Category / Exercise

Benefits of Pilates: Strength and Stability

March 19, 2019

Learn what it is, and how to find the right class and instructor for you
By Camille LeFevre

Tiza Riley’s client has spinal stenosis, severe osteoporosis and a rotator cuff injury that was never repaired. Still, at 82, her client has never felt better. She does Pilates (pronounced pih-LA-tays), the increasingly popular exercise system for women and men.

“I’ve been working with her for 10 years,” says Riley, a master trainer at CORE Conditioning in Studio City, Calif. “She’s limited in what she can do. There are activities she has to avoid completely. But today, she can do so much without pain.”

Like driving to Palm Springs twice a year to see her son — without back pain. And gardening four days a week. During their sessions, Riley works on her client’s core stability on a floor mat, then moves to a piece of Pilates equipment called the Reformer to strengthen her client’s feet and legs.

Pilates Works the Whole Body

Core strength and stability are at the center of Pilates, which works the whole body to improve posture, balance, flexibility and strength. The core, Riley explains, is comprised of the pelvic floor, transverse abdominis, diaphragm and multifidi along the spine, which, when properly engaged, work together to create the effect of a nice snug corset.

“The core holds up your spine,” Riley explains. “On top is the weight of your head, shoulder girdle and upper body. Then, you need to have mobility in your legs. In Pilates, we bring the top and bottom together through the core. If your core is weak, your upper body is not supported, your spine starts to shrink and hunch, and that affects your gait. As we get older, keeping the right posture through proper core engagement makes all the difference in quality of life.”

As Joseph Pilates, creator of the exercise system, famously said, “If your spine is stiff at 30, you are old. If it is flexible at 60, you are young.”

Pilates’ Beginnings

Originally from Mönchengladbach, Germany, Pilates developed the exercise system during World War I, while he was being held at the Knockaloe internment camp on the Isle of Man. He developed a series of floor exercises on a mat that engage and strengthen the core, stabilize the pelvis, strengthen the arms and legs and lengthen and mobilize the spine.

Working with his fellow internees, including some who were bedridden, he innovated a series of straps and pulleys that would support the body while doing the exercises. After the war, Pilates moved to New York City with his wife and formalized the exercise system he had created, which he called “Contrology.”

He also developed the strap-and-pulley system into equipment designed to help accelerate the process of stretching, strengthening, body alignment and increased core strength started by the mat work. The Reformer is the best-known and most popular of this equipment; it “includes a moving platform that inherently challenges stability and balance,” Riley says.

The Reformer also supports the body during Pilates.

“For people over 50, mat Pilates can be stressful on the neck and shoulders,” Riley notes. “Joe did the mat work first, then created the equipment to help people who needed more support while doing the work. The Reformer gives you something to push against, whereas on the mat you’re pulling against gravity.”

Mental and Physical Benefits of Pilates

The benefits of Pilates are not only physical, but mental. “The Reformer gives the body more input and feedback that the nervous and neurological systems need to wake up and become active,” says Cari Riis Stemmler, owner and master teacher at Paragon Pilates & Physical Therapy in Edina, Minn.

“Pilates, whether on the mat or on a piece of equipment, requires precision and focus,” she says. “Pilates requires you to move in intricate ways, which helps with brain activity and mental acuity. We joke all the time that you’re getting smarter when you do Pilates, because you’re learning new things. It refreshes you mentally.”

Other benefits from a regular Pilates practice include arm and leg strength, balanced muscle development, injury prevention and “increased energy and joy for your activities,” Riis Stemmler says. Runners, golfers, swimmers, runners, dancers and horseback riders all benefit from Pilates — so do people who aren’t as fit, or who come to Pilates with injuries or a chronic disease.

“The over-50 demographic is such a diverse group in the twenty first century, from the very fit to the post-surgical, from the sedentary to those with a condition like Parkinson’s,” Riis Stemmler says. “They also come to us with ankle sprains, meniscus tears and joint-related injuries.”

An acute injury should always be treated by a physician, then followed up with physical therapy. After that, Pilates can help with further rehabilitation and strength building.

“A well-trained, certified and experienced teacher will work with a client on the whole body,” Riis Stemmler adds. “With any injury or condition, the body adapts and creates compensatory patterns. As you’re healing, a good teacher will address the whole body and those compensatory patterns so the body is balanced as part of your recovery.”

Finding the Right Pilates Instructor

Today, Pilates is taught and practiced in a variety of styles, from the classical method Joseph Pilates devised to more contemporary iterations, including Stott Pilates, Balanced Body, Peak Pilates and even a new franchise on the scene: Club Pilates.

To find the right teacher, start by visiting the website of the Pilates Method Alliance (PMA), the nonprofit professional association dedicated to the field, and search the directory for an instructor in your area. Check out instructors’ certifications: In which style or program are they comprehensively certified, meaning, they can teach on all of the Pilates equipment? How many years of experience do they have?

Talk to friends and colleagues about instructors they like or who have helped them. When calling or emailing Pilates studios for information, advocate for yourself: Which instructors have experience with your concern, whether it’s a disk or joint injury, back issue or just wanting to improve your core strength and spine flexibility in a safe way? “If they say, ‘Oh, yes, we do that,’ and it feels more like a sales pitch than a conversation, you might want to look elsewhere,” advises Riis Stemmler.

If You Have Osteoporosis

If you have osteoporosis, many of the Pilates exercises are “contra-indicated,” meaning they could cause more harm than good. An instructor certified in a program like Rebekah Rotstein’s Buff Bones might be the ticket, as it combines bone-strengthening techniques with alignment and balance exercises. Ask if the studio also offers physical therapy, or receives referrals from physical therapists, which is an indication that the trainers can provide you with additional resources or instruction in addressing your physical concerns.

Finally, finding an instructor who feels right, someone who you can trust and connect with, is essential. Moreover, after taking a class, “Trust how your body feels. When you’re done with your workout, you should feel good. Worked, but supported and stronger,” Riley says.

When practiced safely and correctly, with an expert instructor, Pilates “is perfect form of exercise for people even into their 90s,” adds Riis Stemmler.

By Camille LeFevre

Camille LeFevre is a professional freelance writer and Balanced Body® certified Pilates mat instructor.

Our Brains Need Exercise, Too

March 12, 2019

Learn the ways you can have a positive effect on your cognitive health
By Paula Spencer Scott

The basics of heart health have been drilled into our brains: Eat less saturated fat. Keep moving. Know your “numbers” for cholesterol, blood pressure and BMI.

But what about that brain itself? Although life expectancy has more than doubled since 1900, our “mindspan” — how long we stay cognitively healthy — hasn’t kept pace.

Forgetfulness, slower processing and feeling less sharp plague most of us as we age. One in five people develops mild cognitive impairment, a decline in thinking skills beyond normal aging, which may or may not advance to dementia. After 65, your odds of developing Alzheimer’s disease are one in 10.

It doesn’t have to be that way, mounting research suggests.

“The very term ‘age-related memory loss’ may be a misnomer,” says neurologist Dr. Richard Isaacson, an Alzheimer’s specialist at Weill Cornell Medicine in New York.

Time and genetics alone don’t erode brain functions. How we spend our lives managing the modifiable risk factors that affect our genes is highly significant for our brain health, researchers say.

That’s why you’re likely to hear a lot more in the coming years about brain health and what you can do for your own. Educating the public on this is, in fact, one of the four core purposes of the Centers for Disease Control’s Healthy Brain Initiative, which recently kicked off its 2018-2023 road map for public health agencies, says program leader Lisa McGuire.

Brain Health: Stop Thinking There’s Nothing You Can Do

“Awareness of the steps to improve cognitive brain function is at least a generation behind that of heart health,” says cognitive neuroscientist Sandra Bond Chapman, director of the Center for Brain Health at the University of Texas at Dallas.

When our fathers and grandparents died of a heart attack or stroke, we chalked it up to tragic luck. Clogged arteries, high blood pressure and high cholesterol were considered normal features of aging before 1948, when Congress commissioned researchers to begin tracking the cardiovascular lives of some 5,200 residents of Framingham, Mass.

The Framingham Heart Study (now three generations old and still going) introduced the phrase “risk factors” to the medical lexicon and helped prove which prevention tactics work.

Today, it’s the brain we’re in the dark about. In a review of public awareness studies by PLOS One, a nonprofit, peer-reviewed, online scientific journal, nearly half of the respondents mistakenly believed Alzheimer’s disease is a normal process of aging that you can’t do anything about. In reality, a third or more of dementia cases can be delayed or prevented by lifestyle factors, according to a 2017 report sponsored by the Lancet Commission on Dementia Prevention, Intervention and Care.

Read on to find out what we can do to help our brains stay in shape.

Use Brain Health to Motivate Your Health Habits

Advances in neuroimaging kicked off this new era of brain health by allowing scientists to see inside the brain. Intervention studies on how lifestyle affects brain function are newer still.

One of the largest such investigations to date, the BrainHealth Project, launched in December. Researchers across more than a dozen institutions will study 120,000 subjects to find out how cognitive training, sleep, nutrition, exercise and more can extend mental strength over time.

What’s already clear: All health roads lead to the brain. “The No. 1 cause of cognitive decline is healthy people letting their brains decline,” says Chapman, the BrainHealth Project’s director.

That’s powerful motivation the next time you’re tempted to skip a workout or not opt for a healthy meal, do nothing about stress or loneliness, or avoid treatment for conditions like depression, anxiety, diabetes and sleep apnea. Effects of all of these choices, and many others, travel north.

Resist Too Much Habit and Routine

A particular challenge from midlife and beyond is the brain’s natural inclination to steer toward efficiency. It figures out the easiest, most comfortable ways to get something done and hits repeat.

But while toweling dry in the same mechanical pattern every morning allows you to get on with the day quickly, running your whole life as a creature of habit — doing the same things, seeing the same people — deprives the brain of something else it craves: newness and challenge.

Hallmarks of brain-stimulating activities that improve cognitive abilities, according to a 2017 report by the Global Council on Brain Health (GCBH) are novelty, high engagement, mental challenge and enjoyableness.

If you like crosswords, fine, but push beyond to new games and challenges. Good examples from the GCBH: Tai chi, researching genealogy, picking up an old hobby you dropped, making art and community volunteering. When activities include a social component, so much the better.

Be Aggressive About Blood Pressure

In 2018, a groundbreaking study became the latest persuasive link between heart health and brain health. Researchers at Wake Forest University in Winston-Salem, N.C., showed for the first time that lowering blood pressure can significantly reduce the risk of mild cognitive impairment (MCI).

Standard medical care had long included a systolic blood pressure of above 140 as the target defining hypertension and requiring treatment. (Systolic pressure is the first number in a blood pressure reading, as in “140 over 80.”) In 2017, that definition was revised to 130 by the American Heart Association and American College of Cardiology.

The recent, long-term, large-scale SPRINT-MIND clinical trial, sponsored by the National Institutes of Health, found that the more aggressively high blood pressure was treated toward reaching a systolic pressure below 120, the lower the risk of MCI. Treatment measures included a combination of not smoking, medication management, nutrition counseling, social and cognitive stimulation and exercise.

Work Your Brain Harder, But Not by Multitasking

Your brain grooves on doing — but only one thing at a time. Multitasking stresses it.

Researchers say one better alternative is a cognitive exercise called “strategic attention.” The Strategic Memory Advanced Reasoning Training program at the University of Texas at Dallas, advises this: Every day, pick two substantial tasks requiring fairly deep thinking. They might be tracking and analyzing your household budget, planning a vacation, writing a memo or following a complex new recipe.

Then carve out two 30-minute sessions to focus without interruption. Turn off email alerts. Shut the door. No quick scrolls through your news feed that will take you off your task. It takes up to 20 minutes to refocus after a disruption.

Over time, you’ll find that you’ll achieve much more, and much more quickly, with improved attention. It’s the equivalent to your brain of a good workout at the gym.

Do (the Right Kind of) Nothing

It’s not all about activity. The brain needs two kinds of downtime to function optimally: Rest and sleep.

Rest means taking intentional breaks from active thinking. Try taking five minutes, five times a day, to sit still and do nothing, Chapman says. Other routes to mental R&R include mindfulness, meditation and yoga nidra (also known as iRest and sleep yoga).

Not least, there’s sleep itself. Our awareness of how important it is to the brain grew with the discovery of the body’s glymphatic system — a kind of internal trash-hauling system — less than a decade ago. The system’s pace increases by over 60 percent during sleep, a possible link to why getting more sleep is linked with a reduced dementia risk. Alzheimer’s prevention experts recommend eight to nine hours a night, Isaacson says.

By Paula Spencer Scott

Paula Spencer Scott is the author of Surviving Alzheimer's: Practical Tips and Soul-Saving Wisdom for Caregivers and An Oral History: Preserve Your Family's Story. A longtime journalist, she's also an Alzheimer's and caregiving educator.@PSpencerScott

Understanding the Types of Rehab for Stroke Therapy

February 15, 2019

A breakdown of the various offerings and where insurance fits in
By Lisa Fields

After a stroke, only about 10 percent of people recover almost completely without intervention. For everyone else, therapy is a crucial part of the recovery process. Whether you need physical, occupational and/or speech therapy following a stroke depends on your needs, but the goal is the same: to help you regain control of your body and be independent once again. The therapy you receive should be tailor-made to suit your lifestyle.

“Is the goal returning to driving or returning to work, or (is the person) a retiree who needs to take care of their own bodily functions and participate in playing with a grandchild?” says Glen Gillen, professor and director of programs in occupational therapy at Columbia University in New York and a fellow of the American Occupational Therapy Association.

Kinds of Rehabilitation Facilities

Most stroke patients stay in the hospital for five to six days. Their therapy needs are assessed within the first two days, and therapy may begin on the second. Some patients are sent home from the hospital right away. They may receive outpatient therapy sessions three times a week or get therapy at home from visiting nurses or therapists.

“If they’re higher-functioning, they can potentially go to outpatient therapy, if they have the means to get there,” Gillen says. “That is a challenge for many.”

Many stroke patients are discharged from the hospital to inpatient rehabilitation facilities, where they receive therapy at an intensity that’s best for their needs, based on the severity of the disability. Some go to acute inpatient rehab facilities, which offer the most intense therapy for the most responsive patients. Those with a greater degree of impairment may be sent to “subacute rehab” facilities, where the therapy isn’t as intense as acute rehab.

At acute rehab facilities, “people are guaranteed a minimum of three hours of therapy a day, and a physician visits six days a week,” says Dr. Alexander Dromerick, professor of rehabilitation medicine and neurology and chairman of rehabilitation medicine at Georgetown University Medical Center in Washington, D.C. “(At a subacute facility), they may get a few minutes a day, up to two hours a day, of therapy, and a physician visits every few weeks. They’re very different levels of intensity of care.”

Patients who are making great strides in a subacute facility might be moved to an acute facility for more intense therapy. Those who don’t have the endurance to tolerate an acute facility’s therapy, might be transferred to a subacute facility. “A subacute unit can be a way station back to the community,” Dromerick says, “or it can be a way station to go to a nursing home for the long term.”

Types of Therapy for Stroke Patients

Stroke patients often need physical therapy to strengthen their muscles, retrain their sense of balance and coordination and relearn certain movements. They may need occupational therapy to ensure they can do the tasks associated with daily living, like getting dressed, feeding themselves, showering or relearning skills necessary to return to work. Speech therapy also might be required to relearn how to speak or swallow food.

“Sometimes occupational therapists and physical therapists work together, but occupational therapists focus more on mobility activities that have to do with returning to work or returning to their role in their family or community,” says Carolee Winstein, professor of biokinesiology and physical therapy and director of the Motor Behavior and Neurorehabilitation Laboratory at the University of Southern California. “Physical therapists work on fundamental skills that are needed to be functional in their particular life, whatever it is. We work a lot on mobility. We teach people a lot about the importance of remaining physically active.”

Physical therapists help patients overcome physical challenges — this includes when a stroke has weakened or partially paralyzed one side of the body. Medical professionals refer to that side as “paretic.”

“If they’re having trouble reaching and grasping with their paretic side, I have them do it with their less paretic side to remind them what it should feel like,” Winstein says. “A lot of motor skills are implicit — we don’t think; we do it automatically.”

Occupational and speech therapists also address cognitive challenges.

“We consider most tasks physical, like dressing yourself, (but) all tasks that we do across the day have a cognitive component,” Gillen says. “With getting dressed, it’s the sequence of the clothing: which goes on what body part, which goes on first. If cognition is involved after a stroke, it’s a time-consuming process. We know it will take much longer, much more repetition of practice to get them there.”

Insurance Plans Could Limit Therapy

Health insurance may limit how much therapy a person can receive during a single calendar year or during his or her lifetime. If a person can afford to pay out of pocket, he or she may continue therapy without interruption. Otherwise, many therapists offer plans that patients can follow at home or at a fitness center either on their own or with the help of a family member, friend or personal trainer.

“You can keep working on the stroke problems indefinitely,” Dromerick says.

Therapists hope to get stroke patients functioning independently again, even after their sessions are complete.

“They may need a cane and a brace, but (we teach) them how to navigate with their disability so their disability does not become a barrier in their participation of being active,” Winstein says. “If there are certain things they can’t do, we show them what they can do and get them to work on those things.”

To learn more about stroke rehab and recovery, check out the American Stroke Association’s website.

By Lisa Fields
Lisa Fields is a writer who covers psychology and health matters as they relate to the workplace. She publishes frequently in WebMD and Reader’s Digest.

5 Hidden Causes of Heart Disease

January 25, 2019

What can increase your risk and how to prevent it
By Frieda Wiley, PharmD

Heart disease kills about 610,000 people in the United States each year — 1 in every 4 deaths — more than any other disease, according the Centers for Disease Control and Prevention. It’s commonly known that exercise and eating a healthful diet are keys to keeping your heart in tip top shape. But there are seemingly unrelated conditions and lifestyle habits that can lead to heart disease.

Here are five lesser-known causes of heart disease that you can do something about: Sleep apnea; stress, anxiety and loneliness; sitting all day, influenza and dental disease.

  1. Sleep Apnea

“Sleep apnea is very common, especially as we get older, and it puts enormous stress on the heart,” says Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver.

People who have sleep apnea tend to also have other conditions that are associated with the disease, such as high blood pressure, atrial fibrillation (a kind of irregular heartbeat) or pulmonary hypertension, which Freeman defines as high blood pressure on the right side of the heart.

Symptoms of sleep apnea include daytime sleepiness, memory problems and irritability. Being overweight or obese and even structural features, such as having a big chin or tongue, may also make you more likely to develop sleep apnea, according to the American Lung Association.

Premenopausal women are less likely to have sleep apnea than men, but postmenopausal women and men of any age share similar risks. After reaching adulthood, sleep apnea becomes more common with age until you reach 60, when the chances of developing it begin to taper off.

One way to treat sleep apnea is to use a continuous positive airway pressure (CPAP) machine at night. However, Dr. Mark Peterman, a cardiologist at Texas Health in Plano, says that many people find the machine uncomfortable to use. Other treatment options, depending on the severity of the problem, include weight loss, oral appliances (similar to a mouth guard), nasal decongestants and surgery.

  1. Stress, Anxiety and Loneliness

Stress can have powerful effects on the body that wreak havoc on your health. Some stresses, such as learning a new language or skill, can be positive. But Freeman says the majority of stress people experience, like worrying about children or finances, tend to have negative effects on the body.

While it might be difficult to see the connection, the lack of social interaction and fulfilling relationships also impacts heart health.

“It might sound strange to hear a heart doctor talk about love, but people need what we call social support and connection,” Freeman says. “People don’t talk about it much, but people who lack social support or are lonely are at higher risk for heart disease and depression.”

The American Heart Association says that, while stress can harm the heart, researchers still haven’t quite figured out the role stress plays in causing heart disease. Even for those who manage stress well, keeping up with life in our increasingly fast-paced world can still take its toll.

“Treating stress with medication can be difficult, so it usually requires counseling and lifestyle changes,” Peterman says.

  1. Sitting All Day

We hear a lot about how important exercise is to keep your body and mind in shape. Studies also show that sitting the majority of the day increases your chance of developing heart disease.

In a 2014 study of how a sedentary lifestyle affects blood pressure, researchers found a strong association between a sedentary lifestyle and an increase in blood pressure. This finding was independent of time spent in moderate to vigorous exercise. A 2015 study came up with similar findings: Sitting down the majority of the day can increase your risk for heart disease, stroke and even diabetes — even if you exercise an hour a day.

Luckily, this heart risk factor is easily remedied with increasing physical activity. If you’re having trouble getting started, Peterman suggests technological devices like Fitbits to help you become more aware of your daily movement and motivate you to exercise.

  1. Influenza

If you think the only consequences of getting the flu are having body aches, a runny nose and fever for a week or two, think again. The flu can increase the risk for heart problems stemming from the inflammation it causes.

Peterman says the flu has been linked to increased risk of heart trouble between the months of October and February. One study published in the 2016 found that people who had the flu were six times more likely to have a heart attack within the first seven days of their condition being confirmed with laboratory testing.

Sounds like your doctor may have more than one reason for recommending you get a flu shot.

  1. Dental Disease

Dental health is important for more reasons than a great smile; it can also work wonders for your heart.

Mouth issues like cavities and gum disease can trigger chronic inflammation, which Peterman warns can speed up hardening of the arteries, or atherosclerosis, causing the risk of heart problems to soar.

But not to worry. This problem is easily remedied by maintaining good brushing and flossing habits along with regular trips to the dentist.

How to Reduce Body Inflammation

Freeman says these five hidden causes of heart disease lead to inflammation in the body, which is the root of other common diseases, including cancer, diabetes and arthritis. Luckily, there are four key practices you can adopt to put your body in anti-inflammatory mode and strengthen your heart in the process:

  • Eat a predominantly plant-based diet; limit your consumption of animal-based products.
  • Get at least 30 minutes of brisk activity each day.
  • Make time for a little stress relief each day. Prayer, yoga, meditation or anything else that helps you become more mindful and live in the moment helps.
  • Build a strong social network so you feel connected, supported and loved.

“Switching the body into an anti-inflammatory healing environment is what we’re trying to do to get people to heal,” Freeman says.

Hopefully these extra tips will help you take a load off your heart — and your life.

By Frieda Wiley, PharmD

Frieda Wiley, PharmD, CGP, RPh, is a board-certified geriatric pharmacist and freelance medical writer based in the Piney Woods of East Texas. She enjoys using her background in patient care to empower people with more knowledge about living well.@frieda_wiley

8 Reasons You’re Losing Sleep

January 8, 2019

Avoid these culprits to get a better night's rest
By Sheryl Kraft


As if there weren’t enough things keeping you tossing and turning each night, here’s a new one: Using short-wave, blue light-emitting e-readers, like the iPad, iPhone, Nook Color, Kindle and Kindle Fire before bedtime can make it harder to fall asleep, according to a December 2014 study at Brigham and Women’s Hospital in Boston.

“When blue light hits the optic nerve, it tells the brain to stop producing melatonin,” which is “the key that starts the engine for sleep,” says Michael Breus, diplomate of the American Board of Sleep Medicine and fellow of the American Academy of Sleep Medicine. “This is especially problematic, since as you get older, the ability to produce melatonin becomes even more compromised.”

Fixes: Open up a real book instead. (Remember those?) If giving up your e-reader is impossible, look for screens and glasses that can block the sleep-stealing blue light on websites like 6 Habits That Ruin a Great Night’s Sleep)


Carry extra pounds, especially in the neck and trunk section, and it’s more likely you’ll suffer from sleep apnea, which causes your airway to become blocked or obstructed during sleep, robbing you of quality deep sleep. The condition affects 90 percent of obese men, though it’s not purely a man’s disease. The Cleveland Clinic reports that after menopause, it’s just as likely to affect women. Even more disturbing, it goes undiagnosed in as many as 80 percent of those who get a lousy night’s sleep.

“Sleep apnea can mask itself as fatigue, trouble with concentration, dry mouth or even depression,” Breus states.

Unfortunately, the relationship between sleep apnea and obesity is a bit of a chicken-egg scenario. Do sufferers have problems because they’re obese, or is their obesity stoked by their compromised sleep? No one knows for sure, but what is known is this: Poor sleep makes people less motivated to increase physical activity, which can lead to more weight gain. Additionally, reduced sleep is associated with elevated levels of the hormone leptin, which helps regulate appetite.

Fixes: Among the various treatments for sleep apnea is a continuous positive airway pressure (CPAP) machine, which delivers air pressure via a mask that sits over your nose or mouth while you sleep. Other treatment options include losing weight, oral appliances (that resemble mouthguards), and Inspire Upper Airway Stimulation (USA) therapy, a new FDA-approved implantable device.(MORE: A Good Night’s Sleep Could Ward Off Alzheimer’s)


Many popular over-the-counter pain medications, like Excedrin and Bayer Back and Body, may contain caffeine, which helps the medication get absorbed more quickly, but can cut into your sleep, according to Breus (who suggests always checking the label first). If you’re feeling under the weather, beware of nasal decongestants and daytime cold or flu medicines, as well, which can contain pseudoephedrine; you’ll feel jittery instead of tired.

Diuretics, water pills for heart disease and high blood pressure, and ADD medications like Adderall and Ritalin can also disrupt sleep, says Dr. Hrayr Attarian, a neurologist at Northwestern Memorial Hospital in Chicago, Ill. Other culprits include steroids and some medications for depression or asthma. “As with any new medication, always check with your doctor first,” Attarian says.

Fixes: If your meds are causing sleep problems, “First, I’d suggest talking to your physician to see if your medication can be changed or the dose adjusted,” Attarian says. “If that doesn’t work, you can go to a sleep clinic to discuss treatment options that may or may not include sleep aids. Taking a sleeping pill is not always the right thing right away, especially if you are taking other medications to manage health conditions.”

(MORE: 6 Foods and Medications That Don’t Mix)


Body temperature naturally begins to drop before bedtime, preparing us for sleep. Although a warm bath can relax and calm you, taking one too close to bedtime will not give your body enough of a chance to cool sufficiently to bring on slumber.

Fixes: To reap the full benefits of your bath, the National Sleep Foundation recommends finishing up your soak at least an hour before climbing into bed. While you’re at it, keep your room cool. “We sleep better in cool rooms,” says Dr. Patrick D. Lyden, chairman of the Department of Neurology at Cedars-Sinai Medical Center in Los Angeles, Calif..(MORE: Can’t Sleep at Night? Look at Your Day)


If you like to snack before bed, watch what you eat. Loading up on foods that contain excessive salt or fat can stimulate brain waves, bringing on nightmares instead of sweet dreams, says the National Sleep Foundation. Choose foods that contain tryptophan (an amino acid linked to sleep quality), whole-grain carbs (which help boost serotonin production) and certain minerals (like calcium and magnesium, which can have a calming effect). Examples include half a banana and a handful of almonds, whole-grain crackers and peanut butter, a mug of warm milk, or half a turkey sandwich on whole-wheat bread.

Fix: In general, stick to a routine of eating early in the evening and try to avoid sugar at night. “Late meals are more likely to make it harder to sleep; snacking in the middle of the night can worsen insomnia,” says Dr. Andrew J. Westwood, a member of the American Academy of Neurology and American Academy of Sleep Medicine. Additionally, eating too much can make you feel physically uncomfortable when you lie down, and may cause heartburn, contributing to wakefulness.(MORE: 6 Healthy Foods to Put in Your Grocery Cart)


The ideal bedroom should be simply furnished and decorated, so there’s not much to distract you from the primary reason you’re in there — to sleep. Excess clutter and mess can often cause anxiety, and remind you of all your unfinished business, making it harder to fall — and remain — asleep.

(MORE: Take the 30-Day Declutter Challenge)


Sure, being physically active can make you tired, promote sleep and improve the quality of your rest, but exercising vigorously too close to bedtime can rev you up instead. “Aerobic exercise can raise your core body temperature long after you’ve finished,” says sleep specialist Rubin Naiman.

Fixes: Naiman suggests completing exercise at least three hours prior to bedtime. However, gentle exercise like yoga, he says, can be helpful to promote relaxation and sleepiness.(MORE: The Best Exercise to Protect Your Bones)


When you’re stressed, your body secretes cortisol, a hormone produced by the adrenal gland. This can disrupt the body’s natural rhythm, says Naiman. “Cortisol is naturally produced in the morning. It peaks at around 8 a.m., when it can be helpful to naturally energize us,” he explains. “But at the wrong time—like nighttime—it can make us hyper-aroused and disrupt our sleep.”

Fixes: In addition to yoga for relaxation, a new study in adults over 55 finds that practicing a popular form of meditation known as mindfulness meditation can reap improvements in sleep quality and reduce insomnia and fatigue. Mindfulness meditation can also help reduce stress, according to a 2009 Massachusetts General Hospital study. Visit to learn some basics.(MORE: 6 Health Risks of Poor Sleep)

If meditation is not your thing, there’s always a good old-fashioned belly laugh; laughter actually induces physical changes in your body, says the Mayo Clinic. It cools your stress response and can increase positive thoughts, which, in turn, causes your body to release neuropeptides to help fight stress.

By Sheryl Kraft

Sheryl Kraft is a freelance journalist, essayist and writer of non-fiction based in Fairfield County, Conn. Her writing covers all areas, with a concentration in health, wellness and fitness.@sherylkraft

Stand Up to ‘Sitting Disease’

December 18, 2018

Adding movement to your day can boost your health and prevent disease
By Lisa Fields

Not long ago, when I interviewed one of the leading experts on “sitting disease” — the buzzy catch phrase that’s been attached to physical inactivity for the past few years — he walked in place on his treadmill desk while we chatted by phone. The irony wasn’t lost on me: I was sitting idly at my desk while writing an article about the health problems associated with sitting idly at desks. Meanwhile, the expert in the know was staying active, even though he had a desk job.

I recently added a treadmill desk to my office, which I fashioned myself out of a regular treadmill and some supplies from the hardware store. It’s empowering to work while walking at 1.6 miles per hour, knowing that I’m taking care of my health.

Why Sitting Has Become More Routine

Unless you make an effort to get moving, it can be easy to fall into a physically inactive lifestyle. You can accomplish some of the same tasks from a seated position today that required walking just a few years ago: Think online shopping and drive-through everything. And with the widespread popularity of screen time, you’re likely allured into a seated position by your smartphone, laptop or TV for several hours daily. Between your desk job, commute, meals and nightly leisure time on the couch, you probably sit for the bulk of your day.

Unfortunately, an inactive lifestyle can be detrimental to your health. Prolonged sitting is linked to a host of health problems, including heart disease, diabetes, obesity, high blood pressure and cancer.

Luckily, research shows that there are simple ways to combat chronic physical inactivity, but it requires consistent effort; your morning walk won’t help to counteract the effects of a full day of sitting. Finding ways to add more movement all day long is key.

“Moving more frequently throughout the day, even at lower intensities and for shorter duration, has a positive impact on health markers and is just as important as regular exercise,” says Lauren Shroyer, director of product development for the American Council on Exercise.

Sneak Movement Into Your Lifestyle

Think about your daily schedule, then figure out ways to be more active.

“The default in America is to end up on your bottom,” says Dr. James Levine, author of Get Up! Why Your Chair is Killing You and What You Can Do About It and president of Fondation IPSEN, a Paris-based nonprofit medical research foundation. “I want the default to be up and doing something.”

The last time that I spoke with Levine — who is also the former director of obesity solutions for the Mayo Clinic — he was walking on his treadmill desk. Now he says that people can inspire themselves to be more active by mapping out a weekly plan, scheduling one appealing activity each day: Window-shopping downtown, volunteering at the library, wandering the aisles at Walmart or spending the afternoon with grandkids.

“The trick is absolutely to find the stuff that you want to do,” Levine says. “There’s no point in going to weight training if you hate going.”

Get Up Often

The problem with sitting is that once you park yourself at your desk or on the couch, you’re likely to stay seated for hours. But regularly shifting from sitting to standing helps to improve your health and preserve your long-term mobility.

“Losing mobility is probably the Number One cause of all the deteriorating we see with aging,” says Joan Vernikos, author of Sitting Kills, Moving Heals: How Everyday Movement Will Prevent Pain, Illness, and Early Death – and Exercise Alone Won’t, and former director of NASA’s life sciences division. “The most basic motion that you can do is structure your life so you have to change your posture often.”

For this reason, Vernikos advocates standing often, whether you place your water bottle just out of reach to encourage movement or train yourself to get up when commercials come on TV. Her research found that standing for one to two minutes every 20 to 30 minutes helps prevent deterioration caused by physical inactivity.

“Your body needs this on-off stimulation of changing posture,” Vernikos says.

Standing from a seated position seems like the simplest of skills, but as people get older, the inability to do this prevents some from being able to use the bathroom independently, which makes them more likely to end up in a nursing home or assisted-living facility, Vernikos says.

Be More Active at Work and Home

There are ways to counteract the inclination to stay seated all day.

“Most modern companies are offering some variant of active work: Walk-and-talk meetings, active lunchtime programs, walking clubs, running clubs, treadmill desks and standing desks,” Levine says. “There’s a whole range of active work opportunities, many of which cost nothing.”

If you’re retired, you don’t have to sit at home all day, even when you have no plans.

“Pacing the room while on the phone, using your standing work station or putting your laptop on the kitchen counter for 15 minutes are additional ways to work in more muscle activity throughout the day,” Shroyer says.

Do Things the Old-Fashioned Way

Just because there are modern conveniences doesn’t mean you have to use them constantly. Try doing activities the way you would have done them decades ago: Walk into your co-worker’s office to share an idea instead of emailing him. Visit the teller at the bank instead of frequenting the drive-through. Order something online, then pick it up at the store instead of having it shipped to you.

“If you want to improve or restore your mobility, be aware of what you’re not doing that you used to do,” Vernikos says. “Every time you go through the drive-through, you are aging yourself. Even getting out of your car and walking two steps to pick up your drugs at the pharmacy is something.”

By Lisa Fields

Lisa Fields is a writer who covers psychology and health matters as they relate to the workplace. She publishes frequently in WebMD and Reader’s Digest.

The Best Way to Improve Brain Health

November 8, 2018

The first in a series of interviews with Longevity Innovators
By The Milken Institute Center for the Future of Aging

(Advances in science and public health are increasing longevity and enhancing the quality of life for people around the world. In a series of interviews with the Milken Institute Center for the Future of Aging, 14 visionaries will be revealing exciting trends and insights regarding healthy longevity, sharing their vision for a better future. The Longevity Innovators interviews highlight new discoveries in biomedical and psychosocial science, as well as strategies to promote prevention and wellness for older adults. This is the first in the series.)

Renowned neurosurgeon Dr. Keith Black (chair of the department of neurosurgery and director of the Maxine Dunitz Neurosurgical Institute at Cedars-Sinai Medical Center in Los Angeles) has pioneered advances in our understanding and treatment of brain cancers and complex neurological conditions. Black is also a research scientist studying targeted drug delivery, cancer stem cells and Alzheimer’s detection through retinal imaging, among many other areas. In an interview with the Milken Institute Center for the Future of Aging, Black talks about the importance of developing a test for early onset Alzheimer’s and his goal to inspire the next generation.

Dr. Keith Black

What is the most important thing that people should know about improving brain health?

People need to know how important lifestyle is to sustain health. Lifestyle, diet, exercise, moderating stress, making sure you get a good eight hours of sleep when you can, making sure you keep your brain engaged particularly in novel activities — all of these matter. You have to remember the brain is a living organism very much like a muscle — the more you use it, the stronger it becomes.

We need to treat our brains better. For example, try to avoid excessive alcohol and make sure that you screen yourself for diseases like diabetes and hypertension that can be devastating to the brain.

What will be the benefits of having a reliable test for early onset Alzheimer’s?

I think there’s a huge misconception that if you get Alzheimer’s or if you’re going to get Alzheimer’s, there’s nothing that you can do about it. And I think the science shows that that perception is incorrect.

We know two things now that address your question. The first is that Alzheimer’s starts about two decades before a person develops symptoms. During that period of 20 years, you’re losing brain cells, and you’re losing brain connectivity. If you can detect the disease at the very start, particularly before you lose enough brain cells to become symptomatic, we may have the ability to stop the process or at least slow it down and prevent an individual from becoming symptomatic.

If people are developing Alzheimer’s in their 50s and 60s, they are going to become symptomatic in their 70s and 80s. If you can slow the overall process and have people become symptomatic in their late 90s or 100s, you have the ability to essentially prevent the disease from being symptomatic in most of our lifetimes. That’s really the major reason to move towards early detection, because preventing brain loss is a lot easier than restoring brain cells once they’ve died.

The other reason people should be interested is that even though we don’t have a pill that can stop the progression, we know that Alzheimer’s also has a lifestyle component. The scientific evidence shows that lifestyle habits such as a Mediterranean diet, exercise, sleep, meditation and other types of mindfulness modify stress levels. We’re seeing that potentially even micronutrients like the omega-3 fish oils may be very important in slowing the progression of Alzheimer’s disease.

What’s your take on Pfizer ending research to find new drugs aimed at treating Alzheimer’s and Parkinson’s diseases? How do you think it will impact ongoing research?

I think a lot of the trials that have failed for Alzheimer’s disease, including the Pfizer trial, could’ve been better designed and better developed. I think we have a lot to learn from the failure of those trials.

For example, how do we get the drugs into the brain more effectively? How can we better select the right population of patients to treat? I think addressing those potential reasons for the failures of those drugs will lead to successful therapies and hopefully successful approvals.

By The Milken Institute Center for the Future of Aging

The Milken Institute Center for the Future of Aging aims to improve lives and strengthen societies by promoting healthy, productive and purposeful aging.

Christina Soriano: The Impact of Improvisational Dance on Parkinson’s

October 23, 2018

This 2018 Influencer believes artists and scientists can learn from each other

By Julie Pfitzinger, Senior Editor for Features
September 13, 2018

Christina Soriano, associate professor of dance and director of the dance program at Wake Forest University in Winston-Salem, N.C., as well as associate provost of the arts for the school, is a 2018 Influencer in Aging and the founder of IMPROVment ®, a program focused on physical and mental fitness for those with neurodegenerative diseases. Since 2012, Soriano has led free weekly community dance classes in Winston-Salem for people living with Parkinson’s disease (PD) and Alzheimer’s disease.

Along with Christina Hugenschmidt, an assistant professor of gerontology and geriatric medicine at Wake Forest University Baptist Medical Center, Soriano recently received a $1.5 million grant from the National Institutes of Health for a three-year clinical trial focused on improvisational dance. The goal is to learn how dance affects different body systems and to determine whether the movement aspect or the social engagement aspect — or both — affect quality of life in people with dementia.

Next Avenue: How did you first become interested in improvisational dance for those living with neurogenerative diseases?

Christina Soriano: My mentor, Glenna Batson, who is the emeritus professor of physical therapy at Winston-Salem State University, is a physical therapist, dancer and leading practitioner in the field of dance and movement. She knows how the benefits of dance and movement can benefit wellness.

In 2012, she invited me to be part of a study she was doing about balance. I had no previous scientific experience — I trained as a performer and choreographer. But I had always admired her work, and the opportunity came at a point where I was ready for a new way to fall in love with my art.

I have also admired the work of David Leventhal of the Mark Morris Dance Group in New York City; he’s the director of the Dance for PD® which started as a collaboration between the Mark Morris Dance Group and the Brooklyn Parkinson Group. They created a program that is now international; dance is recognized as an effective tool for people living with Parkinson’s.

In the IMPROVment classes, what are the strategies used that make it comfortable and enjoyable for the participants?

The classes are based on a series of auditory prompts or cues. The improvisational nature of the experience gives everyone the opportunity to create exercise while honoring where they are physically. They can be more confident in their movements. They aren’t being asked to learn something. There are no ‘wrong’ movement choices. There is no judgment.

An important clarification to make is that this is not dance therapy. I am not a trained dance therapist, and there is also a danger in thinking that this type of movement is only for a prescribed period of time, as therapy would be. We call this a practice — taking a movement class becomes not only part of your day, but part of your life.

I really observe a different type of physical confidence that happens after class ends. The strides and gait lengths of the participants may be increased. I also believe the social benefits, as much as the physical ones, are huge. And there is laughter. They leave a little bit renewed — I know I do, too.

Another benefit of these classes is that the caregivers participate. The pair shares a movement experience that is joyful in so many ways. The idea of who has PD and who doesn’t have it goes away.

How do you believe that an art form, like dance, can impact aging?

In May, we hosted the Aging Re-Imagined Symposium 2.0 at Wake Forest; the first one was held in 2016. The event came about because I started working with scientists, like Christina, and as the artist in the room in our meetings, I realized there is so much that artists and scientists can learn from each other. Aging Re-Imagined features speakers and presentations that look at aging from so many different perspectives.

The event is open to the community, as well as faculty members and researchers. It is our goal to allow those in the fields of arts and of science to meet to dialogue together. In my case, my lab is a dance studio.

Where do you find the most joy in working with dancers who have PD (or other neurodegenerative diseases)? What have you learned?

An incredible community has been created. The class has become like a family. We celebrate birthdays and anniversaries. Some of my dance students from Wake Forest lead classes at an adult day center in Winston-Salem with individuals who are far along in their dementia journey. I really believe that it’s important for the younger and older generations to be part of a creative process together.

Shy of becoming a parent, this has been the most meaningful experience of my life. It all began with an invitation to do something I didn’t know anything about, but I want to continue doing this work, bringing it out there to others.

Dance is a deep reflection of our lives. What we practice in the studio is part of humanity.

By Julie Pfitzinger

Julie has worked as a writer and editor for more than 20 years; most recently she was a managing editor for the community lifestyle magazine group at Tiger Oak Media in Minneapolis, where she also served as editor of Saint Paul Magazine. Julie can be reached via email at    Follow her on Twitter @juliepfitzinger.

7 Ways to Become a Lifelong Exerciser After 50

October 5, 2018

The secret is in factors that you can control

On a typical morning, you’re likely to find Chris Kelly, 64, at his neighborhood YMCA in Downers Grove, Ill. The retired captain for United Airlines starts his day with an early workout.

“I’ve always enjoyed physical activity,” says Kelly. “I wasn’t a natural athlete but I gravitated toward things like running and lifting weights… and I played hockey for about 20 years.” While his hockey days are behind him, he stays fit with a mix of cardio and lifting weights.

Kelly doesn’t have to make himself go to the gym; it’s simply part of his lifestyle. And anyone over 50 can make the transition from sporadic workouts to a more committed routine. The key to becoming a lifelong exerciser has less to do with access to a gym or even having perfect health and more to do with other factors that you can control.

Here are seven ways you can start working out — and stick with it:

1. Put It On the Calendar

“Most people who are regular exercisers are able to self-regulate,” says Danielle Wadsworth, an assistant professor and head of the Exercise Adherence and Motivation Lab at Auburn University in Auburn, Ala. “They manage their time for exercise.”

That means scheduling it like you would any other activity. And while working out in the morning increases your chance of sticking with it, choose a time that works for you. Some people prefer midday workouts, while others opt for late-afternoon sessions.

2. Create a Support Network

Research shows that having a workout buddy makes you more likely to stick with an exercise program.

“If you have a spouse or significant other, that person has to be supportive and realize that it’s a priority for you,” says Wadsworth. “Is your partner willing to allow for funds to be spent on a gym membership or for equipment, for example?” Talk to your significant other about your intentions and get him or her on board. Or enlist a friend to work out with you.

Kelly has belonged to the same YMCA for 25 years and has made longstanding friends there.

“When I was younger, I did a lot more by myself, but the social part of it has become a much larger part of what I enjoy,” he says.

3. Up the Ante

It may sound counterintuitive, but pushing yourself a little harder than normal can increase the pleasure you derive from exercise. A recent study published in PLoS One found that upping the ante — doing a more challenging workout that includes intervals as opposed to steady-state cardio — can increase the amount of enjoyment you get from your workout. And when you feel good post-workout, you’re more likely to want to keep doing it.

4. Get Creative

Hate working out in a gym? Then don’t do it! Maybe standup paddle boarding or a barre class will be a better fit.

“There are lots of opportunities to exercise,” says Wadsworth. “At this time in your life, you can make yourself more of a priority… traditionally we thought of exercise as doing something for 30 minutes or longer, but even 10 minutes is fine. Try new things and see what you enjoy. Enjoyment does help with adherence over time.”

5. Protect Your Body

Regardless of what you choose to do for exercise, it’s important to include range-of-motion activities on a regular basis. That might be taking yoga once a week or doing flexibility or stretching exercises several times a week. This will help reduce your risk of injury and help you maintain your mobility as you get older.

Another non-negotiable? A couple days of strength training every week.

“For women especially, I always encourage strength training,” says Wadsworth. That will allow you to continue to do the everyday tasks you may now take for granted.

6. Develop Intrinsic Motivation

People who exercise for extrinsic reasons — like to lose weight or to look a certain way — aren’t as likely to stick with it as those who have intrinsic motivation, which is doing exercise for its own sake. Being mindful about your workouts — paying attention to the feeling of moving your body and the satisfaction you feel at the end of workout — can help develop this inner motivation.

7. Invest in Your Future

“Everyone is looking for the magic pill… well, exercise has the ability to affect you physically, emotionally, intellectually and cognitively,” says Wadsworth. “And it’s not something you have to work hard to do! You have to figure out how to incorporate it into your daily life so you’re able to do the things you want to do and have the quality of life you want. Exercise is one of the things that will allow you do that.”

Kelly said exercise will continue to be part of his retirement.

“When I leave the Y after my workout, I feel great. There’s no other way to put it. So why would anybody stop doing things that make you feel good?” he asks.

© Next Avenue - 2018. All rights reserved.

Hole in One:

August 21, 2018

Golfing Creates Bond Between Team Member and Resident

Lori Mittereder, lifestyle engagement team leader at Westminster Place, the personal care community at our Oakmont campus, has a special bond with John Eisenmen, or “Coach John,” as she likes to call him. John has lived at Westminster Place for three years and when he moved in, he brought his clubs with him.

Lori noticed this, and knowing a little about golf herself, thought it may be a good time to learn more about the game and learn a little more about John.

She found out that John, who is 90-years old, has been golfing at local courses for over 25 years. After talking with John, Lori wanted to hit the course and get back in the golf game. She asked John if he would join her, he agreed, making them instant golf buddies. This past summer, the duo played golf at least two times a week.  

Lori shares, “Coach John gives me guidance on how to slow down, and hit through the ball not at the ball.” John’s tips have helped Lori improve her golf game, and while they two golf for fun, they do keep score. As for who usually wins after a nine holes, Lori laughs, “I keep score and John adds it up.” John slyly added, “as long as I add, I win.”

When John is not golfing, he enjoys tending to the community garden in the Courtyard at Westminster Place.  

This story is a perfect example of our person-centered culture. By taking just a few moments to get to know each other, Lori and John have started to create a lifetime of memories.


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