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News Tips

Living Well

Health tips from Indiana University

EDITORS: This monthly tip sheet is based on Indiana University faculty research, teaching and service. "Living Well Through Healthy Lifestyles" is the guiding philosophy of IU Bloomington's School of Health, Physical Education and Recreation. In keeping with that philosophy, this tip sheet offers information related to both physical and mental well-being. Faculty in other IU schools and departments also contribute their expertise in this area.

This month's tips discuss the importance of exercise and annual dilated eye exams for people with diabetes (November is American Diabetes Awareness Month), insights into memory, and questions to pose when looking for a personal trainer.

As early as 42 B.C., the ancient Greeks knew that exercise could help diabetes. It is only recently, however, that scientists are discovering all the benefits of exercise in treating diabetes. While researchers have long known that exercise can help control glucose, lower insulin requirements and reduce body fat, exercise physiologist Janet P. Wallace, professor in Indiana University Bloomington's Department of Kinesiology, said researchers also are beginning to explore what exercise can do for the serious complications of diabetes. Peripheral neuropathy, a condition where sensation in the feet is lost, is just one of the many complications. Diabetic patients who cannot feel their feet tend to move with an altered gait and often injure their feet without realizing it. What's worse is that healing of injuries may take too long or be incomplete. Far too often, the result of a simple infection that won't heal is amputation. Wallace said that research from 20 years of exercise programs for diabetic adults is showing health care professionals across the country expanded benefits to participants. The programs, including one offered at IU's School of Health, Physical Education and Recreation since 1987, generally include moderate exercise -- usually walking. Wallace said many participants claim to feel so much better they can "feel their feet again and want to go dancing." Because of this promising feedback, IU faculty have been engaged in a series of studies to investigate this exercise phenomenon. Wallace said she and her colleagues think the increased blood flow from exercise may contribute to revitalizing the nerves of the lower limbs. They have found that diabetics who are physically active have a higher limb blood flow and better leg reflexes. Their next set of experiments is to begin in January with a blood flow and nerve function study. In this study they will control the blood flow to the lower leg and see how the leg reflexes respond. The Department of Kinesiology is part of HPER. Wallace can be reached at wallacej@indiana.edu.

Nearly half of the nation's estimated 18 million people with diabetes will develop some degree of diabetic retinopathy, the most common form of diabetic eye disease, said Dr. Victor Malinovsky of the Indiana University School of Optometry. Typically, diabetic retinopathy has no early symptoms. Malinovsky said vision impairment does not develop until the disease has advanced into its later stages, but by then vision loss cannot be restored. This makes it crucial to have regular dilated eye exams before any vision is lost. "Taking just an hour or so to have a dilated eye examination at least once a year can save people with diabetes from a lifetime of blindness," Malinovsky said. Diabetic retinopathy damages the tiny blood vessels in the retina, the light-sensitive tissue that lines the back of the eye. As many as 25,000 people annually go blind from the disorder, making it a leading cause of blindness among working-aged Americans. More than 90 percent of the cases of blindness can be prevented with early detection and timely treatment, Malinovsky said, yet only 60 percent of people with diabetes receive annual dilated eye exams. "We want to make this information common knowledge among people with diabetes so they realize that while eye disease is a possible complication of diabetes, vision loss is not inevitable," Malinovsky said. Annual dilated eye exams are key to preventing diabetic retinopathy. People with diabetes can also take the following steps:

• Take prescribed medications as instructed
• Stick to a suitable diet
• Exercise regularly
• Control high blood pressure and cholesterol levels
• Avoid alcohol and smoking

Malinovsky can be contacted at 812-856-4470 and malinovs@indiana.edu. More information about diabetic retinopathy can be found at the Web site of the National Eye Institute, http://www.nei.nih.gov/.

It's a myth that aging leads to an inevitable, noticeable decline in the memory, says Lesa Lorenzen Huber, gerontology curriculum coordinator for Indiana University Bloomington's Center on Aging and Aged. What changes with age is how effectively memory strategies are used. All around us, Huber said, school-age and university students are practicing memory strategies -- the information might be on a test, after all! But few people face such tests to their memory after graduation. One's ability to encode and retrieve everyday information becomes rusty and out of practice. Richard M. Shiffrin, Distinguished Professor and Luther Dana Waterman Professor in IUB's Department of Psychology, concurs. Shiffrin said certain kinds of memory tasks can show decline with age, but most of these areas respond to practice. And by practice, he means actively thinking. "Any loss that occurs is minimized by maintaining your intellectual vitality," said Shiffrin, who is noted for his research related to memory and attention. Earlier this year he received the Distinguished Scientific Contribution Award from the American Psychological Association. At any age, he said, the use of one's cognitive processes makes them continue to work well. This could involve such simple activities as reading and thinking, creative planning and writing. Even, he said, watching television -- as long as one "actively" watches by questioning and evaluating what is watched. "There's almost no intellectual activity that humans partake in that wouldn't be useful in maintaining memory and cognitive function," Shiffrin said. "In general, memory requires some effort and work to integrate the new material with one's knowledge," he said. "The effort does not prevent memorizing interesting things such as the games of the World Series, but prevents memorizing less interesting things like the names of distant in-laws." Sadly, some people succumb to the stereotype of older, forgetful people, Huber said. American society has a somewhat negative view of aging. Older people sometimes internalize these stereotypes, Huber said, and consequently perform less well on a variety of measures, including memory performance. In Huber's classes and presentations, her memory-boosting tips include the use of memory aids, such as calendars, sticky notes and palm pilots; talking to yourself, restating events and issues to be remembered; placing important things in the same place; and the use of visual imagery and mnemonic tricks, such as acronyms and rhymes. Some medications, Huber said, can interfere with remembering, learning and problem-solving. Interactions between medications can be especially troublesome. Pharmacists or doctors should be consulted to make sure medications are not causing problems. The Department of Psychology is in the College of Arts and Sciences. The Center on Aging and Aged is in the Department of Recreation and Park Administration in the School of Health, Physical Education and Recreation. Huber can be reached at 812-855-0816 and lehuber@indiana.edu. Shiffrin can be reached at 812-855-4972 and shiffrin@indiana.edu.

A growing number of Americans are hiring personal trainers to help them reach health and fitness goals and to fix fitness problems. "More people are working with personal trainers because they want to get in shape and tone up," said Chad Coplen, a personal trainer and program assistant for personal training with Indiana University Bloomington's Division of Recreational Sports, which has seen the demand for its personal trainers increase significantly. "People are reading about the growing issue of obesity and want to take action." Working with a personal trainer involves one-on-one or small-group exercise instruction designed to meet an individual's specific needs. Personal training often incorporates goal setting and health education. Packages, prices and services vary widely, but a typical session may last 30 minutes to an hour with costs ranging from $20 to $100. Coplen said skilled, knowledgeable, professional personal trainers can open their clients' eyes to exercise possibilities while addressing fitness goals. The right trainer can provide a safe environment and instruction for individuals with pre-existing health issues such as high blood pressure or diabetes. Personal trainers also can add more challenge and variety to the workouts of experienced exercisers. Personal trainers initially should meet with clients to learn about their health and exercise history and goals. Only then can the client and trainer create a customized exercise plan. Coplen said it is important to keep in mind when selecting a personal trainer that the title "personal trainer" does not automatically signify qualifications. According to the American College of Sports Medicine, there are currently no national standards or minimum requirements for carrying the title of "personal trainer." ACSM suggests asking the following questions:

• Does the trainer have a four-year degree in the health and fitness field?
• Does the trainer have additional training and a certification by a nationally recognized organization?
• Is the trainer certified in CPR and First Aid and prepared to respond to emergencies?
• Does the trainer have more education and experience than just having been a "weight lifter," a "body builder" or "active in fitness"?
• How long have they been training?
• What types of clients have they worked with in the past?

Friends and "word of mouth" can be a good source of reference when seeking a personal trainer. Personal trainers also can be found on the Web sites of the American Council on Fitness, http://www.acefitness.com, and the American College of Sports Medicine, http://www.acsm.org. For more information, contact Bryan Stednitz at 812-855-9653 and bstednit@indiana.edu.

For additional help with these tips, contact Tracy James at 812-855-0084 and traljame@indiana.edu.

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