The US weight loss industry is estimated to be a $66 billion dollar industry. There is a hundred different types of diets to try and even more new exercise trends that claim to shed the pounds off. We now even have apps that can track every step we take and calorie taken in. Weight loss should be simple: take in less calories, burn more calories and the weight should fly off and stay off.  However, this is not the case.  70% of Americans still remain overweight or obese. A UCLA study has shown that slightly more than 80% of successful dieters end up gaining all their weight back in two years!
Scientists are studying weight loss and trying to find out what is the best way to lose weight and how to keep it off.  

Exercise and Weight Loss

Exercise is essential for weight loss but also for a healthy body and mind.  Many studies show that it has multiple benefits including: better mental health, better brain health, better muscle and bone health, and helps to prevent aging.  Muscles need energy, through calories,  to function.  They are essentially calorie furnaces for the body.  There is no one ideal exercise that works for everyone.  Research is now showing any kind of exercise is beneficial for weight loss, with walking being the most successful among people who are able to keep the weight off.  Michele Olson, PhD, professor of physical education and exercise science at Auburn University at Montgomery, Alabama says "Data shows that to lose weight with exercise and keep it off, you don’t need to run marathons. You just need to build up to five to seven workouts a week, 50 minutes each, at a moderate intensity, like brisk walking or Zumba." This is proven through many studies with the point being that you need to make being active on a regular basis, an essential part of your weight loss plan.  
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Strength training with high intensity interval training is very time effective and helps to build muscle mass and therefore add more tissue to burn calories. It also causes hormones and enzymes to be produced by the body that positively affects your metabolism causing the body to function more efficiently.  It also eventually effects various hormones in your body that also are connected to losing weight.   

Diet and Weight Loss

Weight loss and the commercialization of dieting started to take off in the 1960's.  Since that time we have seen many different diets and debates come and go.  From the Grapefruit diet, Atkins diet, low-carb, low-fat, keto, and calorie counting, we have been told what the magic fix is to shed those pounds. 

Understanding what it is about a given diet that works for a given person is the unsolved mystery of weigh-loss science.  Hall, a researcher from the National Institutes of Health, has been studying weight loss for many years and has found that when you take a group of people and randomly assign them to a follow a low-carb diet or a low- fat diet and follow them for a few years, what you tend to see is that average weight loss is almost no different between the two groups as a whole.  But within each group , there are people who are very successful, people who don't lose any weight and people who gain weight. 
People lose weight, but often gain it back. However, there are those that keep it off. What is it that helps keep weight off?  The common factors of over 10,000 people researched that have kept over 30 pounds, or more, off for over a year or longer are:
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1. They eat breakfast every morning and it helps to control insulin and jump start metabolism
2. They exercise every day for a total of 60 minutes, sometimes all at once or in intervals
3. They watch less than 10 hours of TV a week
4. They check their weight on a scale at least once a week to help monitor their gains
5. They have a meaningful goal behind them. Such as avoiding disease or want to live longer to spend time with their family. 
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Research is showing that there is not a specific diet or eating style that is perfect for everyone.  A balanced diet with lower carbohydrate levels, 30% protein intake, and lots of fruits and vegetables is very appropriate. Staying away from trans fats and sugary foods helps to keep your insulin sensitivity functioning properly, therefore avoiding weight gain and cravings. 

The Answers to Weight Loss
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1. Weight loss is about changing bad habits into good habits- We eat something sweet after supper every night, we order gravy with our fries, we order a sugary drink when eating out.  These are all examples of habits that we don't even realize we do.  You must take time to recognize your bad habits and replace them with good habits.  This also is appropriate for exercising.  The book "The Power of Habit" by Charles Duhigg is a great read for discovering what habits are and how to change them. 
2. Have a higher purpose for losing weight- Find a reason why you want to lose weight beyond wanting to look like a super model. Be healthy for your family, be healthy to slow aging and you will have more time with your children, be healthy to fight cancer or cardiovascular disease. 
3. It takes several tries- like quitting smoking, it takes many tries to change habits! Don't give up if you aren't losing weight or if you gain it back. 
4. Not one method works for everyone- as mentioned before, there is no magic exercise or diet to losing weight.  Different methods work better for different people. You must try different methods to see what works and this will involve gains and losses. 
5. There are multiple reasons for not being able to lose weight- losing weight isn't from one simple reason.  Psychological reasons, example stress eating, is a major cause of weight gain, hormonal imbalances, medications, the wrong diet, sitting too much, and many other factors can all contribute to weight gain. Evaluate and make changes to help these factors.   
6. Like What you Do- It is obvious we don't want to do things that we don't like and it is the same with diet and exercise.  Find healthy foods you enjoy and find exercises that you look forward to doing. 

Weight loss is not as simple as eat less and burn more. ​So what is better to concentrate on, Diet or Exercise?  The answer is both are important. However, you can never out exercise a poor diet.  Start by evaluating your habits and slowly make changes. It takes time.  Avoid fads and stick to your plan. 
 
Activity fact- On average there is 16 calories in a spoonful of sugar. If you put a teaspoon in your coffee everyday, and drink two cups a day, you are consuming 11,680 calories a year! 

Osteoporosis is a  condition where a person has low bone mass due to loss off bone or the lack of production of bone, or both. It is a condition known as the "silent thief", as the condition can progress over years undetected and when a fracture occurs, and it is too late to get treatment. According to Osteoporosis Canada, it is estimated that 2 million Canadians are affected by osteoporosis with 1 in 3 women and 1 in 5 men suffering from an osteoporotic fracture in their lifetime. 
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Risk Factors for Osteoporosis

The government of Canada public health lists the following risk factors: 

Younger adults (age < 50 years):

• Fragility fracture (breaking a bone as a result of a minor accident)
• Long term use of glucocorticoids such as prednisone
• Hypogonadism or premature menopause (age < 45 years)
• Having other disorders strongly associated with rapid bone loss and/or fracture such as rheumatoid arthritis, malabsorption syndrome, and primary hyperparathyroidism.

Older adults (age > 50 years):

• Being 65 years or older
• Clinical risk factors for fracture (menopausal women, men age 50 to 64 years):
  • Fragility fracture (breaking a bone as a result of a minor accident)
  • Long term use of glucocorticoids such as prednisone
  • Having a parent who had a hip fracture
  • Having a spine fracture or low bone mass identified on x-ray
  • Being a smoker
  • High alcohol intake (greater than or equal to 3 units per day on a consistent basis)
  • Low body weight (less than 60 kg or 132 lbs) or major weight loss (present weight is more than 10% below your weight at age 25)
  • Having other disorders strongly associated with rapid bone loss and/or fracture as mentioned above.  

Consequences of Osteoporosis

Fracture is the biggest risk for people with osteoporosis.  An astounding 80% of fractures in people over 50 years of age are contributed to osteoporosis.  The most common areas to fracture are the spine, shoulder, wrist and hip. 
Hip fractures are common, with roughly 70% to 90% of the 30,000 of them a year in Canada, contributed to osteoporosis. 28% of women and 37% of men who suffer a hip fracture will die within one year and also have a 50% chance of another hip fracture within 5 years.  
Spinal fractures also contribute to a lot of disability.  The pain and loss of mobility has a direct impact on quality of life.  Spinal fractures have a 20% re-occurrence rate in the first year, causing progressive spinal deformity and lack of mobility.  

Treatment for Osteoporosis

No single cause for osteoporosis has been identified but there are a number of preventative things you can do. Peak bone mass is achieved for women at the age of 16-20 and for men at the age of 20-25.  This means building strong healthy bones during childhood and adolescence is essential to help avoid osteoporosis as an adult. Osteoporosis has been called a "pediatric disease with geriatric consequences". 

1. Diet
Diet is an essential start in the prevention of osteoporosis. Calcium rich foods are essential for your body to create bone mass. How much calcium do we need? Dietary guidelines state that age 19 to 50 you require 1000 mg, age 50 plus you require 1500 mg, and pregnant or lactating women require 1000 mg. 
Calcium rich foods include dairy products and green leafy vegetables. If you can't consume dairy products, try calcium fortified almond or soy milk.  Canned salmon or tuna is also a great source of calcium. According to the National Osteoporosis Foundation "Recent research has found that olive oil, soy beans, blueberries and foods rich in omega-3s, like fish oil and flaxseed oil may also have bone boosting benefits. While additional research is needed before the link between these foods and bone health can definitively be made, the many overall health benefits of these foods make them excellent choices to add to your diet".
Foods that should be avoided in excess include caffeine, alcohol, wheat bran, soft drinks, and high protein diets. 
A nutritional guideline resource can be found at https://www.nof.org/healthy-bones-guide/

2. Exercise
In childhood and adolescence, exercise will stimulate the body to create more bone mass. In adulthood, exercises help in the prevention of further bone loss but unfortunately has minimal effect of producing more bone mass.  However, it is never too late to start exercising.  It is important to consult with your healthcare provider to determine your limitations with an exercise program.  This is very important if you have cardiovascular conditions. Research shows that weight bearing exercises are the best for osteoporosis. There is low impact and high impact type weight bearing exercise. Low impact include: Tai Chi, Palates, yoga,  walking, stair stepper, and glider workouts. High impact include: aerobics, running, dancing, racquet sports, weight lifting and climbing stairs.  
There are many other benefits to exercise as it also helps with muscle strength and balance which directly helps to prevent falls.  

3. Medication
Osteoporosis medications slow down the breaking down of bone.  Bones naturally break down and re-build, but as we get older the rebuilding of bone can't keep up with the break down.
Bisphosphonates are the most common medications prescribed for osteoporosis treatment. These include:

• Alendronate (Fosamax)
• Risedronate (Actonel)
• Ibandronate (Boniva)
• Zoledronic acid (Reclast)

Your doctor might also prescribe different medications depending on your kidney function, hormonal levels, and  if you are using steroid medications. 

Osteoporosis is "The Silent Thief".  Children and adolescents need calcium rich balanced diets to help grow strong bones.  As adults we need to keep active with weight bearing exercises and work outs that promote the preservation of strength and balance to help reduce fall risks. Avoid smoking, excess alcohol along with a healthy diet.  If you have risk factors for osteoporosis, contact your medical doctor for possible bone density screening and treatment.

Activity fact:  Fractures from osteoporosis are more common than heart attack, stroke and breast cancer combined!  Get active and keep strong. 

Metatarsalgia is the condition were the metatarsal joints, located at the ball of the foot, get inflamed and irritated due to excess force placed upon them. This force can be due to trauma or from repetitive stress on the area. It is a common foot pain presentation, especially as we break out the flip flops for summer.  The condition can often be very aggravating and limit people from walking or exercising. There are many simple things you can do to help your feet feel better.

Symptoms
The metatarsal joints are located at the balls of the feet were the toes meet the main body of the foot. These joints are formed in a way so that there is an arch transverse across your forefoot. The pain will be located in the metatarsal joint, with the second metatarsal being the most common to be aggravated. Symptoms usually occur with vigorous exercise involving high impact sports and is of gradual onset.  Other symptoms can include burning pain in the joints and the feeling of a stone under the skin at the metatarsal joints affected.  

Causes
Metatarsalgia can be contributed to a number of causes including:
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a) Overuse Injuries- The metatarsal arch is involved in shock absorption when walking and running.  Therefore, when excess repetitive force is placed on the arch, the metatarsal joints get irritated and inflamed.  This can occur when people take up running and progress too fast in their training and overuse the area. In excessive cases, a compression fracture can occur in one of the metatarsal bones, causing a  sharp, deep pain in the metatarsal area. 
b) Improper footwear- high heel shoes or poorly fitting shoes can place excess weight onto the metatarsal joints.  High heel shoes with a pointy end can compress the forefoot and also be a  cause of pain. 
c) Genetic Predisposition- People with high rigid arches tend to have a higher chance of getting metatarsal pain.  The foot is more rigid and the foot has a harder time rolling over to the first toe for push off and therefore the metatarsal area takes most of the force. Often over time, people with high arches tend to get hammer toes which also contribute to the problem. People with a Morton's toe, a shorter first toe, are more susceptible to metatarsalgia because the metatarsal area takes the majority of the force for push off. 
d) The Aging Foot- As we get older the thick fat pad on the bottom of our foot starts to thin.  Mileage and natural tissue changes can cause a decrease in our shock absorbing pad over the metatarsal bones. Arthritis and inflammatory arthritis can also cause joint irritation in the foot. 
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 Treatment

Treatment for metatarsalgia is usually very successful. The first step is to get a thorough foot examination to determine if there is a structural cause for your pain.  This would include: a fallen transverse arch, a Morton's toe, a hammer toe, or loss of the fat pad. An evaluation of your gait and your callus pattern on your foot can also be helpful to determine if the cause is of mechanical nature.  We have a force plate at the Neepawa Chiropractic Centre that can measure your foot in dynamic motion and determine the amount of force that is being distributed across the foot. The second step is to take a look at your footwear.  Stop wearing flip flops and high heal shoes and change to a shoe with fore foot padding.
Therapeutic treatments can include: massage, manipulation/mobilization of the toes and metatarsal joints, ultrasound, and ice or heat therapies. General foot exercises like pulling a towel under your foot with your toes, picking up a marble with your toes, or general foot stretches can also help. 
There are a number of items you can add to the shoe to help support the metatarsal arch or correct improper foot motion.  The most common used for metatarsalgia is the metatarsal pad.  This should be placed in a position on the insole of the shoe so that the pad lies behind the balls of the feet, not directly on them.  If you have a loss in the fat pad across the metatarsal area, a metatarsal bar pad is appropriate and can be placed in a position on the insole of the shoe so that the pad lies directly under the balls of the feet. Orthotic insoles are also often used to help correct improper gait. 

Activity fact: An ideal amount of steps in a day for the average person is 10,000. However, the average American only achieves 3,000 steps a day. Get up and get active!

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Foot pain is one of the most prevalent muscle and joint pain complaints.  This can be located in the arch, at the heel, or at the ankle.  Many times the pain can originate from weakened muscles and ligaments located deep in the foot that are caused by us wearing restrictive footwear or by not using our feet enough so that they stay strong. Strengthening the muscles of the ankle and foot can help eliminate falls and reduce general foot pain. This article will give you 5 great exercises to help eliminate or prevent foot pain. 

1. Curl Them up!

There are four layers of muscles on the bottom of your feet and they help to stabilize your arch and curl your toes down.  They have a direct effect on your balance and overall foot posture. The big toe has it's own set of muscles but these too have the same main functions. 
Place a thin towel on the ground, put your bare foot on the edge of it, and collect the towel under your arch by grabbing onto it and pulling it under your foot. A similar exercise, but harder, is to do the same thing with a medium size rope placed between your first and second toe. Flex your toes so that the rope is pulled along under your foot. A third method is to use resistance bands. place your toes into the band and hold onto the ends of the band in each hand.  Then flex your toes down into the band.  Ten minutes a day of these exercise can help reduce foot fatigue and early symptoms of plantar fasciitis. 

2. Resistance Bands

As mentioned in the first exercise, you can flex your toes into the band to help strengthen the bottom of your foot.  You can also strengthen the foot by flexing your whole foot down against the resistance of the band.  Do this 10 times, then perform the same movement 10 times but rotate you foot inwards while flexing.  The same movement can be performed with rotating your foot outwards.  
The opposite muscles can be strengthened when having the band anchored facing away from your feet so that there is resistance when pulling your foot towards your body. 
Resistance bands can come in many different strengths and are usually found at your local pharmacy. 

3. Roll Out Your Arches

​Its a classic foot exercise, but it works so well!  When you have had a long day on your feet, nothing feels better then relaxing that arch by using a ball to roll out your instep. A ball the size of a tennis ball is usually perfect, but you can also use foot roller bars and other foot massage devices.  Like any massage, rolling out your feet helps to promote blood flow to the muscles and flush away lactic acid. The connective tissues also get a great stretch. This is an essential exercise if you have plantar fasciitis. 
Use a plastic water bottle filled with frozen water in it when rolling out an inflamed and painful arch. 

4. Toe Raise, Point and Curl

This exercise is a great way to mobilize and stretch out your entire foot.  People with osteo-arthritis should perform this exercise daily. It is a great way to get arthritic toes moving and stretched out. 
Sit in a chair with your feet flat on the ground, raise your heels off the ground so that you are on the balls of your feet and hold this position for  10 seconds. Then push your toes into the ground and hold for ten seconds. You will feel a tightening in your arch as you hold this position. After the 10 seconds lift the front of your foot off the ground and maximally curl your toes down and hold for another 10 seconds. 
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5. Stretch out Your Lower Limb

The part of your leg below the knee is the source of the long muscle that go to the foot and are essential in motion and stability of the ankle and foot joints.  High heel shoes, sitting too much, and restrictive footwear all contribute to these muscles being tight and sore. 
Stretch your calf muscle by placing the front of the foot on a step and hang your heel over a step, using your body weight to stretch it out. You can do this stretch with a straight leg and also a bent knee to stretch both of the calf muscles. 
To stretch the shin muscles in the front of the lower limb, point your foot downward and place your little toe on the ground. Roll the ankle forward and you will feel a good stretch into the front of your lower leg. 

Conclusion:

Our feet can often be the cause of back pain or lower limb pain.  Wearing tight fitting shoes, like high heels, or general lack of activity can both cause weakening of the foot muscles.  This causes a higher risk of injury and falls.  Getting into the habit of doing these simple five exercise every week can help strengthen the foot and relieve pain. 

Activity Fact:  "Our feet have three arches, 26 bones, 33 joints, and over a hundred muscles and ligaments!