Exercise for Individuals with Eye Impairments

While starting an exercise program poses unique challenges if you are visually impaired or legally blind, a few precautions and modifications can open your world to the many benefits and joys of regular physical activity. Following are some tips to help you get started.

Before you walk through the doors of a health club or purchase your first piece of equipment, talk to your ophthalmologist. This step is especially critical if you have recently had an eye operation or are at risk for intraocular bleeding from conditions such as diabetes or age-related macular degeneration. (In such cases, strenuous activity should be avoided.) Ask for a referral to a fitness professional who can help you begin a safe, effective and enjoyable exercise program. If your doctor doesn’t have a recommendation, check out www.acefitness.org/profreg/ to find an ACE-certified Advanced Health & Fitness Specialist near you.

If you will be exercising at a gym, ask for a facility orientation. Determine if doors are completely closed or open versus dangerously half open. Are exercise areas well-lit with as much glare control as possible? Is the facility large enough to assure ample space between equipment and minimal clutter?

Once you commit to a program, think of exercise as part of your daily routine. Set short-term, achievable exercise goals. This will help you to experience good results and the benefits of being active. Plus, modest, realistic goals also build confidence and enthusiasm, making exercise more fun.

Aim to be physically active doing something that you enjoy for at least 30 minutes on most, preferably all, days of the week. Once you’ve developed an exercise routine, gradually increase intensity, duration, or frequency to maximize your fitness improvements. Also be sure that your trainer develops a program for you that includes cardiovascular exercise (walking, swimming, biking, running), resistance training (free weights or machines, push-ups, core-strengthening exercises), and flexibility training (stretching, yoga). As you become more comfortable with your exercise program, you may choose to complete some of your workouts without a personal trainer. In those cases, make sure to work out with a sighted partner to assure your safety.

Just as it is important to challenge yourself physically to achieve your goals, it is also important to know when to limit physical activity. If you’ve recently had an eye operation, a serious illness, or a change in your vision, modify your exercise program to reduce the risk of complications. Decrease your intensity with exercises such as walking, swimming or water aerobics. When weight training, use lighter weights and increase your repetitions instead of increasing the amount of weight. Avoid exercises that stress isometric muscle contractions (e.g., pushing against an immovable object). Also make sure that you are exercising at an intensity that is comfortable for you and not overly strenuous.

Terminate exercise if you experience loss or dimming of vision, new floaters (spots or shapes floating through vision) or light flashes or other symptoms.

A positive attitude will help with motivation and adherence to your program. Here are some tips for making your exercise routine enjoyable:

Keep routines interesting and fun. Choose activities you enjoy and feel comfortable with.Vary the types of exercise you do so you can avoid falling into a rut. Exercise variables must be changed not only for the sake of interest, but also to foster progress.Make your exercise routine fit your personality and daily lifestyle with respect to time, location, expense and degree of social interaction. The more comfortable the routine, the more likely you will be able to maintain it.Even when you are feeling tired or stressed, try to maintain your program. You will feel better after your workout. Focus on your successes, no matter how small. Remember, persistence pays off.

Lesley Teitelbaum, a research assistant professor at the department of psychology, Syracuse University, and Mitch Lemelbaum, a faculty member in the department of exercise science, Syracuse University, provided exercise tips and recommendations for this educational handout.

National Federation for the Blind: www.nfb.org
Medline Plus—Visual Impairment and Blindness: www.nlm.nih.gov/medlineplus/visionimpairmentandblindness.html
National Eye Institute: www.nei.nih.gov

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Healthy Resolutions for the Whole Year

As the first few months of the new year slip away, do you find your resolutions slipping away as well?

Resolutions should be reasonably attainable so that you are setting yourself up for success rather than disappointment. Try focusing on small intermediate goals that will ultimately lead you to your primary goal. Do not expect to be perfect. Aim for a healthy lifestyle with which you will feel comfortable.

Simply establishing the goal of leading a healthy lifestyle should make you feel good about yourself. To make that goal more attainable, come up with small goals that you know you can meet each day to help keep yourself feeling positive. Accomplishing the smaller goals will leave you with a more immediate feeling of success.

If your goals are too large, you may get caught up in them and feel disappointed when you do not see immediate results.

Small behavior-change plans are easier to stick to than vague resolutions like “I will lose 10 pounds.” If your resolution is too large, add a plan of action that will guide you toward your goal.

Rather than “I will exercise more,” try “I will go for a walk at lunch on Tuesdays and Thursdays and work out in the gym Mondays and Fridays.” This way you can feel a sense of accomplishment every day, and if you miss a day, you can get right back on track rather than feeling like a failure.

Any goals that you set should come from a sincere desire to change for yourself. Research has shown that negative feelings are a frequent cause of relapse in behavior-change programs, and resolutions that feel like punishment can cause negative feelings.

All resolutions should be perceived as positive changes that will help you reach optimal health and well-being. Don’t decide to change to please anyone other than yourself.

And remember, resolutions are an opportunity for you to look forward in a positive way rather than to punish yourself for past behaviors.

Perhaps you can find ways to exercise while also accomplishing other goals. If weather permits, try walking to do errands that are in close proximity to your home or office. Maybe you want to spend more time with your family. Try walking with a family member or bringing your children along on bikes while you walk or jog.

If your goal is to make new friends, try taking classes where you will meet other people who share your same exercise interests.

Be sure that your plan of action is realistic. Plan to work out at times when it is convenient for you. If you are not a morning person, do not plan to work out early in the morning or you’ll just be setting yourself up for failure.

Try to make things as easy as possible for yourself. Set your goals at reasonable heights so that you can reach them one by one without feeling overwhelmed.

The only way your goal is going to become reality is if you believe in it and, most of all, if you believe in yourself. It may help you reinforce your goal if you can find a realistic role model who is actually living your goal. If he or she can do it, so can you!

If things like weather and illness will prevent you from sticking to your plan, make alternate plans for situations that you cannot avoid. Most importantly, do not let a missed day or two throw you completely off target. Instead, do your best to get back on track as quickly as possible, which should not be extremely difficult if you have set appropriate goals.

It is easier to stick to your plan when you feel good about yourself. Try to find a new way to reward yourself when you meet your smaller goals. If you are trying to eat healthier, be sure that all of your meals are still delicious, and allow yourself a small dessert after a few days of healthy habits.

Be sure to get involved in activities that keep you feeling happy and fulfilled.

Get the support of your family, friends and coworkers. If your resolution involves quitting a serious addiction like smoking or drinking or overcoming an eating disorder, get professional help and join a support group if possible.

Remember that you are your best supporter. You are trying to improve your own health. Appreciate what you have and then try to treat it a little bit better than you have in the past. If you take better care of your body, you will feel better and perform better at all that you do.

Keep in mind that a well-thought-out resolution can be a useful tool to help you live your life the best way possible, starting from the inside.

President’s Council on Physical Fitness and Sports—Physical Activity and The Stages of Motivational Readiness for Change Model: www.fitness.gov/Reading_Room/Digests/march2003digest.pdf

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Don’t Deprive Yourself of the Rewards of Exercise

Talking to committed exercisers about the benefits of physical activity is like introducing a dedicated shopper to the joys of an anniversary sale at Nordstrom™. After all, those who exercise are no strangers to the freedom elicited by movement or to the sense of accomplishment felt at the end of a long walk or strength workout.

Those uninitiated in the pleasurable rewards of regular physical activity, however, remain skeptical. After all, how can something as basic as exercise not only improve one’s life today, but perhaps even also save one’s life tomorrow?

Researchers have sought to answer this question for years. In 1996, the Surgeon General’s Report on Physical Activity was released, detailing the research behind the benefits associated with exercise. This report goes beyond the anecdotal “it-just-feels-good” reason for exercising.

What follows are the conclusions of years of research on the health benefits of physical activity.

While not all types of exercise are appropriate for everyone, everyone can benefit from some type of exercise. After all, exercise is not limited to running or aerobics.

You can try water workouts or seated-chair classes. You can play softball or squash, go in-line skating or even take a turn or two around the mall, provided you don’t spend all your time lingering in front of shop windows. And if you think activities such as ballroom dancing or tending the garden don’t qualify as exercise, think again.

The primary factor in choosing an activity should be whether or not you enjoy it. Of course, an okay from your doctor also is advisable, particularly for men over 45 and women over 55, or those with special medical conditions or risk factors for heart disease.

How much one exercises is an individual decision, but numerous research studies indicate that hours of intense exercise are not necessary to reap the benefits detailed in the box above. In fact, health specialists now recommend that most adults accumulate 30 minutes or more of moderate physical activity on most days of the week.

Moderate activity is any activity that raises your heart rate and gets the blood pumping without leaving you out of breath or exhausted. So, rather than blocking off a large portion of one’s day, 10 minutes of walking at lunch and another 20 minutes after dinner, for example, is all it takes.

For those who are so inclined, exercising at slightly higher intensities for longer periods of time can bring about even greater health benefits. Less important than the intensity or duration of each exercise session is making the commitment to perform some type of physical activity every day, whether you focus on aerobic, strength or flexibility training. Soon, the exhilaration of movement and the empowerment that comes with greater fitness and health will have you hooked on exercise.

It won’t happen overnight, and there may be some aspects you find less enjoyable (some people just can’t get over the sweating part of it), but the sense of feeling better, of feeling healthier, will overpower any negative attitudes toward exercise that you may still be harboring.

Don’t worry. These, too, will pass. So, isn’t it about time you got started?

Individuals who exercise regularly are less likely to develop:

Heart diseaseDiabetesHigh blood pressureHigh cholesterolCertain forms of cancerOsteoporosis

Individuals who exercise regularly are more likely to:

Maintain a healthy body weightEffectively control the pain and joint swelling that accompany arthritisMaintain lean muscle, which is often lost with increasing ageHave higher levels of self-esteem and self-confidenceContinue to perform activities of daily living as they grow olderExperience overall feelings of well-being and good health

National Institutes of Health Weight Control Information Network—Active at Any Size: www.win.niddk.nih.gov/publications/active.htm

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Be a Savvy Fitness Shopper

The benefits of exercise are well-researched and well-documented. Unfortunately, that’s not always the case with advertising claims for exercise equipment.

Some advertisers claim—without evidence—that their exercise products offer a quick, easy way to shape up, keep fit and lose weight. The truth is, there’s no such thing as a no-work, no-sweat way to a healthy, toned body.

Deriving the benefits of exercise requires doing the work.

Before you jump into the next home fitness fad, the Federal Trade Commission (FTC) offers this advice: Exercise good judgment and carefully evaluate advertising claims for exercise products.

Read the performance claims critically. Be leery of those that say the equipment or device can:

Provide easy or effortless results or burn excessive calories. The claims may be true for athletes in top physical condition, but not for most people.Help you burn more calories or lose weight faster than other types of equipment. In general, exercise equipment that works the whole body or major parts of it probably helps you burn more calories than devices that work one part of the body. And, the more you use the equipment, the more calories you’ll burn.Help you “spot reduce”—for example, help you trim your hips or lose the proverbial “spare tire.” Toning and losing weight in one particular area of the body requires regular exercise that works the whole body.Always read the fine print. The advertised results may be based on more than just the use of the machine; they also may be based on restricting calories. The fine print may explain this.

Be skeptical of testimonials or before-and-after pictures from “satisfied” customers. Their experiences may not be typical: Just because one person had success with the equipment doesn’t mean you will, too. As for those popular celebrity endorsements, they, too, are no proof that the equipment will work as claimed.

After you’ve evaluated the advertised claims—but before you make a final purchasing decision—consider these questions:

Will the equipment help you achieve your desired goal, whether it’s to build strength, increase flexibility, improve endurance or enhance your health?Will you stick to the program? Before you buy, prove to yourself that you’re ready to act on your good intentions.To help you choose the best equipment for your needs, check out consumer and fitness magazines that rate exercise equipment. Then test various pieces of equipment at a local gym, recreation center or retailer to find the machine or device that feels comfortable to you.Don’t be fooled by companies that advertise “three easy payments of” or “only $49.95 a month.” The advertised price may not include shipping and handling fees, sales tax, and delivery and set-up fees. Ask about all the costs before you close the deal.Get details on warranties, guarantees and return policies: A “30-day money-back guarantee” may not sound as good if you’re responsible for paying a hefty fee to return a bulky piece of equipment.Check out the company’s customer and support services. Call the advertised toll-free number to get an idea of how easy it is to reach a company representative and how helpful he or she is.

You may get a great deal on a piece of fitness equipment from a secondhand store, consignment shop, yard sale or the classified ads. Buy wisely: Items bought secondhand usually aren’t returnable and don’t carry the warranties that new equipment does.

Whether used or new, home exercise equipment can be a great way to shape up—but only if you use it regularly. Don’t be taken in by claims of quick, easy and effortless results: There’s no such thing as a no-work, no-sweat way to a toned body.

Federal Trade Commission, Bureau of Consumer Protection, Office of Consumer and Business Education—Avoiding the Muscle Hustle: Tips for Buying Exercise Equipment: http://www.consumer.ftc.gov/articles/0051-tips-buying-exercise-equipmentThe Federal Trade Commission works for the consumer to prevent fraudulent, deceptive and unfair business practices in the marketplace and to provide information to help consumers spot, stop and avoid them. To file a complaint, or to get free information on any of a variety of consumer topics, call toll-free, 1-877-FTC-HELP, or use the complaint form at www.ftc.gov.

The FTC enters Internet, telemarketing, identity theft and other fraud-related complaints into Consumer Sentinel, a secure, online database available to hundreds of civil and criminal law enforcement agencies in the U.S. and abroad.

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Exercising in the Cold

The biggest concern for exercising in the cold is hypothermia, or too much heat loss. When you exercise in a cold environment you must consider one primary factor: How much heat will your body lose during exercise?

Heat loss is controlled in two ways:

Insulation, consisting of body fat plus clothingEnvironmental factors, including temperature, wind and whether you’re exercising in the air or in the water. Each of these factors plays a role in the body’s ability to maintain a comfortable temperature during exercise.

 Although many people aspire to have a lean figure, people with a little more body fat are better insulated and will lose less heat. Clothing adds to the insulation barrier and is clearly the most important element in performance and comfort while exercising in the cold. Generally, heat loss from the head alone is about 50% at the freezing mark, and by simply wearing a helmet or hat, a person can stay outside indefinitely.

Clothing is generally a good insulator because it has the ability to trap air, a poor conductor of heat. If the air trapped by the clothing cannot conduct the heat away from the body, temperature will be maintained. Unlike air, however, water is a rapid conductor of heat and people will sweat and risk significant heat loss even in the coldest of temperatures. With this in mind, you want to choose clothing that can trap air but allow sweat to pass through, away from the body.

By wearing clothing in layers, you have the ability to change the amount of insulation that is needed. While many new products can provide such a layered barrier, it is important to avoid heavy cotton sweats or tightly woven material that will absorb and retain water. Because these materials cannot provide a layer of dry air near the skin, they can increase the amount of heat your body loses as you exercise.

Keeping the hands and feet warm is a common concern when exercising in the cold. Lower temperatures cause blood to be shunted away from the hands and feet to the center of the body to keep the internal organs warm and protected. Superficial warming of the hands will return blood flow to prevent tissue damage. Blood flow will not return to the feet unless the temperature of the torso is normal or slightly higher [0.5 to 1.0 degree Fahrenheit (F) above normal]. So, to keep your feet warm you must also keep the rest of your body warm at all times.

Always check the air temperature and wind chill factor before exercising in the cold. Data from the National Safety Council suggest little danger to individuals with properly clothed skin exposed at 20° F, even with a 30 mph wind. A danger does exist for individuals with exposed skin when the wind-chill factor (a combined effect of temperature and wind) falls below –20° F.

That can be achieved by any combination of temperatures below 20° F with a wind of 40 mph and temperatures below –20° F with no wind. If you are exercising near the danger zone for skin exposure, it also is advisable to warm the air being inhaled by wearing a scarf or mask over your nose and mouth.

Check the temperature and wind conditions before you go out and do not exercise if conditions are dangerous.Keep your head, hands and feet warm.Dress in layers that can provide a trapped layer of dry air near the skin (avoid cotton sweats and other similar materials).Warm the air you are breathing if temperatures are below your comfort level (usually around 0° F).

How to Exercise Safely in Cold Weather: www.sportsmedicine.about.com/cs/environment/a/aa121100a.htm
Runner’s World—Run and Race Well in the Cold: www.runnersworld.com/article/0,7120,s6-238-267-269-12331-0,00.html
Runner’s World—Is Cold Weather Running Bad for You? www.runnersworld.com/article/0,7120,s6-238-267-269-7442-0,00.html

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Fantastic Fiber

Most of us hear the word fiber and automatically think of bland, chalky and all-around unappetizing foods. Fortunately, with the advancements in food science and technology, this is no longer the case. Our generation has been freed from health foods that taste like cardboard and have the visual appeal of hamster food!

Fiber is a string of sugar molecules that are bonded together in such a way that they cannot be digested. So why bother eating something you can’t digest? Well, that is actually the point. Fiber makes its way through the digestive tract and cleans it out. And since fiber can’t be digested, it is calorie free. Some bacteria in your colon is able to break fiber down into smaller useable units that may have other health benefits.

There are two types of fiber. For optimal benefits, you should get enough of both in your diet.
Soluble fiber dissolves in water and has been linked with lowering levels of “bad” low-density lipoprotein (LDL) cholesterol. Insoluble fiber cleans out your gut and is associated with a reduced risk of cardiovascular disease.

A diet high in fiber has many health benefits. Besides being important for digestive health, fiber is most famous for reducing cholesterol and preventing diseases related to high cholesterol. Not a bad deal for a calorie-free nutrient. There are also indications that a high-fiber diet improves glucose tolerance.
Fiber is also beneficial for weight loss. The large, bulky molecule structure increases your sense of being full without adding any calories. It also slows the emptying of your stomach, further prolonging that sense of satisfaction so that you won’t eat as frequently.

The current daily recommendations for fiber are as follows:

Ages 9–13: 31 grams for boys and 26 grams for girlsBoys and men ages 14–50: 38 gramsGirls ages 14–18: 26 gramsWomen ages 19–50: 25 gramsAges 50 and older: 30 grams for men and 21 grams for women

When increasing your fiber intake, it is important to start slowly. Surprising your digestive tract with more fiber than it’s used to can lead to constipation, nausea and other gastrointestinal discomfort. So start increasing your fiber intake by a few grams per day until you work up to the recommended levels. Fiber also absorbs water, so when you increase your fiber intake, it is important to increase your water intake as well.

There are many fiber-fortified cereals, crackers, yogurts and other products from which to choose. Foods naturally rich in fiber include whole grains, nuts, fruits and vegetables. Here are some simple things you can do to incorporate more fiber into your diet.

Start your day with a bowl of oatmeal, which is one of the best sources of soluble fiber. Add dried fruit and nuts for some texture and additional fiber.Switch from refined grain products to whole-grain products. Make sure your groceries say 100% whole wheat and have at least 3 grams of fiber per serving. Many whole-wheat pastas and breads are being engineered to resemble the taste and texture of their white counterparts, which may make your transition easier.Mix half brown rice with half white rice to ease the transition from white rice to brown rice.Snack on fruits and vegetables. Trail mixes that have nuts and dried fruit are packed with fiber.

American Heart Association—Fiber:
http://www.americanheart.org/presenter.jhtml?identifier=4574
Institute of Medicine—Dietary Reference  Intakes http://www.iom.edu/Object.File/Master/21/372/0.pdf

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