Body Mass Index

 The body mass index is an advance from the older and less meaningful height and weight charts. And is the current tool used by health and insurance agencies to assess body weight and degree of obesity. However, it does not allow for individual variation of muscle mass and bone structure. 


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Although body mass index (BMI) has been adopted by WHO as an international measure of obesity, it lacks a theoretical basis, and empirical evidence suggests it is not valid for all populations.1 The body mass index (BMI) does not accurately represent the amount of [body] fat,"2
The BMI has been around since the 1840s, but it has a number of weaknesses. Firstly, it doesn't give a real estimate of percentage body fat. Secondly, the BMI can be quite different for a man and a woman with the same percentage of body fat. And thirdly, your BMI can be high even if you don't have much fat, especially if you are male and very muscular. It turned out that hip circumference and height are more correlated with percentage body fat than anything else, including waist circumference and weight. The Body Adiposity Index. is a good predictor of percentage adiposity, so if your BAI is 30, then your percentage body fat is around 30 per cent. It is reasonably accurate - not terribly accurate - but usable as a clinical tool. It appears to be a better tool than BMI, yet research is still necessary before it can be used confidently. Unlike BMI, the BAI for men and women is the same if they have the same percentage body fat. It has been validated the BAI in African American populations. Its utility has not been confirmed in Caucasian subjects, although it has been tested it on a small group and it seems to fit. The real challenge is to be able to predict the risk of obesity-related diseases such as cancer, diabetes, cardiovascular disease and hypertension, and then to intervene. It remains to be shown that BAI is a more useful predictor of these outcomes than other measures of body adiposity.3

To calculate both BMI and BAI for comparison, please visit  http://www.intmath.com/functions-and-graphs/bmi-bai-comparison.php

1. Bagust A, Walley T. An alternative to body mass index for standardizing body weight for stature. QJM 2000;93((9)):589-96.
2.Richard N. Bergman, Keck Professor of Medicine at the University of California's Keck School of Medicine. http://www.medicinenet.com/script/main/art.asp?articlekey=139331
3. Richard Bergman.http://www.newscientist.com/article/mg20928030.200-obesity-expert-a-better-fat-measure-than-bmi.html

Red Meat Increases Risk Of Diabetes


This article from Scientific American reports that people who eat red meat have much higher probability of developing diabetes. There is some indication that red meat may actually have a causative factor, perhaps due to an overload of iron in the diet, or animal source fats. However, the most significant factor is that generally, people who eat more red meat, also eat more dairy, eggs, starchy, and processed foods, and are less likely to be physically active. Essentially, higher consumption of red meat is associated with a lifestyle that promotes excessive eating and weight gain. Excessive body weight is the leading indicator of age related diseases such as diabetes, heart disease, arthritis, and some cancers.  

Generally, people who actively choose to avoid red meat are more attentive and discerning toward their overall nutrition and lifestyle, and make healthier choices.

As I have promoted in other posts to this blog, progress toward a diet that is less dependent on meat, dairy, eggs, and processed foods, and more toward fruits, vegetables, and whole grains. A multivitamin and mineral supplement is a good idea. Eat less and be more active.

Best regards, Dr. Wayne Coghlan.


People who eat as little as one serving of red meat a day, whether it is processed or unprocessed, have an increased chance of getting type 2 diabetes

August 10, 2011 

THE OTHER RED MEAT: Both pork and beef have been implicated as upping people's risk for getting type 2 diabetes, even when consumed in small portions once a day.

Sugary soda and other sweet treats are likely not the only foods to blame for the surge in diabetes across the U.S. New research out of Harvard University supports the theory that regular red meat consumption increases the risk of getting type 2 diabetes.

An average of just one 85-gram (three-ounce) serving of unprocessed red meat—such as a medium hamburger or a small pork chop—per day increased by 12 percent the chances a person would get type 2 diabetes over the course of a decade or two. And if the meat was processed—such as a hot dog or two slices of bacon—the risk increased to 32 percent, even though serving sizes were smaller.

The new study, published online August 10 in the American Journal of Clinical Nutrition, is not the first to find the link between red meat and diabetes risk. But it is the largest and one of the first to look separately at unprocessed and processed meats.

"On a gram-per-gram basis, unprocessed red meat is still better," says Frank Hu, a professor of nutrition and epidemiology at the Harvard School of Public Health and co-author of the new paper. "But unprocessed red meat is still associated with a significantly increased risk."

More than 8.5 percent of U.S. adults have been diagnosed with diabetes, and in some counties in the so-called "diabetes belt" in the South, the numbers exceed 11.2 percent. The rates are expected to keep climbing in the coming years.

Hu suggests that based on the analysis there is indeed a "disease burden that can be attributed to consumption of either processed or unprocessed red meat."

It's what's for dinner, for many
A U.S. adult consumes an average of more than 45 kilograms (100 pounds) of red meat a year. "There's no question that consumption of red meat is too high," Hu says, suggesting nuts, whole grains and low-fat dairy products as healthier alternatives. And diabetes is not the only reason to switch to lighter forms of protein. People who ate 113 grams (four ounces) of red meat a day are more likely to die from any cause over 10 years, according to a 2009 Archives of Internal Medicine study of half of a million people.

Of course, eating red meat for a week "is not going to give someone diabetes—we're talking about habitual consumption," Hu says. And for those uncertain about trading in a filet mignon for a fistful of almonds, the researchers behind the new paper also list poultry and fish as alternatives, although Hu cautions that other research also supports the move to a more plant-based diet.

"It really confirms what other studies have suggested," says Elizabeth Seaquist, director of the Center for Diabetes Research at the University of Minnesota, who was not involved in the new study. The new report analyzed health and dietary information from three large-scale cohort studies (the "Health Professionals Follow-Up Study," and the "Nurses' Health Study I and II"), which encompassed some 200,000 adults. It combined that data with previous studies for a meta-analysis that covered a total of 440,000 men and women who were followed for 10 years or more. 

Seaquist puts great confidence in the findings based on the study's sample size, but notes that as an epidemiological study like this one should, it "raises more hypotheses than gives us answers."

The additional incriminating evidence for this category of food seems to swing the pendulum away from refined carbohydrates as the only culprits in advancing diabetes. And the new paper "will heighten awareness of the potential for different dietary components to contribute to diabetes," Charles Burant, director of the Metabolomics and Obesity Center at the University of Michigan Medical School, who also was not involved in the new paper.

For people who have been following the research, however, "the findings are not particularly surprising," Hu says. In fact, despite the big play that sugars and other highly processed carbohydrates have gotten, red meat is actually "one of the most well-established dietary risk factors," he notes.

Size matters

One of the tricky aspects of lifestyle studies like this one is that unhealthful behaviors often go together, making it tough to tease them apart to see if one is having a larger effect than others. And in the studies, those who reported eating the most red meat also tended to have other risk factors for diabetes, such has having a higher body mass index (BMI), smoking and not getting much physical activity. "People who eat a lot of meats tend to gain more weight," Hu says.

So the new findings might be more "a reflection of poor dietary intake by people who eat meat," Burant says. Seaquist explains more plainly that perhaps "people who eat red meat end up eating French fries with it."

Burant is not convinced that red meats—or any other food category in particular—are to blame for diabetes. "My own personal bias is that it's not just what you eat but how much you eat," he says. As obesity is the largest known risk factor for developing type 2 diabetes, "calories are probably the primary driver for the risk for diabetes," Burant says. As a clinician, he says, he tells his patients who might be at risk for diabetes: "I don't care what you eat—just eat less of it."

But, after Hu and his colleagues adjusted their analysis to account for weight gain, they still saw a modest association between red meat and type 2 diabetes. That might mean that there are other factors at work independent of extra pounds, the researchers posit.

One theory is that the type of iron prevalent in red meat, known as heme iron, unlike forms of iron found in plants and nutritional supplements, is readily absorbed by the body and can in fact lead to iron overload. Studies have shown that too much iron can lead to oxidative stress and higher levels of inflammation, both of which can be precursors to diabetes. Seaquist cautions that plenty of people still need to make sure they get enough iron, but adds that, "there is a strong link to iron overload in the body and risk for diabetes."

Another reason for an increase in diabetes risk could be the types of saturated fats in red meat as well as the additives (such as nitrates and sodium) in processed food. But as Hu acknowledges, "it's very challenging to pinpoint the exact components of food that are responsible."

Many researchers are waiting for more evidence. "I don't think we can tell" yet whether red meat can be separated from overall weight gain as a factor for diabetes risk, Seaquist says. But, she notes, the fact that the study was so large and there was still a correlation between red meat consumption and diabetes risk after adjusting for BMI "makes me a little more concerned that maybe there really is something specific about red meat" that pushes the body toward diabetes.

In addition to looking to better understand the mechanisms at work in the body, Hu says, he will be keeping a close eye on other countries where diets are changing.

"It's very important to locate the effects of meat consumption on chronic disease risk in countries that are undergoing nutritional transitions," Hu says. But as in the U.S., the panoply of food and lifestyle choices that people make are difficult to tease apart.

In the meantime, Seaquist says, the best nutritional tactic is akin to good investing: diversify. "We need to watch our total calories," she says. But we also "need to have a broad range of foods in our diet"—especially fruits and vegetables, she says.
Scientific American is a trademark of Scientific American, Inc., used with permission

© 2011 Scientific American, a Division of Nature America, Inc. All Rights Reserved.

Beat Gluttony with Gullibility

Beat Gluttony with Gullibility

Eating-behavior expert Brian Wansink offers tips on fooling yourself into eating less. Katherine Harmon reports

Our eyes are bigger than our stomachs. And visual perception plays a big fat role in eating—often without our realizing it. So says Brian Wansink, a professor of consumer behavior and nutritional science at Cornell. His research has shown that people eat more when their food is served on larger dishes. Because lots of folks use an empty plate—rather than a full stomach—as a cue to put down their fork. Wansink reviewed his findings last week at the American Psychological Association meeting in Washington.

In one experiment, he had unsuspecting subjects eat soup from bowls that continually refilled from the bottom. And volunteers who unknowingly ate from these bowls consumed on average 73 percent more soup than those who had had a finite supply. But both groups thought they had eaten about the same amount.

Wansink’s advice is to use such propensities in our favor. Just serving meals on smaller plates can trick us into cutting calories. Because it's way easier to stop after finishing a half-sized bowl of ice cream than it is to eat only half of a full-sized bowl.
—Katherine Harmon 


http://www.scientificamerican.com/podcast/episode.cfm?id=beat-gluttony-with-gullibility-11-08-09&WT.mc_id=SA_CAT_MB_20110810 | August 9, 2011 |

Straw Bale Gardening for Low Back Pain


In this post, I’ll discuss two things I enjoy very much: helping you become and stay healthier through chiropractic, and gardening.

More specifically, let me introduce you to STRAW BALE GARDENING.

The idea is that you plant our tomatoes or zucchini, petunias if you like, or pretty well anything you would plant in the ground, directly into a straw bale. The benefits are: you can grow a garden over any type of soil, including the sandy conditions in Wasaga Beach, or even over a drive way if you so choose; there are few if any weeds growing in the straw to disturb your prize veggies (Caution! Use straw bales, not hay, as hay bales contain seeds); the straw retains moisture which lessens watering somewhat; it eliminates the problem of root nematodes and other soil born pathogens that can carry over in the soil and prevent tomatoes from thriving; and… here is the part that relates to chiropractic and your health … the straw bales raise your garden and requires less bending a stooping! There is also less tilling, hoeing, and weeding, and ease of harvest. ****That is great for those who have low back pain, disk injuries, and arthritis****

To begin, lay the bale with its cut ends up (string parallel to the ground) and condition your straw bales over a ten day period. The recommended procedure is to sprinkle a ½ cup of cheap fertilizer (30-0-0) over each bale on days 1, 3, and 5, then water thoroughly. On days 2, 4 and 6, water. Days 7 through 9 use a ¼ cup of the fertilizer plus water. On day 10, apply one cup of 10-10-10 fertilizer and water. Use the least expensive fertilizer available. By the end of the conditioning period, the straw inside the bale has begun to compost. Don’t be surprised if earth worms have made a new home and mushrooms are sprouting.

You can now plant directly into your conditioned straw bales by digging a hole large enough to take your transplants. If you are starting from seed, spread a 1 to 2 inch layer of soil over top to stop the seeds from falling into holes in the straw. As top soil often contains weed seeds, you may wish to use a sterilized mix. Space your plants as you would if planting in soil. (This method may not work well for corn as you can only plant one or two stalks per bale).  Because the composting process produces warmth, the roots will develop faster than normal leading to stronger plant growth and perhaps an earlier start for the gardening season.

You can use tomato cages to support your plants or let them sprawl. However, if you have a row of bales, secure a post at each end and string wires or fencing between them. Place your bottom wire about 12 inches above the straw bales and then each successive wire at 10 inch intervals to tie up your plants as they grow. The bottom wire allows you to use plastic sheet as a tent to protect young plants from cold spring conditions. When your bales are done in after a year or two, they can be spread out as mulch or compost and replaced with fresh bales quite easily.

Don’t forget to share the bounty with your bounty with your neighbours and tell them you got the idea from your chiropractor. Credit to Joel Karsten for his work in perfecting the technique and sharing it via www.strawbalegardens.com

Miracle Mediterranean Diet


Olive Oil, Fresh Vegetables, and Wine are part of the Mediterranean Diet.

People who have scanned my blog will appreciate that I promote doing the basic things well, and most of the other problems we have tend to diminish. I do promote a diet with more fruit, vegetable, whole grains, and less meat, dairy, and egg. Alcohol, if at all, in moderation.  How much more fruit, veggies and grains? More than you are eating now. How much less meat, dairy, and egg? Less than you are eating now. No drastic changes.. just whatever you are doing…keep tweaking and you’ll get it right.

Here is a well written article that gives some more information how the simple things are often the best.

drwaynecoghlan.blogspot.ca
Get ’em to the Greek (diet)

LESLIE BECK, Globe and Mail, Mar. 22, 2011

It’s arguably the healthiest diet in the world. The Mediterranean diet – which emphasizes fruit and vegetables, grains, nuts and olive oil – is recognized as the gold standard for promoting good health. The diet helps guard against heart disease, certain cancers, obesity, diabetes, asthma, Parkinson’s disease and Alzheimer’s. And it’s been shown to increase life expectancy.

Now, after reviewing 50 studies conducted on more than 500,000 people, researchers say the diet substantially lowers the risk of metabolic syndrome and is highly protective against all the risk factors that cause the disorder. According to the International Diabetes Federation, a person has metabolic syndrome if he or she has a large waist circumference plus two or more of the following: high blood triglycerides (blood fat), high blood pressure, elevated fasting blood sugar (glucose) and low HDL (good) cholesterol.
Metabolic syndrome doubles the risk of heart attack and increases the likelihood of developing Type 2 diabetes fivefold.

Abdominal obesity is one of the main causes of all the symptoms of metabolic syndrome. Fat inside the abdomen produces hormones and inflammatory chemicals that disrupt the body’s ability to metabolize glucose and fat properly; it also releases inflammatory chemicals into the bloodstream.

The study, published this month in the Journal of the American College of Cardiology, revealed that those following a Mediterranean-style diet were significantly less likely to develop metabolic syndrome. What’s more, they had smaller waist circumferences, higher HDL cholesterol levels, lower blood triglycerides, lower blood pressure and better blood-sugar metabolism than folks who didn’t follow this eating pattern.

Scientists speculate the Mediterranean diet’s health benefits are due to its strong antioxidant and anti-inflammatory effects. The Mediterranean diet reflects the dietary habits of Crete, Greece and southern Italy in about 1960, when rates of chronic diseases in these regions were among the lowest in the world and life expectancy was the highest.

Low in saturated fat, high in monounsaturated fat, high in fibre and packed with protective phytochemicals, it’s primarily plant-based, with fruits, vegetables, whole grains, legumes and nuts eaten daily. Milk, cheese and yogurt are also part of the daily diet. Red meat is eaten only a few times a month, while poultry and fish are consumed at least twice a week. The diet also allows up to seven eggs a week, including those used in cooking and baking.
The principal fat is olive oil; butter and margarine are seldom used. Herbs and spices rather than salt are used to flavour foods.

While the North American diet has moved toward more meat and less fruit and vegetables over the past half-century, the Mediterranean diet is minimally processed and incorporates seasonal and locally grown foods when possible.

Meditteranean Diet and You
drwaynecoghlan.blogspot.com












Use the following strategies to adopt a Mediterranean-style diet:

Have fruit and vegetables daily. These foods deliver fibre, vitamins, minerals, antioxidants and phytochemicals and should be eaten at most meals. Include whole fresh fruit at breakfast and at snacks and serve fruit salad or berries for dessert. Make sure lunch includes at least one vegetable serving such as a spinach salad, grated raw carrot or red pepper sticks. Aim to cover half your plate at dinner with vegetables.

Switch to whole grain. Minimally processed grains such as barley, bulgur, couscous, farro, millet and oats are a central part of the Mediterranean diet. Choose 100 per cent whole grain breads and cereals. Eat brown rice and whole grain pasta more often than white.

Choose low-fat dairy. These foods supply protein, calcium and B vitamins. Buy yogurt with 1 per cent milk fat or less. Eat cheese in small portions; look for part skim versions (less than 20 per cent milk fat).

Eat fish twice weekly. To get heart-healthy omega-3 fatty acids, eat oily fish twice a week. Good choices include salmon, sardines, herring and trout. Enjoy (unbreaded) fish baked, grilled or steamed.

Scale back red meat. No more than three times a month (maximum of 12 to 16 ounces a month). Instead of having a large steak, have smaller portions of meat in a stir-fry, stew or pasta dish. As a main course, limit your portion to three ounces – this fills only one-quarter of your dinner plate.

Add vegetarian meals. To increase your intake of vegetarian protein, eat a legume-based meal at least twice a week. Try a lentil soup, vegetarian chili or black bean tacos.

Choose healthy fats. Fats should be unsaturated. Use olive oil in cooking and baking. (Extra virgin olive oil is not suitable for high-heat frying.) Include a small handful of nuts or seeds in your daily diet. Instead of butter or margarine, add sliced avocado to sandwiches.

Drink in moderation. A moderate amount of wine may be consumed with meals. This means no more than five ounces a day for women and 10 ounces for men. Wine is optional; alcohol, even in moderation, is not healthy for everyone.


Mediterranean Diet is Good for You

Mediterranean diet linked with lower risk of heart disease among young U.S. workers
February 4, 2014




http://www.hsph.harvard.edu/news/press-releases/mediterranean-diet-linked-with-lower-heart-disease-risk/?utm_source=SilverpopMailing&utm_medium=email&utm_campaign=HSPH%20Update%20February%202014%20--%20Friends%20%281%29&utm_content=

Boston, MA — Among a large group of Midwestern firefighters, greater adherence to a Mediterranean-style diet was associated with lower risk factors for cardiovascular disease (CVD), according to a new study led by researchers from Harvard School of Public Health (HSPH) and Cambridge Health Alliance (CHA). The study is the first to assess the effects of Mediterranean-style diet among a group of young, working U.S. adults.

The study was published online in PLOS ONE on February 4, 2014. “Modified Mediterranean diet score and cardiovascular risk in a North American working population,” Justin Yang, Andrea Farioli, Maria Korre, Stefanos N. Kales, PLOS ONE, February 4, 2014

“Our study adds more evidence showing the health benefits of a Mediterranean diet, even after adjusting for exercise and body weight,” said Stefanos Kales, associate professor in the Department of Environmental Health at HSPH and chief of occupational and environmental medicine at CHA.
U.S. firefighters are known to have a high prevalence of obesity and risk factors for CVD. A Mediterranean diet, rich in fish, nuts, vegetables, and fruits, has been shown in previous studies to lower risk of CVD. However, those studies have primarily been conducted among older people, those with existing health conditions, and among Mediterranean populations.

The researchers analyzed medical and lifestyle data, including dietary habits, from an existing cohort of 780 male firefighters in the Midwest. They developed a modified Mediterranean diet score (mMDS) to assess the participants’ dietary patterns.

The firefighter group with greatest adherence to Mediterranean-style diet showed a 35% decreased risk in metabolic syndrome, a condition with risk factors that include a large waistline, high triglyceride level, low HDL (“good”) cholesterol level, high blood pressure, and high blood sugar. The group with the highest mMDS also had a 43% lower risk of weight gain compared with the lowest mMDS group. Additionally, greater adherence to a Mediterranean-style diet was significantly associated with higher HDL cholesterol and lower LDL (“bad”) cholesterol. Consistent with previous investigations, obese participants in the firefighter study reported a higher intake of both fast foods and sugary drinks.

The study shows that promoting Mediterranean-style diets could have significant health benefits for young, working populations. “The logical next steps from our investigation are studies using the workplace to specifically promote Mediterranean dietary habits among firefighters and other U.S. workers,” said Justin Yang, lead author of the study and a post-doctoral fellow at HSPH.

Read the study: http://dx.plos.org/10.1371/journal.pone.0087539
Support for the study was provided by the U.S. Department of Homeland Security (EMW-2006-FP-01493 and EMW-2009-FP-00835).

Snow Shovelling Safety Tips

How not to break your back shovelling snow

February 1, 2011
Brandie Weikle

What could be more natural than a Canadian shovelling snow?
A Canadian with a back, arm or wrist injury, apparently.
The Ontario Chiropractic Association (OCA) conducted a survey of members and found that the most common cause of winter injury treated by chiropractors is careless snow shovelling.
“The number one reason is that people don’t realize how heavy the snow is,” explains Natalia Lishchyna, an Oakville chiropractor and vice president of the OCA. “A shovel full of snow is probably five to seven pounds, so it’s probably several hundred pounds per driveway. They go out there and try to do it all at once, and that’s when you get strains and sprains, or worse, a disc injury.”
When a bunch of people who don’t get enough exercise are faced with 20-30 centimetres of snow, their bodies just aren’t prepared, says Lischyna.
That’s why Ontario’s chiropractors have launched a public awareness campaign geared at encouraging people to Lift Light and Shovel Right.
Here are some tips for getting through the snow storm with your back intact.
Don’t let the snow pile up: “What we want people to think is, ‘Every two to three centimetres I should go out there and clear it off,” says Lischyna. “During a big storm, it could be every hour that you go out and clear it for a few minutes.” Frequent shovelling will allow you to move smaller amounts of snow at once. Plus, it makes you a better neighbour.
Warm up: As with any strenuous activity, you should take the time to warm up before shovelling. A 10- to 15-minute walk to your coffee shop could do it, followed by some simple stretching. “Don’t get out of bed and run out there to do the shovelling,” she says.
Pick the right shovel: Use a lightweight pusher-type shovel. Newer models are far more ergonomic. Snow is more likely to stick to a plain metal shovel so look for one that has a coating that encourages snow to slip off easily.
Push, don’t throw: Always push the snow to the side rather than throw it. This way you avoid lifting heavy shovelfuls of snow, and sudden twisting or turning movements. “Keep your nose between your toes,” says Lishchyna. “Keep your shovel within the line of sight instead of twisting your entire back.”
Bend your knees: If you find you do have to lift a shovelful of snow, handle it the way you would any heavy object. Use your knees and your leg and arm muscles to do the pushing and lifting, while keeping your back straight.
Take breaks: If you feel tired or short of breath, stop and take a rest. Shake out your arms and legs. Stop shovelling immediately if you feel chest pain or back pain. If you have back pain that is severe or that persists for more than a day after shovelling, see a chiropractor. If you have chest pain that is severe, see a medical doctor immediately.
“It’s not unusual for people to have some aches and pains after doing this kind of work,” says Lishchyna, who recommends five minutes of stretching when you’re done. “Don’t lie down and watch TV. Just before you go to bed, do a little bit of stretching again.”
You can expect to be a little sore for about a day. “If it’s going beyond a couple of days, seek professional help.”

What could be more natural than a Canadian shovelling snow? A Canadian with a back, arm or wrist injury, apparently. The Ontario Chiropractic Association (OCA) conducted a survey of members and found that the most common cause of winter injury treated by chiropractors is careless snow shovelling. “The number one reason is that people don’t realize how heavy the snow is,” explains Natalia Lishchyna, an Oakville chiropractor and vice president of the OCA. “A shovel full of snow is probably five to seven pounds, so it’s probably several hundred pounds per driveway. They go out there and try to do it all at once, and that’s when you get strains and sprains, or worse, a disc injury.” When a bunch of people who don’t get enough exercise are faced with 20-30 centimetres of snow, their bodies just aren’t prepared, says Lischyna. That’s why Ontario’s chiropractors have launched a public awareness campaign geared at encouraging people to Lift Light and Shovel Right. Here are some tips for getting through the snow storm with your back intact. Don’t let the snow pile up: “What we want people to think is, ‘Every two to three centimetres I should go out there and clear it off,” says Lischyna. “During a big storm, it could be every hour that you go out and clear it for a few minutes.” Frequent shovelling will allow you to move smaller amounts of snow at once. Plus, it makes you a better neighbour. Warm up: As with any strenuous activity, you should take the time to warm up before shovelling. A 10- to 15-minute walk to your coffee shop could do it, followed by some simple stretching. “Don’t get out of bed and run out there to do the shovelling,” she says. Pick the right shovel: Use a lightweight pusher-type shovel. Newer models are far more ergonomic. Snow is more likely to stick to a plain metal shovel so look for one that has a coating that encourages snow to slip off easily. Push, don’t throw: Always push the snow to the side rather than throw it. This way you avoid lifting heavy shovelfuls of snow, and sudden twisting or turning movements. “Keep your nose between your toes,” says Lishchyna. “Keep your shovel within the line of sight instead of twisting your entire back.” Bend your knees: If you find you do have to lift a shovelful of snow, handle it the way you would any heavy object. Use your knees and your leg and arm muscles to do the pushing and lifting, while keeping your back straight. Take breaks: If you feel tired or short of breath, stop and take a rest. Shake out your arms and legs. Stop shovelling immediately if you feel chest pain or back pain. If you have back pain that is severe or that persists for more than a day after shovelling, see a chiropractor. If you have chest pain that is severe, see a medical doctor immediately. “It’s not unusual for people to have some aches and pains after doing this kind of work,” says Lishchyna, who recommends five minutes of stretching when you’re done. “Don’t lie down and watch TV. Just before you go to bed, do a little bit of stretching again.” You can expect to be a little sore for about a day. “If it’s going beyond a couple of days, seek professional help.”

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