Anyone that has ran for any period of time will likely be faced with a running injury as studies of distance runners report injury rates of 30-75% per year.^2,3 Attempts by shoe manufacturers to design better shoes have not significantly decreased injury rates over the last 30 years.¹ Many factors can contribute to the risk of injury including prior injuries, gender, body weight, flexibility, shoes, core strength, and training frequency and intensity.¹ Another factor which may impact risk of injury is foot strike pattern. There are three general patterns of foot strike:

• rearfoot strike where the heel contacts the ground first,
• forefoot strike where the ball of the foot contacts the ground followed by the heel,
• midfoot strike where the ball of the foot and heel contact the ground at the same time.

Rearfoot strikers typically land on the heel with the knee extended and foot contacting the ground in front of the knee and hip. This creates a rapid, high impact force. In contrast, forefoot runners land with more knee bend and the foot is more pointed (plantar flexed). In runners with forefoot landing patterns, peak impact forces are not as high as in rearfoot strikers. Midfoot strikers show less predictable landing patterns than the other strike patterns.

Barefoot runners and those wearing racing flats on hard surfaces tend to use a forefoot landing pattern. Runners that typically run in training shoes but are asked to run barefoot also adopt a more forefoot landing style. The absence of shoe heel cushioning to absorb impact forces may explain this change in landing style. The forefoot pattern is also more common at faster running speeds. For this reason, scientists think that before running shoes were invented humans may have utilized a forefoot landing pattern. This pattern may be better suited to reduce landing impact forces when running barefooted or in uncushioned shoes like sandals or moccasins. Therefore, the body may be better suited to using a forefoot landing pattern. Although some running coaches recommend runners adopt a forefoot pattern, scientific data to support this is lacking.

A recent study¹ published ahead of print in Medicine and Science in Sports and Exercise examined the effect of foot strike pattern on injury rates in cross country runners. Researchers studied the number and types of running injuries associated with the different footstrike patterns. Rearfoot strikers would be expected to experience more repetitive types of injuries to the knee, hip and low back, as well as plantar fasciitis and stress fractures of the lower leg due to the higher peak landing forces. Forefoot runners would be expected to have more foot injuries, Achilles tendinitis and stress fractures in the foot.

Adam Daoud and his colleagues¹ studied 52 experienced, collegiate middle and long distance cross country runners over a 4.5 year period. The runners followed similar training programs which were developed by one coach. During this time they raced on the track and natural surfaces like grass and dirt. A video camera was used to determine the primary foot strike pattern used by each runner. Researchers also measured the number, type and severity of injuries during that period.

Researchers reported that 69% of runners were rearfoot strikers and 31% were forefoot strikers. Male and female runners averaged 45 and 40 miles per week, respectively. Approximately 75% of runners reported at least one moderate or severe injury per year. Rearfoot strikers were twice as likely to have a moderate or severe injury compared to forefoot strikers. There were more injuries in females than males. Not surprising, rearfoot strikers had two to four times more repetitive types of injuries including hip, knee and low back injuries, plantar fasciitis and lower leg stress fractures compared to forefoot strikers. The incidence of injuries to the Achilles tendon and foot and stress fractures which was predicted to be higher in forefoot strikers was not different between the two groups.

It is important to remember that other factors such as speed, running surface, fatigue, body weight, type of shoe can also affect impact landing forces and risk of injury. However, this study does suggest that adoption of a forefoot strike pattern may yield lower injury rates. More research is needed to determine if changing footstrike pattern changes injury rate. There is always some concern about changing self-selected running styles. For example, a forefoot landing pattern requires stronger calf and foot muscles and could lead to Achilles tendinitis, plantar fasciitis, calf strains, foot pain and stress fractures of the foot in a rearfoot striker whose foot is not accustomed to forefoot running.

If you are currently a rearfoot striker experiencing a high rate of injury, it is a good idea to check with your doctor or physical therapist before switching to a forefoot running pattern. The lower injury rate in forefoot strikers sounds promising but needs more research. Let us know if you have changed your footstrike pattern and if that has affected your injury rate.
 
¹Daoud, A.I., Geissler, G.J., Wang, F. et al. (2011). Foot Strike and Injury Rates in Endurance Runners: A Retrospective Study. Medicine and Science in Sports & Exercise. Published ahead of print.doi:10.1249/MSS.0b013e3182465115
 
²van Gent R.M., Siem D., Van Middlekoop, M. et al. (2007). Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review. British Journal of Sports Medicine. 41, 469-479.
 
³van Mechelen, E. Running injuries. (1992). A review of the epidemiological literature. Sports Medicine. 14, 320-335.

Just this week, the Journal of the American Medical Association published the prevalence of obesity and trends in the distribution of BMI (body mass index) among U.S. adults from 1999 to 2012. Study authors concluded, "In 2009-2010, the prevalence of obesity was 35.5% among adult men and 35.7% among adult women, with no significant change compared with 2003-2008^."1

Analyzing data from the National Health and Nutrition Examination Surveys (measured heights and weights from a nationally representative sample of civilian noninstitutionalized U.S. men and women), researchers also found the following:

• Over the 12-year period from 1999 through 2010, obesity showed no significant increase among women overall
• Over the 12-year period there were statistically significant increases in obesity in non-Hispanic Black women and Mexican American women
• For men, there was a significant linear trend over the 12-year period
• For both men and women, the most recent 2 years did not differ significantly from the previous 6 years in obesity prevalence

So what's caused the leveling off? Maybe our messages (e.g., NYC's campaigns), policies (e.g., nutrition information on food packages, menu labeling), and programs (e.g., SUAE, MyPyramid/ChooseMyPlate, Fruits and Veggies: More Matters, FITNESSGRAM/NFL PLAY 60) are making a difference!?

What's important is not to give up now! Staying at current, high obesity rates is not necessarily a good thing. A significant reduction in U.S. obesity rates is going to take many more years, and many more messages, policies, and programs.

Share your thoughts on our Facebook page!

¹Flegal, K. M., Carroll, M. D., Kit, B. K., & Ogden, C. L. (2012). Prevalence of obesity and trends in the distribution of body mass index among us adults, 1999-2010. JAMA, 307(5), doi: 10.1001/jama.2012.39.

Most adults (80%) will experience low back pain at least once in their lifetime and low back pain is the most common reason for missed work.¹ Additionally, work accidents to the back occur twice as often as other injuries. Most episodes of lower back pain are sudden and temporary; in fact, 70% get better within one month and 90% get better within 3 months. Only about 1% of all episodes require surgery.

The most identifiable contributing causes for low back pain are:

• Poor posture
• Muscle weakness
• Muscle imbalances
• Improper biomechanics
• Chronic poor flexibility
• Upper body obesity
• Smoking

The reason most back pain occurs in the lower back is because the low back (lumbar vertebrae) supports most of the body’s weight. Low back pain is often felt after lifting a heavy object, moving suddenly, sitting in one position for a long time, or incurring an injury or accident. It's important to note that before the accident or injury the structures in one's back were losing strength or changing due to many of the above mentioned causes. These causes lead to a mechanical breakdown of the low back such as lumbar strain or sprain (70%), degeneration of disks and facets (usually age related) (10%), herniated disk (4%), and others reasons each accounting for 3% to less than 1%.

Therefore, the aim of a recent study² was to identify the effectiveness of two different forms of exercise and self-care strategies in the reduction of low back pain for adults. These interventions are relatively inexpensive when compared to ongoing visits to a medical practitioner or health practitioner to alleviate this issue.

A total of 228 adults with chronic low back pain were randomly assigned to either 12 weeks of viniyoga, 12 weeks of conventional stretching exercises or 12 weeks self-care book guidance. The viniyoga classes included 5 to 11 relatively simple postures with variations and adaptations (important because all the study subjects were exercise novices), deep breathing exercises, and guided deep relaxation.  The stretching classes consisted of 15 stretching exercises that emphasized the trunk and legs and 4 strengthening exercises. The self-care subjects received the book, "The Back Pain Helpbook."³

Since participants only attended the exercise class once per week each exerciser was given a corresponding CD or DVD to do the exercises at home and record their time spent in said activities. The self-care group was to log, as well, and indicate how much of the book they read.

Prior to the study, participants engaged in a disability questionnaire and a “bothersomeness of pain” numerical scale. Study outcomes were assed at baseline, 6, 12, and 26 weeks.

Results Highlights:

• The median number of classes (out of the 12) attended by the yoga and stretching subjects was 10 vs. 9, respectively.
• Nine or more weekly home practice logs were completed by over 70% of class attendees (63%) of yoga and (82%) of stretching.
• At both the 6 and 12 weeks most participants reported practicing at home 3 days per week.
• Eighty six (86%) of the self-care subjects read some of the book with nearly half reading 75% of the book.
• The yoga participants (85%) reported higher probability of recommending the class to others vs the stretching group at 54% probability of recommendation.
• Back Related Dysfunction (RDQ) scores declined over time in all 3 groups.
• The yoga group compared with the self-care group reported statistically significant superior function (less RDQ) at week 12 and 26.
• The stretching group compared with the self-care group reported statistically significant superior function (less RDQ) at week 6, 12 and 26.
• There was no statistical significance between the yoga or stretching interventions.
• The self-care group did not reduce their pain medication intake until week 26, whereas the exercise groups reported less medication usage at weeks 12 and 26.
• The yoga benefits were widely attributable to the exercise benefit and not to the mental component of yoga.

1. The amount of stretching performed in the stretching classes is substantially greater than that typically found in publically available classes. The national recommendation is to perform stretches for 15 to 60 seconds per muscle group for 4 repetitions or more. Thus, if a person did 6 stretches of 4 repetitions for 60 seconds but we will assume the total stretches is 12 in order to stress both sides of the body (in many cases) the total time spent stretching would be 12 exercises x 60 seconds x 4 repetitions = 48 minutes of stretching. This would be close to total time the subjects spent stretching in the once per week class (53 minutes out of a 75 minute class) and most subjects stretched 3 times per week for 20 minutes on their own (with a DVD).
2. The classes were taught by highly trained and very experienced instructors. This is important for desired outcomes.
3. The fact that exercise participants were asked to exercise on their own and they successfully did that, seems to imply internal motivation due to validated pain reduction.
4. For some chronic low back pain such as sciatica pain, certain low back stretches will actually increase the pain.
   

How can we correct low back problems with exercise?

Check in next month for a follow up on low back pain for assessments tips, body mechanic corrections tips, and exercises to strengthen and stretch for a sound, strong lower back! Until then, check out our previous related blog, Don't Forget About Your back. 

¹ Valifors, B. Scan J Rehab Med Suppl, 1985.

² Sherman KJ, Cherkin DC, Wellman RD, Cook aj, Hawkes RJ, Delaney K, and Deyo RA. A Randomized Trial Comparing Yoga, Stretching, and a Self-care Book for Chronic Low Back Pain. Arch Intern Med. 2011;171( 22).

³ Moore JE, Lorig K, VonKorff M, Gonzalez VM, Laurent DD, The Back Pain Helpbook. Reading, MA: Perseus books; 1999.

Over the past five years, the New York City Department of Health and Mental Hygiene (DOHMH) has released a series of campaigns targeting sugary drinks and excessive calories and encouraging people to exercise. Along with the City's ongoing requirement that chain restaurants post calorie counts, their new campaign, attacking oversized restaurant portions, hopes to provide New Yorkers with the information they need to make healthy choices.

The poster shown above depicts an overweight man who has type 2 diabetes and an amputated leg. Under the ad a statement reads, "Cut your portions. Cut your risk."

In a previous blog we asked you about scare tactics like this. We discussed research that shows that fear can be a great motivator as long as the recipients of the message believe they are able to protect themselves. What's great about this ad is that it does provide the message, "Call 311 for your Healthy Eating Packet." In addition, the New York DOHMH's website provides many consumer-friendly brochures and fact sheets on obesity, physical activity, and nutrition. Thus, while this campaign provides the scare, it also provides the solutions.

Restaurants nationwide are recognizing the need for providing healthier options; with many introducing meals with less calories, fat, and sugar, and in a variety of portion sizes. The National Restaurant Association has recently launched the Kids LiveWell program to help parents and children select healthful meal options when dining out. 

The key is that Americans must purchase these healthy items so restaurants continue to sell them. Americans have to understand that while large high-fat and -calorie "value" meals may seem like a good deal, their affects on health and weight are quite bad.

Have you ever watched a kid run around and think, “Wow, they are on the move nonstop?” Research has shown that indeed physical activity declines as we age. This decline, however, is not linear in nature nor does it follow the same path for males and females. Recent research published in the American Journal of Preventative Medicine explored this relationship.¹ The study included 640 Canadian adolescents whose ages were between 12- and 15-years-old at baseline. Participants were interviewed every 2 years for seven cycles of the National Population Health Survey (NPHS). Across the 12 year period of the study there was a 24% decrease in physical activity overall from adolescence into early adulthood. This was equivalent to approximately 1 MET/day. When gender was accounted for, however, a steeper decline was shown for males (30% decrease or 1.54 METs/day) than for females (17% decrease or 0.59 METs/day). The authors noted that the greatest declines for females probably happen before or during adolescence accounting for the gender differences found here. In fact research has shown a 50% decline² in activity of adolescent girls up to even an 83% decline!³ This study also looked at binge drinking and smoking and while these unhealthy behaviors also rapidly inclined during this time, they have been shown to level off or decrease in adulthood whereas physical activity has been shown to continue to decline. 

This research is significant because it can help direct our intervention efforts. A great deal of research and many resources are dedicated to increasing the physical activity levels of adults but they have traditionally been geared more for those who are of middle age. And while this is worthy, these findings indicate that efforts need to begin earlier and be geared towards preventing the decline that occurs at this particular age. Research should be conducted to learn which strategies will be most effective with this group, as they potentially could be very different than those that are currently in use. Large efforts are made at preventing binge drinking and smoking in this population, and again while these are worthy, preventing the decline in physical activity should be viewed as just as important, especially since the decline of physical activity continues into adulthood. Focusing on preventing the decline may finally be the answer to significantly affecting physical activity levels as it is much easier to maintain your fitness than to get it back once it is lost!

¹Kwan MY, Cairney J, Faulkner GE, Pullenayegum EE. Physical activity and other health-risk behaviors during the transition into early adulthood. Am J Prev 2012; 42 (1): 14-20.
²Heath BW, Pratt M, Warren CW, Kann L. Physical activity patterns in American high school students: results from the 1990 Youth Risk Behavior Survey. Arch Pediatr Adolesc Med 1994; 148: 1131-6.
³Kimm SY, Glynn NW, Kriska AM, Barton BA, Kronsberg SS, Daniels SR, Crawford PB, Sabry ZI, Liu K. Decline in physical activity in black girls and white girls during adolescence. N Engl J Med 2002; 347 (10): 709-715.

Check out the U.S. Department of Agriculture's (USDA's) new www.ChooseMyPlate.gov website and SuperTracker tool. Create a profile; set goals; track your weight, food, and physical activity; and run reports to see how you are progressing. 

Give it a try for a few days and let us know what you think! Which features are helpful? Which features do you like better on other lifestyle tracking websites or apps?

Embarking on a New Year, we all plan and hope to find the time to meet the Physical Activity Guidelines from the States Department of Health and Human Services. To help with that, we provided tips last week for smarter exercise and how to burn the most calories during your workout. But sometimes it is still hard to get in all of our exercise.

So what about all of the incidental physical activity throughout the day? Things like:

• Parking your car further away
• Taking the stairs instead of an escalator
• Carrying a hand basket instead of using a cart at the store
• Using a shared printer further away from your office at work
• Cleaning or vacuuming your house
• Going inside versus using the drive thru at businesses

We commonly hear some of these simple suggestions to increase incidental activity throughout the day. I was even contacted recently by the Dallas Morning News when they had an article on steps to better health and a healthier environment in which they suggested changing the way you travel to work that included a few of these types of suggestions.

Recently a study evaluated these types of activities with accelerometers (a device that measures movement through acceleration).¹ The study of 135 inactive overweight and obese participants found that their incidental sporadic activities or movement throughout the day did not equate to enough activity to meet the physical activity guidelines for health benefits. But those who participated in more overall activity throughout their day did have higher cardiorespiratory fitness levels compared to those with less activity. In the study, the strongest predictor of those with higher cardiorespiratory levels was intensity versus duration of activities performed. Thus, if thinking about two choices for parking your car further away, be sure to pick the one that will require you to walk uphill versus just a longer distance.

While those participants engaging in more sporadic activities had higher cardiorespiratory levels than those doing less activity, these levels were still at the very low end. Individuals participating in levels of activity that meet the physical activity guidelines would likely have much higher levels of cardiorespiratory fitness. Still, among these mostly inactive overweight and obese individuals, the separation between those engaging in more activity, while only sporadic, provided protective value. Those who did 10 additional minutes per day of moderately intense activities than the least active group (which only did approximately 7 minutes) “may be associated with a decreased risk of 6.5% for all cause mortality and 7.5% for cardiovascular disease.” Those who accumulated 30 minutes of moderate activities compared to the group who only did approximately 7 minutes “may be associated with a risk reduction of 13% in all cause mortality and 15% in cardiovascular disease.”

Significant health concerns do still exist for the participants of this study due to obesity compared to non-obese individuals. “Nevertheless, previous research has demonstrated that in individuals with obesity, those who have higher cardiorespiratory fitness are at a substantially decreased risk of morbidity and mortality than those with low cardiorespiratory fitness.”²

The Bottom Line
All activity is beneficial. But as seen in this study, intensity is one of the most important factors. Many of the incidental activities we commonly think about of parking the car further away elicit low intensity levels. While they do provide benefit, more health benefits may be achieved by working towards the physical activity guidelines for health benefits.

But doing something still remains better than doing nothing and continues to offer at least some protective value.

Share with us other ways that you have found to incorporate physical activity into your day.

¹Ross, R., McGuire, K.A. Incidental Physical Activity is Positively Associated with Cardiorespiratory Fitness. Med. Sci. Sports Exerc., vol. 43, No. 11, pp. 2189-2194, 2011.
²Farrell, S.W., Braun, L., Barlow C.E., Cheng Y.J., Blair S.N. The relation of body mass index, cardiorespiratory fitness, and all-cause mortality in women. Obes Res., 10(6):417-23, 2002.

This weekend many of us will be looking back to the past year and looking forward to 2012. We'll reflect on the changes we want/need to make and resolve to do things like eat better, move more, and live well.

As you lay out your resolutions, take note that a new program launched by The Cooper Institute (CI) in January 2012 will help you follow through with your changes. Funded by the Cancer Prevention and Reseach Institute of Texas (CPRIT), www.TodayIWill.com is an interactive weight management website based on years of CI behavior modification research. Developed for healthcare providers, their patients, and the general public, Today I Will provides:

• Easy-to-use tools for:
  • determining daily calorie needs;
  • determining calories burned through lifestyle and structured activities;
  • identify overweight, obesity, and risk for chronic diseases;
  • setting realistic goals;
  • breaking down barriers to change; and
  • tracking progress toward eating better and moving more.
• Tailored activities and tips based on how ready you are to make lasting changes.
• Discussion forum for asking questions and sharing helpful weight management strategies.
• Success stories from participants of CI's lifestyle change programs.
• Exercise library with videos of "real people" performing 75 cardiovascular, strength, flexibility, and balance exercises.
• The Cooper Institute blog, with over 4 years of searchable weight loss, physical activity, and healthy eating articles based in science and written by leading experts in the field.

Based on the concept that small changes can lead to big results over time and that every day is a chance to change, Today I Will will inspire you to make choices that will lead to better health in 2012. Rather than rehashing the recommendations of eating more fruits and vegetables and exercising for 150 minutes a week, Today I Will focuses on the bigger picture including breaking down your barriers to healthy choices; finding time for healthy behaviors; planning ahead for risky situations; and staying committed. We all know we need to consume fewer calories and more healthy, whole foods and spend more time being physically active. The real challenge is doing it--and keeping it up.

To be notified of Today I Will's launch, go to www.TodayIWill.com and enter your email address. We're looking forward to helping you achieve your goals in 2012!

Another year, another resolution to shed those unwanted pounds? For most folks, time is the biggest hurdle when it comes to consistent exercise and healthy eating patterns. So why not recommit yourself to exercise in 2012 with a consistent goal of 3 days per week. But this time, train smart and go for the burn, the best calorie burn that is. 

For most of us, small, daily changes are the best way to lose that unwanted fat. Small changes add up over the course of a year. In fact, eating an extra 100 calories a day leads to a 10 pound weight gain over the course of a year.  That is 20 Fritos, 1 cup of soda or half of a Subway chocolate chip cookie each day.  It works both ways.

Your tips to smarter exercise in 2012:

1. The higher the intensity of your cardio workout, the more calories you burn. If your doctor has cleared you for higher intensity exercise then consider increasing the intensity of your workout. Higher intensity exercise burns more calories. If you are able to exercise for the same length of time at a higher intensity then you just burn more calories. Don’t be tricked into exercising at a lower intensity to stay in the “fat burning zone” which actually burns fewer calories. A calorie is a calorie. More calorie burning means more weight loss. Plus, you get the added bonus of greater improvements in aerobic capacity which decreases your risk of death due to both cardiovascular disease and certain types of cancer.²
2. Don’t forget resistance training to work the major muscle groups 2-3 times per week. Pound for pound, it takes more calories to sustain a pound of muscle mass (6 calories per pound per 24 hours) compared to a pound of fat (2 calories per pound per 24 hours).⁶ While that might not sound like much, it all adds up. 
3. Try supersets. During resistance training, perform a set of repetitions for a muscle group then immediately perform a set for the opposing muscle group. This decreases the amount of rest time during your workout while providing time for each muscle group to recover. One study reported that males performing the same resistance training workout using the superset method burned an average of 8.0 calories/minute compared to 6.3 calorie/minute during traditional training with 60 seconds rest between each set.³ Circuit training where you alternate resistance training exercises with 60-180 second bouts of cardio exercise to keep the calorie burning elevated also increases caloric expenditure during resistance training.
4. Choose resistance training exercises that use large muscle groups, engage core muscles and require the body to travel (like when performing a lunge).⁴  The more muscle mass recruited during an exercise, the more calories burned. For example, a machine leg press would not be expected to burn as many calories as a squat exercise using similar amounts of resistance.  The squat exercise recruits more core and other muscles to stabilize and balance the body. The biceps and triceps are small muscle groups people like to work but don’t increase calorie burning that much. So try working biceps while holding a squat or lunge position to recruit more muscles and burn more calories. Or better yet, perform a cable standing low row in a static lunge position to engage the bicep, shoulder, back, core and leg muscles at the same time.
5. Keep things in perspective. If you just can’t pass on that chocolate chip cookie, then plan to cut back somewhere else or think about it in terms of your exercise program. For example, a 145 pound person would have to walk approximately 58 minutes or jog for 24 minutes to work off a medium sized chocolate chip cookie. Is it worth it? Only you can decide but putting it into perspective before reaching for the cookie just might change your mind.

What about burning extra calories post workout?  The longer it takes the body to recover, the more calories burned post exercise. Try incorporating these calorie burning boosters into your workout.

1. Try splitting your aerobic workouts into 2 parts. Studies^1,5 show that splitting a 30 minute session of cardio into 2-15 minute sessions or 3-10 minute sessions burns more calories post exercise. Although the amounts were small, subjects burned an average of 10-15 more calories during recovery when splitting the cardio sessions. Researchers believe that the body has to go through a recovery process which elevates calorie burning after each bout of exercise. Splitting the sessions means the body has to go through these same processes multiple times.  This is similar to the concept of eating multiple small meals per day which raises your metabolism more times as the body burns extra calories to digest the food.  If you are really pressed for time, splitting your workouts might have some added benefit. 
2. When you have the extra time, longer cardio workouts yield more calorie burn post exercise. In one study⁷ where participants walked at 70% of maximal aerobic capacity for 60 minutes, they burned an average of 76 extra calories post exercise.  However, after 20 and 40 minutes of exercise, they burned an extra 43 and 49 calories, respectively.
3. More resistance elevates post exercise calorie burn. A study⁸ which compared calorie burn during and after two resistance training programs did not find any difference in caloric expenditure between lifting 2 sets of 15 repetitions and lifting 2 sets of 8 repetitions using more resistance. This is not surprising given that the total volume (sets X reps X weight) or amount of weight lifted was equal for both workouts. However, after the workouts post exercise calorie burn was an additional 13.5 calories for the low intensity lifting session compared to 25 calories for the high intensity session. Always remember to use good form; sacrificing form for the sake of lifting more weight is never appropriate. If you tend to perform higher repetitions (>15 repetitions), lower resistance sets, you may want to consider increasing the resistance slightly. 

While it is another year, it doesn’t have to be another missed opportunity. If you are pressed for time, take advantage of every calorie burning tip. Let’s assume you can reasonably commit to exercising 3 days per week performing 30 minutes of cardio and 30 minutes of resistance training. By changing your weight training workout to a superset or circuit format, possibly bumping up the amount of resistance you use and increasing the intensity of your cardio workouts could increase calorie burn during exercise and recovery by 100 calories per workout. Depending on your health status and current fitness level, some of these options may be appropriate for you but check with your doctor first. These small changes just might just tip the scales in your favor in 2012.

¹Almuzaini, K.S., Potteiger, J.A., and Green, S.B. (1998). Effects of split exercise sessions on excess post-exercise oxygen consumption and resting metabolic rate. Canadian Journal of Applied Physiology, 23(5), 433-443.
²Blair, S.N et al. (1989). Physical Fitness and All-Cause Mortality. Journal of the American Medical Association, 262, 2395-2401.
³Kelleher, A.R. et al. (2010). The Metabolic Costs of Reciprocal Supersets vs. Traditional Resistance Exercise in Young Recreationally Active Adults. Journal of Strength and Conditioning Research, 24(4), 1043-1051.
⁴Lagally, K.M. et al. (2009). Physiologic and Metabolic Responses to a Continuous Functional Resistance Exercise Workout. Journal of Strength and Conditioning Research, 23(2), 373-379.
⁵Lyons, S. et al. (2006). Excess post-exercise oxygen consumption in untrained males: effects of intermittent durations of arm ergometry. Applied  Physiology Nutrition and Metabolism. 31, 196-201.
⁶McClave, S. A.  & Snider, H. L. f(2001). Dissecting the Energy Needs of the Body. Current Opinion in Clinical Nutrition & Metabolic Care, 4 (2), 143-147.
⁷Quinn, T.J., Vroman, N.B., and Kertzer, R. (1994). Post-exercise oxygen consumption in trained females: effect of exercise duration. Medicine and Science in Sports and Exercise, 26(7), 908-913.
⁸Thornton, M and Potteiger, J. (2002). Effects of Resistance Exercise Bouts of Different Intensities but Equal Work on EPOC. Medicine and Science in Sports and Exercise, 34(4), 715-712.

Which might make you think twice about scarfing down holiday treats this season - knowing the actual calorie count (e.g., 320 calories in 2 sugar cookies); knowing the calorie count as a percentage of total daily intake (e.g., 16% of your daily calories in 2 sugar cookies); or knowing how long you have to exercise to burn off the calories (e.g., 44 minutes of brisk walking to burn off 2 sugar cookies)?

Results from a recent study show that while providing any calorie information reduced the odds of purchasing an unhealthy item, providing the physical activity equivalent was the most effective in reducing calories in purchases.¹ Their study was conducted in 4 corner stores in a low-income neighborhood of Baltimore, MD. They randomly posted 1 of 3 signs (absolute calorie count, percentage of total recommended daily intake, and physical activity equivalent) next to sugar-sweetened beverages. They then observed beverage-purchasing habits of adolescents before and after the signs went up. Odds of sugar-sweetened beverage purchases were significantly reduced with providing any calorie information relative to no signs; but when the 3 conditions were compared, the only condition that was significant in changing purchasing behaviors was providing the exercise equivalents of the various beverages.

More studies with diverse populations (ages, income levels, geographical locations) are needed, but the study authors suggest that if the same results are found, providing exercise equivalents on food/beverage labels may be an effective strategy for promoting healthy choices.

Want to know how much exercise it takes to burn off your favorite holiday treats? Read this previous blog:

Antidote for Holiday Calories

Knowing that it'll take 57 minutes of brisk walking to burn off a piece of fruit cake will help me say "no, thank you!"

¹Bleich, S. N., Herring, B. J., & Flagg, D. D. (2011). Reduction in purchases of sugar-sweetened beverages among low-income black adolescents after exposure to caloric information. American Journal of Public Health, doi: 10.2105/AJPH.2011.300350.