Increase weight loss by working out less?

Really? -
Judging from the ever rising overweight/obesity rates in the United States, I think it's safe to assume that a majority of Americans subscribe to the work out less plan. I find it a bit alarming when scientific data is released and the news takes a portion of a study's findings out of context and reports on it. Typically we can end up misguided and confused. That's why it's so important to understand the bigger picture surrounding "sound bites" like this post's title. This reminds me of a radio ad that would, ironically, air while I was training at the gym.  The advertisement was pushing a diet pill which promised weight loss without the "unhealthy stress and strain of exercise"! I'll spare you a rant, but I will say that the ad was eventually changed so that it did not include the word unhealthy.  Calling exercise unhealthy is blatantly inaccurate. Yet, unfortunately this isn't obvious to everyone. But I digress...

What's going on? -
Saying that we can increase weight loss by working out less is ambiguous because this statement tells only part of the story. So, before you scratch that workout off your to-do list, please read on. According to a study published in the American College of Sports Medicine's (ACSM) Journal of Medical Science and Sports Exercise, it's possible to burn more calories and spend less time working out. However, the key to this result lies in how intensely you workout. Before I go on, it might be helpful to recall the caloric balance equation and its role in weight maintenance, and you can read more about this in a past post found here.

Image from CDC website

Consider a typical day of food consumption and energy expenditure. Simply put, if calories eaten exceed calories burned, we end up with a calorie surplus for that day and over time this leads to weight gain. On the other hand, if we burned more calories than we ate, than over time this leads to weight loss. If  calories in are equal to calories out, the scale is in balance and weight is maintained. Another thing to keep in mind is that we are always expending energy, even while we're resting.


Back to the study - The researchers wanted to see what the energy expenditure at rest of males, aged 22 to 33, would be on a day when they performed a vigorous indoor cycling exercise bout vs. on "a controlled resting day" when they performed no exercise at all.  I underlined and bold faced the word vigorous because this is very important to note. In this case vigorous exercise is defined as performing a physical activity at a level that causes you to be too out of breath to talk. Working out at this intensity level "resulted in a significant [emphasis added] elevation in post exercise energy expenditure, that persisted for 14 hours" after the exercise bout ended (ACSM).


Wow! This sheds some much needed light on that rather ambiguous statement that implies we can increase weight loss by working out less. Now we understand that it's possible to decrease the amount of time we spend working out, but this must be accompanied by an increase in the intensity of our workout to a vigorous level. This is because the research suggests that we can burn additional calories above and beyond what we burned during the workout, even while we're at rest! This is sometimes referred to as caloric after burn.

Here's the data: During the vigorous cycling bout these guys expended 520 calories (kcal).  This isn't surprising because we all know exercise expends calories. We also know that vigorous exercise burns more calories than low and moderate intensity exercise. However, what is really exciting is that after the men finished exercising, and with their post exercise activity level restricted and monitored, they continued to  burn an additional 190 calories (kcal)  during the 14 hours after their workout, as compared with control days when the men were inactive. "The 190 calories burned after exercise above resting levels represented an additional 37% to the net energy expended during the 45-min cycling bout." 

Bottom Line - 
The study's test subjects were young men, so the results may not be the same for women, or for an older population.  Also, we might not be able to workout at a vigorous level for 45 minutes. Given this and other studies on vigorous intensity exercise which show the added benefit of caloric after burn, it seems beneficial to try to incorporate little bouts of vigorous intensity exercise in our workouts. But if you've never exercised, or haven't worked out in years - BEGIN SLOWLY and always consult your physician before beginning any exercise program. Obviously any exercise is better than none, but I like the idea of putting in a little more effort, giving it a little less time and reaping bigger rewards from my workout.  It seems like a win/win to me and that's no sound bite.

In the next post there will be some suggestions for vigorous intensity bout exercise programs and also a discussion relating to another study that shows bouts of vigorous intensity exercise have been shown to be beneficial in reducing inflammation in overweight and obese men. Chronic inflammation is linked to all kinds of health problems.

In the meantime, keep moving! 

Sources
CDC - http://www.cdc.gov/obesity/data/trends.html
ACSM - American College of Sports Medicine - http://journals.lww.com/acsm-msse/Abstract/2011/09000/A_45_Minute_Vigorous_Exercise_Bout_Increases.6.aspx
CDC - http://www.cdc.gov/healthyweight/calories/index.html
chronic inflammation -  http://www.drweil.com/drw/u/ART02012/anti-inflammatory-diet

Try a new f-word while exercising - FUN!

How's that New Year's resolution you made to exercise coming along? Maybe you've doubled down on your efforts, but are wondering if it's really worth it. Why does something that we know is good for us and that seemed so exciting just a few weeks ago, turn into a lackluster chore we begin to avoid? Rather than dreading it, slugging it out half-heartedly or abandoning your goal altogether, how about considering a different strategy? Try putting a little fun in your exercise program!

Yes, you read that right. FUN! Okay, so, maybe for you another F-word comes to mind when thinking about exercising, but, before you discount the idea as absurd, think about it for a minute... Can exercise really be fun and if so, what could make it fun? I think our response to this question might be influenced by our past experiences with physical activities.  Reflect back to when you were a kid. Did you ride a bike, a skateboard, or a scooter? Did you play tag, hide and seek, jump rope, and run races? What about shooting hoops, roller-blading or hula-hooping? You get the idea. These are all physical activities that for most of us are associated with fun. Now, what comes to mind when you think about your next workout on the treadmill, elliptical trainer or recumbent bike? If you said fun, good for you, but you're definitely in the minority.

The bottom line is for many of us is that physical activity has lost this element of fun. So, if your wondering why you're struggling with waning motivation, or you've moved past that stage to just giving up altogether, take a look at your workout and ask yourself - is this fitness routine boring and uninspiring? Case in point, faced with taking the stairs or the escalator, which would you choose? Well, not surprisingly, an experiment conducted by Volkswagen found that the majority of people would use the escalator - that is until they made the stairs fun.  Check it out:

 

The Fun Theory

 If you're wondering, how do I make my workouts fun?  Here are a few suggestions:

1. Revisit some of the childhood activities you once liked to do, although you may have to scale them back to accommodate your current fitness level
2. Know what you like and reward yourself for doing it. If you find being outside exhilarating, than choosing a form of indoor exercise isn't going to work for you.  Consider hiking through a local park, planting a garden or walking the dog.  Commit to it and reward yourself when you reach a predetermined goal. See SMART goals post here on how to set specific, measured, attainable, realistic and time-targeted goals, another key to being successful.
3. Progress g r a d u a l l y. This prevents pain and injuries. Remember, we had to learn to crawl before we walked. This applies to everyone. Even if you were a super athlete in college. If you've not exercised in a few years - you need to take it slowly. A few words about exercise and pain. Now, don't get me wrong, there will be a measure of discomfort, but this isn't pain and it will decrease over time. Exercise shouldn't be torture.  The old "No pain no gain" thinking has been replaced with the much wiser - "Train, don't strain."
4. Mix up your activities.  Variety is the spice of life, so they say and in this case it helps to prevent overuse injuries, as well as boredom and monotony.
5. Enlist the help of a buddy. Exercise is more fun if you have the support of a like minded friend. Mutual encouragement is a wonderful motivator.
6. Make exercise less like a "routine" and more like a game - a mental game that is.  Set a little "contest" for yourself for each physical activity you undertake.  For example, today when I perform the plank I'm going to hold this position for 10 extra seconds.  Make this  mini-challenge attainable, but not too easy, and then make sure you congratulate yourself when you win. 

Of course, always check with your physician before beginning any exercise program.

So, are you ready to stop cursing those dreaded workouts and put some fun back into fitness? Just give these ideas a try and perhaps you'll find a new attitude about your exercise resolution. You've got nothing to lose, right? Well, except maybe the few pounds you've resolved to lose already.   I look forward to hearing all your success stories. Happy new year!

References
Association for Applied Sports Psychology - Exercise Adherence - http://www.appliedsportpsych.org/Resource-Center/health-and-fitness/articles/exercise-adherence
The Fun Theory - http://thefuntheory.com/

Am I burning fat? Aerobic exercise & energy use

Now that we have a general understanding of the energy balance equation which was discussed in last week's post found here, let's focus on how this all relates to something commonly referred to as the fat burning zone. You may have seen this zone, along with the cardio zone, illustrated on the treadmills, elipticals or aerobic exercise heart rate charts at your fitness center or gym. These zones are based on aerobic training principles and in theory are true, but in application can be somewhat misleading.

Basic Principles of Fitness Training-

If one of your fitness goals is to lose weight, you might be thinking that the fat burning cardio workout listed on your treadmill is the way to go. However, before we look at the fat burning zone specifically, I want to highlight a few basic principles of fitness training first. In order to put together an effective exercise program we need to address:

1. Overload - Overload is the amount of stress or demand that we put on our body during exercise. In order to improve our level of fitness we need to challenge our bodies during our workouts by increasing our level of effort. The amount of overload effects the level of intensity of our workouts and this in turn influences the improvements in our fitness level. If we work out too easily we are likely to see little change in our fitness level, whereas too much overload can lead to injury or burn out.(3)
2. Progression - The human body has the amazing capacity to adapt to the demands of exercise by improving its functioning. Because of this ability it is essential to make changes to your workout after you notice that the current level you're working at is becoming too easy. This isn't always a simple assessment, nor is it something many people want to do.  We get comfortable with a routine, so it is easy to become complacent.  This is why many people plateau, or find themselves at a point where they see little to no change in their fitness level (3).

Now that we understand two core principles of fitness training, we need to know how to apply them. When putting together a workout we now know that we must consider the amount of overload needed to maintain or improve our particular level of fitness and for a specific fitness component.  In this post, for example, we're looking at improving our cardiovascular fitness level and body composition by doing aerobic exercise. In order to address the progressive overload principles we must consider 4 areas that are represented by the acronym FITT, which stands for:

• Frequency (how often we perform the activity)
• Intensity (how hard we are challenged by the activity)
• Type (mode of activity)
• Time (how long/duration of the activity) (4)

I prefer the acronym FITTER - which adds Enjoyment and Rest into consideration as well. Adherence to an activity is more likely if it is enjoyed. Arguably more important is the balance between exercise and rest. Too much of a good thing is possible with exercise.  Having said that, over training is something I rarely see.  In fact, the opposite is more often the case.

So, at this point you might be wondering what all this has to do with the fat burning zone. Well, what the fat burning zone is referring to is the level of intensity, along with the amount of time an aerobic activity is performed at, and the macronutrient (fats, carbs, proteins) energy sources used by the body to accomplish the task. By the way, if you're curious to know what exactly constitutes an aerobic workout you can read more here, and if you'd like to catch up on our discussion of energy sources from last week you can find that here.  Now, this bring us to the three energy systems utilized by the body during physical activity. 

Physical Activity and the Three Energy Systems-

As discussed last week, in order to function our bodies need energy in the form of food. We get this fuel from the carbs, fats and proteins found in what we eat and drink. However, the amounts of  these macronutrients the body uses for energy vary depending on the type of activity we're performing.

1. For immediate, explosive energy needs the body uses the immediate energy system. This system fuels activities that last for about 10 seconds or less.
2. For high intensity acitivities lasting for about 10 seconds to 2 minutes the body uses the nonoxidative (anaerobic) energy system. 
3. For any activities lasting longer than 2 minutes the oxidative (aerobic) energy system kicks in. (3)
   

It's important to note that the body typically uses all three energy systems when we exercise, or in activities of daily living (3).  "The intensity and duration of the activity determines which system predominates" (3). For example, if you're running late and walking quickly to catch the bus you're using the oxidative energy system. But if the bus pulls up and you need to sprint to catch it, the other systems become important because the oxidative energy system isn't able to supply energy fast enough to sustain this high-intensity effort.

Modified Borg Rate of Perceived Exertion Scale
Image from ACE

Fat Burning Zone and Exercise Intensity-

So, back to the fat burning zone... The wisdom behind this zone is that if you're exercising in a target heart rate range (read more about this here) of between 50-60% of your maximum heart rate (MHR) (4), or a level 3-4 on the on the modified Borg Rate of Perceived Exertion (RPE) Scale shown at left, (more about that here) you will be utilizing more of the oxidative system, which draws more energy from the body's fat stores.  While this is true, it's just part of the picture.

 Let's look at an example taken from research done at the University of Wisconsin at LaCrosse.  "A 160 pound male walks at a pace of 3.5 miles per hour. At this pace 40% of his energy is supplied from fat sources and 60% from carbohydrate sources.  On another day the same subject runs for 30 minutes at a pace of 6.5 miles per hour.  At this faster pace (higher intensity exercise), 25% of his energy is supplied from fat sources and 75% from carbohydrate sources" (7). Clearly, this would seem to validate the theory that lower intensity exercise utilizes a greater percentage of fat for energy.

However... Please hang in there for a little math, because this will distinctly illustrate the key point I'm attempting to make. "At the 3.5 miles per hour pace the subject burned a total of 240 calories during his 30 minute walk. He therefore burned 96 total fat calories (40% of 240 calories = 96 calories). At the 6.5 miles per hour pace, the same subject burned a total of 450 calories during his 30 minute run. Therefore, he burned 112 total fat calories (25% of 450 calories = 112 calories), which exceeds the number of fat calories burned during the lower intensity exercise session" (7). Not only did this study subject ultimately burn more fat calories, but he was able to burn more total calories overall working out at the higher intensity level for the same amount of time.

The bottom line-

Remember the energy balance equation? Calories in = calories out. When it comes to changes in body composition and weight loss, clearly higher intensity exercise is a better zone to shoot for because it burns more calories than the lower intensity so-called "fat burning zone". That being said, it is important to keep in mind your level of fitness. Obviously, if you're just beginning an exercise program you want to start at a lower intensity and build up gradually. This is where the progression and overload we talked about earlier comes into practice.  With all this talk about burning calories, let's not forget the impact that a healthy nutrition plan has on the "calories in" part of the energy balance equation. Armed with these fitness tools and knowledge, you're closer to achieving your weight loss goals and better health. 


Sources
(1) Whitney, E., Rolfes, S., Understanding Nutrition 11th ed., Thomson Wadsworth
(2) http://en.wikipedia.org/wiki/Metabolism
(3) Fahey, T., Insel, P., Roth, W., Fit & Well: Core Concepts in Physical Fitness and Wellness, 6th ed.
(4) IDEA Fit - http://www.ideafit.com/fitness-library/comparing-intensity-monitoring-methods-0
(5) American Council on Exercise (ACE) -http://www.acefitness.org/
(6) American Heart Association on body composition -http://www.americanheart.org/presenter.jhtml?identifier=4489
(7) Wescott, W.,  What is Fat Burning Zone?
(8) Hoeger, W. K., Hoeger, S. A., Lifetime Physical Fitness and Wellness: A Personalized Program 

Breast cancer prevention strategies

National Cancer Institute

When you hear health messages about cancer or any disease do you find yourself filtering it out? Well, if you do than this next sentence might cause you to stop reading, but please continue because there's a point I'm hoping to make. 1 out of 7-8 women will get breast cancer in their lifetime (American Cancer Society). Are you still reading? That's good, because the purpose of sharing that statistic was to illustrate that even though we frequently hear these kinds of health messages, we don't always feel connected to them. Perhaps you might be thinking as I did when hearing those numbers, wow, that sounds like a lot, but I'm not going to be the one.  Unfortunately, this kind of thinking often translates into inaction. Statistical health data, although sometimes shocking and troubling, may not be meaningful enough to inspire change for some of us.

If you find that you aren't motivated by statistics, you're not alone. Evidence suggests that health messages which highlight health consequences and the numbers of people who get disease aren't as effective as was once thought. What can be more successful in motivating change in health behaviors are messages that focus on causes and solutions for disease (McKenzie).

Obviously there is no clear solution to breast cancer at this point in time. However, there is a great deal of data available that is linking lifestyle factors with increased risk. This suggests that our best prevention strategy is to take steps to reduce our risk factors as much as possible. So, let's take a closer look at the modifiable risk factors -  in other words, the things we can do to lower the probability of  becoming one of the seven or eight women who will get breast cancer.

Prevention Strategies-

• Avoid weight gain and obesity - According to the National Cancer Institute (NCI), a gain in body mass index (BMI) may substantially increase a women's risk for breast cancer, especially after menopause.The NCI states, " In a recent analysis, women who reported a gain in BMI of five points [equivalent to about 30 pounds] or more between age 20 and postmenopausal age (ages 55-74) had nearly twice the risk of developing postmenopausal breast cancer compared to women who maintained their BMI during the same time period."  (You can read more about BMI in this post and more on this study here).  Interestingly, women who had never used hormone replacement therapy had the strongest association between breast cancer and BMI increases. It's also worth noting that regardless of a woman's starting BMI, if it went up 5 points the risk increased also.  This means that even if a woman's BMI is in the normal range to start with, a 30 pound weight gain during her lifetime doubles the breast cancer risk.
• Avoid hormone replacement therapy (HRT) - The study results of the Women's Health Initiative trial  showed that women taking hormones after menopause had more breast cancer than the women who took a placebo. Not only was increased cancer a risk, according to the Center for Science in the Public Interest, women taking estrogen plus progestin hormones were "29% more likely to have a heart attack, 41% more likely to have a stroke, twice as likely to have a blood clot and 47% more likely to show a marked drop on tests of memory and other mental abililties." Yikes! If avoiding HRT isn't an option, the Mayo Clinic suggests using the lowest dose possible and to shoot for short term use.
• Watch your diet, particularly the fats consumed - This will help with the first prevention strategy mentioned: avoid weight gain and obesity. The Mayo Clinic recommends limiting fat intake to "less than 35 percent of your daily calories" and also restricting "foods high in saturated fat." The findings from the Women's Intervention Nutrition (WIN) Study further suggests a diet consisting of  "lower proportions of saturated fats and higher proportions of polyunsaturated fats." If you want more details on dietary fat you can read more here and more specific details about the omega fats (polyunsaturated fats) here. 
• Get moving - Along with good nutrition, being more physically active will also help control weight gain. In addition, research from a recent study published in the American Journal of Clinical Nutrition on the relationship between BMI, physical activity and a woman's sex hormones showed that "low physical activity is linked with higher amounts of estrogens which is in turn linked with a higher risk of breast cancer."  So, how much physical activity should you aim for? According to the NCI, "existing evidence shows a decreasing risk of breast cancer as the frequency and duration of physical activity increase. Most studies suggest that 30 to 60 minutes per day of moderate- to high-intensity physical activity is associated with a reduction in breast cancer risk." 
• Limit alcohol consumption - Even though red wine has received a lot of good press with regard to heart health lately, it doesn't appear to be beneficial for reducing breast cancer, nor does drinking any alcoholic beverage. On the contrary, according to the Million Women Study which tracked over a million women for 7 years, "each daily alcoholic drink raised the risk of postmenopausal breast cancer by 12%." This is considered a modest, but significant increase in risk, especially when combined with additional risk factors. Another reason to limit alcohol is because calories contained in alcoholic beverages can be a factor in raising the daily amount of calories consumed, and therefore contribute to weight gain. 

If thinking about tackling the prevention strategies discussed above has you feeling overwhelmed, consider beginning with the most important step first - maintain or get to a healthy weight. This isn't just a positive step to take for breast cancer prevention, it's good for your overall health. There are many great resources on the internet to help you take action, just make sure they are credible sources. Also, make sure to talk these strategies over with your health care professional.

Making healthy choices is within reach when we have the information we need and the motivation to put the information into practice. Having knowledge of the known risk factors for breast cancer, as well as a corresponding plan of attack can be more empowering than a vague threat of becoming a negative health statistic. I know now that becoming a breast cancer statistic is a very real possibility. So it's important to take action sooner rather than later. 

Sources
http://www.cancer.org/acs/groups/content/@nho/documents/document/f861009final90809pdf.pdf
McKenzie, J. An Introduction to Community Health, 5th ed.
http://www.cdc.gov/healthyweight/assessing/bmi/
NCI - http://benchmarks.cancer.gov/2010/04/gain-in-body-mass-index-increases-postmenopausal-breast-cancer-risk/
Center for Science in the Public Interest, Nutrition Action Newsletter
http://www.mayoclinic.com/health/breast-cancer-prevention/WO00091
http://www.ajcn.org/cgi/content/full/86/3/878S
http://www.ajcn.org/cgi/content/abstract/86/3/817S
http://www.cancer.gov/cancertopics/factsheet/prevention/physicalactivity
http://www.millionwomenstudy.org/introduction/
http://mason.gmu.edu/~montecin/web-eval-sites.htm

Work out smarter not harder

When you think of working out do images of grunting, straining, vein bulging hard work come to mind? Isn't fitness training all about working this hard? Well, I'm going to go out on a limb and say not necessarily. Now, before you slack off, or completely bale out of  your next workout, I'm clarifying that the working smarter not harder concept of fitness training doesn't mean doing either.

So, what does training smarter mean? Well, for one, it means beginning with the design of an exercise program that takes you and your goals into consideration. This may seem obvious. Unfortunately this step is often neglected. Without goals how do you know where to begin, change direction or end a phase and move into the next?  This is where SMART goal setting comes in.

SMART stands for Specific, Measurable, Attainable, Realistic/Relevant and Timely. When it comes to goal setting this is the gold standard.  If you're considering taking a stab at designing your own fitness program, I encourage you NOT to skip the goal setting step.  This is because when it comes to success, all too often failing to plan means planning to fail. After all, how do we know where we are going if we don't know where we are or where we've been? Hopefully I haven't overstated the importance of the goal setting step to training smarter.  If you're ready to take a stab at it, way to go! You can find a SMART goal worksheet here.

Another aspect of training smarter has to to with working at a level that is suitable to your skill, experience and abilities. Deciding to try the latest, greatest workout routine torn out of a magazine or taken from the internet usually isn't the smartest way to work out. Whether your a novice or an elite exerciser, it's absolutely critical to success to workout at an appropriate level. If you're wondering what your level is, you're not alone.  That's why many people seek the expertise of a trainer. Wisdom about fitness training is constantly evolving. Old school thinking about strength training is the no pain, no gain mentality. Current understanding is train, don't strain. This perspective is being underscored by some emerging research.

Recently, a study conducted by researchers at McMaster University found that study participants were able to build muscle size (hypertrophy) by training in a way that was previously not associated with this result. You can view the published paper here. It can be a little surprising, but exciting as well, to learn that conventional wisdom may be changing in light of new scientific discovery.  That's exactly what the McMaster study has done. It has shed light on a potentially new way of thinking about resistance training. Thankfully discovery happens frequently in the health industry. Otherwise we might still be using those vibrating belt machines for weight loss like the women in the photo above.

One way that fitness trainers determine the ideal amount of training weight to be lifted is by predicting a client's one rep (short for repetition) max.  This is where the client is asked to lift an average amount of weight until they can't perform any more repetitions of the exercise. In other words, until they reach the point of fatigue.  Then the trainer can calculate or refer to a table to estimate the percentage of one rep max. If you're interested, you can find a chart here. Conventional wisdom regarding resistance training has been that to build muscle it is necessary to lift approximately 85% of one rep max for 4-8 reps (American College of Sports Medicine's 2002 guidelines).  This is some pretty heavy lifting and results in the ability to perform less repetitions.

So, what does all this have to do with the McMaster University study? Well, their research results surprisingly suggest that using significantly lighter weights, those that were 30% of one rep max, while performing a higher number of repetitions (known as low-load, high volume training), was actually more effective at building muscle than the traditional high-load, low volume resistance training method. Their study findings are equivalent to the world turning upside down, at least the fitness world. Okay, I exaggerate, but only a little.

Why are these study findings important? For one, the ability to build muscle with this type of training protocol has the potential to reach a wider population. In particular, the low-load, high volume training will become practical for "people with compromised skeletal muscle mass, such as the elderly, patients with cancer, or those who are recovering from trauma, surgery or even stroke" (McMaster Univ.). As we move into the second decade of the new millennium, it's exciting to see scientific research underscoring a training protocol that is suitable for a larger, more diverse group of people.  It will be interesting to see where this paradigm shift in resistance training leads. After all, this is a small initial study in this area of research. In the meantime, I'm still going to train smarter not harder. Now let's go pump some, er, lighter iron? 

Sources
American College of Sports Medicine - http://www.acsm.org/AM/Template.cfm?Section=About_ACSM&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=1273
Centers for Disease Control - http://www.cdc.gov/physicalactivity/growingstronger/motivation/define.html
http://www.exrx.net/Calculators/OneRepMax.html
McMaster University - http://dailynews.mcmaster.ca/story.cfm?id=6908

Because you're worth it!

If you've ever flown you probably have listened to the flight attendant's safety drill. They talk about how in the event of cabin depressurization a parent needs to put their oxygen mask on first and then put their child's mask on. Obviously, if we put our child's mask on first we run the risk of passing out from lack of oxygen ourselves. Isn't this a good metaphor for motherhood?

Good metaphor or not, it typically isn't easy for a mom to put herself first. I hear it all the time. Who has time to exercise? I'm too busy with ______________ (fill in your list here). I don't mean to single out women, but generally speaking we do tend to put ourselves at the very end of our list of priorities. Yes, women tend to be more nurturing and giving, but usually not to themselves. So, in honor of Mother's Day let's consider ourselves for just a moment.

Constantly putting yourself last is an unhealthy habit that can be difficult to break, especially if you might end up feeling a little selfish and guilty about taking time out for you. As a result, we may end up feeling stressed out, anxious, irritable and maybe even a little depressed. The result? Sort of like an empty cup, with not much left to give. Ultimately, this isn't healthy for us, or for the ones we care for.

What if we change our perspective and view making time for ourselves as important as taking care of others? This mindset is a win/win! We fill up our cup and when it is full we have more to give. This allows us to be more patient and loving caregivers. If you're not convinced yet I took these points straight from a paper on the mental health benefits of physical activity published by Dr. Daniel Landers, a leading authority on exercise and mental health.

Physical activity:

• Reduces anxiety and depression.

• Increases positive self-esteem.

• Increases restful sleep.

• Improves ability to respond to stress.

These are just a few of the health benefits associated with increased physical activity. Don't put yourself last on your list. It's okay to put your oxygen mask on first.

Happy Mother's Day.