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Exercise is Medicine initiative stresses your level of physical activity as a vital sign | CNN

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Exercise is Medicine initiative stresses your level of physical activity as a vital sign | CNN

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Has your doctor quizzed you about your level of physical activity? If so, you can thank Exercise is Medicine, a global health initiative managed by the American College of Sports Medicine.

Created in 2007, the initiative encourages health care providers to assess patients’ physical activity during visits, plus include regular exercise when designing care plans. The amount and types of exercise that medical professionals recommend should be based on each person’s current health and ability.

The philosophy behind the initiative is simple: Physical activity promotes optimal health. Regular movement also helps to prevent and even treat various medical conditions. Overwhelming evidence links physical inactivity to poor health and high health care costs, according to a 2020 article in the American Journal of Lifestyle Medicine. The study concluded that health care and fitness programs should be merged.

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In addition, people who were moderately to vigorously active for at least 150 minutes per week had nearly half the health care utilization compared with those who were sedentary, according to a study done by Salt Lake City-based health care system Intermountain Health that was presented at the 2019 annual meeting of the American College of Sports Medicine and accepted for publication.

The study also found the active people had half the total cost of health care compared with the sedentary folks, defined as those who engaged in one minute per week of moderate to vigorous activity, said Dr. Elizabeth Joy, chief medical officer at health technology company Lore Health and chair of the EIM governance board.

Unfortunately, while EIM has expanded and achieved many successes, only 22.9% of adult women and 17.8% of adult men were advised by health care professionals to increase their physical activity levels, according to the 2022 US National Health Interview Survey, Joy noted.

With the average primary care visit lasting less than 20 minutes and with health care providers needing to cover many issues, it’s not surprising that so few are addressing physical activity, Joy said.

“It takes very little time to write a prescription,” Joy said. “It takes a whole lot more time to do evidence-based behavior-change counseling.”

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Despite EIM’s lack of progress in the doctor’s office, it has created numerous programs, initiatives and exercise prescriptions to help people outside of it.

EIM now includes Exercise is Medicine on Campus, for example, a program that helps colleges and universities promote and assess physical activity among students, faculty and staff. To date, more than 200 US schools and over two dozen international education institutions participate.

The EIM-OC program at Grand Valley State University in Grand Rapids, Michigan, has achieved gold status, said Amy Campbell, associate director of recreation and wellness, which means the university routinely assesses and promotes physical activity on campus. The university offers perks such as free personal training via its exercise science majors, plus a wealth of group fitness classes and wellness coaching.

While some of these offerings were in place before GVSU signed on with EIM-OC, Campbell said the university is working more collaboratively to stress the importance of physical activity.

“The CARE team (which connects distressed students to support services) now always asks students, ‘What do you do outside of class? Are you staying physically active? What are activities you enjoy?’” Campbell said. “If they see an opportunity to work with our department, they’ll reach out. For example, if someone can’t afford to participate in an intramural program, we’ll make sure they have access.”

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There’s also Moving Through Cancer, the first disease-specific initiative within EIM. The initiative assists with exercise and rehabilitation programming for those living with cancer and beyond. Most people who are physically active during cancer treatment have less severe side effects, feel better more quickly after treatment and, in some cases, have a lowered risk of their cancer returning, research has shown.

EIM also created the Rx for Health Series, which provides exercise prescriptions for people with a wide variety of common chronic conditions, such as Alzheimer’s, depression and anxiety, osteoarthritis, and heart failure.

“If you’ve had a heart attack, you’re at far greater risk of having another one if you spend most of your time on the couch versus going for a walk,” Joy said. “The couch is more dangerous than your walking shoes.”

While EIM will continue to educate health care providers and students in health care fields about the importance of assessing patients’ activity levels and creating physical activity prescriptions, it’s also looking at other options.

“People don’t respond well to being told to do something,” Joy said. “Rather, people are more likely to engage in and sustain healthy behavior changes when done within their community. If someone’s family, neighborhood, faith-based community or even work environment is supportive of regular physical activity, they’re likely to be more active.”

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Absolutely, said Gerren Liles, a certified personal trainer and owner of Gerren Liles Vision Fitness in New York. Various New York City companies have brought in Liles to teach fitness classes for their employees, and he has seen the benefits.

“It’s always good to unite people into working out,” he said. “That can inspire people to take charge of their fitness. It would be great if companies would invest in fitness, if schools would create programs and events for students and even parents, and if media and movies were all promoting physical activity.”

“Healthy behaviors are contagious,” Joy said. “We also have some personal responsibility around physical activity — to really think about how we influence the people around us.”

So the next time you head out for a walk, Joy said, invite a friend or neighbor along.

Melanie Radzicki McManus is a freelance writer who specializes in hiking, travel and fitness.

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Fitness

A 3-Step Plan to Give Your Diet, Fitness Routine and Mindset a Reset for Spring

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A 3-Step Plan to Give Your Diet, Fitness Routine and Mindset a Reset for Spring

To help you do this, we’ve tapped our Start TODAY experts for simple tips to lighten up meals, move in ways that boost metabolism and and refocus our mindset to get motivated to keep working toward your goals. Apply their strategies and finish the month feeling lighter, more energized and motivated to move forward. Here’s the plan to make it happen:

>>Download the 31-day calendar here

31-Day HIIT & Walking Challenge

This month’s workout plan is focused on short workouts that pack a punch. “HIIT workouts give you a bigger bang for your workout buck! They provide a more efficient workout because you’re alternating the pace and intensity rather than sticking to a steady, moderate pace,” says Mansour. “Changing things up with HIIT prevents boredom and keeps your muscles guessing. This is how we can get the body to change — whether that change is speeding up your metabolism, burning more calories, building muscle, losing weight, or just improving overall health — keeping your body guessing is the magic ticket to seeing results!”

Active recovery days include stretching to improve flexibility and walking for a cardiovascular workout that aids muscle recovery. When weather permits, Mansour encourages people to get outside on walking days. “Walking outdoors isn’t just a workout, it’s a chance to breathe in fresh air and get out of the house to change your environment,” she says. “Each time you go outside on a walk, even if you go on the same path, you’ll see or feel something different. Maybe it’s a change in weather, plants or flowers, people or things. Prioritizing taking your walk outside can hugely benefit your mental health. Getting out of your regular environment and into nature can be a form of meditation, too.”

Get the full 31-day workout plan with unique workouts sent to you daily — plus, walking podcasts, healthy spring recipes and mindfulness tools — in the Start TODAY app!

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Start TODAY Spring Asparagus Pasta recipe
Lighten up comfort food favorites by adding seasonal ingredients, like in this Spring Asparagus Pasta.

3 Simple Spring Diet Tips

In addition to mixing up your workout routine, use spring as an opportunity to start lightening up your meals by packing them with seasonal ingredients. Start TODAY dietitian Natalie Rizzo shares her top tips:

  1. Incorporate more seasonal foods. After a long winter of eating the same foods, your palate is ready for a change! Aim to add at least one spring fruit or vegetable to your meals each day, like asparagus, peas, spinach, radishes, citrus or strawberries. This Spring Asparagus Pasta is a simple weeknight dinner that feels both light and comforting. Seasonal produce is fresher, more flavorful, and an easy way to naturally boost vitamins and fiber. Plus, seasonal produce is more affordable than other items in the produce section.
  2. Use fresh herbs to brighten up your dishes. Fresh herbs like basil, cilantro, parsley, mint, or dill can instantly upgrade simple meals without extra salt or heavy sauces. Sprinkle them on salads, roasted veggies, eggs, soups, or grain bowls for a burst of spring flavor. Cilantro is the perfect finish to this Mexican Stuffed Sweet Potato, while herbs are blended into cottage cheese in this Herby Cottage Cheese Toast with Tomato recipe for a pop of fresh flavor.
  3. Shift from heavy comfort meals to balanced plates. As the weather warms up, it’s time to move away from heavy comfort foods and embrace lightened up spring dishes. Build plates with a mix of lean protein, whole grains or starchy veggies, and plenty of colorful produce. Think roasted veggie grain bowls, hearty salads like this BBQ Chicken Quinoa Salad, or simple stir-fries instead of creamy casseroles or heavy stews.
Start TODAY Mexican Stuffed Sweet Potato
A sprinkle of fresh cilantro is the perfect finish to this Mexican Stuffed Sweet Potato.

Spring Clean Your Mindset with This Mental Health Exercise

Yes, we are working to propel ourselves forward toward our health goals, but an important part of that process is slowing down and reflecting.

Getting permission not to rush in a world that feels like it’s moving faster than we can keep up is a reminder that most of us need.

Yasmine Cheyenne, start TODAY mindfulness expert

“Getting permission not to rush in a world that feels like it’s moving faster than we can keep up is a reminder that most of us need, but how often would we admit that?” says Cheyenne. “ When the to-do list feels long, and we’re trying to get everything done, we often say the opposite, disregarding how we feel, and push ourselves. Yes, we all have deadlines and things that need to be done. But we also need the reminder to take care while handling our responsibilities.”

This can be easier said than done. So Cheyenne offers up a simple exercise to help: Write down the words you need to hear each day to make yourself a priority and work toward your goals. Put them somewhere you see often, like your fridge or bathroom mirror, and recite them out loud daily.

“This is a perfect example of a reminder that seems small, but can come at the perfect time and help us care for ourselves,” she explains. “One of my favorite examples is: Take it slow and don’t rush, your nervous system deserves peace.”

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“When you tell yourself the thing you’ve been needing to hear, it allows you to admit the quiet rumbling within you and take the steps you need. It might be admitting ‘I’m tired and will give myself an early night this week.’ Or you’re saying ‘I’m so proud of the way I’ve committed to moving my body everyday.’ Whether you’re cheering yourself on or reminding yourself of what you need, we don’t always slow down enough to hear what we need from ourselves, and this practice is a great way to start.”

Talking out loud to yourself may feel strange at first, but Cheyenne says over time it will help shift your mindset and translate those words into action. “When we hear ourselves recite these words, it’s like we’re planting positive seeds within us. The more we say what we need, the more we remember it, and we’re more likely to follow through and care for ourselves,” she says. “Our actions really start with the words we say to ourselves. Reading them out loud helps us rewire the way we talk to ourselves and that inner shift is exactly what opens the door to transformation.”

Join our live “Spring Reset Workshop” on March 22 to get one-on-one coaching from Yasmine Cheyenne and connect with other Start TODAY members. Sign up here!

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Exercise scientist says ‘eating more’ is key to losing weight in perimenopause – here’s why

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Exercise scientist says ‘eating more’ is key to losing weight in perimenopause – here’s why

If you’ve ever wanted to lose weight, you’ve probably heard the phrase ‘calories in versus calories out’. While it’s true to a degree, losing weight in menopause isn’t about eating less, but rather eating differently.

Speaking to fitness coach Loretta Hogg, Dr Stacy Sims says: “One of the first things that women often do, because we grew up in an era of calories in, calories out, less calories means fat loss. That is not true because if you are not eating enough, your body holds on to fat.”

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Building the No Neck Army: The Army’s Holistic Health and Fitness Program – Modern War Institute

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Building the No Neck Army: The Army’s Holistic Health and Fitness Program – Modern War Institute

Editor’s note: This article is the seventh in an eight-part series led by retired General James Mingus, the thirty-ninth vice chief of staff of the Army, on transforming the Army to meet the challenges of tomorrow’s battlefield. You can read other articles in the series here.


The battlefield in America’s next war will offer no sanctuary. The war won’t be fought from forward operating bases equipped with elaborate gyms, contractor-provided dining facilities, or coffee shops. The battlefield will be austere, harsh, and unrelentingly violent, with victory only possible by combining physical strength, endurance, and a will to prepare.

The Army’s Holistic Health and Fitness (H2F) program is the bedrock upon which this preparation begins. Winning America’s next war requires an Army that can get to the fight, win the fight, and get home from the fight—a mission profile that demands not just fit soldiers built for endurance, but warrior athletes built for endurance and able to leverage strength, speed, and power, and grounded in sound sleep and nutrition.

Culture Shift Begins with Mindset Shift

For the last several decades, the Army took pride in fielding formations rooted in a physical fitness culture relying heavily on push-ups, sit-ups, and miles of running and ruck marching. Physical training began predictably after saluting the flag at 0630 and ended promptly when the basic exercises, calisthenics, and formation run were complete. It was one-dimensional, unimaginative, boring, and, ironically, lazy. Army fitness during this period was solely focused on physical endurance.

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In the early 2000s, however, Army fitness began to change, led by special operations units like the 75th Ranger Regiment, which began experimenting with trending fitness regimens like Gym Jones, CrossFit, and Mountain Athlete. By combining emerging principles from several of these programs, special operations units began designing their own programs, such as the Ranger Athlete Warrior program. The rest of the active Army quickly started to model these programs, and the first H2F pilot kicked off in 2018.

Advances in exercise science and twenty years of war helped reframe the Army’s fitness mindset to encompass mental, physical, nutritional, and sleep dimensions. This mindset shift forms the basis of the H2F culture, changing how we train and care for soldiers. The focus is now on building strength and resilience like professional athletes—or more fittingly, warrior athletes. Where mission endurance was the goal before, tactical athleticism is now the goal, with an emphasis on strength, speed, power, and agility.

You Can’t Fake Results

A key part of any fitness program is the ability to measure its effectiveness, and in only a few short years, the return on investment for the H2F program has been profound. Currently sixty-six brigades have an H2F performance team, which consists of twenty-two professionals: a program director, dietitian, physical therapist, and occupational therapist; seven strength and conditioning coaches; four athletic trainers; one cognitive performance specialist; and six military personnel. By 2029, the program will expand to cover the entire active Army, as well as four states of Army National Guard and two Army Reserve commands.

According to analysis from the US Army Research Institute of Environmental Medicine, if H2F had been implemented across the entire Army, over a five-year period it would have added 1,080 deployable soldiers to the fighting force. If that’s not compelling enough, also consider these complementary H2F data points compiled by the Center for Initial Military Training Research and Analysis team after analyzing data from 2019 to 2023:

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  • 61 percent decrease in musculoskeletal injury referrals
  • 44 percent decrease in behavioral health profiles
  • 79 percent decrease in substance abuse cases
  • 22 percent decrease in fitness test failures
  • 33 percent increase in expert rifle marksmanship qualification

Expanding the Tools

As part of continuous transformation, the Army is looking for unique ways to leverage technology to enhance the H2F program. Several units are experimenting with wearables like rings and watches that measure sleep efficiency, heart rate variability, and blood oxygen saturation—providing rich data to inform approaches to physical, nutritional, and sleep aspects of fitness. Today, entire Army divisions are turning physiological data into leader decision-making information. A company commander who knows his or her soldiers’ sleep scores, for example, is equipped with data to combine with other information to help select the most well-rested platoon to lead a dangerous mission. Individual soldiers will also learn the correlations that exist between their fueling, recovery, and performance habits, which will help in multiple facets of their personal lives.

The Army is also continually working to improve facilities and services that support H2F. Most units now have access to twenty-four-hour functional fitness gyms on post and many units utilize fitness containers—effectively, gyms in a box. Plans are also in place to build additional facilities to ensure soldiers at every post have adequate equipment to train. To improve nutrition, the Army is experimenting with campus-style dining facilities that will supplement, and in some cases replace, traditional dining facilities—affording soldiers a myriad of quick, 24/7 accessible healthy food options. A no excuse not to work out and no excuse not to eat healthy mentality now abounds across the Army.

Soldiering has no offseason and no time-outs, and wars wait on no one. When America calls, the Army responds. Unlike professional athletes who can vary training volume, intensity, and specific exercises over planned cycles or offseasons, a practice known as performance periodization, soldiers have no such luxury. Tactical athleticism via compound periodization is the goal for soldiers—ensuring peak performance at all times by developing key physical attributes (e.g., strength, endurance, and power) year-round to maximize efficiency, prevent burnout, and improve overall warfighting readiness. The H2F tools highlighted above aid in measuring and maximizing this readiness.

What’s Next?

Imagine two Army squads ascending Colorado’s Pikes Peak carrying fifty-pound fighting loads. Squad A trained to get to the top through push-ups, sit-ups, and miles of running. The soldiers of Squad B are warrior athletes who took the H2F approach. When Squad A’s soldiers finally struggle to the top, they’re just happy to be mission complete and they flop on the ground. The soldiers of Squad B assault the mountain, and when they get to the top, they still have enough juice to rip the arms off their adversaries and steamroll into the next mission. In their post-hike squad photo, they’re all standing tall—straight backs, satisfied smiles, and trap muscles extending inches above their shoulders so they almost appear to have no necks. For them the mission is just getting started, and their smirks seem to say, “Is that it? What’s next?”

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Welcome to the No Neck Army.

Retired General James Mingus served as the thirty-ninth vice chief of staff of the Army.

Colonel Graham White is an infantry officer and the executive officer to the vice chief of staff of the Army.

The views expressed are those of the authors and do not reflect the official position of the United States Military Academy, Department of the Army, or Department of Defense.

Image credit: KCpl. GeonWoo Park, US Army

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