A 12-week study shows that low-impact yoga and exercise can significantly reduce urinary incontinence episodes in older women, offering a safe, accessible alternative to medications
It’s more likely than not that personal trainers will work with female clients who deal with incontinence issues, which could be an obstacle on their path to the fitness and wellness goals. Recent research supports the belief that solutions are available, and exercise may be one of them.
A recent study led by Stanford Medicine and the University of California, San Francisco, has found that low-impact exercise programs, such as yoga and general stretching, significantly reduce urinary incontinence episodes in older women. The research, published in Annals of Internal Medicine on August 27, provides promising alternatives for women seeking non-pharmacological treatments.
A Underreported & Common Issue
Urinary incontinence affects more than half of middle-aged women and up to 80% of women over 80 and can interfere with daily activities and significantly impact quality of life. The study examined the effects of a 12-week low-impact yoga program and found a 65% reduction in incontinence episodes among participants.
“We were testing the kind of yoga that just about anyone can do, with modifications for different physical abilities,” said Dr. Leslee Subak, chair of obstetrics and gynecology at Stanford Medicine and the study’s senior author. “What I love about it is that it’s safe, inexpensive, doesn’t require a doctor and is accessible wherever you live.”
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The research set out to find cost-effective and accessible solutions for a problem that is often stigmatized and underreported. According to Subak, incontinence is mistakenly viewed as an inevitable part of aging, though treatments are available.
“Incontinence is not only common, but it also interferes with people’s lives,” Subak noted. “It takes away independence. Many women avoid staying with their children or grandchildren due to the fear and embarrassment of an accident.”
Study Parameters
The study involved 240 women between the ages of 45 and 90, all experiencing daily incontinence. Participants were divided into two groups: one practicing 16 hatha yoga poses aimed at strengthening the pelvic floor, and the other group performing general stretching and strengthening exercises.
Both groups attended two 90-minute exercise sessions weekly and were asked to practice independently for at least an hour per week.
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Both the yoga and the control groups experienced significant improvements. Participants in the yoga group reported an average of 2.3 fewer daily incontinence episodes, while those in the general exercise group saw a reduction of 1.9 episodes per day. These results are comparable to the 30% to 70% improvement rates seen with medications for incontinence, according to the researchers.
Subak emphasized the importance of regular activity, which is good news for fitness professionals who work with this population.
“One of the take-home messages from this study is ‘Be active!’ I’m impressed that exercise did so well and that yoga did so well,” Subak added.
The benefits of physical activity, including yoga, extend beyond managing incontinence. As the study’s lead author, Dr. Alison Huang, professor at UCSF, pointed out, being physically active helps reduce the risk of other health issues, such as falls and bone fractures, which can be exacerbated by conditions like incontinence.
The study was funded by the National Institutes of Health, with contributions from researchers at Yale University and San Francisco State University.
The end of 2024 is coming up fast. Have you seen the results you’ve wanted on your fitness journey? If you’ve been exercising but seeing limited results, there’s a chance some of your habits are holding you back. A few simple changes can help you avoid weight cycling, which is when you gain weight right after losing it, and begin promoting healthy habits that you’ll be able to rely on for a lifetime.
Don’t forget that weight doesn’t determine your health. You should always check with your doctor to discuss other aspects of your wellness that you can focus on instead of weight loss.
Here are the top pitfalls you should avoid to help improve your chances of success. They’re not as big of a change as you might think.
1. Stop thinking in the short term
From talking fridges to iPhones, our experts are here to help make the world a little less complicated.
Everything on this list is somewhat of a hard truth, but this is often the hardest to accept (and change). If you approach weight loss with a short-term attitude, you may not make it anywhere except on the yo-yo diet train.
Without a long-term approach to weight loss, you may lose 10 or more pounds in two weeks and then suffer a rebound when you discover that regimen wasn’t working for you. This is all too common when people embark on strict diets such as keto or paleo or fad diets that promise rapid weight loss. In reality, for most people, a well-balanced diet that includes all food groups and even some treats works best in the long run.
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Part of successful, sustainable weight loss — losing the weight and keeping it off for good — is understanding that fad diets, excessive exercise and “detoxes” don’t usually work. They last only as long as your willpower lasts, and I’m willing to bet that’s not more than two weeks to a couple of months.
There are no quick fixes, miracle cures or magic pills when it comes to weight loss, despite what the wellness industry might have you believe: Losing weight requires dedication to a plan that supports long-term healthy habits.
The general recommendation for weight loss is a rate of 1 to 2 pounds per week, although initial weight loss might surpass that for people who are very overweight, and then slow down to the suggested one to 2 pounds per week. Studies have shown this to be an effective way to lose weight without losing too much water or lean tissue — and to avoid a rebound.
From talking fridges to iPhones, our experts are here to help make the world a little less complicated.
2. An all-or-nothing mindset could be harmful
Many people who struggle with a short-term attitude also struggle with an all-or-nothing mindset. I began my health and fitness journey with this mindset. I cut out all processed foods: no bread, no pasta, no milk, no cheese and no individually wrapped snacks. I basically existed on chicken, vegetables and berries.
This was great until it wasn’t, and I ended up on a CVS run for all the chocolate and Goldfish I could hold in two hands. Then, because I’d “ruined” my diet, I would eat as much as I could physically handle, because, “Why not? I already ruined it.”
Then I’d feel bad about the snacks I ate and return to my overly restrictive regimen the next day. This is a destructive cycle to be in, but it’s something I see all the time with personal training clients. An all-or-nothing mindset can keep you in a perpetual cycle of lose-gain-lose, not to mention shame and guilt around food.
This all-or-nothing concept applies to fitness, too: If you’ve been doing the most effective workouts to get in shape in the least amount of time left and right but don’t feel fitter or stronger, you might be doing too much. Toning it down could — counterintuitively — be the answer to improving your fitness (and playing the long game).
3. A stronger support system could do the trick
Supportive friends, family members and significant others are critical to successful weight loss. If I was asked to cite the most common reason for not sticking to a healthy diet from my past personal training clients, I would say stigma.
That’s right. As silly as it sounds, people really do get made fun of for eating healthy, especially in regions where food is an integral part of the culture. Growing up in southern Louisiana near New Orleans, I experienced this very often when I decided I was making changes to my diet.
At family gatherings and social outings, I’d get comments like, “That’s all you’re eating?” or, “You’re really not going to eat any dessert?” or, laden with sarcasm, “Next time we’ll have a salad potluck.”
It’s not fun to be ridiculed or scoffed at, especially for things you care about (like your health!), so it can be very easy to fall into a trap of eating — and drinking — for the sake of your social life. This is why a solid support system is key to long-term weight loss. Without it, the journey can feel lonely and intimidating.
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If you currently feel you lack a support system, try having open conversations with your friends, family and partner about it. You can make it clear that they don’t have to change their eating habits if they don’t want to, but that your health means a lot to you and you’d appreciate it if they didn’t mock or downplay your hard work.
If an IRL support system isn’t working out, turn to online communities that promote both health and body positivity. I really love Flex and Flow on Instagram, Health At Every Size and the Intuitive Eating Community. These communities emphasize health without emphasizing weight, which is helpful because when you focus on health outcomes, you’ll reach your happy weight with ease. Reddit also has a great forum (/r/loseit) where you’ll find lots of real-life stories about weight loss.
4. Exercise doesn’t always conquer all
If you’re at all attuned to the wellness industry, you’ll know this saying: “Abs are made in the kitchen, not the gym.” Even if your goals don’t include a shredded stomach, the adage is still relevant. You just can’t out-exercise a poor diet.
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Exercise should be part of your overall approach to weight loss because it’s proven to aid weight loss (not to mention its long list of other health benefits), but it’s difficult to lose weight from exercise alone. Many people overestimate the number of calories they can burn from their workouts; it’s typically a lot less than you think, and far less than the calories your body burns at rest during the day just maintaining your current physique.
For example, a 154-pound man will burn fewer than 450 calories during an intense, hourlong weight-lifting workout. You can easily cancel that effort out if you don’t pay any attention to your diet. The exact number of calories you burn during exercise depends on many factors, including your current weight, the intensity of the activity, the length of the workout, your age and your body composition.
Plus, focusing on only exercise can lead to a destructive cycle of exercising extra to burn off calories you feel you shouldn’t have eaten. Or you may end up feeling like you need to “earn” your calories through exercise. Either way, taking this approach can lead to a strained relationship with food and exercise, as well as stalled weight loss.
Some people, such as those who have spent years putting on muscle mass, can eat lots of calorie-dense food and not gain weight because muscle burns more calories at rest. Even if you can eat whatever you want and lose or maintain your weight, that doesn’t mean it’s healthy for you.
A diet rich in fruit, vegetables, healthy fats, lean proteins and some whole grains will serve you best in terms of sustainable weight loss and health. Combined with a consistent exercise routine, you’ll experience sustained weight loss and weight maintenance once you reach your goal weight.
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5. Sleep more, lower stress and eat better
Losing weight will be much harder if you’re chronically stressed, sleep-deprived or overworked. This scenario may sound familiar to you:
You wake up motivated and ready to seize the day. You have plans for a post-work interval run and your healthy, prepped dinner is waiting in the fridge for you.
A few hours into the day, your lack of sleep catches up with you. You reach for the afternoon coffee.
By the time work is over, you’re way too drained to go for that run. You decide to skip it.
You’re tired and maybe a little stressed or moody, so you nix the healthy dinner and hit a drive-through instead — because you want comfort food.
This is OK if it happens occasionally (everyone deserves a lazy evening every once in a while), but weight loss will seem impossible if this happens all the time.
The truth is that nutrition and exercise are only two components of a healthy life that can lead to weight loss. While important, too strong of a focus on nutrition and exercise can cause you to overlook other factors that are just as important: sleep and stress management.
6. Supplements can’t do all the heavy lifting
I hate to be the bearer of bad news, but that fat burner supplement in your medicine cabinet isn’t going to do the work for you. Certain supplements may help you reach your weight loss goals, but you have to work to make your supplements work.
For example, incorporating a daily protein shake in the mornings can help you feel fuller throughout the day, which may help keep cravings at bay. Increased protein intake can also help you build muscle, which aids in body recomposition.
Certain weight-loss supplements do have some evidence backing them, but no supplements are proven like the method that no one wants to take: eat fewer calories than you burn.
FRIDAY, Nov. 1, 2024 (HealthDay News) — Maintaining or initiating regular physical activity (PA) after a dementia diagnosis is associated with a reduced risk for all-cause mortality, according to a study published online Oct. 29 in the British Journal of Sports Medicine.
Kye-Yeung Park, from the Hanyang University College of Medicine in Seoul, South Korea, and colleagues examined associations between the amount and changes in regular PA before and after a diagnosis of dementia and all-cause mortality risk and whether these associations differ by PA intensity (light, moderate, or vigorous). The analysis included data from 60,252 individuals newly diagnosed with dementia (2010 to 2016) followed for a mean 3.7 years.
The researchers found that higher PA levels after dementia diagnosis were associated with a dose-dependent decrease in mortality risk. Compared with remaining inactive, maintaining regular PA was associated with the lowest mortality risk (hazard ratio [HR], 0.71). This decrease in mortality risk with sustained engagement in PA persisted across intensities (light: HR, 0.70; moderate: HR, 0.74; and vigorous PA: HR, 0.70). There was a 20 percent reduction in mortality risk with initiating any PA intensity after a dementia diagnosis. Associations remained in Alzheimer disease.
“Lifestyle modifications promoting PA might offer survival benefits for individuals with dementia,” the authors write.
Everyone loves a shortcut. Any time you see a patch of grass at the corner of a pavement, it’s bound to be trampled down by people looking to shave milliseconds off their journey. The problem is, in the fitness world, you’ll be hard-pressed to find many shortcuts that actually work.
Rucking – wearing a weighted backpack while you walk – could be one of the few exceptions. So I decided to give it a go, committing to walking 10,000 steps a day for a week with a weight on my back.
The practice originates in the military, but it’s attracted the masses in recent years thanks to its accessibility and appealing effort-to-reward ratio. Simply add weight to your walks to amplify the intensity and challenge your heart, lungs, legs, core and more. This can boost your fitness and build strength throughout your body – not a bad return from a pop to the shops, or any similar short jaunt.
With the practice promising to make fulfilling my fitness fix feel like a walk in the park, I slid on my rucksack and set off – here are five things I learned.
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Rucking is accessible
When you start a new type of exercise, there’s usually a period where you don’t have a clue what you’re doing. Case in point: my early teenage gym sessions consisted of a few ropey bicep curls and 20 minutes on the treadmill. But with rucking, I found this wasn’t the case.
Without wanting to brag, I’ve walked with a backpack before, and rucking was just that with a little extra weight. Once I’d acknowledged the slight shift in my centre of gravity, I was good to go.
Another important point to note is that, while I used a purpose-built backpack and weight plates from rucking specialists GoRuck, you don’t actually need any specialist equipment to get started.
“If you want to start with a lighter weight, I suggest just throwing a few household items in a bag,” says Nichele Cihlar, GoRuck’s director of training. “My water bottle is really large and heavy, so you can put something like that in your ruck then work your way up.”
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It’s versatile
I walk quite a lot anyway, so rather than trying to fit in regular long rucks I decided to wear the weighted backpack as I went about my day-to-day life. And for me, this worked a treat.
“I always recommend keeping [your weighted bag] by the front door,” Cihlar says. “If you have to go and find the rucksack then find the weight plate for it, you might not bother to bring it. But if it’s right by the door, it’s easy to put it on.”
I wore mine for dog walks, a day in the office, a pop into town; when I was out of the house, the rucksack rarely left my shoulders. And I found I was able to rack up 10,000 steps per day fairly easily by taking this approach.
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But rucking can also be a handy tool if you struggle to fit movement into your day. By increasing the intensity of walking as an activity, it means you can draw more benefits from a shorter stroll.
“I have a couple of French bulldogs and I live in Florida where it’s very hot, so they can’t go super long distances,” says Cihlar. “It’s shorter walks for us, so by adding a ruck to that I can get more out of it.”
It can help you build strength
Wearing a weighted rucksack makes walking harder, and very few people would choose to make something harder unless it offered a whole bunch of benefits. Fortunately, rucking delivers on this front.
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“Walking is largely a lower body activity, so the quadriceps, hamstrings and gastrocnemius [muscles in the thigh and calf] are going to have to accommodate that heavier load,” Dr Elroy Aguiar, assistant professor of exercise science at The University of Alabama, tells me.
“As a result, you would get small improvements [in strength and bone density], especially if you do it over a prolonged period of time. You would also get some improvement in muscle mass from rucking, although it probably won’t be equivalent to what you could achieve from strength training.”
“Rucking also helps develop your core strength and the postural muscles in your upper back, because you’re holding that weight on your shoulders,” Cihlar adds.
After walking particularly hilly routes with a heavier weight, I found my thighs felt the familiar dull ache more commonly associated with a challenging leg day. And my upper traps (the muscles you can see around the base of your neck) were hit particularly hard when I was carrying higher loads.
It’s not just a workout for your muscles
Strength is only one benefit to come from rucking. You’ll also call your heart and lungs into action for cardio perks, and you’ll work them harder than if you simply went for an unweighted walk.
“You’re carrying extra weight, and that extra weight costs you energy to move,” explains Dr Aguiar. “It’s going to increase your oxygen consumption and heart rate if you’re trying to maintain the same speed of walking.”
To test this, I did three 1.2km loops of my undulating local park – once without the rucksack, once carrying 15kg and once with 35kg, all at the same pace. According to my Apple Watch, he first lap burned an estimated 102 active calories and my heart rate averaged 88bpm, while the final lap used 119 active calories and my heart rate averaged 108bpm.
Perhaps this isn’t the most mind-blowing difference, but I found these incremental jumps added up over the course of the week. Regularly raising your heart rate can help improve cardiovascular fitness too, and by hiking it higher you’re more likely to experience this benefit.
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As someone who exercises regularly, this final fitness perk wasn’t as much of a pull factor for me. But I did draw another less expected benefit from my rucking ventures: I enjoyed the challenge.
“The benefits are as much physical as they are mental,” says Cihlar. “I always say that you never leave the house to go for a ruck and come back in a bad mood. It’s a great way to clear your mind or get outside and get some fresh air, all while getting a good bang for your buck as far as time and fitness is concerned.”
The weight you use is important
Though it’s last on this list, this might be the most important point of all: rucking with a light backpack feels very different to rucking with a heavy one. That’s why it’s very important to find a weight that works for you, and vary it depending on the type of activity you’re doing.
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Cihlar says she usually prescribes 30lb for men and 20lb for women (roughly 15kg and 10kg in UK plates) as baseline weights, but highlights how these loads “aren’t a starting point for everyone”.
“You can literally start with any backpack and put some weight in it, which can be your water bottle, some magazines, your snacks, whatever,” she says.
This can be progressed over time as your strength and fitness builds. Then, when you can happily carry more than 5kg, it might be worth investing in some rucking plates and a purpose-built backpack for comfort.
“We also make our Rucker 4.0 rucksacks so they can hold two plates, so if you’re a heavy hitter and you’re training for a hike you can bump it up to 60lb or 75lb,” Cihlar adds.
These heavier weights are more likely to trigger strength adaptations, but you don’t want to lift a load that’s too heavy for you and risk inury.
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“As long as you’re [using a weight that means you’re] still able to walk and talk, as we say, then you’re OK,” Cihlar summises. “Your heart rate will be up, but you should still be able to carry on a conversation and breathe well.”
Personally, as someone who lifts weights regularly and weighs roughly 95kg, I found varying my rucksack between 15kg and 35kg worked for me, using the lighter load on longer walks or incidental steps, and the heavier total when I wanted to really push myself.
These heavier sessions were far more taxing on my muscles, and I could feel the impacts in my thighs and traps afterwards. Whereas, by the end of the week, carrying 15kg had become like a default setting and I felt comfortable carting it around.
Will I continue rucking?
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Even though my rucking challenge is over, my backpack and plates remain by the front door. I no longer use them as religiously as I did during my seven-day streak – I don’t feel the need to pick them up for every walk, or hit a quota like 10,000 weighted steps a day – but I still reach for them when taking my dog to the park, among other ventures.
Why? Because I like being able to elevate a short walk into an impromptu workout, especially on busy days when it would otherwise be tricky to fit one in. I really enjoy the challenge too, and find I invariably feel better after a quick weighted walk.
For these reasons and more, I’m hoping that rucking is a fitness trend that sticks around.
Read more: I tried the viral 75 soft fitness challenge – here’s what I learnt