Winter Wellness

by Heather Goodell, PT

SLEEP	NUTRITION	EXERCISE
CHEMISTRY/IMMUNITY (Endorphins, Serotonin, Insulin, Histamines, Cortisol)
MOOD / ABILITY TO SLEEP / STRESS	APPETITE	ENERGY LEVEL

Sleep

8 -9 hours ideal for most people
Melatonin made in darkness helps us sleep
Circadian Rhythms dictate our sleep and are influenced by light and darkness
Affects of Sleep – increases Serotonin, decreases insulin, decreased histamines
Affects of Stress (emotional, physical/over exercising)– increases Cortisol which heightens arousal, decreases sleep and leads to higher levels of insulin, histamines, slower healing, worse immunity
Cycle of stress and no sleep leads to weakened immunity

Nutrition

Food provides the building blocks that make up our body’s critical chemicals (i.e. turkey has a key ingredient/tryptophan in making serotonin), and the energy to fuel the “engine” to do its job (concentrating, exercising, boosting our metabolism, healing, fighting illness)
Water – we need 64 oz/day of non-alcoholic, non-caffeinated fluid/day to keep our muscles from cramping, skin healthy, mucous membranes moist to fight infection, and to burn fat!
Chocolate – proven to increase mood for 1.5 hours (but may then lower below baseline without exercise!), for other benefits stick around to hear the next talk!
Sugar – caution with diabetes, increases insulin, histamines, physical stress, try to pair with protein to buffer the affect of the insulin generated since protein breaks down slower and the insulin burst can work on the protein instead of placing you at a sugar low that then further stresses your body and diverts energy away from healing/fighting infections

Vitamins and minerals affect our brain chemistry and mood. Recommended doses to have the resources to make the “happy chemicals” we all want and need:
- B-1, B-2, B-6 50 mgs of each/day
- Vit D 400 IU (recent research says 1000)/day
- Folic Acid 400 mcg/day
- Selenium 200 mcg/day

Exercise:

Huge affect on mood and “The Body Blues”: prescription is 20 minutes of moderate intensity exercise outside 5 days/week (not necessarily more or more intense unless you are trying to improve cardiovascular fitness or achieve weight loss effects) RPE of 12-15/20
- Increased Serotonin levels
- Improved sleep
- Clarity of thought
- Less irritability
- Less daytime fatigue/increased energy
- Normalized appetite (less late day carb cravings affects body weight and diabetes risk)
- Increased libido
- Treats mild anxiety and mild depression
- Feel less sensitive to rejection or criticism
Weight loss – 45 minutes of moderate intensity exercise 5 days/week; the more intense = the more weight was lost in a recent research study at Duke University
Regulates insulin and blood sugar levels. Recommended Prescription for diabetes/pre diabetes:
- Aerobic exercise 20-30 minutes with 5-10 min warm up and cool down at 40-70% of your maximum heart rate or calculate target heart rate below: Target Heart Rate = [[(180-age) – resting HR] x 40-70%] + resting HR
- Weight training:
  - 8-10 repetition max weight start with 1 set and progress to 3 sets
  - 8-10 major muscle groups
  - 2-3x/week

The Body Blues

Most misdiagnosed and undertreated condition
Affects 2-3x more women likely associated with differences in hormonal affects, less light on average
Typical signs of depression in men (most research on depression is on men making women hard to diagnose): loss of appetite, loss of weight, expressing little or no feelings
Typical signs of depression in women: over eating, gaining weight, mood swings
3 pronged treatment can cut depression/anxiety/the blues by 50% or more

get enough light during the day and enough dark at night
- 20 minutes at 5000-10,000 lux (outdoors provides 1000-50,000 and/or light box 5,000-10,000; inside only provides 50-200 lux)
- Light on skin produces vitamin D but not in the Northwest so supplement!
- Light in eyes produces Serotonin (watch out for UV rays or dark sunglasses)
- Melatonin is made in the dark to help with sleep – 1-2 hrs before bed dim the lights, avoid computer and TV screens
20 min brisk outdoor walk 5x/week (moderate intensity)
Get recommended doses of vitamins listed above

References:

The Promise of Sleep by William C. Dement, MD, PhD (The connection between Health, Happiness and a Good Night’s Sleep)

When Your Body Gets the Blues by Dr. Marie-Annette Brown www.thebodyblues.com

For more information on Diabetes and exercise: visit www.apta.org/pfsp.
Look for the article titled “Physical Fitness and Type 2 Diabetes Based on Best Available Evidence”, supplement to PT Magazine, October 2007.

See Heather’s recent Article in Advance Magazine at http://physical-therapy.advanceweb.com/