PUSH-as-Rx ®™ Wellness Exercise & Fitness

For individuals working at a desk or work station where the majority of the work is done in a sitting position and increases the risk for a variety of health problems, can using a standing desk help prevent musculoskeletal problems and improve short and long-term wellness?

Stand Desks

More than 80% of jobs are done in a seated position. Stand desks have proven to help. (Allene L. Gremaud et al., 2018) An adjustable stand desk is intended to be the standing height of an individual. Some desks can be lowered to use while sitting. These desks can improve:

• Blood circulation
• Back pain
• Energy
• Focus
• Individuals who are less sedentary may experience decreased depression, anxiety, and risk of chronic disease.

Improve Posture and Decrease Back Pain

Sitting for prolonged periods can cause fatigue and physical discomfort. Back pain symptoms and sensations are common, especially when practicing unhealthy postures, already dealing with existing back problems, or using a non-ergonomic desk set-up. Instead of only sitting or standing for the whole workday, alternating between sitting and standing is far healthier. Practicing sitting and standing regularly reduces body fatigue and lower back discomfort. (Alicia A. Thorp et al., 2014) (Grant T. Ognibene et al., 2016)

Increases Energy Levels

Prolonged sitting correlates with fatigue, reduced energy, and productivity. A sit-stand desk can provide benefits like increased productivity levels. Researchers discovered that sit-stand desks could improve the general health and productivity of office workers. Individuals in the study reported:

• A significant increase in subjective health.
• Increased energy in work tasks.
• Improved work performance. (Jiameng Ma et al., 2021)

Chronic Disease Reduction

According to the CDC, six in 10 individuals in the U.S. have at least one chronic disease, like diabetes, heart disease, stroke, or cancer. Chronic disease is the leading cause of death and disability, as well as a leading force of healthcare costs. (Centers for Disease Control and Prevention. 2023) While further research is needed to see if standing desks can reduce the risk of chronic disease, one study looked to quantify the association between sedentary time and the risk of chronic disease or death. Researchers reported that sedentariness for prolonged periods was independently associated with negative health outcomes regardless of physical activity. (Aviroop Biswas et al., 2015)

Improved Mental Focus

Sitting for extended periods slows down blood circulation. This decreased blood flow to the brain lowers cognitive function and increases the risk of neurodegenerative conditions. One study confirmed that healthy individuals who worked in a prolonged sitting position had reduced brain blood flow. The study found that frequent, short walks could help prevent this. (Sophie E. Carter et al., 2018) Standing increases blood and oxygen circulation. This improves cognitive function, which also helps improve focus and concentration.

Depression and Anxiety Reduction

Modern lifestyles typically contain large amounts of sedentary behavior. However, there is a small amount about the mental health risks of prolonged sedentary behavior. There have been a few studies aimed at improving public understanding. One study focused on a group of older adults, having them self-report sedentary habits that included television, internet, and reading time. This information was compared to their scoring on the Centre of Epidemiological Studies Depression scale. (Mark Hamer, Emmanuel Stamatakis. 2014)

• The researchers found that certain sedentary behaviors are more harmful to mental health than others.
• Television watching, for example, resulted in increased depressive symptoms and decreased cognitive function. (Mark Hamer, Emmanuel Stamatakis. 2014)
• Internet use had the opposite effect, decreasing depressive symptoms and increasing cognitive function.
• Researchers theorize that the results come from the contrasting environmental and social contexts in which they are happening. (Mark Hamer, Emmanuel Stamatakis. 2014)
• Another study looked at the possible correlation between sedentary behavior and anxiety.
• Increased amounts of sedentary behavior, especially sitting, seemed to increase the risk of anxiety. (Megan Teychenne, Sarah A Costigan, Kate Parker. 2015)

Incorporating a standing desk into the workspace can help to reduce the negative effects of sedentary behaviors, leading to improved productivity, improved mental and physical health, and a healthy work environment for individuals who work long hours at a desk or workstation.

Understanding Academic Low Back Pain: Impact and Chiropractic Solutions

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to discuss the subject matter above further, please contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Gremaud, A. L., Carr, L. J., Simmering, J. E., Evans, N. J., Cremer, J. F., Segre, A. M., Polgreen, L. A., & Polgreen, P. M. (2018). Gamifying Accelerometer Use Increases Physical Activity Levels of Sedentary Office Workers. Journal of the American Heart Association, 7(13), e007735. https://doi.org/10.1161/JAHA.117.007735

Thorp, A. A., Kingwell, B. A., Owen, N., & Dunstan, D. W. (2014). Breaking up workplace sitting time with intermittent standing bouts improves fatigue and musculoskeletal discomfort in overweight/obese office workers. Occupational and environmental medicine, 71(11), 765–771. https://doi.org/10.1136/oemed-2014-102348

Ognibene, G. T., Torres, W., von Eyben, R., & Horst, K. C. (2016). Impact of a Sit-Stand Workstation on Chronic Low Back Pain: Results of a Randomized Trial. Journal of occupational and environmental medicine, 58(3), 287–293. https://doi.org/10.1097/JOM.0000000000000615

Ma, J., Ma, D., Li, Z., & Kim, H. (2021). Effects of a Workplace Sit-Stand Desk Intervention on Health and Productivity. International journal of environmental research and public health, 18(21), 11604. https://doi.org/10.3390/ijerph182111604

Centers for Disease Control and Prevention. Chronic disease.

Biswas, A., Oh, P. I., Faulkner, G. E., Bajaj, R. R., Silver, M. A., Mitchell, M. S., & Alter, D. A. (2015). Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Annals of internal medicine, 162(2), 123–132. https://doi.org/10.7326/M14-1651

Carter, S. E., Draijer, R., Holder, S. M., Brown, L., Thijssen, D. H. J., & Hopkins, N. D. (2018). Regular walking breaks prevent the decline in cerebral blood flow associated with prolonged sitting. Journal of applied physiology (Bethesda, Md. : 1985), 125(3), 790–798. https://doi.org/10.1152/japplphysiol.00310.2018

Hamer, M., & Stamatakis, E. (2014). Prospective study of sedentary behavior, risk of depression, and cognitive impairment. Medicine and science in sports and exercise, 46(4), 718–723. https://doi.org/10.1249/MSS.0000000000000156

Teychenne, M., Costigan, S. A., & Parker, K. (2015). The association between sedentary behaviour and risk of anxiety: a systematic review. BMC public health, 15, 513. https://doi.org/10.1186/s12889-015-1843-x

The human body is a complex system, that requires consistent development in all areas. When it comes to weight loss being too strict can cause the body to rebel. Examples are individuals that have lost weight, then put it right back on, or get stuck in a plateau. The objective is to step off the weight loss rollercoaster and embrace weight-loss strategies that work. Here, we explore a few evidence-based weight loss strategies that focus on long-lasting success.

Improve insulin sensitivity

When consuming carbohydrates, it is broken down into sugar.

The body needs a certain amount of sugar to function. However, it is a narrow safety range. If the level gets too high for too long, cellular damage happens. The role of insulin is to guide the excess sugar/glucose into the cells. However, more individuals are experiencing high blood insulin levels, called hyperinsulinemia. Possible symptoms can include:

• Sugar cravings
• Unusual weight gain
• Frequent hunger
• Excessive hunger
• Unable to concentrate
• Anxiety or feelings of panic
• Lack of focus
• Extreme fatigue

Insulin rises because the blood sugar does. It’s dangerous to let glucose levels stay elevated, which is why more insulin gets produced to bring the blood sugar down. Given enough time constant hyperinsulinemia can result in a condition called insulin resistance, where the cells become resistant to the effects of insulin and are less effective.

Insulin sensitivity and weight loss

A high level of insulin in the blood can trigger weight gain and make losing it difficult. Results of high insulin:

• Disrupts the breakdown of fat known as lipolysis
• Raises the potential for fat storage
• Increases the risk of regaining weight despite following a low-calorie diet

Improving insulin sensitivity can be done by:

• Consuming whole, low glycemic foods
• Eating healthy fats
• Incorporating high-intensity interval training
• Going for optimal gut health
• Managing stress effectively

Manage stress levels

Stress and stress eating could be contributing to an expanding waistline. Examples could be eating a favorite meal while barely being conscious of the process or the inability to resist a chocolate bar after a long, distressing day. Research published in the Journal of Health Psychology found that stress-related eating has a preference for calorie-dense and highly tasty foods. And when stress levels rise, food cravings rise, triggering fat gain.

Reducing stress

There are a variety of techniques that can help the mind and body relax turning off the stress response. Here are some science-based favorites:

• Meditation
• Exercise
• Progressive Muscle Relaxation
• Yoga
• Emotional Freedom Technique
• Foods that have B vitamins, zinc, and Omega-three fatty acids. These include:

1. Free-range eggs
2. Nuts
3. Seeds
4. Fatty fish
5. Dark chocolate

• Journaling
• Therapy

Proper sleep cycle

Proper sleep means sound sleep eight hours each night. Many individuals have convinced themselves that five or six hours is enough. Unfortunately, research shows otherwise. In a study published in PLOS Medicine, researchers studied the effects of short sleep duration on hormones that lessen or increase hunger, and on body mass index or BMI. They found the participants with short sleep had reduced leptin and elevated ghrelin which increases appetite and can contribute to weight gain.

Improving sleep quality

• Developing a healthy sleep routine
• Have the same sleep and waking time
• Time to wind down
• Meditate a little before sleep
• Take a warm bath 90 minutes before bed
• Avoid blue light at least 90 minutes before going to sleep
• Limit caffeine intake as it can negatively affect sleep even when taken six hours before sleep
• Avoid/limit alcohol in the evenings
• Regular physical activity can help release stress and tension, tiring the body out so sleep comes naturally
• 30 to 40-minute endurance sessions a week are plenty. However, for some individuals, exercising too close to bedtime can have the opposite effect. Therefore, take note of whether this would be a problem.

High-Intensity Interval Training

There are a variety of approaches to exercising. But there is one evidence-based approach that has been proven to:

• Burn abdominal fat
• Reduce waist circumference
• Address insulin resistance

It is known as HIIT.

High-Intensity Interval Exercise involves:

• Repeated brief sprints with all-out intensity immediately followed by low-intensity exercise or rest.
• This type of exercise is a perfect match for:
• Treadmill workout
• Elliptical trainer workout
• Skipping/jumping rope
• Rowing workout
• Walking workout

Increasing Muscle Mass

An increased amount of muscle increases the basal metabolic rate or BMR. This increases the body's ability to burn fat and lose weight. A loss of lean body mass lowers resting energy expenditure and increases fatigue and injury risk. For individuals trying to lose weight the metabolic decline triggered by a loss of lean body mass can cause regaining the fat previously lost. What this means is that when muscle mass drops so does metabolism along with the ability to keep the weight off.

When muscle mass increases the body can easily burn fat, making it possible to achieve and maintain a healthy weight. It’s important to remember that as the body's muscle mass increases the body needs more energy to nourish and support this new tissue. This means that higher calories are allowed, as not having enough calories becomes counterproductive. Muscle mass increase can be achieved by:

• A healthy diet will help build muscle
• Strength and resistance training
• Taking protein supplements

Weight loss strategies takeaway

With the right approaches, permanent weight loss is possible. Instead of deprivation, focus on science-backed approaches that work:

• Improved insulin sensitivity
• Stress management
• Sound sleep
• High-intensity interval training
• Increasing muscle mass
• Choose approaches that are enjoyable and fun

This will make sticking to the weight loss strategies easier and will contribute to a happy, healthy life.

Body Composition

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*

References

Chao, Ariana et al. “Food cravings mediate the relationship between chronic stress and body mass index.” Journal of health psychology vol. 20,6 (2015): 721-9. doi:10.1177/1359105315573448

Taheri, Shahrad et al. “Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index.” PLoS medicine vol. 1,3 (2004): e62. doi:10.1371/journal.pmed.0010062

Many individuals are trying to get fit and stay active through physical activity and exercise. Getting back to a previous fitness routine is an achievable and realistic goal. Fitness means having the energy and strength to perform physical activity and the body feeling as good as possible. Getting fit improves total health. But it does not require training like an athlete. Just walking for a half-hour every day can help individuals reach an adequate fitness level that helps them feel better and increase energy levels.

Benefits of Getting Fit

Getting the body fit and in shape:

• Increases endurance
• Increases muscle strength
• Delivers oxygen and nutrients to tissues
• Improves cardiovascular health
• Helps release toxins
• Improves overall energy levels
• Improves sleep
• Handle stress better

Being fit allows the body to work harder without as much work, the mind is better focused, the body burns more calories, even when at rest, and proper weight is maintained. Fitness reduces the risk of falls, heart attack, diabetes, high blood pressure, and certain cancers.

How Much Physical Activity Is Needed?

Experts say the goal should be one, or a combination, of these:

• Moderate aerobic activity, like brisk walking, for at least 2½ hours a week.
• It is up to the individual how many days to exercise, but it is best to be active at least three days a week.
• Activity is recommended at least 10 minutes at a time. For example, an individual could:
• Take a 10-minute walk three times a day, five days a week.
• Take a half-hour walk three days a week.
• On the other four days, take a 15-minute walk.
• Take a 45-minute walk every other day.

Vigorous exercise is recommended at least three days a week for at least 10 minutes at a time. This activity makes the body breathe harder and increases heart rate. More vigorous activities, like running, could be included for at least one hour a week. This can be spread out 75 minutes, whichever way is more convenient for the individual. For example, an individual could:

• Run for 25 minutes 3 times a week.
• Run for 15 minutes 5 times a week.

Children as young as preschool age need activity as well. Encourage children ages 6 to 17 to engage in moderate to vigorous exercise for at least 1 hour every day.

Types of Physical Activity

Aerobic fitness

• This makes the body breathe faster and makes the heart work harder.
• Activities include walking, running, cycling, and swimming.
• It is also known as cardio or cardiovascular training.

Muscle fitness

• Muscle strength means building stronger muscles and increasing the length of time they can be used.
• Activities like weight lifting, push-ups, squats, and resistance bands can improve muscular fitness.

Flexibility

• Flexibility is the ability to move the joints and muscles through their full range of motion.
• Stretching exercises can help generate flexibility.

Being More Physically Active

Moderate physical activity is safe for most individuals, but it's recommended to talk to a doctor before engaging in physical activity/exercise. To help get started:

Make physical activity part of everyday

• Make a regular habit of using stairs, not elevators, and walking, bicycling to do errands near home.

Start walking

• Walking is a great fitness activity that most individuals can do.
• Make it a habit to take a daily walk with family, friends, coworkers, or pets.

Find a workout partner

• Working out with a partner can make exercising more enjoyable.

Find fun activities that you can stick with

• Vary activities, so they don't become boring and monotonous.
• Use a calorie-burning application to determine how many calories are burned during exercise and daily activities.

Body Composition

Damaged Collagen

There are several reasons the body's collagen production can slow down or become less efficient. The quality of the collagen made can decrease as well. Environmental factors can be avoided to protect collagen production; however, damage from disease and natural processes is inevitable. Aging is the most common cause of decreased natural collagen. As the body ages, collagen production and quality decrease. This leads to thinner, more fragile skin and achy joints. Certain chronic diseases like lupus and rheumatoid arthritis cause collagen deficiency, leading to issues that include:

• Joints
• Blood vessels
• Organs
• Skin

To avoid collagen damage, avoid environmental factors like:

• Smoking 
• UV exposure can accelerate the average rate of collagen damage that comes with aging.
• UV exposure damage can also play a role in certain skin cancers.
• Excessive sugar and fat intake increases inflammation and decreases protein synthesis.

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

American College of Sports Medicine, et al. (2009). Position stand: Exercise and physical activity for older adults. Medicine and Science in Sports and Exercise, 41(7): 1510–1530.

Anspaugh DJ, et al. (2011). Building muscular strength and endurance. Wellness: Concepts and Applications, 8th ed., pp. 111–137. New York: McGraw-Hill.

Centers for Disease Control and Prevention (2004). Strength training among adults aged 65 or older. MMWR, 53(2): 25–28.

U.S. Department of Health and Human Services (2008). 2008 Physical Activity Guidelines for Americans (ODPHP Publication No. U0036). Washington, DC: U.S. Government Printing Office. Available online: http://www.health.gov/paguidelines/guidelines/default.aspx.

Williams MA, et al. (2007). Resistance exercise in individuals with and without cardiovascular disease: 2007 update: A scientific statement from the American Heart Association Council on Clinical Cardiology and Council on Nutrition, Physical Activity, and Metabolism. Circulation, 116(5): 572–584.