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Physioball
By MAJ Patrick Schachle, SG 17C
   

The APFRI “Physioball” instruction was conducted at Gruber Gym September 29 with two students from CGSC. It was very informational from an overall exercise perspective. The instructor taught us how to effectively use a pilates ball, which is a stability ball from which you can perform a multitude of exercises for the entire body.

 

APFRI instructor, Tracy McClung, provided a handout that showed the proper size pilates ball for an individual based on their height. She also demonstrated the proper way to find a neutral position on the pilates ball by bouncing up and down a few times and gradually coming to a stop with the least amount of tension and stress on your

Army Physical Fitness Research Institute
   
 

muscles and joints. This is called the “neutral” position. The entire exercise regimen is focused on an individual’s “core” strength.

 

Once we were able to find our neutral position on the pilates ball, the instructor told us the proper technique to increase the difficulty of the exercises by reducing the width of our feet on the floor. From the neutral position the instructor showed us several exercises to include the alternating leg raise and the movement to a bridge position. The bridge position was probably the most universal position from which to conduct numerous abdominal exercises and the instructor placed great emphasis on the fact that these exercises reduce the strain on the back and neck, and focus the exercise on the “core” of the individual.

 

We also used 15- pound dumbbells to perform several upper body exercises to include the overhead press, unilateral and bilateral tricep extension and the chest press. All of these exercises were performed while on the pilates ball, which constantly required muscle contraction in the “core” area to maintain balance, regardless of whether the exercise was performed in the sitting or bridge position.

 

All of these exercises were performed for approximately three sets of between eight to twelve repetitions.

 

I would highly recommend this class to any other students who just want to expand their knowledge of what the pilates ball exercises can do to improve their “core” strength. It also increases an individual’s overall flexibility, which is a key component of physical fitness, along with cardiovascular fitness and muscular strength. After 30 minutes of exercise using the pilates ball, I could definitely feel the positive benefits on my core as well as my upper and lower body. Mrs. McClung concluded the exercise routine by informing us that the APFRI instructors were available to conduct training during scheduled class times for an entire CGSC class.

 

MAJ Patrick Schachle

CGSC SG 17C

     

 
     
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Restorative Sleep
by MAJ John McLaughlin, SG 16C
   

On May 19, Dr. Gregory Ellermann gave a presentation to CGSC students on restorative sleep in the Lewis and Clark Center. Dr. Ellermann is a clinical psychologist employed by the Army Physical Fitness Research Institute. The brief focused on the causes of poor sleep and strategies designed to mitigate those deficiencies.

 

Dr. Ellermann initiated the lecture with a brief discussion of how the homeostatic sleep drive and the circadian rhythms regulate an individual’s sleep. He then proceeded to personalize the class for each of the attendees. Rather than covering the myriad of causes of poor sleep, he solicited

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the audience to describe what causes poor sleep for them as individuals. The two primary responses included difficulties falling asleep due to anxiety over past or future tasks and disruptions in sleep caused by various background noises. Based on those responses he then tailored the remainder of the brief to those specific issues.

 

As he transitioned the lecture to mitigating strategies, Dr. Ellermann highlighted that disruptive sleep patterns are learned behaviors. Consequently, these patterns can be overcome and replaced with positive behaviors. To address the issue of background noises, Dr. Ellermann recommended using a white noise source such as a fan. In addition to cooling the room one or two degrees, it also provides a consistent noise that will not wake you up yet will drown out other noises. Another typical cause of poor sleep is the use of caffeine. Caffeine remains in the brain for up to twelve hours. In lieu of turning to caffeine to stave off sleep in the afternoon or evening hours, he recommends cold non-caffeinated drinks, a light snack, or exercise. Finally, he discussed the benefit of psychologically accepting disturbed sleep or its causes to mitigate the impacts of frustration on the quality and quantity of sleep.

 

The next strategy addressed was preparing for sleep. In addition to the normal response of following a routine which includes exercise, Dr. Ellermann talked to the importance of the window of time right before you go to bed. The key during this time period is to wind down and turn off your mind. For those of us who have difficulty forgetting about the myriad of tasks we need to accomplish the following day or obsess on the events of that day, he recommends a “notebook by the bedside” technique. This technique has the individual write down tomorrow’s tasks or events of that day. Besides generating a to-do list or lessons learned notes, it clears your mind and allows you to wind down before sleep. Although this technique, or other techniques designed to prepare for sleep may cut into the time allotted for sleep, the net result is a higher quality of sleep. The final technique discussed was diaphragmatic breathing. This technique involves slow and deep breaths in a rhythmic pattern. The breaths include a four count inhale and a four count exhale. Once again the intent is to relax the body and mind to allow for the onset of quality sleep.

 

Personally, the breathing technique, when combined with a rhythmic chant such as a prayer, was the most effective technique I gleaned from this lecture. Additionally, obsessing about poor sleep or the causes of poor sleep is counterproductive. To truly fix the problem, the television and other distractions must be eliminated or psychologically accepted to improve the quality of sleep and my alertness and effectiveness when awake.

 

MAJ John McLaughlin

CGSC SG 16C

     

 
     
 
Metabolic Syndrome
by MAJ Marvin Atchison, SG 16A
   

On May 7, 2010, Mrs. Christy McKnight provided a lecture on Metabolic Syndrome. Mrs. Knight is a Registered Nurse working for the Army Physical Fitness Research Institute (APFRI). She focused on several objectives.

  • To promote understanding of Metabolic Syndrome as defined by the National Cholesterol Education Program (NCEP), Adult Treatment Panel III (ATP III), at the National Institute of Health (NIH)
  • To discuss the prevalence and morbidity/morality associated with Metabolic Syndrome
  • To increase awareness of the cause and signs and symptoms of Metabolic Syndrome
  • To motivate individuals to take action toward the goals of treatment for Metabolic Syndrome


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During the lecture, Mrs. McKnight explains factors linked to the Metabolic Syndrome. Metabolic Syndrome is comprised of a group of risk factors linked to being overweight and obese that increases your chance for heart disease and other health problems, such as diabetes and stroke. Metabolic Syndrome is diagnosed when you have three of the following: Large waistline (40 inch or greater for men and 35 inch or greater for women), increased triglycerides (greater than 150mg/dl), high blood pressure (greater than 130/85 or on Rx to control blood pressure), and elevated fasting blood sugar (greater than 100mg/dl). The more risk factors you have increase your chance for developing heart disease, diabetes or stroke. Mrs. McKnight also stated that statistics show that 47 million adults in the United States have Metabolic Syndrome. Metabolic Syndrome may overtake smoking as the leading risk factor for heart disease. As smoking rates continue to decrease, metabolic syndrome rates are increasing. Mexican Americans are the highest ethnic group that is diagnosed with Metabolic Syndrome with African Americans being the lowest.

 

Risk factors, like being overweight/obese, lack of physical activity, and insulin resistance can be controlled, but aging and genetics can not be controlled. Metabolic Syndrome can be treated by a healthy lifestyle change (weight loss, increased physical activity, healthy diet, and quitting smoking). If lifestyle changes do not help, prescription drugs can treat high blood pressure, high triglycerides, and high blood sugar.

 

The lecture informed me about the different lifestyle changes that can help reduce those risk factors associated with Metabolic Syndrome, like a healthy eating plan, physical activity durations, and quitting tobacco use. Also, when making lifestyle changes, make realistic goals and have patience. This lecture informed me about the many health risks that can cause heart disease. Mrs. Knight’s lecture personally helps me realize the need to keep my lifestyle in check. Some things in life we can’t control, but the things we can control will help improve our health.

 

MAJ Marvin L. Atchinson

Section 16A

     

 
     
 
Nutrition Supplemental a Boon and a Bain
by LCDR Arrvid Carlson, SG 6B
   

On May 3 Major Trisha B. Stravinoha MS, RD, CSSD, CSCS provided an informal lecture on the benefits and potential pitfalls of nutritional and so called performance enhancement supplemental products. Major Stravinoha is a performance runner and has served on numerous Army teams over the years. She has participated in the sports medicine process as an athlete and as a care giver, which has provided her with an indispensable appreciation of the holistic approach to care. The lecture tackled the $24 Billion supplemental industry facts and myths as well as reviewed potential benefits and the numerous dangers and pitfalls associated with misuse or ignorance.

Major Stravinoha reviewed necessary components of any fitness plan: diet, exercise, hydration, stress control and rest. Rest was particularly highlighted as important because the average individual requires 7-9 hours of sleep a day. Fish oil was highlighted as a frequently used beneficial supplement, however, users need to be aware of the EPA and DHA levels in the oil and adjust dosage as required.


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Reviewing the data, 53% of current Army service members use some form of nutritional supplemental -predominantly multi-vitamins. Major Stravinoha revealed that in the supplemental business “proprietary blend” on an ingredient label is industry code for “contamination”. Since ingredients are not closely regulated, many common ingredients have multiple names, part marketing ploy partly to conceal the actual ingredients. Many ingredients are also blood thinners and can additionally reduce or enhance the effectiveness of prescription drugs often leading to unpredictable reactions. If that were not bad enough many natural ingredients either contain or are metabolized as steroids. This finding also applies to many products that claim to be steroid free. Manufactures are also not required to list all ingredients and many “natural” ingredients are complex compounds that allow the manufacture to hide the actual ingredient list. Natural does not equal safe, and steroid free may be an inaccurate claim. The best advice was to be skeptical of all claims and be an informed consumer. 
     

 
     
 
Aerobic Power: A Key to PFT Success
by MAJ Michael Ebner, SG 23A
   
On April 13, E. Susanne Koch Dale provided an informational lecture on increasing aerobic power. Ms. Dale is an exercise physiologist working in the Army Physical Fitness Research Institute who helps both military personnel and civilians tackle personal physical fitness issues. The lecture covered aerobic power and the importance of increasing it, anaerobic threshold and tips for strength training and running. By increasing an understanding of aerobic power, military members gain further knowledge that could result in improved physical fitness test scores.

The aerobic power triad consists of VO2 Max, movement economy and anaerobic/lactate (AT) threshold.  The primary means of measuring an athlete’s aerobic power is to analyze the VO2 Max score.  VO2 max is the
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E. Susanne Dale, APFRI exercise physiologist, presents a noon-time lecture on aerobic power April 13.
  maximum capacity of oxygen the body can bring in during maximum effort.  While genetics determines a significant portion of VO2 max, the only way to improve VO2 max is through physical fitness.  The next part of aerobic power is movement economy.  Here, those who are unfit are more likely to gasp for air simply because their bodies are not used to using the muscle groups required to exercise.  That leads to the third part of aerobic power, the AT threshold.  The AT threshold is the point when the body producesmore lactic acid than the blood
can handle, forcing the body to stop exercising.  Untrained individuals’ AT typically corresponds to 40-50% of the maximum heart rate (MHR); however, physically fit individuals should reach AT around 75-88% MHR.  As a side note, Ms. Dale mentioned that Lance Armstrong operates at 92% MHR, signaling his high AT threshold.  While most of us do not have Lance Armstrong’s genetics, we all possess the ability to increase our aerobic power through proper physical training. 

To increase our VO2 max, movement economy and AT threshold, Ms. Dale recommended a combination of interval training, long slow-distance training and high-intensity, continuous training.  One example on interval training for running is to do a set of 4 x 400 meter runs.  Each run should be moderately fast, say 1:45, and the relief time should equal the time spent exercising, in this case about 2:00.  As you get in better shape, consider adding more runs, increasing the pace and shortening the relief period.  Long, slow-distance training is useful for burning off fat rather than just the carbohydrates.  When working over 20 minutes, the body starts burning more fat than carbohydrates, ultimately helping shed those tough-to-lose, excess pounds.  Finally, high-intensity, continuous exercise helps aerobic power.  One example is the physical fitness test (PFT).  Combining strength training and aerobic activity in a short, but highly intense period will help improve the AT threshold and ultimately increase VO2 max.  When seeking to improve your aerobic power, it is important to include strength training as well.  Strength training increases joint integrity and muscle mass while improving movement economy.  The human body does not instantly change, so if you are looking to improve your PFT, do not start the week before. Adaption for the body takes 6-8 weeks.

If you are like me, when I prepare for the PFT test, I primarily focus on running longer distances and practice push-ups and sit-ups.  With greater knowledge of aerobic power, I now know better techniques for aerobic improvement.  By varying aerobic and strength training regimens, individuals can improve the three areas of the aerobic power triad, leading to improved PFT scores.
     

 
     
 
Anger Management  by MAJ Thomas Kochenauer (SG 16D)
   
The Army Physical Fitness Research Institute (APFRI) conducts an executive resiliency lecture series on various topics for the military officers attending the resident course at Fort Leavenworth’s Command and General Staff College.  On March 29, APFRI hosted “Anger Management: Balancing the Force-Threat Ratio,” a lecture presented by Dr. Gregg Ellermann. The main premise of the lecture was the fundamental understanding of anger, sources leading to an anger response, and associated risk factors affecting an individual’s health. 

“Anger is an emotional state that varies in intensity from mild irritation to intense fury and rage,” said Dr. Charles Spielberger, former president of the American Psychological Association. According to Dr. Ellermann, within the United States military there is a trend of anger filling our ranks due to
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increased expectations for ensuring mission success throughout the Middle East. Today’s new service member has limited time for deployment preparation, managing families, and focusing on higher education. The military must implement educational training for entry-level personnel on the negative effects of anger. Anger resiliency training will provide life lasting dividends for the individual’s health and their families long after their military service.

Dr. Ellermann said the three most common sources of anger are threats to an individual’s time, physical well-being, and psychological well-being. External and internal events may affect an individual’s response to anger. Many times family issues contribute as the leading cause of work place insubordination and rage. Young soldiers experience pressure from their significant other due to the fact of high operational tempo within the military. Establishing a balance between professional and personal is easy to say, however, many struggle in their attempts, leading to unnecessary stress and anger.

According to Dr. Ellermann, anger as a negative emotion contributes to a higher rate of heart disease in both men and women. Research also suggests that 4-18% of heart attacks are immediately preceded by severe emotional distress. Eight percent of individuals who survive heart attacks experienced intense anger within 24 hours prior to their heart attack. Tightening of the muscles in the jaw, shoulders, neck, and increased blood pressure and heart rate make up the most common physiological responses.

Dr. Ellermann noted that going forward it is important for our society to recognize that increasing the demands on our service members may prompt an increase in anger within our officer and enlisted ranks. While focusing on maintaining and increasing our edge, placing too much stress on Soldiers may backfire on what our nation strives to accomplish. Military leadership must demonstrate the importance of establishing balance for our force to be successful and live long, productive and happy lives.
     

 
     
 

Essentials of Aerobic Conditioning APFRI Presentation Review (24 March 2010)
by MAJ Craig A Martin (SG 16D)

   
“Why can’t I lose these last 10 pounds?”  “I really enjoyed my workout for about eight weeks and then it seemed like I was not seeing any more gains.”  “I’ve been killing myself to lose these last few pounds but since I've been working out twice a day I feel worse than ever!”  These types of comments are often heard throughout CGSC and our Army.  In each case it is likely that the individual making the comment has not been properly educated on how to conduct aerobic training.  Furthermore, in order to successfully maintain good physical fitness it is important to understand the essentials of aerobic conditioning as well as the five components of physical fitness.

As part of the Army Physical Fitness Research Institute (APFRI), exercise physiologist Will North (MS), conducted a superb hour-long special purpose class for CGSC students on 24 March to discuss and educate individuals on just such issues.  Mr. North's presentation
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on aerobic conditioning covered five pertinent areas: the five components of physical fitness, training guidelines, energy metabolic pathways, the benefits of aerobic fitness and quality fitness tips which will help make training easier, more enjoyable and effective.

As a refresher Mr. North covered the five components of physical fitness in order to help the audience understand where aerobic conditioning fits into the overall scheme of a holistic physical exercise program.  Successful physical fitness requires aerobic, strength, endurance training as well as flexibility exercises.  Also maintaining and regulating your body fat is critical.  Of note, aerobic exercising doesn't just benefit its particular field but aids in strength, endurance, and flexibility as well as maintaining an individual's body fat.  Thus, aerobic conditioning is essential to proper physical fitness.

Methods to conduct training and the guidelines by which an individual should properly conduct a workout were discussed at length.  Mr. North highlighted how important it was to maintain proper frequency, duration and intensity as well as the importance of understanding an individual’s maximal heart rate and how this applies to the types of workouts one will conduct. Further guidelines were provided for individuals seeking to understand how they can improve weight loss or simply conduct “maintenance” physical condition over time.  A key take away from this portion of the discussion was what you ought to be doing as a minimum workout.  Doing no physical exercise or physical exercise conducted at less than the minimum requirements greatly increases the chances of heart disease in an individual.

To provide a little bit of scientific understanding for the audience, Mr. North discussed energy pathways and how an individual's metabolism works.  The bottom line here is that, unless you are a superior athlete, it will take your body at least six minutes to begin aerobic metabolism.  Prior to your body beginning aerobic metabolism, short-term energy is provided to your body through the ATP-CP (creatine phosphate system) which gives your body the capability of conducting high-intensity bursts for up to 30 seconds followed by Glycolysis which provides additional short-term energy to the body at maximum rate for 30 to 90 seconds after ATP-CP.  Subsequently a drop-off occurs until your aerobic metabolism kicks in around the six minute mark.  So what does all this mean?  Essentially, conducting  a good warm-up, which helps your body,  gets aerobic metabolism up and running for at least six minutes prior to conducting any long-term aerobic exercises.  By doing this your motor will be fully running and ready to take on the challenges of a long-term physical training event.

So what does aerobic fitness do for you?  Beyond strength and flexibility which other types of exercising provides, aerobic training helps the body increase its ability to utilize oxygen at various intensities and under all endurance activities.  It also decreases the amount of fatigue with that situations require stamina and endurance.  For those seeking to lose weight, aerobic training is the most recommended type of exercise because it is directly linked to burning fat and calories needed to make fat.  As a soldier, aerobic conditioning is important because it lessens the severity of heat stress, aids in acclimatization, which is especially relevant given our current conflict in Afghanistan, and specifically it significantly increases APFT performance!

How much is too much?  Mr. North explained that is critical to understand one's aerobic capacity and the subsequent effect of detraining for those who conduct too much training in the aerobic realm.  Detraining is applicable in as little as three days as one can lose aerobic conditioning when training is not conducted.  Also, individuals who conduct the same type of exercise over time reach a plateau and then actually begin detraining their body because their body has gotten so used to a particular type of training that its aerobic conditioning begins lessening.

Mr. North concluded his presentation by providing some helpful training tips to maximize aerobic conditioning and create an individual training plan which prevents detraining, achieving a plateau or attaining an injury.  Numerous key suggestions were provided.  The overload principle was identified as important because it prevents achieving a plateau by increasing at least 10% effort each week.  Also, to prevent plateau it is important to create periodization by alternating hard and easy workouts as well as type (i.e. long moderate workouts such as running and short duration workouts such as weightlifting).  Items which would be beneficial in aiding the quality of workouts was suggested including: a good heart rate monitor, wearing properly fitted shoes and replacing them as often as needed (250-350 miles or 4 months), and wearing proper clothes to conduct training.

Lastly, Mr. North advocated some essential fundamentals of conducting a proper physical workout: 1) understand how to properly perform the training exercise you undertake (i.e. taking the proper amount of strides while running) and 2) Rest…Rest…Rest! In order to see maximum benefits from aerobic conditioning or any other type of exercise it is important that you allow the body to recover by resting and getting a good night’s sleep.

In summary, the APFRI lecture on aerobic conditioning given by Mr. North provided useful information for determining how to successfully develop a physical fitness regimen which properly takes advantage of every training event, aids the body in reducing the likeliness of heart disease and effectively prepares Soldiers for the physical rigors of combat while also helping maintain good physical fitness.
     

 
     
 
Summary of Dr. Daniel Jackson’s
“Wisdom in Movement” presentation
by Major Andrew Sims, Staff Group 8C
   
Dr. Daniel Jackson gave a presentation to CGSC in coordination with the Army Physical Fitness Research Institute (APFRI) March 8 on lower back pain. Information covered five major topics:
       
    Understanding how structure plays a role in lower back pain.
       
    Understanding how moving the wrong way leads to abnormal stress.
       
    Understanding the importance of muscle balance as a component of posture.
       
    Understanding the importance of exercise in correcting movement.
       
    Understanding the importance of modifying the disease.

According to Dr. Jackson, over $40 billion is spent in the US on lower back pain each year and it’s the number one reason for disability in adults over the age of 45. Eighty percent of people experience lower back pain in their lifetime and 90% have recurring lower back pain.
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CGSC Student Blog
 
Low Back Pain


"Physical Sagacity" - Combating Lower Back Pain


Dr. Jackson’s Lecture on Physical Sagacity
 
 
   
 

Dr. Daniel Jackson

Dr. Daniel Jackson during a presentation on low back pain March 8.

  The initial discussion addressed the need to understand a person’s physical structure and its role in the early identification of possible warning signs that may eventually lead to lower back pain. Straight, upright posture is critical in contributing to lower back health. Secondly, appropriate movement techniques are essential to ensuring the lower back remains strong and pain-free. In one demonstration, Dr. Jackson asked an audience member
to demonstrate a lunge, which he followed up by commenting on her (and others’) tendency to keep the back ridged and upright when performing a lunge. He corrected this myth by recommending a slight bend at the waist when performing a lunge, similar to the slight bend when executing a squat.

The presentation emphasized the need to understand the body’s ability to have muscle balance. This muscle balance (strength in core areas) allows for the full range of motion in walking, running, and those activities we find ourselves performing daily. Ultimately, the lower back has only ligaments and tendons, which means it relies heavily on the abdominal muscles, rib cage area, and upper back regions, as well as the gluteus muscles for support. Four muscle groups support the lower back region, thus demonstrating the complexity associated with the interconnectivity of muscle networks in support of one another as the body attempts basic movements.

Remedies for lower back pain may require several strengthening exercises in multiple areas. Flexibility in the hip flexor region appeared to be linked to the ability to perform multiple functional movements. A consistent theme was evident in the presentation in that the medical field seems to be fixated on reactive medicine when it comes to issues pertaining to lower back pain. Dr. Jackson’s recommendation in modifying the disease is to find the problem that is causing the lower back pain and work to correct the situation before it causes more harm.  Find the problem, don’t treat the symptom.

In addition, Dr. Jackson shared a tip regarding a technique for those of you who use the elliptical machine in the gym. Your technique on the machine should not include a bouncing motion - focus on using your legs and keep your hips close to the same point as far as distance from the ground. He suggested that the exercise will be much more difficult after the adjustment.
     

 
     
 
Cholesterol and You, Gearing Up for Change
by MAJ Alan Kozlowski, Fort Leavenworth, Kansas
   
My cholesterol level is off the chart!  My doctor just told me that my total cholesterol is above 240, my HDL is below 40, and my triglycerides are above 500.  I feel fine, but everyone tells me I am high risk for a heart attack.  What do I need to do to get my cholesterol manageable to be healthy?

The APRFI lunchtime lecture on February 3 was titled “Cholesterol and You; Gearing up for Change,” and it provided valuable information on increasing awareness of the National Cholesterol Education Program (NCEP) and U.S. health statistics; motivating individuals to take action to reduce cardio vascular disease (CVD) risk factors; promoting an understanding of lipid values, trans fats, and saturated fats; and increasing public knowledge about dietary principles for reducing blood cholesterol levels.


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Relaxation Techniques for the Type-A Personality


Leveraging Type-A Behavior
 
 

Christy McKnight

Christy McKnight presents a special effort APFRI class on cholesterol Feb. 3 in Arnold Auditorium.

  According to a CDC study conducted in 2006, cardio vascular disease was the number one cause of death in the Unites States, with more than 630,000 deaths occurring for both males and females (the next leading cause of death for males and females is lower respiratory disease with over 550,000 deaths overall).   How can we as Americans reduce the number of deaths caused by cardio vascular disease?  We can start by becoming familiar with what cholesterol is, how
it affects our cardio vascular system, and knowing what we can do to reduce the risks for cardio vascular disease.

“So, my cholesterol levels are ‘bad;’ why are they so bad, and what can I do to reduce them?”


First of all, one has to know that while there are risk factors that can change cholesterol levels, such as diet, smoking, high blood pressure, obesity, physical inactivity, and high blood sugar levels, there are others which cannot be changed, such as heredity, family history, or age. 

“What does it mean when my doctor tells me, ‘your overall cholesterol is 350, your HDL is 25, your LDL is 210, and your triglycerides are over 500’?”

To understand what the doctor just said, one has to understand what some of the terms are and what the numbers mean.  “HDLs” and “LDLs” are “high density lipoproteins” and “low density lipoproteins.” HDL is “good” cholesterol; the higher the number, the better it reduces risk of high overall cholesterol. So, if ones HDLs are below 40, one is at risk for CVD, while having HDLs over 60 can reduce the risk of CVD. LDL, on the other hand, is “bad” cholesterol; the higher the number (above 190 is considered very high) the greater the chance for CVD (below 100 is optimal). Triglycerides below 150 are normal while those above 500 are considered very high.  These three types of cholesterol are used to determine ones overall cholesterol, with less than 200 being desirable and above 240 being high.

How do I improve my ‘good’ cholesterol and triglycerides?”
There are some easy things one can do to improve HDLs, such as: do an aerobic activity for more than 30 minutes per day; stop smoking; achieve a healthy weight; avoid trans fat and saturated fats; increase intake of high fiber foods; and moderate the use of alcohol. These simple steps, plus moderating carbohydrates can help reduce triglyceride levels.

“What are ‘saturated fats’ and how much can I have?

Saturated fats are fats normally found in animals, as well as some plant oils, such as coconut and palm.  One can reduce saturated fats in their diet by limiting their consumption of meat to 6 oz. per day, as well as using low fat dairy products when cooking.

What are trans fats?”

Trans fats are partially hydrogenated vegetable oils which are artificially created.  They can raise ones total cholesterol and LDLs while decreasing HDLs.  One should limit their intake to less than one gram per 1000 calories.
What kinds of fats are healthy?”

There are basically three types of “healthy” unsaturated fats: monounsaturated, polyunsaturated, and omega-3 fatty acids.  All three can raise HDL levels (the good cholesterol) and lower triglyceride levels.  Monounsaturated fats can be found in certain oils, such as canola, sunflower, olive, and peanut, while polyunsaturated fats can be found in oils such as corn, soybean, and cottonseed.  Omega-3 fatty acids can occur in both plants (such as walnuts) as well as fish (especially cold water fish). 

I heard that alcohol and chocolate can reduce cardio vascular disease.  Is that true?
Alcohol and chocolate may reduce cardiovascular disease.  Studies suggest that the reseveratrol in red wine assists in increasing HDL levels and reduces the sticky platelets which stick to the walls of one’s arteries.  Chocolate can have the same effects while also lowering blood pressure.

“Where can I get more information on cholesterol?”

The Army Physical Fitness Research Institute has great information on cholesterol on the web.  One can find it at https://apfri.carlisle.army.mil . Other useful sites are the American Heart Association, www.americanheart.org, the National Heart Lung and Blood Institute, www.nhlbi.nih.gov, and the American Dietetic Association, www.eatright.org.

In summary, the APFRI lecture on cholesterol provided useful information on knowing risk factors for high cholesterol, how to control them, what the different cholesterols are and which are beneficial (or not), and the benefits of exercise and proper nutrition to reduce overall cholesterol levels.  Our health is important to us, and the APFRI lecture series demonstrate that our health is important to them too.
     

 
     
 
Keep the Sword Pointed at the Enemy
by MAJ James L. Booth, Fort Leavenworth, Kansas
   
Dr. Greg Ellermann of the Army Physical Fitness Research Institute (APFRI) recently gave a lecture at Fort Leavenworth titled “Leveraging type-A Behavior: Keeping the Sharp Edge of the Sword Toward the Enemy.”  Dr. Ellermann was addressing officers and leaders at the Command and General Staff College (CGSC) on how to properly leverage type-A personality traits in officers for the good of an organization and how to simultaneously mitigate the negative physical impacts on the type-A leaders.

The American Heritage Dictionary defines type-A personality as, “A temperament marked by excessive competitiveness and ambition, an obsession with accomplishing tasks quickly, little time for self-reflection, and a strong need to control situations.” These traits are resident in many leaders throughout the world and are also readily evident in military leadership. APFRI is targeting the population at CGSC to improve the functioning of the military and its leaders by improving their resiliency and leveraging the positive aspects of these personalities.
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Relaxation Techniques for the Type-A Personality


Leveraging Type-A Behavior
 
 

Type-A behaviors produce benefits in the areas of individual and family, organization, and health.  Type-A individuals tend to be high achievers who are responsible and are capable of acting independently.  They are organized and can have positive impacts in running organizations.  They also have the potential to be peak physical performers when their attentions are focused on aerobic fitness and physical strength.  These are all good traits but there can be negative implications in the same areas.

Type-A behaviors can have unhelpful impacts on organizations, individuals/ families, and health.  They can cause a loss of individual and family time that can lead to decreased intimacy and interpersonal skills.  Type-A individuals can cause negative competition in organizations which can lead to decreased teamwork and initiative.  Increased stress brought on by the increased hostility and irritability of type-A individuals can impact health by increasing blood pressure, the presence of artery clogging cholesterol, and insomnia.

Dr. Ellermann recommended diaphragmatic breathing and autogenic training as two techniques to mitigate the physical effects of stress induced by type-A behaviors.  Diaphragmatic breathing uses a deep breathing process that lowers the heart rate and blood pressure while increasing focus and relaxation.  Autogenic training is a system of psychosomatic self-regulation where the person silently repeats various phrases to themselves to relax and reduce heart rate and blood pressure.  These techniques used daily can dramatically reduce the impacts of stress related health problems. 

"type a personality." The American Heritage® New Dictionary of Cultural Literacy, Third Edition. Houghton Mifflin Company, 2005. 04 Jan. 2010. <Dictionary.com http://dictionary.reference.com/browse/type a personality>.
     

 
     
 
General Fitness by MAJ Paul Savel, MD - MC USA
   
On the afternoon of 4 DEC 2009, Ms. Susanne Dale, an exercise physiologist from the Army Physical Fitness Research Institute (APFRI), provided an informative presentation entitled “General Fitness” at the Lewis & Clark Center.   This presentation covered the positive effects of aerobic and strength training to help prevent and treat high blood pressure, high cholesterol, elevated blood sugar and problems with low bone density and high body fat composition.

It was interesting to find out that both CGSC students and students at the Army War College are at risk or already suffering from many of these conditions – consider the following: For the Class 09-01, Ms. Dale noted that approximately 30% of students had elevated systolic blood pressures (the top number in a blood pressure reading,
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CGSC Student Blog
 
Exercise Is Medicine


Susanne Dale APFRI Presentation


“General Fitness: What You Need To Know”

APFRI “General Fitness” Blog
 
 

APFRI
E. Susanne Dale, Exercise Physiologist with
APFRI, during a special effort presentation
Dec. 4 on General Fitness.
  defined as above 130) and 60% had elevations in their diastolic blood pressures (the bottom number in a blood pressure reading, defined as above 80).  Likewise, for lipids, many of the current class has elevations in one or more components that make up the total cholesterol numbers. In the area of diabetes, or elevated blood sugar, 27% of the Army War College is reported to be at least in the ‘pre-diabetic’ stage. Finally, as those who have attended APFRI assessments
can attest to, body fat measurements are often not in the ‘ideal’ range and significantly higher than traditional Army tape tests when measured in the APFRI BOD-POD.  This striking information about our own current health set the stage for the remainder of the lecture.

Ms. Dale’s presentation then focused on the role of aerobic and strength exercise in each disease state.   While the specific effects of each level of exercise on each disease state was presented, the take home points were the following:  1) Aerobic exercise undertaken 3-5 days a week at 70-85% of your maximal heart rate (defined at 220 - <your age>) will contribute to better cardiovascular health and increased fat burning.   This will have positive effects in reducing your blood pressure, lowering your bad cholesterol (LDL = Lousy cholesterol) and raising your good cholesterol (HDL = Happy cholesterol), increasing your bone density, decreasing your fasting blood sugar, and assisting you in losing weight.    Ms. Dale specifically pointed out that the goal here is at LEAST 30 minutes of exercise, but we should strive to complete 45-60 minutes for maximal effect.   2) Strength training, on the other hand, had a smaller beneficial effect than aerobic activity for cardiovascular health, but did have positive effects on bone density, blood sugars and body composition.

As a Family Medicine physician, I agree wholeheartedly with the information and recommendations presented – APFRI is right on target in stating that “Exercise is Medicine”!

 
     
 
The APRI Experience By MAJ Jo Dible
   
For those of you that have not yet been to APFRI, I wanted to offer a look at the APFRI program from the individual experience.  After filling out the online questionnaire and having my blood drawn, I scheduled my APFRI assessment via Blackboard.  The assessment itself consisted of body measurements, to include the Bod Pod; walking on the treadmill; stretching; and lifting (Leg Flexion, Leg
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Extension & Bench Press). Once the assessment was over, it was time for the debrief.  The information presented was consolidated, easy to understand and thorough.  The most helpful feedback was the one page summary, “Health & Physical Fitness Profile” which showed areas for improvement.  The packet also included other helpful items such as:  a Body Composition Analysis, a cardiac health Calculated 10 Year Risk, a Comprehensive Fitness Assessment Interpretation Guide and other personalized handouts.  If you don’t think that getting personal areas for improvement is enough, my debrief didn’t stop there.  I was provided very specific guidance on what changes to make, such as increase HDL by 10 and bench press 12 more pounds.  These goals were both measurable and easy to accomplish.  Still not enough feedback to be worthwhile?  The APFRI folks gave me specific, easy tasks such as adding a few things to my diet and exercises to meet my goals. 

Still not enough to be considered worth the effort?  I inquired about any concerns I should have lifting weights while recovering from an arm injury.  The APFRI staff immediately set me up with a personalized consultation with a Physical Therapist.  At this consult about week later, I received an hour-long session, focused on my ability and injury.  Training centered on practical exercise and demonstrations focused on appropriate weights and techniques that I could use anywhere.  I also received Strength Training Guidelines, and a Strength Training Log to keep me on track. 

Still not enough?  Not only did APFRI give me the tools I needed to change my health while here in garrison, they also offer information concerning future fitness challenges.  In their recent class, “Deployment/High OPTEMPO Challenges to fitness”, they showed the effects of harsh environments on the physiology of the human body.  More importantly, they focused on providing recommendations on maintaining fitness parameters during prolonged deployments.  APFRI offers these types of beneficial classes weekly and the topics are tailored to match up against your needs based on your personalized APFRI assessment or any health/fitness interest.   For most of us, we acknowledge that changes need to be made for optimal health & fitness, but are not sure where to start or how drastic those changes need to be.  APFRI provides the “What” to change, the “How Much” to adjust and exactly “How” to make those changes.  The APFRI experience provides a level of free, customized and detailed health care you will not find elsewhere – take advantage of the opportunity if you haven’t already.  

 
     
 
Challenges to Fitness By MAJ Stanton Goings
   
On October 16 Tom Davis, an Army Physical Fitness Research Institute (APFRI) exercise physiologist, presented a briefing for the Command and General Staff College (CGSC) on physiological responses experienced by deployed Soldiers and alternative fitness methodologies to optimize coping with environmental change.

Mr. Davis outlined several findings unique to the military when faced with a deployment; specifically he focused on the distinctive climate
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Tom Davis, Exercise Physiologist at APFRI, addresses ILE students during a special effort class on fitness challenges Oct. 16.
     
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  characteristics of Afghanistan and Iraq.  Afghanistan’s high altitude and Iraq’s hot climate highlighted the importance of establishing and maintaining a fitness regimen that is relevant to sustained combat missions for quicker acclimatization and recovery from injuries. He further
explained the need for greater exercise variety by developing goals based on aerobic power, anaerobic strength and power, and core strength.  Study-based recommendations also provided additional insights to understanding caloric expenditures during combat activities, body regulation, and the role of the heart rate reserve. 

An increased metabolic rate, hypoxia, and combat activity contributed to the increased caloric requirement in Afghanistan to prevent the significant weight loss occurring among Soldiers.  Although Soldiers in Iraq experienced the same combat activity; studies have shown a decline in Soldier fitness in Iraq based the hot environment.  The alternative exercises illustrated by Mr. Davis prevent the declining themes associated with deployment by offering alternative fitness strategies for a better physiological adaptation to the deployed environment. 

After two separate deployments to Iraq the presentation is right on the mark.  I also found pure enjoyment from following a goal-based fitness plan to unwind from the day while deployed.  The renewed understanding for our cardiovascular responses prepares us and those we supervise for the challenge we face when conducting operations for a successful mission.    
 
CGSC Student Blogs
  APFRI Exercise Physiologist visits CGSC by MAJ Stanton Goings
     
  APFRI Presentation Review Blog by LTC Michael Parker
     
  APFRI Presentation Review by MAJ D.W. Schmidt
     
  Deployment/ High OPTEMPO Challenges to Fitness by MAJ John McLaughlin
     
  Tom Davis APFRI Briefing by MAJ Paul W. Tappen
 

 
     
 
Stress and Life Balance
by Brenda Short
     
The Command and General Staff College continued its emphasis for the students to achieve balance this year by conducting a lunch time seminar Friday September 25th, 2009 on the subject. APFRI’s clinical psychologist, Dr Gregory T. Ellermann was the facilitator for this event at the Lewis and Clark’s Marshall Hall.
 

 

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Dr Ellermann began the hour with basic instruction on the dangers of stress in our life and explained the physiological reactance of the stress response. He explained it as cyclical in nature and based on one’s thoughts and feelings. Our attitudes, beliefs, and assumptions create our automatic thoughts, they in turn create negative physical symptoms, negative moods and emotions which move onto maladaptive behavior which causes stress and the cycle continues back with our automatic thoughts. This response focuses on the negative aspects, however, Dr Ellermann then offered an adaptive approach to the same cyclical process with a positive outlook. This cycle begins with the openness of the mind or mastery of thought then moves onto one’s ability to adjust to physical and psychological demands. Being able to adjust to the demands creates positive moods and emotions which creates adaptive behavior and the resiliency to life’s challenges and the cycle continues.

Dr Ellermann explained everyone reacts to stressful situations differently; the key is to know yourself. He stressed that you need to understand what triggers your stress in order to be able to anticipate stressful moments and mentally prepare yourself for those times. He also provided examples of relaxation exercises that help to reduce the physiological stimulation of stress and took the audience through what he called a “tactical” breathing exercise.

Dr Ellermann moved onto the topic of achieving “life balance” by explaining the steps to achieve balance includes: 1) realizing what is important and placing that first on your list of priorities, 2) reducing the demands on your time, 3) bolstering your resources and 4) enhancing your resiliency. Dr Ellermann provided a few examples on how you can achieve this by limiting your connectivity, maintaining a daily routine, adding family time and leisure activities to your schedule, and improving mental and emotional fitness. He then provided a handout to the audience and took them through creating a life balance plan for themselves. After completing this exercise he instructed the participants to ask themselves how they will follow through with this plan. He concluded his presentation by encouraging the audience to share what they have learned during his presentation.
 
               
  Dr. Gregory Ellermann   CGSC Student Blog     Dr. Gregory Ellermann  
               

 
     
 
New Physical Fitness Research facility opens
at Fort Leavenworth
Wednesday, January 7th, 2009
     
FORT LEAVENWORTH, Kan. — Officials from the Combined Arms Center here and the U.S. Army War College, Carlisle Barracks, Pa., cut the ribbon to a new $1 million facility for the Army’s Physical Fitness Research Institute (APFRI)
Jan. 7.  The annex, located in Eisenhower Hall of the Command and General Staff College campus, features some of the most technologically advanced diagnostic equipment available for fitness assessment.
 

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The expansion of APFRI to Fort Leavenworth signals the Army’s commitment to the health and welfare of its Soldiers and their families. Multiple operational deployments have created a downward trend on the overall physical fitness of the force over the past few years.  Senior leaders are expanding APRFI leader education programs to address those trends, by increasing awareness and providing tools for individuals to manage their own health and make appropriate lifestyle changes.  An APFRI annex at the U.S. Army Sergeants Major Academy has been operational since 2006 and leaders at USASMA will hold a grand opening for an upgraded facility there later this year.  

“This program is changing lives – we’ve seen it happen right here already,” said Lt. Gen. William B. Caldwell, IV, commander, Combined Arms Center and Fort Leavenworth. “We’re excited to know the future impact it will have on the students and our entire force as they go out and share what they’ve learned with those they will lead in the future.”

APFRI is the Army's center for Leader Education in Health and Fitness through research, education and outreach. In 1982, the commander of Training and Doctrine Command directed the establishment of APFRI in Carlisle, Pa., to develop a comprehensive health and fitness program for senior officers studying at the Army War College. A key focus was to reduce the risk of cardiovascular disease. In 2006, General William Wallace, CG TRADOC, directed APFRI to expand their program to the U.S. Army Sergeants Major Academy. Through the years, the APFRI leader education programs evolved to address the complex interplay of leadership, health and fitness as a component of professional military education. 

Since then the Army has expanded the program at Fort Leavenworth to focus on the more than 1,200 mid-grade officers attending the Command and General Staff College annually, as well as the staff and faculty of CGSC. APFRI has also opened its services to the family members of Soldiers in order to increase awareness and to allow families as a whole to implement healthy lifestyle changes.

“It’s about educating the force so they can be role models and they can go out and be those role models for their subordinates in the future,” said Maj. Gen. Robert Williams, U.S. Army War College commandant.  “To show them what health and fitness means, and carry that forward in a century where we’re going to have challenges as a nation and a people.” 

 
     
     
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