If you have diabetes — or for that matter, nearly any other chronic illness — exercise is one of the most powerful tools that can help you control your weight and blood sugar. And it can help you feel great, too.

The list of exercise benefits is long. Exercise helps control weight, lowers blood pressure, reduces harmful LDL cholesterol and triglycerides, raises healthy HDL cholesterol, strengthens muscles and bones, and reduces anxiety. Exercise can help regulate blood sugar and increase the body’s sensitivity to insulin. Both are important for people with diabetes.

Many studies have documented that exercise is a strong ally in treating diabetes. Here are a few examples:

• All forms of exercise — aerobic, resistance, and a combination of both — have been shown to be equally good at lowering HbA1c values.

• Resistance training and aerobic exercise both helped to lower insulin resistance in previously sedentary older adults at risk for diabetes. Combining the two was better than either one alone.

• People with diabetes who walked at least two hours a week were less likely to die of heart disease than their sedentary counterparts, and those who exercised three to four hours a week cut their risk even more.

• Women with diabetes who spent at least four hours a week doing moderate or vigorous exercise had a 40% lower risk of developing heart disease than those who didn’t exercise.

If you have diabetes, generally it is best to exercise one to three hours after eating, when your blood sugar level is likely to be higher. If you use insulin, be sure to test your blood sugar before exercising. If it is below 100 mg/dL, eat a piece of fruit or have a small snack. This will bump your blood sugar up and help you avoid hypoglycemia. Test again 30 minutes after your snack to be sure your blood sugar level is stable. It’s also a good idea to check your blood sugar after any particularly grueling workout or activity. If you’re taking insulin, your risk of developing hypoglycemia may be highest six to 12 hours after exercising. Experts also caution against exercising if your blood sugar is too high (over 250).

A medical alert bracelet should be part of your workout wardrobe. It should indicate that you have diabetes and whether you take insulin. Also, keep hard candy or glucose tablets with you while exercising in case your blood sugar takes a nosedive.

To learn more about how to live a healthy life with diabetes and ways to keep your blood sugar in check and avoid complications, contact Ronald @gyminmotion 07929 256856.

Our bodies can obtain vitamin D from diet and make it from sun exposure. Even with these two routes for obtaining vitamin D, however, inadequate vitamin D is common, and deficiencies can be found on all continents, in all ethnic groups, and across all ages—a major concern, given the many ways that vitamin D helps protect our health. (1) There are a number of factors that increase the risk of having inadequate vitamin D, among them, lifestyle, sunscreen use, geographic location, skin tone, age, and body weight.

• Lifestyle: People who spend less time outdoors, or who cover up with clothing when they are outdoors, get less exposure to the sun, so they make less vitamin D. (1)
• Sunscreen Use: Correctly-applied sunscreen blocks the harmful ultraviolet B rays that cause skin cancer, but it also blocks most of the skin’s production of vitamin D. So people who use sunscreen daily are more likely to be low in vitamin D. (1) But don’t ditch the sunscreen: The American Academy of Dermatologists says that sunlight exposure to unprotected skin increases the risk of skin cancer, and that there’s no safe level of sunlight exposure that allows you to make vitamin D without increasing skin cancer risk. Their advice? Use sunscreen or other sun protection daily, skip the tanning booths, and get your vitamin D from diet or supplements. (2) Some Vitamin D experts take issue with the American Academy of Dermatologists’ hard line on sun exposure, and they recommend a more moderate option: Put sunscreen on your face, and allow your arms and legs to get a small amount of unprotected sun exposure—say, 15 minutes max—before applying sunscreen or covering up. It’s still a matter of scientific debate.
• Geographic Location and Season: In the summer, if you sat out in a bathing suit on a sunny afternoon for long enough to turn your skin slightly pink, you could make plenty of vitamin D. Yet during the late autumn and winter, people who live at higher latitudes produce little or no vitamin D from the sun, because the sun is at too low an angle in the sky. In the northern hemisphere, people who live in Boston (U.S.), Edmonton (Canada), and Bergen (Norway) can’t make enough vitamin D from the sun for 4, 5, and 6 months out of the year. (3) In the southern hemisphere, residents of Buenos Aires (Argentina) and Cape Town (South Africa) can make far less vitamin D from the sun during their winter months (June through August) than they can during their spring and summer. (3) The body stores vitamin D from summer sun exposure, but it must last for many months. By late winter, many people in these higher-latitude locales are deficient. (1)
• Skin Tone: People who have a darker skin tone have more melanin in their skin, and this pigment is a “natural sunscreen” that slows down skin production of vitamin D. (3)  This the main reason why African Americans are more likely to be low in vitamin D. (4)
• Age: The ability to make vitamin D in the skin drops as we age, and is one of the reasons why older individuals are more likely to have low vitamin D levels. (1)
• Body Weight: People with excess body fat have lower vitamin D levels, so those who are overweight or obese have a higher risk of having inadequate vitamin D.  (1, 5, 6)

The bottom line: Low vitamin D can be found in all ethnic and age groups, around the world, for a host of reasons. Even if you are taking a standard multiple vitamin, the amount of vitamin D in most vitamins (400 IU) is not enough to prevent low blood levels. If you suspect that you are at risk of vitamin D deficiency, you can ask your physician to order a blood test for vitamin D.

Vitamin D Deficiency: A Global Concern

If you live north of the line connecting San Francisco to Philadelphia and Athens to Beijing, odds are that you don’t get enough vitamin D. The same holds true if you don’t get outside for at least a 15-minute daily walk in the sun. African-Americans and others with dark skin, as well as older individuals, tend to have much lower levels of vitamin D, as do people who are overweight or obese.

Worldwide, an estimated 1 billion people have inadequate levels of vitamin D in their blood, and deficiencies can be found in all ethnicities and age groups. (1-3)  Indeed, in industrialized countries, doctors are even seeing the resurgence of rickets, the bone-weakening disease that had been largely eradicated through vitamin D fortification. (4-6)

Why are these widespread vitamin D deficiencies of such great concern? Because research conducted over the past decade suggests that vitamin D plays a much broader disease-fighting role than once thought.

Being “D-ficient” may increase the risk of a host of chronic diseases, such as osteoporosis, heart disease, some cancers, and multiple sclerosis, as well as infectious diseases, such as tuberculosis and even the seasonal flu.

Currently, there’s scientific debate about how much vitamin D people need each day. The Institute of Medicine, in a long-awaited report released on November 30, 2010 recommends tripling the daily vitamin D intake for children and adults in the U.S. and Canada, to 600 IU per day. (7) The report also recognized the safety of vitamin D by increasing the upper limit from 2,000 to 4,000 IU per day, and acknowledged that even at 4,000 IU per day, there was no good evidence of harm. The new guidelines, however, are overly conservative about the recommended intake, and they do not give enough weight to some of the latest science on vitamin D and health. For bone health and chronic disease prevention, many people are likely to need more vitamin D than even these new government guidelines recommend.

Vitamin D Sources and Function

Vitamin D is both a nutrient we eat and a hormone our bodies make. Few foods are naturally rich in vitamin D, so the biggest dietary sources of vitamin D are fortified foods and vitamin supplements. Good sources include dairy products and breakfast cereals (both of which are fortified with vitamin D), and fatty fish such as salmon and tuna.

The body also manufactures vitamin D from cholesterol, through a process triggered by the action of sunlight on skin, hence its nickname, “the sunshine vitamin.”  Yet some people do not make enough vitamin D from the sun, among them, people who have a darker skin tone, who are overweight, who are older, and who cover up when they are in the sun. (1)

Correctly applied sunscreen reduces our ability to absorb vitamin D by more than 90 percent. (8) And not all sunlight is created equal: The sun’s ultraviolet B (UVB) rays—the so-called “tanning” rays, and the rays that trigger the skin to produce vitamin D—are stronger near the equator and weaker at higher latitudes. So in the fall and winter, people who live at higher latitudes (in the northern U.S. and Europe, for example) can’t make much if any vitamin D from the sun. (8)

Vitamin D helps ensure that the body absorbs and retains calcium and phosphorus, both critical for building bone. Laboratory studies show that vitamin D can reduce cancer cell growth and plays a critical role in controlling infections. Many of the body’s organs and tissues have receptors for vitamin D, and scientists are still teasing out its other possible functions.

New Vitamin D Research: Beyond Building Bones

Several promising areas of vitamin D research look far beyond vitamin D’s role in building bones. And, as you might expect, the news media release a flurry of reports every time another study links vitamin D to some new ailment. These reports can be confusing, however, because some studies are stronger than others, and any report needs to be interpreted in the light of all other evidence. More answers may come from randomized trials, such as the VITamin D and OmegA-3 TriaL (VITAL), which will enroll 20,000 healthy men and women to see if taking 2,000 IU of vitamin D or 1,000 mg of fish oil daily lowers the risk of cancer, heart disease, and stroke.

Here, we provide an overview of some of the more promising areas of vitamin D research, highlighting the complex role of vitamin D in disease prevention—and the many unanswered questions that remain.

Vitamin D and Bone and Muscle Strength

Several studies link low vitamin D levels with an increased risk of fractures in older adults, and they suggest that vitamin D supplementation may prevent such fractures—as long as it is taken in a high enough dose. (9-13)

A summary of the evidence comes from a combined analysis of 12 fracture prevention trials that included more than 40,000 elderly people, most of them women. Researchers found that high intakes of vitamin D supplements—of about 800 IU per day—reduced hip and non-spine fractures by 20 percent, while lower intakes (400 IU or less) failed to offer any fracture prevention benefit. (13)

Vitamin D may also help increase muscle strength, which in turn helps to prevent falls, a common problem that leads to substantial disability and death in older people. (14-16)  Once again, vitamin D dose matters: A combined analysis of multiple studies found that taking 700 to 1,000 IU of vitamin D per day lowered the risk of falls by 19 percent, but taking 200 to 600 IU per day did not offer any such protection. (17)

A recent vitamin D trial drew headlines for its unexpected finding that a very high dose of vitamin D increased fracture and fall risk in older women. (18) The trial’s vitamin D dose—500,000 IU taken in a once-a-year pill—was much higher than previously tested in an annual regimen. After up to 5 years of treatment, women in the vitamin D group had a 15 percent higher fall risk and a 26 percent higher fracture risk than women who received the placebo.

It’s possible that giving the vitamin D in one large dose, rather than in several doses spread throughout the year, led to the increased risk. (18) The study authors note that only one other study—also a high-dose, once-a-year regimen—found vitamin D to increase fracture risk; no other studies have found vitamin D to increase the risk of falls. Furthermore, there’s strong evidence that more moderate doses of vitamin D taken daily or weekly protect against fractures and falls—and are safe.

So what is the significance of this study for people who want to take vitamin D supplements? A reasonable conclusion would be to continue taking moderate doses of vitamin D regularly, since these have a strong safety record, but to avoid extremely high single doses. This recent finding does present a challenge to scientists who will work to understand why the extreme single dose appears to have adverse effects.

Vitamin D and Heart Disease

The heart is basically a large muscle, and like skeletal muscle, it has receptors for vitamin D. (19) So perhaps it’s no surprise that studies are finding vitamin D deficiency may be linked to heart disease. The Health Professional Follow-Up Study checked the vitamin D blood levels in nearly 50,000 men who were healthy, and then followed them for 10 years. (20) They found that men who were deficient in vitamin D were twice as likely to have a heart attack as men who had adequate levels of vitamin D. Other studies have found that low vitamin D levels were associated with higher risk of heart failure, sudden cardiac death, stroke, overall cardiovascular disease, and cardiovascular death. (21-24) How exactly might vitamin D help prevent heart disease? There’s evidence that vitamin D plays a role in controlling blood pressure and preventing artery damage, and this may explain these findings. (25) Still, more research is needed before we can be confident of these benefits.

Vitamin D and Cancer

Nearly 30 years ago, researchers noticed an intriguing relationship between colon cancer deaths and geographic location: People who lived at higher latitudes, such as in the northern U.S., had higher rates of death from colon cancer than people who live closer to the equator. (26) Many scientific hypotheses about vitamin D and disease stem from studies that have compared solar radiation and disease rates in different countries. These can be a good starting point for other research but don’t provide the most definitive information. The sun’s UVB rays are weaker at higher latitudes, and in turn, people’s vitamin D levels in these high latitude locales tend to be lower. This led to the hypothesis that low vitamin D levels might somehow increase colon cancer risk. (2)

Since then, dozens of studies suggest an association between low vitamin D levels and increased risks of colon and other cancers. (1,27)  The evidence is strongest for colorectal cancer, with most (but not all) observational studies finding that the lower the vitamin D levels, the higher the risk of these diseases. (28-38) Vitamin D levels may also predict cancer survival, but evidence for this is still limited. (27) Yet finding such associations does not necessarily mean that taking vitamin D supplements will lower cancer risk.

The VITAL trial will look specifically at whether vitamin D supplements lower cancer risk. It will be years, though, before it releases any results. It could also fail to detect a real benefit of vitamin D, for several reasons: If people in the placebo group decide on their own to take vitamin D supplements, that could minimize any differences between the placebo group and the supplement group; the study may not follow participants for a long enough time to show a cancer prevention benefit; or study participants may be starting supplements too late in life to lower their cancer risk. In the meantime, based on the evidence to date, 16 scientists have circulated a “call for action” on vitamin D and cancer prevention: (27) Given the high rates of vitamin D deficiency in North America, the strong evidence for reduction of osteoporosis and fractures, the potential cancer-fighting benefits of vitamin D, and the low risk of vitamin D supplementation, they recommend widespread vitamin D supplementation of 2000 IU per day. (27)

Vitamin D and Immune Function

Vitamin D’s role in regulating the immune system has led scientists to explore two parallel research paths: Does vitamin D deficiency contribute to the development of multiple sclerosis, type 1 diabetes, and other so-called “autoimmune” diseases, where the body’s immune system attacks its own organs and tissues? And could vitamin D supplements help boost our body’s defenses to fight infectious disease, such as tuberculosis and seasonal flu? This is a hot research area and more findings will be emerging.

Vitamin D and Multiple Sclerosis: Multiple sclerosis (MS) rates are much higher far north (or far south) of the equator than in sunnier climes, and researchers suspect that chronic vitamin D deficiencies may be one reason why. One prospective study to look at this question found that among white men and women, those with the highest vitamin D blood levels had a 62 percent lower risk of developing MS than those with the lowest vitamin D levels. (39) The study didn’t find this effect among black men and women, most likely because there were fewer black study participants and most of them had low vitamin D levels, making it harder to find any link between vitamin D and MS if one exists.

Vitamin D and Type 1 Diabetes: Type 1 diabetes is another disease that varies with geography—a child in Finland is about 400 times more likely to develop it than a child in Venezuela. (40) Evidence that vitamin D may play a role in preventing type 1 diabetes comes from a 30-year study that followed more than 10,000 Finnish children from birth: Children who regularly received vitamin D supplements during infancy had a nearly 90 percent lower risk of developing type 1 diabetes than those who did not receive supplements. (41)  Other European case-control studies, when analyzed together, also suggest that vitamin D may help protect against type 1 diabetes. (42) No randomized controlled trials have tested this notion, and it is not clear that they would be possible to conduct.

Vitamin D, the Flu, and the Common Cold: The flu virus wreaks the most havoc in the winter, abating in the summer months. This seasonality led a British doctor to hypothesize that a sunlight-related “seasonal stimulus” triggered influenza outbreaks. (43) More than 20 years after this initial hypothesis, several scientists published a paper suggesting that vitamin D may be the seasonal stimulus. (44) Among the evidence they cite:

• Vitamin D levels are lowest in the winter months. (44) 
• The active form of vitamin D tempers the damaging inflammatory response of some white blood cells, while it also boosts immune cells’ production of microbe-fighting proteins. (44) 
• Children who have vitamin D-deficiency rickets are more likely to get respiratory infections, while children exposed to sunlight seem to have fewer respiratory infections. (44) 
• Adults who have low vitamin D levels are more likely to report having had a recent cough, cold, or upper respiratory tract infection. (45)

A recent randomized controlled trial in Japanese school children tested whether taking daily vitamin D supplements would prevent seasonal flu. (46) The trial followed nearly 340 children for four months during the height of the winter flu season. Half of the study participants received pills that contained 1,200 IU of vitamin D; the other half received placebo pills. Researchers found that type A influenza rates in the vitamin D group were about 40 percent lower than in the placebo group; there was no significant difference in type B influenza rates. This was a small but promising study, and more research is needed before we can definitively say that vitamin D protects against the flu. But don’t skip your flu shot, even if vitamin D has some benefit.

Vitamin D and Tuberculosis: Before the advent of antibiotics, sunlight and sun lamps were part of the standard treatment for tuberculosis (TB). (47) More recent research suggests that the “sunshine vitamin” may be linked to TB risk. Several case-control studies, when analyzed together, suggest that people diagnosed with tuberculosis have lower vitamin D levels than healthy people of similar age and other characteristics. (48)   Such studies do not follow individuals over time, so they cannot tell us whether vitamin D deficiency led to the increased TB risk or whether taking vitamin D supplements would prevent TB. There are also genetic differences in the receptor that binds vitamin D, and these differences may influence TB risk. (49) Again, more research is needed. (49)

Vitamin D and Risk of Premature Death

A promising report in the Archives of Internal Medicine suggests that taking vitamin D supplements may even reduce overall mortality rates: A combined analysis of multiple studies found that taking modest levels of vitamin D supplements was associated with a statistically significant 7 percent reduction in mortality from any cause. (50) The analysis looked at the findings from 18 randomized controlled trials that enrolled a total of nearly 60,000 study participants; most of the study participants took between 400 and 800 IU of vitamin D per day for an average of five years. Keep in mind that this analysis has several limitations, chief among them the fact that the studies it included were not designed to explore mortality in general, or explore specific causes of death. More research is needed before any broad claims can be made about vitamin D and mortality. (51)

Boston, MA – Men who do weight training regularly—for example, for 30 minutes per day, five days per week—may be able to reduce their risk of type 2 diabetes by up to 34%, according to a new study by Harvard School of Public Health (HSPH) and University of Southern Denmark researchers. And if they combine weight training and aerobic exercise, such as brisk walking or running, they may be able to reduce their risk even further—up to 59%.

This is the first study to examine the role of weight training in the prevention of type 2 diabetes. The results suggest that, because weight training appears to confer significant benefits independent of aerobic exercise, it can be a valuable alternative for people who have difficulty with the latter.  

The study will be published online in Archives of Internal Medicine on August 6, 2012. 

“Until now, previous studies have reported that aerobic exercise is of major importance for type 2 diabetes prevention,” said lead author Anders Grøntved, visiting researcher in the Department of Nutrition at HSPH and a doctoral student in exercise epidemiology at the University of Southern Denmark. “But many people have difficulty engaging in or adhering to aerobic exercise. These new results suggest that weight training, to a large extent, can serve as an alternative to aerobic exercise for type 2 diabetes prevention.” 

Type 2 diabetes is a major public health concern and it’s on the rise. An estimated 346 million people worldwide have type 2 diabetes, and diabetes-related deaths are expected to double between 2005 and 2030, according to the World Health Organization. More than 80% of these deaths occur in low- and middle-income countries. 

The researchers, including senior author Frank Hu, professor of nutrition and epidemiology at HSPH, followed 32,002 men from the Health Professionals Follow-up Study from 1990 to 2008. Information on how much time the men spent each week on weight training and aerobic exercise came from questionnaires they filled out every two years. The researchers adjusted for other types of physical activity, television viewing, alcohol and coffee intake, smoking, ethnicity, family history of diabetes, and a number of dietary factors. During the study period, there were 2,278 new cases of diabetes among the men followed. 

The findings showed that even a modest amount of weight training may help reduce type 2 diabetes risk. The researchers categorized the men according to how much weight training they did per week—between 1 and 59 minutes, between 60 and 149 minutes, and at least 150 minutes—and found that the training reduced their type 2 diabetes risk by 12%, 25%, and 34%, respectively, compared with no weight training. Aerobic exercise is associated with significant benefits as well, the researchers found—it reduced the risk of type 2 diabetes by 7%, 31%, and 52%, respectively, for the three categories above. 

The researchers also found that the combination of weight training and aerobic exercise confers the greatest benefits: Men who did more than 150 minutes of aerobics as well as at least 150 minutes of weight training per week had a 59% reduced risk of type 2 diabetes. 

Grøntved said that further research is needed to confirm the results of the study as well as to analyze whether or not the findings can be generalized to women. 

“This study provides clear evidence that weight training has beneficial effects on diabetes risk over and above aerobic exercise, which are likely to be mediated through increased muscle mass and improved insulin sensitivity,” said Hu. “To achieve the best results for diabetes prevention, resistance training can be incorporated with aerobic exercise.” 

Other HSPH authors included Eric Rimm, associate professor in the Departments of Epidemiology and Nutrition, and Walter Willett, Frederick John Stare Professor of Epidemiology and Nutrition and chair of the Department of Nutrition. 

Support for the study was provided by the National Institutes of Health (DK58845 and CA55075). 

“A Prospective Study of Weight Training and Risk of Type 2 Diabetes Mellitus in Men,” Anders Grøntved, Eric B. Rimm, Walter C. Willett, Lars B. Andersen, Frank B. Hu, Archives of Internal Medicine, online August 6, 2012.

The story of a four-year-old boy in India who has been running distances of up to 60 kilometers has led to a lot of discussions, including among the Take The Magic Step® team. We spoke to Dr. Henning Ohlert about appropriate exercise for young children, as well as about some strategies for parents to deal with this issue.

Dr. Ohlert, 46, is a lecturer of training science at the University of Potsdam. He was a professional athlete for ten years, and as a 23-year-old ran the 800 meters in 1:45.9. He is working on a long-term study of motor skills and development of ten-year-old children.

How much exercise can a child cope with?

Over the years, our attitude towards children’s capabilities has changed tremendously. Basically, you could say that children are “little champions of endurance.” The big advantage of children is that they stop what they are doing automatically when they feel that they are getting tired and reach their physical limits. If children are tired out during playing, they simply take a break, and once they have recovered, they get active again. I think that you cannot do anything wrong with children-you just cannot challenge them physically in the wrong way. They know how to adjust themselves, and will utter their disapproval when it gets too much for them. And this disapproval should be respected.

What you have to watch out for with children, however, is problems with their thermoregulation; that is, the loss of body warmth during physical activity. Children get red faces when they are playing, bouncing around or playing sports. The body warmth which develops causes fast panting while breathing. The reason for this is that their perspiration system with does not function as that of an adult yet. That’s why you have to be careful to prevent children from overheating. In general, however, children have quite a sensitive feeling for the right proportion of activity and rest. It is highly dangerous, though, what is demanded of the little boy in India.

How can parents tell what and how much they can expect and ask from their children?

I believe you can ask more from children than most parents would think. You can judge by certain subjective criteria if a physical activity is enough: the color of the skin (for example, if the paleness of the skin is extreme), the frequency of the breath, the heart rate as well as the quality of movements. You will realize pretty quickly that movements seem to become uncontrolled and the way children fall changes. These are clear indications for the necessity of a break.

At what age should children start to train on a regular basis?

In order to answer this question, you would have to define the term “systemically organized training” first. I think that until a child has reached the age of eight, we shouldn’t call it training. There is nothing wrong with daily exercise or physical activities. Children should be active in various non-specific ways and thereby gain a broad range of experiences. This is the best prerequisite for successful involvement in sports later on.

Is there such a thing as unathletic children?

In my opinion, there is no such thing as unsporty kids. At times someone gets called “unathletic” just because he is judged by certain skills and abilities. It is just normal, however, that you are not able to do things which you have never done or practiced before. Often you get also judged by your family background. But just because your parents consider themselves unathletic, it does not necessarily have to mean that the son or daughter is as well. Every child is athletic. The question is only if she is athletic enough to become a champion.

Don’t children have a natural urge to move?

Absolutely. Unfortunately, this urge is lost throughout the ontogenetic development. At puberty, this urge to move decreases. This is when young athletes often lose interest in their sport and don’t show up for training anymore.

Should parents try to intervene?

It would not be good if the enthusiasm for the sport got completely lost. It is normal and should be tolerated that there are phases of less motivation. You should still try to talk to your child, his or her coach and friends about the situation, options and possible wasted opportunities.

Children tend to change their enthusiasm for different things quite quickly. Today they are playing tennis, tomorrow they want to become a professional swimmer, the day after tomorrow a famous basketball player. Sometimes they are not sure at all. Should children do several kinds of sport or should they better concentrate on one?

I strongly recommend that children experience a rather broad range of physical activities. I assume that not every child should be trained to become a Davis Cup player. Instead, most children will just want to play tennis for fun, or they just want to go inline skating, running or play soccer. I am a great supporter of children practicing a variety of sports.

Is it naive to believe that children will be grateful one day if parents put some pressure on them and force them to keep up a certain sport, hoping that they will be successful and the sport turns out to be the right one for the child?

This wish or hope might be honorable, but children think differently. Children think very emotionally, and are not as rational as adults are. The reasons why children give up on something are not easily understood. A little bit of pressure might not be wrong. It is a great achievement, however, if children discover themselves what they like.

Should parents tell their children which expectations they have regarding their sporting performance?

Parents’ expectations should not put too much negative pressure on the children. There is a lot of evidence in pedagogy that children fail just because their parents were asking too much of them. Children often act paralyzed if they are put under too much pressure. Then they are often criticized for failing mentally, but no one realizes how much pressure has been put on them: “You have to do this, you have to do that!”

Parents have to learn to judge their children’s mental condition and figure out how they can teach them ambition and determination. As a matter of fact, a runner participates in a race to get to the finish line among the best and not far behind the first ones. Consequently, you can, of course, tell your children that sport is often about being better and faster than others. This should be done sensibly, however, and without any pressure. It is nearly impossible to get children’s enthusiasm back if you have put them off doing sports once and if sports have become a trauma for them. This is proven by scientific research. The next chance you get to convince them of doing sports again is when they have grown up and when stress at work and an unhealthy diet have caused health problems and the cardiologist tells them, “You have to get moving, you have to exercise!”

On the other hand, children are often highly motivated when their parents watch them at training or competitions.

It is obvious that children are extremely motivated when they realize that their parents fully support what they are doing. At some stage, however, their own motivation will become so high that they don’t need their mother’s or father’s support anymore. But even professional athletes are more motivated when their parents are in the stadium or along the race course, no matter if in tennis, soccer or running. The question is just how parents react to their children’s failure. It is important that you find out together-maybe even with the coach-where mistakes might have been made and how you could adapt the training. Children have to feel that you support them and don’t give up on them.

What should parents do if their child suddenly, after two years, does not like judo anymore and would rather want to do athletics or tennis? Should parents demand that their children continue doing what they have started to do and not to give up on something just because it is no fun at the time?

I don’t find it too bad to change from one kind of sport to the other. You should have a conversation and clarify why they don’t like the sport they used to do anymore. There are certainly understandable reasons for it. And if they are not understandable, you still should not act against your child’s wish.

What should parents do if they recognize sporting talent in their child, but are not sure if they want to support it?

If someone thinks his child has got talent in some area which is illustrated by being better at something than other children of the same age, I would recommend approaching a sporting club close by and asking if there are facilities to support this talent specifically. I don’t find it very good to place children in “talent factories” far away from home where they waste a lot of time traveling to and from the place. Children should be able to pursue their training without many hassles. If they further develop and prove their talent, there are more opportunities of support in young adulthood, such as elite sporting schools or scholarships.

And vice versa: How are mothers and fathers to act if children desperately want to become professional athletes, but just seem to lack the talent?

I would still give the child the same chances, as eventually the “moment of truth” will show if the child is as good as she thinks she is. In cases of constant failure, however, you should be honest with your child, and tell him that another kind of sport might be more suitable for him. There are a lot of children who change to another kind of sport after the advice of a friend or parents and who have become really successful at it. Children who are motivated and ambitious should initially do what they prefer and should try things out.

If parents for some reason think that they should apply sanctions against their child-maybe because of bad marks at school-are prohibiting going to training and doing sports reasonable disciplinary measures?

I find prohibiting sports as punishment pedagogically not wise. Children have a natural urge to move and to play in order to cope with stress and emotions, and you cannot just switch this behavioral pattern off. If they are aggressive at school, they will be aggressive at sports, too. But particularly here, those negative emotions can be turned around into positive ones-through the pure movement, through the contact with the coach, through the group dynamics in team sports where bonding and camaraderie are crucial.

When you decide on your favorite summer workouts—we discussed a few fun options in Part I—you can move on to organize everything so you stay healthy and well-hydrated during your fitness routine.

First of all, add extra care to how you prepare for your workouts. Make sure you are properly hydrated beforehand. Drink small amounts of water frequently, beginning two hours before you go out. I would not necessarily drink too much for 20 to 30 minutes prior to your start, though, because it can make you need to “go” while working out.

If you plan to work out for more than one hour, you might want to run with a water bottle belt, as many athletes do. You also could leave one or more water bottles on the course. If you decide on that strategy, it is best to stay on a loop course. This gives you a chance to replenish every few miles. And, if you want to be absolutely safe, ask a friend to join you on a bike. For bikers, use both your water bottles, and stay ahead of the game by stopping at any convenience store or gasoline station to fill-up your bottles before you need them again.

Listen to Your Body, Stay Healthy

Nothing is more important than listening to your body. If you do not feel well, please be very cautious. Before, during, and after your workouts, the first signs of a possible problem might be heavier breathing, an elevated heart rate, or losing concentration. Consider wearing a heart rate monitor—it can caution you before you run into trouble.

When you feel unwell, admit it to yourself early on and get out of the heat right away. Cool off with a cold towel, use ice cubes, and hydrate! Please, do not wait to see a physician if you do not feel better immediately. Be familiar with some of the early warning signs of overheating: dizziness, fainting, fatigue, hot skin and followed by chills, lack of perspiration, feeling thirsty, and elevated heart rate. If you stop sweating, you most likely are very dehydrated⁽¹⁾.

Also be careful after your workout. Take a dry shirt to put on after your run, and always take some fluid to drink. If you feel cold—even in summer, for example when you come from outside into an air-conditioned room while still wearing your wet workout clothes—change immediately into dry clothes. It may be summer, but you need to stay “warm” after your workouts to avoid weakening your immune system and maybe getting a cold.

For adequate protection, sunscreen, glasses, a summer hat, and a rain jacket are always good to have close by.

Hydrate Well Throughout the Day

It can be very warm and dry during the summer, so make sure you stay cool and hydrated at all times. There are some guidelines I would suggest, and one of my favorite is to keep a bottle of water or a sports drink close by. This will remind you to drink and get replenished with small amounts continuously and evenly spread out throughout the day.

Hydration is critical for many body functions, such as digestion, regulation of body temperature, and the circulatory processes that bring nutrients to the cells and transport waste from them. This is even more understandable when considering that our bodies are up to 75% water in total, depending on age and build, with blood being 83% water and the brain being 75 to 78% water. These are the levels when each of those organs work best⁽²⁾.

When you get dehydrated, every cell in your body suffers, causing you to feel less fit and fatigued⁽³⁾. This puts more stress on your body and makes you more prone to illness and disease. And you can be at risk of overheating, which can have terribly serious consequences—including being life-threatening.

For proper hydration, start with juice from a fresh squeezed lemon with lots of water first thing in the morning. It is good for re-hydration after your night’s sleep and also will help your body to detoxify.

And as mentioned earlier, drink enough before, if possible during, and right after your training. It is best to replenish within 30 minutes of finishing your workout—the so-called “recovery window.” I like to eat a big slice of water melon right after my training, it is a great source of water, antioxidants, and easily digested carbohydrates. In the following article “General Guidelines,” you can find more information on this topic.

A Few Thoughts on Summer Nutrition

Many people like to adjust their nutrition and take advantage of everything that is fresh and more available in the summer, like tasty fruits and vegetables. It is berry season—maybe you are lucky enough to be able to pick your own on a berry farm. Eat food that has high water content like melon, citrus fruits, berries, and vegetables.

Diluted fruit juices with 1 part juice and up to 2 parts water can help you to stay hydrated. The juice from sour cherries, for example, has many health benefits and can even support faster strength recovery for runners.

You also can try the many different kinds of unsweetened iced teas. My favorite flavor is mango.

Enjoy what you eat and make it tasty. Add some cool summer nutrition like different kinds of smoothies. Depending on the amount you make, they even can be served as an entire meal. Just add water, berries (like raspberries and blueberries), banana, whey protein, and some ice cubes into a blender. Mix it and enjoy. Or try a variation with mango or pineapple. And for more health benefits, add a teaspoon of ground flaxseeds.

There also are many delicious salad creations with great dressings. You could try a variety of citrus dressings. Other choices of salads include my favorites—fresh cucumber salad with dill and onions or a tomato salad with olives, feta, and basil.

Sashimi and sushi can be delightful lighter dinner fare when well-portioned. And when you prepare your meals, add more vegetables than pasta or potatoes. And how about cold summer soups like water cress and gazpacho?

And for all you BBQ lovers, here are some thoughts on “Healthier Grilling.” I hope you can enjoy many relaxing summer evenings with your family and friends.

Good luck for your summertime fitness!