. Fourth, come onto your hands and knees for Cat-Cow: round your back as you breathe out, then lift your chest and tailbone as you breathe in, about eight times. Fifth, sit back on your heels in Child’s Pose, forehead resting on the mat, for five to eight breaths. Finish with a seated or lying rest for the last minute or two, breathing quietly.

How should you breathe?

Breathe through your nose if you can, and let the belly expand a little as you breathe in. The National Center for Complementary and Integrative Health describes diaphragmatic breathing as taking slow, deep breaths, and says that relaxation techniques are generally considered safe for healthy people. A small number of people report increased anxiety or intrusive thoughts, so if a breathing exercise makes you uncomfortable, return to normal breathing.

When should you skip it?

Stop if you feel pain, dizziness or numbness. NCCIH points out that people with some health conditions, such as lumbar spine disease, severe high blood pressure, glaucoma or balance problems, may need to change certain poses, and that pregnant women and older adults should talk to a health care provider first. If you are feeling tired all the time, a few minutes of yoga is not a substitute for talking to a doctor, because persistent exhaustion can have medical causes.

How can you make it a habit?

Pick a time that is already part of your day: right after you brush your teeth, or when you get home from work. The old post suggested doing the postures separately or in sequence, and that flexibility helps. On a very busy day, do just two moves. If you would like a longer option on a weekend, try our gentle morning routine for beginners, or read the basic yoga postures and their variations to add more moves. Over a few weeks you will notice whether it helps your energy and your mood, and that is the best measure.