Archive for December, 2011

The Mind-Body Connection: How it Relates to Our Eating Behaviors

December 31, 2011

 Blog # 40

(Much of the following first paragraph is excerpted from the December 29, 2011 obituary of Dr. Robert Ader, written by Paul Vitello and published in The New York Times.)

Dr. Ader was an experimental psychologist who was among the first scientists to show how mental processes influence the body’s immune system, a seminal discovery that changed modern medicine.  You might say that he was the father of the “mind-body” connection.  His research was a touchstone for studies that have shown the communication network among immune cells, hormones, and neurotransmitters.  This field—psychoneuroimmunology—provides the science behind notions too often considered “magical thinking”:  that meditation helps reduce arterial plaque; that social bonds improve cancer survival; that people under stress catch more colds; and that placebos work not only on the human mind, but also on cells themselves.  Dr. Ader demonstrated that stress worsens illnesses, sometimes even setting them off, and that stress reduction is essential to health care.  To summarize Dr. Ader’s work in one phrase: Stop worrying or you’ll make yourself sick.

The fact that mental processes affect the immune system, hormones, and neurotransmitters has a profound influence on our eating behaviors.  An understanding of our mind-body relationship is fundamental in the effort to conquer eating issues.

Carly, age 40: “When I am stressed or have things on my mind or I am really tired, I eat sweets, like cakes and cookies. I don’t even give it any thought. I feel bad after and think about eating better or exercising, but I don’t act on these thoughts.”

Although it is convenient to think of our minds and bodies as separate and discrete entities, our emotional and cognitive sides do not exist independently of our flesh and physical beings. Our minds and bodies are very much commingled, and our mind-body connection is extensive. Our bodies house our minds, and our minds control our bodies, but our minds are made of matter just as our bodies are, and our bodies have a vast array of neural networks running through them that essentially are peripheral extensions of our minds. When our minds are unhealthy, often our bodies become unhealthy, and vice-versa. Optimal human functioning and performance requires a coordinated and harmonious relationship between our minds and bodies.

The following are a few examples of the mind-body connection:

When you become embarrassed your cheeks get a crimson flush.

When you are driving and the car in front of you comes to a sudden and unexpected stop, you respond by slamming on your brakes and just miss a rear-ending collision, your heart races, your pupils dilate and your breathing pattern is rapid and deep. 

When you are fatigued after a hard day of work but can muster up the fortitude for a workout, you can emerge physically and emotionally invigorated, stress relieved, fatigue washed away—refreshed with a wonderful feeling of well-being.

The above examples show how our minds can affect our bodies—blood flowing to our face in the blush response and the classic physiological stress response; and how the body can affect the mind—physical exercise transforming an emotional state. The essence of the mind-body connection is that our thoughts, feelings and emotions can affect our body chemistries and cause a physical response, and conversely, our physical actions, like exercise or laughter, can influence our brain chemistries and affect our thoughts, feelings and emotions.

How is the mind-body connection relevant to eating?

We are highly emotional creatures and it these feelings that are one of the key features that separate us from other members of the animal kingdom. We bring our emotions to every situation, and on a certain level we are all emotional eaters since we all bring our emotions “to the table” in this sense. It is impossible to separate emotions from eating and, with this in mind, it becomes easier to understand how our emotions can cause unhealthy eating patterns.

There are wide ranges of emotions that can trigger eating. Exhaustion, stress, boredom, anxiety, anger, loneliness, sadness, depression, frustration, resentment, disappointment, issues of self-esteem, and interpersonal conflicts are some of the negative emotions that can drive eating. Positive emotions including hopefulness, happiness and confidence can also spark emotional eating. In general, it appears that negative emotions demand neutralizing and positive emotions fuel our passion for eating. There are many among us who use food as a refuge from negative emotions, and for whom food serves as both a “friend” and “therapist”; however, there are certainly, some of us who turn off from eating under the same circumstances. Thus, there is a wide range of eating responses to emotions and all of us “metabolize” our feelings differently.

Stress seems to be our most compelling emotional drive to eat, second only to hunger as a motivation to eat. It is the rare person who does not lead a stressful existence. Stress seems to pummel our souls and eating serves as a mechanism to sooth our beaten-up inner beings— a means of distracting us from our troubles and escaping from the real-life problems and unpleasant aspects of our daily lives.  Life can oftentimes be very tough and food can provide an immediate source of comfort and relief, just as a cigarette can to a smoker or alcohol to a drinker. Many of us, particularly after a very stressful day, head straight for the refrigerator after arriving home from work, seeking solace, refuge and sanctuary.

Interestingly, it seems that when we eat for negative emotional reasons we tend to gravitate to unhealthy foods—it would appear that we desire the kind of foods that will match the emotion driving the eating. Self-destructive emotions beg for self-destructive eating behaviors and self-destructive foods.

In accordance with the work of Dr. Ader, there is a biochemical explanation for stress eating. The adrenal gland hormone cortisol—released in response to stress—can stimulate our appetites and cravings for sugar.  This is the very reason people on corticosteroid medications tend to have enormous appetites, gain weight, and have a tendency for obesity. Cortisol also functions to reduce the satiety hormone leptin, further stimulating our appetites. Additionally, the consumption of certain foods, especially those containing sugar and fat, can cause release of endorphins that are powerful morphine-like chemicals with pain-relieving properties. Is it any wonder that food serves a role as a sedative?  It is of great interest to note that exercise can also release large amounts of these endorphins, so better to head to the gym than the fridge when stressed!

In summary, our emotional state—in a constant state of flux—affects our neurotransmitters, hormones and immune cells.  The variable state of our internal biochemical environment that occurs in response to our emotional state is capable of profoundly influencing our behaviors, including eating. In spite of the biochemical imperative to eat driven by certain emotions, understanding the influence of the mind-body connection is one of the first steps towards overcoming unhealthy eating patterns.

A healthy and sunny 2012 to all!

Andrew Siegel, M.D. for more info on my book: Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship With Food


Harmonize (Like Simon and Garfunkel) with Good Eating and Physical Activity

December 24, 2011

Blog #38 by Andrew Siegel, M.D.

Harmonizing is combining simultaneously sounded musical notes to produce chords having a blended, soothing and pleasant effect. In my opinion, Simon and Garfunkel harmonize like no other two singers—each alone have amazing voices but together they combine with a powerful chemistry to create a really special sound—think Scarborough Fair:

The mathematical metaphor for harmonizing (synergy) is 1 + 1 = 3.  I am reminded of one of my favorite sci-fi movies, The Fifth Element, directed by Luc Besson, in which a climactic scene shows the harmonizing of the four elements earth, wind, water and fire with the fifth element (a character played by the actress Milla Jovovich) to create a unique and memorable synergy.

I borrow these music, mathematical and cinema metaphors and apply them to the wellness arena.  Here, the two players are healthy eating and exercise.  There are four permutations of these two players:

Healthy eating + exercise

Healthy eating + no exercise

Unhealthy eating + exercise

Unhealthy eating + no exercise

On the wellness index, the top combination reigns supreme; the middle two, less so; and the bottom clearly ranks as a bad duo.

To put it another way, if Paul Simon’s voice represents healthy eating, Art Garfunkel’s voice represents exercise, my tonally challenged voice represents unhealthy eating and my wife’s tonally challenged voice represents no exercise, then we have the following combos:

Paul Simon + Art Garfunkel = Simon and Garfunkel

Paul Simon + my wife = not so good, as my wife will poison Paul Simon’s sound

Me + Art Garfunkel = not so good, as I will poison Art Garfunkel’s sound

Me + my wife = disaster (lol)!

The foundations of wellness are the combination of healthy eating and exercise.  Healthy eating means the right quality and quantity of the food that we consume.  Healthy eating and maintaining a healthy weight are very important, but are simply not enough to achieve wellness, in the absence of exercise.  By the same token, subjecting our bodies to exercise on a regular basis is fundamental to our good health, but not sufficient to maintain wellness.  Physical fitness has everything to do with how much we exercise and does not bear a direct correlation with our weight. (Of course, if we are obese, there is no way that we can be fit since fitness demands a reasonable weight.) There are very lean individuals who eat well but never exercise and are clearly in a poor state of physical fitness; if they had to run a couple of miles, they would likely end up incredibly winded. By the same token, there are very athletic and physically fit individuals who exercise daily but do not eat well, consuming excessive calories and carrying too many pounds. So, wellness demands healthy eating, maintaining a reasonable weight AND exercising to achieve cardiovascular health (endurance) and strength (involving our core and skeletal muscles).

A human body is far better engineered than the most expensive Mercedes Benz.  Both the costly vehicle and our bodies need to be cared for.  They both require high quality fuel in their tanks.  They both need to be used regularly—the way they were designed to—not sitting idle in the garage or couch, respectively, wasting away and gathering dust.  They both thrive on being taken out on the road for sprints as well as long rides.  They both demand being cared for and not abused.  If their engines and their bodies are kept clean, shiny, bright and humming, they will both last a very long time. Both the car and our bodies may have a lot of miles and years on them, but if attended to properly, they can run like new for many more miles and years.

It makes sense to fuel up with premium fuel so that our engines run as efficiently as possible.  We are most fortunate to be alive and only go through life once, so it behooves us to eat quality, nutritious foods that will provide us with energy and the proper balance of carbohydrates, proteins, fats, vitamins, and minerals to allow us to live a healthy and long existence.  Unlike our vehicles, our bodies are in a constant state of flux—tissues are continually being destroyed and remade.  The building blocks for the repair process come from the makeup of our diets.  So we literally are what we eat.  Furthermore, we are what we eat eats, and what we eat eats eats as well.  In other words, if your salmon dinner last night originated from the Pacific Northwest and dined on krill and other natural foods, its composition was very much different from the farmed salmon brought up on corn products and processed salmon feed.  The point is to have your building blocks be high quality components, just as you would use if you were replacing vital parts in your car.

Our food choices go a long way in terms of forming the foundation of our wellness destiny. Healthy eating is a lifelong experiment that should continue to evolve if one eats mindfully.  It is not so much what we choose to eat, but what we elect not to eat—essentially, by avoiding the “bad,” by default we will be fueling ourselves with the “good.”  In other words, there are a great variety of quality, healthy foods that can nourish us, and it is not that important what our specific choices are as long as there is balance, sufficient intake of macro-nutrients (protein, fats and carbohydrates) and micro-nutrients (vitamins and minerals), and avoidance of excessive calories. The key is to stay away from processed, reconstituted, unhealthy, mystery, fake foods. Processed food is real food that has been altered in order to lower its cost, lengthen its shelf life, make it look more appealing and make us want to eat more of it, resulting in a reduction of nutritional content and an increase in chemicals, dyes, preservatives and toxins.

Like our vehicles, our bodies also need to be used the way they were meant to be.  We were not designed to be sedentary creatures, but were given the gift of motion to help us survive.  Whether this motion is organized into exercise, sports or fitness pursuits, or is integrated into our lifestyles matters not; what matters is that we keep on moving.  Exercise burns calories, improves our strength and fitness and makes us feel energized.  The short-term positive effects of exercise are the psychological and physical benefits of stress busting, improvement of mood, fatigue reduction, and increase of energy. Long-term benefits include reduction in risk for diabetes, cardiovascular diseases, stroke, hypertension, some cancers, osteoporosis, chronic medical problems, falls, and physical disability. An exercise regimen is also useful for increasing muscular strength and tone, reducing body fat, and helping with weight control. Exercise will help lower blood pressure and our “bad” cholesterol (LDL) as well as raise our “good” cholesterol (HDL). Biological aging is thought to be partly on the basis of oxidative stress, which is reduced by exercise, so exercise can keep us looking and acting youthful.

When our physical fitness improves, it seems to help inspire good eating habits. Equally so, good eating habits seem to motivate many of us to exercise. So, there seems to be a harmony between exercise and healthy eating—healthy habits engender more healthy habits and unhealthy habits promote unhealthy habits. Many of those I interviewed for Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship With Food reported that if they were actively engaged in some sort of exercise regimen, they were less likely to binge or eat poorly, and if they were not exercising, they were more likely to succumb to unhealthy eating behaviors. The military term cascading system failure refers to a failure in one area causing a failure in a different area that would not ordinarily fail. That is precisely what often happens to our eating habits when we fail to maintain our exercise regimen and what often happens to our exercise regimen when we are not vigilant about our eating. Hopefully, the cognitive dissonance that occurs when healthy eating occurs without exercise or exercise occurs with out healthy eating will act to promote the harmonious incorporation of both into our daily routines.

Why do exercise and healthy eating harmonize so nicely together?

Many of those who have the self-restraint to eat a healthy diet and maintain a good weight come to an understanding that adding exercise improves the way they feel and their overall well being.  Those who are ardent exercisers usually come to the realization that they need to fuel up with quality nutrition to maximize their performance and keep their weight steady.  Additionally, those with the discipline and perseverance to put in the hours and the effort to exercise on a regular basis simply do not want to spoil their hard work by poor eating.

Bottom line: healthy eating and exercise harmonize in a way that will make your heart sing!

George, age 53

“When I exercise, I am more careful about eating.”

Justin, age 35

“Exercise drives my healthy eating; when I fall off my exercise regimen, I start eating pizza, burgers and deli sandwiches. The combination of exercise and healthy eating creates great rhythm.”

A wonderful Christmas and Hanukkah to all!

Andrew Siegel, M.D.

“Health and wellness sure beats wealth and hellness.”

Why Should You Bother to Read My Blog?

December 17, 2011

Blog # 38

Let me start with a true story: Twenty-three years ago, I saved a person’s life.

I was moonlighting in a Kaiser-Permanente emergency room in Los Angeles when a young man was rushed in with a gunshot wound.   He happened to be a receptionist who worked in that very emergency room. He had sustained a chest wound and his blood pressure remained dangerously low despite having received many liters of intravenous fluid. At that time, I was a resident working the graveyard shift in the emergency room, covering surgical “emergencies,” most of which were rather minor; this, however, was major as he was at imminent risk of dying.   I entertained the possibility of a condition in which there is bleeding into the tissues around the heart, which compresses the heart and will not allow it to beat normally—cardiac tamponade.  There was simply no time as the patient was rapidly going downhill, and as there was no chest surgeon around, I—never previously having had done this, having only read about it—took a syringe and needle, carefully penetrated his chest wall, passed the needle into his pericardial space and was able to suck out a syringe of blood.  His blood pressure instantaneously rose and as he stabilized, I accompanied him on the elevator to the operating room, leaning over him and holding the syringe that was impaled in his chest, continuing to suck out blood.  As soon as the thoracic surgery team arrived, the patient had his chest cracked, the tear in the pericardium repaired, and the tamponade corrected.  He was discharged from the hospital within a few days, stopping down in the ER and offering me a profusion of thanks before he went home.

What a delightful and rewarding feeling it was to be able to save a person’s life!  I will never forget that unusual day, because for us urologists, absolute life-and-death emergencies are few and far between, and we are in the habit of saving lives “slowly.”  I believe (hope!) that a blog about health and wellness issues is also capable of saving lives, not acutely like the intervention for a cardiac tamponade, but slowly, gradually and meaningfully by the process of education and instilling a sense of the importance of proactive, preventative, pre-emptive measures.

The original intent of my blogging efforts was a means of marketing my Promiscuous Eating book.  That stated, the blog writing evolved into an enjoyable weekly process that I relish and look forward to creating.  I guess this shouldn’t be surprising as I have always been rather fond of writing, wellness advocacy, and education and communication with respect to public health issues.  To date, I have written almost 40 blogs (listed below), and plan on continuing to do so weekly.  I find the topics stimulating to work on and I am provided with a great sense of gratification in that I am “trying to make a dent in the universe,” in the words of Steve Jobs.  In the future, I intend to expand into broader general health issues, going beyond the diet and exercise arena. There clearly exists a communication gap between physicians and patients and my blog attempts to bridge that gap and provide a free service that will help educate, inform and engage. Hopefully, the information provided—in some way—will help readers obtain and maintain both quality and quantity of life.

You can subscribe to the blog (no charge for this, of course) at the following site:

Feel free to recommend the blog to friends, colleagues or relatives who may be interested.  I welcome constructive criticism and recommendations for topics.

My background: I grew up in Teaneck, New Jersey and after attending Middlebury College and Syracuse University, attended Chicago Medical School.  I did surgery training at North Shore Hospital and urology at U. Penn followed by a fellowship at UCLA.  I have been in urology practice in Northern New Jersey since 1988.  I have been an active writer throughout my career, contributing chapters to several textbooks and numerous articles in an array of medical journals. I have presented papers at professional meetings for many medical societies both nationally and internationally. I am actively involved in medical student and resident education at Hackensack University Medical Center.

I am an avid believer in remaining young, healthy and fit through the practice of exercise, nutritional conscientiousness and intelligent lifestyle choices. I have written FINDING YOUR OWN FOUNTAIN OF YOUTH: The Essential Guide to Maximizing Health, Wellness, Fitness and Longevity, published in 2008. My second book, PROMISCUOUS EATING— Understanding and Ending Our Self-Destructive Relationship with Food, was published in 2011. I am passionate and enthusiastic about public health issues and wellness advocacy and my goal is educating the community about healthy lifestyles and preventative measures that help ensure maximum fitness, nutrition, disease avoidance and longevity.  I have done over thirty educational videos on a variety of health subjects, all accessible on my YouTube channel at: and have written many patient education monographs, all available online at: www.

I live in Ridgewood, New Jersey, with my wife, Leslie, and 12 year-old daughter, Isabelle and English Springer Spaniel puppy, Charley Morgan.  My oldest child, Jeff, graduated New York University Film School in 2006 and my 19 year-old daughter, Alexa, attends Tulane University. I am an avid reader and enjoy photography, movies, tennis, cycling, golf, yoga, Pilates and fitness training.

Andrew Siegel, M.D.

My Blogs:

1)   FATigue Eating

2)   Seasonal Eating and Weight Gain

3)   Food Perspectives

4)   Strategies for Combating Opportunistic and Temptation Eating

5)   My Own Promiscuous Eating: Fatigue Eating Redux

6)   So you want to drop a few pounds: what’s more efficient…eating less or exercising more?

7)   Have a Very Sweet Mother’s Day…But Not With Too Much Fructose

8)   Maximizing Our Beach Body Appearance

9)   Is Processed Food Really Any Different From Tobacco?

10)                  Does Weight Gain Influence Urinary Control Issues?

11)                  A Synopsis of Gary Taubes’ “Why We Get Fat And What To Do About It”

12)                  Elective Male Sexual Dysfunction: How We Are Eating Ourselves Limp

13)                  100 Pearls excerpted from Promiscuous Eating Book

14)                  Hydration for Health

15)                  Questionable Cuisine

16)                  A Synopsis of Brian Wansink’s: “Mindless Eating: Why We Eat More Than We Think”

17)                  E. Coli Contamination Of Our Food

18)                  Scary Stuff: Our Drinking Water

19)                  Male Obesity Causes Low Testosterone With Potentially Dire Medical Consequences

20)                  What is the best diet for us?

21)                  My Freshman Fifteen

22)                  To Vitamin Supplement or Not…That is the question

23)                  Tempus Fugit (Time is flying)

24)                  Wealth is Health: Your Exercise Savings Account

25)                  Aging Young

26)                  Psych 101 as it relates to eating

27)                  Prostate Cancer: Can Diet and Lifestyle Make a Difference?

28)                  Until Apple Invents the iFinger, PSA Is The Next Best Thing

29)                  Boredom Eating

30)                  Prelude to Excess—Strategies to Deal With Eating Orgies

31)                  I’m Your Doc, Not Your Provider!

32)                  Eating Mantra

33)                  Exercise to Exorcise

34)                  My Favorite Quotes: Health, Wellness and Miscellany

35)                  Promiscuous Eating: Food Naughty Behavior

36)                  Is There a Best Exercise?

37)                  S.A.D. (Seasonal Affective Disorder) Makes Me F.A.T.

S.A.D. (Seasonal Affective Disorder) Makes Me F.A.T.

December 10, 2011

If we had no winter, the spring would not be so pleasant; if we did not sometimes taste adversity, prosperity would not be so welcome.

Anne Bradstreet (17th century poet)

Like many others, I adore the spring and summer—relishing the sunshine, the vibrant blues and greens that dominate the outside palette, and the long hours of summer daylight.  One of the greatest thrills I have ever experienced was to be in Northern Europe in June where it stayed light until near midnight.  I feel most alive when exposed to sunlight, warmth, vibrant natural colors, scents such as honeysuckle and lilacs, and the background white noise of cicadas.  How delightful it is to be outdoors scantily clad in shorts and a short-sleeved shirt—cycling, playing tennis or golf, or just throwing a Frisbee for my English Springer Spaniel, Charley Morgan.

Light profoundly affects my mood.  Sitting in my living room on one of those days when the sun is in and out behind a cover of clouds, I am made acutely aware of how a sudden darkening of my environment makes me gloomy and a sudden lightening makes me happy.  I can virtually dial up my mood when the brightness of the lighting in my basement or living room is controlled with a rheostat.

I am among the 5-10% of the population that suffer with an affliction known as Seasonal Affective Disorder (S.A.D.). The prevalence of S.A.D. is highest towards the north and south poles and lowest at the equator.  It is quite common in the Scandinavian countries, where light is in limited supply during the winter.  Due to the very short winter days, these winter blues are characterized by variable degrees of melancholy brought on by the dark, cold and colorless external environment. The feelings of hibernation and stagnancy are distinctly unpleasant for any of us who are afflicted with S.A.D.  I am fortunate to be affected in only a mild way, much less so than many who suffer with depression, concentration issues, loss of energy and sexual drive, sleep disturbances, exhaustion, and withdrawal from friends, family and social activities. Various theories have been proposed to explain S.A.D., including a biochemical basis involving the chemicals serotonin and melatonin, but the jury is still out on the precise underlying basis.

Cold weather and darkness also directly affect our eating behaviors; they seem to conspire against healthy and disciplined consumption patterns and beg for relief by means of comfort foods.  For many of us, winter fosters a type of foraging activity that causes us to satisfy carbohydrate cravings and seek solace in rich, heavy foods including stews, creamy soups and starches.  Additionally, being more housebound in the winter leaves abundant opportunities for “boredom” eating, providing fewer distractions from eating that are possible in the warmer times of the year. The sleep disturbance that many with S.A.D. experience can lead to “fatigue” eating. During winter, outdoor exercise/activities dramatically decline; at the same time, there is less availability of healthy fresh fruits and vegetables that are abundant in summer.  There is less opportunity for grilling, a healthier form of cooking than many other alternatives. Unfortunately, all of the forces discussed above can work together and lead to winter weight gain.

So what to do to cope with S.A.D. causing the winter doldrums and the potential for unhealthy weight gain?  Options include melatonin supplements (a naturally-occurring hormone that maintains our circadian rhythms); anti-depressant medications; and cognitive-behavioral therapy or occupational therapy (both of which can help S.A.D. sufferers function at more optimal levels during their “dark” times).  My preference is to use exercise as an effective means of keeping the blues at bay.  It nudges the pharmacy within to release a cocktail of “happy” chemicals including serotonin (which modulates mood, emotion, sleep and appetite). A daily dose of exercise will not only help release the natural anti-depressants within, but will burn calories and help prevent the weight gain.  I wholeheartedly recommend tapping into our own pharmacy within before reaching for the products of Big Pharma.

If you can swing it, a winter vacation to a nice sun-drenched Caribbean island can be just what the doctor ordered.  If this is not feasible, a therapeutic bright light box is an alternative that can provide the much-needed daily dose of light.  Another tonic to soothe the blues is music, capable of producing a steep rise in a listener’s serotonin levels.  Ultimately, having purpose and remaining busy, productive and engaged in meaningful activities is one of the best means of staying focused and keeping the effects of S.A.D. at bay.  So whatever it is you choose to do to chase those blues away, do it with passion and gusto.

 In the depth of winter, I finally learned that within me there lay an invincible summer.

Albert Camus

Andrew Siegel, M.D.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship With Food

Available at; e-book available on Amazon.

Is There a Best Exercise?

December 3, 2011

Is it running, cycling, swimming, weight training, yoga, Zumba or spin class?  Does it need to be at a fitness center or at a gym?  Are personal trainers a necessity?

The short answer is that although any form of exercise is good, it is great to be able to exercise in a balanced fashion, as is addressed below.  It is desirable to get our hearts pumping, our chests heaving, our cheeks flushed and sweat dripping out of our pores.  It is also important to have fun!  We don’t need to be gym rats to get sufficient exercise, and although personal trainers are great, we can do without.

One of the main goals of exercise is to improve our physical fitness.  Physical fitness has a number of parts: cardiovascular or aerobic fitness in which the heart and lungs have adapted to endurance efforts; musculo-skeletal fitness in which our muscles and underlying bony framework have adapted to bearing loads and working against resistance leaving our muscles sinewy, strong and toned; core strength that implies fitness of our trunk muscles that allows us to have good posture, stability and a good sense of balance and coordination; additionally, our core strength serves as a platform for efficient use of our arms and legs; flexibility fitness in which our muscles are elastic, limber and supple and more resistant to injury. If we can find an exercise regimen that has all of the aforementioned components, we are on the right track.

Exercise is all about adaptation. Our bodies are remarkably adaptable to the stresses that we place upon them.  This is why both endurance and resistance exercises get easier the more effort we put into doing them.  The heart, lungs and muscles adapt and a “new normal” level of fitness is achieved.

Fitness attained through exercise is essential in helping to maintaining good health at any age.  Exercise has physical, psychological, and social benefits for which there is no substitute. Exercise helps control blood pressure, glucose, cholesterol and triglyceride levels and will lower the risk for angina, heart attacks, claudication (pain in the legs and buttocks associated with insufficient blood flow), strokes, and sexual dysfunction. Exercise will help the cardiovascular system, the lungs, muscle tone and strength, posture, and bone mineralization. Exercise promotes weight loss, makes us feel and look better, improves our well being and outlook on life, and helps us achieve peace of mind. It will help prevent injuries, help us deal with stress, combat depression, keep us alert during the day, and sleep more soundly at night. Exercise will help prolong our lives and maintain the highest quality of existence. Exercise is the miraculous, magical, life-saving tonic that can do all of the above and so much more.

Exercise “Rules”

  • Any activity is better than no activity: For example, tennis is better than table tennis but table tennis trumps sitting in the Lay-Z-Boy recliner.   Non-Exercise Activity Thermogenesis (NEAT) is the term applied to how we reap major benefits through thousands of minor movements each day.  Essentially, it is the body’s means of fighting inertia.  Certain people do not gain weight despite increased caloric intake because of compensation via subconscious movements including taking the stairs; trotting down the hall to the water cooler; bustling about with chores; even fidgeting in one’s seat.
  • Any time spent moving is better than no time moving: Working out for an hour or more is desirable, but even if you have only ten minutes, it is better than no minutes!
  • Shake it up: The concept of balance is a good one, mixing it up for variety, fun and cross-training purposes and to avoid stagnation and routine.  Remember, balanced fitness is aerobic (endurance/cardiovascular), strength, core, flexibility and balance.  It is nice to participate in a variety of different exercises.  For this reason, I think the P90x workout on dvd ( really passes muster—it simply covers it all.  If you prefer something outdoors, consider an activity that you initially might not think of as exercise per say.  Take “real labor”—such as cutting firewood—it has all of the aforementioned components.  “Synergistic” exercise, which emphasizes using multiple muscles working together in synchrony, is what we use in real life—it is really beneficial if we can simulate this in the gym versus doing isolated muscle exercises.
  • Carve out the time for it:  It is easy to find reasons for not exercising.  Common excuses are long workdays and time spent commuting that does not allow enough time in the day for exercise.  By making exercise time “sacred” such that it can only be interfered with under emergency circumstances, it will help ensure its happening.  Clearly, some of the time spent in our sedentary leisure activities, such as watching television, could alternatively be devoted to more active and healthy pursuits.  My attitude has always been that if I have the time to eat, shower and use the bathroom, then I have the time to exercise.
  • Persistence: Once we have established a routine and have allotted the time to exercise on a regular basis, the key is to persevere and not to allow complacency to mess with our regimen.  Once we are “cruising” along, it becomes so much easier to maintain our schedule than to stop and then start up again.  It is an astonishing fact to me that the Tour de France cyclists, arguably the most fit aerobic athletes in the world, generally engage in a three hour or so ride on their rest day! Why? Simply because too little activity on rest day would lead to a sluggish performance on the following day, a potential disastrous occurrence in a grueling three-week marathon.
  • Be an active spectator: I am an advocate of exercising while being a fan.  So, when I watch the Jet game, I might do so while on the treadmill walking up an incline for 30-60 minutes at 3.5 mph, instead of sitting on the couch munching on chips and dip.  It is really a painless way of getting in some exercise while enjoying a diversion.
  • Integrational exercise:  This is exercise that is incorporated into our daily activities.  So, park the car as far away from the shops at the mall as possible and walk to the stores.  Self-park instead of valet parking.  Power vacuum your home, mix batter for a cake by hand as opposed to using an electric mixer, open cans with a hand opener as opposed to an electric opener, walk the golf course instead of taking the cart, etc.  You get it—gardening, snow shoveling, mowing the lawn, sawing tree branches, walking the dog, carrying a heavy laundry basket, taking out the recycling, carrying your child on your back, dancing, anything at all that involves movement can actually be good exercise without the need for an expensive gym membership.
  • Tailor your exercise to your needs and desires: What is the right fitness regimen for you? Anything you like, as long as it gets your heart pumping, your lungs expanding, and your sweat glands secreting. Swimming, tennis, racquetball, jumping rope, kayaking, rowing, trekking, cross-country skiing, ice skating, team sports such as soccer, basketball, volleyball or hockey, aerobics class, spin class, kick-boxing or Pilates, martial arts training, salsa or belly dancing, gymnastics, clog dancing or ballet—all qualify. Playing Nintendo’s Wii Fit is another option to get you moving and off your derriere. What does matter is that you find some activities that you like and that you stick with them!                                                                                                                                                                                                                                                                                                                                                                                                                                Exercise needs to be customized to our individual personalities. Some people avoid exercise because they are not goal-oriented, they do not enjoy the actual exercise process, or because their self-image is at odds with the image of the models promoted by the fitness industry. “Conventional” exercise is typically goal-oriented and often competitive with an emphasis placed on performance, with the ultimate objective of achieving fitness, wellness, maintaining or losing weight, and a healthy physical appearance. The “holistic” approach is more focused on the inner experience and energy, the self-actualizing process and journey—with more emphasis on engagement, connection, and tuning “in.” It has a meditative and philosophical level to it with a goal of achieving a calm and relaxed state. Yoga, tai chi and qigong are good examples of holistic exercises.

So, whoever you are, what is most important with regard to exercise is that you actually DO some sort of exercise.  Tailor it your specific mindset, but be sure to that it’s not just your mind that is experiencing the workout!

Andrew Siegel, M.D.