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OBESITY & COVID-19 MORTALITY; WHY IS THERE SUCH AN INCREASED RISK?

by Uncategorized

It has been a pretty hot topic since the start of the pandemic; What are the comorbidities of Covid-19? The further we go into this pandemic, the more we know about who is at risk. More importantly, we know how we can help alleviate that risk. However, the warning signs have been there before when it comes to our general health. All of the research is showing the escalating risk of hospitalisations and deaths from Covid-19 to those overweight or obese. So why is the topic still the elephant in the room? Rather than honest and open conversations about the risks of living with obesity.

There is, and always has been, a huge stigma around the words ‘fat’, ‘overweight’ and ‘obese’. We are in an industry that is trying to tackle obesity and unhealthy lifestyles, and yet even writing this blog outlining the risks of obesity in the current pandemic, we run the risk of it being taken the wrong way.

This just outlines the uphill battle we face as a society in tackling obesity.

The purpose of this blog is to not only highlight the risk. It is also to understand why being overweight or obese increases the risk of hospitalisation and death from Covid-19. If we truly want to help and get our message across, there’s no point highlighting it without helping to understand why this occurs. So, if you think being obese is just about how someone looks, it is far from that.

We don’t judge people for how they look on the outside. Our concern is what is happening inside the body, where the real damage is occurring. 

UK STATISTICS

NHS statistics in 2018 showed that over a quarter of UK adults are obese and 63% are overweight or obese. This number has doubled since 1993. This has resulted in obesity costing the UK £6.1 billion per year, and £27 billion as a wider society. This is taking into account the further health risks of obesity on issues like type 2 diabetes, hypertension and certain cancers.

In 2019, there were 876,000 hospital admissions where obesity was recorded as the primary or secondary diagnosis. That is 2,400 hospital admissions per day.

The most concerning numbers are the rise in child obesity. According to Public Health England 2015 statistics, 28% of children between ages 2-15 are either overweight or obese. Even children aged 4 to 5, nearly 10% are obese and another 12.8% are overweight.

The amount the UK spend is astronomical. How they spend that money could be criticised, as strategies time and time again have been delivered to almost zero effect.

However, the general changes in our lifestyles since 1993 that have contributed to obesity levels doubling should be on us. 

OUR HEALTH IS OUR OWN RESPONSIBILITY.

THE RESEARCH

BMI MEASUREMENT

Firstly, let’s start with how obesity is measured in most scientific studies. The simplest way of measuring is through BMI (body mass index). A calculation of a persons weight compared to height is how BMI measurements are taken. Every PT reading this is rolling their eyes at the mention of BMI. It is a measurement that has received a lot of criticism. Mainly because it does not take into account what amount of our body mass is fat, and what is our skeletal system (muscle and bone).

This is where the measurement can certainly be improved. As the population of people lifting weights and sports people may have a relatively low amount of body fat with higher muscle mass, but still be classed as overweight on a BMI scale. This can be improved slightly by taking a waist measurement. The NHS recommend a weight loss strategy if your waist is 94cm+ for men and 80cm+ for women. So, if your BMI classes you as overweight but you have a good amount of muscle mass and your waist is below these numbers, then there is a good chance you are not overweight.

Despite this, BMI is a useful measurement for the general population. As it is so simple to measure and very non-invasive. This makes it relevant to research studies that require hundreds or even thousands of participants, particularly if the cohort are mainly the general population. Below are the classifications of BMI from underweight to extremely obese.

OBESITY & GENERAL HEALTH

The effect of being overweight or obese is a health issue regardless of Covid-19. The metabolic stress it puts on the body puts us at risk of many illnesses and diseases. We store excess fat in the wrong places, mainly around key organs such as the liver and lungs. This impairs their function and makes them have to work harder. The extra fat in skeletal muscle and liver can disturb our metabolic function by increasing insulin levels in the blood. This reduces our ability to control those insulin levels, hence why it makes us more at risk of diabetes.

The information we have on Covid-19 is only going to be as strong as it can be after 12 months. We will start with what we have learnt from other outbreaks such as SARS-CoV from 2002 and Swine Flu (H1N1) from 2009. This shows that the warning signs have been here for a long time.

Studies on Swine Flu showed that both the amount of virus shed within the body and the duration of virus shed increased in obese individuals compared to lean individuals (graph below).

An American study in 2009 revealed that in California, 51% of all adult Swine Flu cases were in those with obesity. This resulted in 61% of all deaths occurring in obese individuals.

The main mechanisms behind why overweight and obese individuals may suffer more from these types of viruses are mainly based around the bodies inflammatory state. This can inhibit the immune systems response to the virus. We will go into the mechanisms in a little more detail later.

OBESITY & COVID-19 RESEARCH

Now for the main event. So far, we have found the most common comorbidities associated with severe symptoms and mortality to be older ages (65+), obesity, hypertension, diabetes and various cardiovascular diseases. Out of these, I think it’s safe to say that obesity is the one that we can do something about. Especially as obesity also makes someone more susceptible to hypertension, diabetes and many CV diseases.

In a study on the first wave of the pandemic (see graph below), it showed that of the critically ill patients with Covid-19, over 70% of those patients were either overweight or obese (BMI >25). This was a bigger contributor than age (being 50+). 

Another Spanish study on the traits of patients admitted to ICU due to Covid-19, found obesity to be the most common comorbidity out of everything (48% of patients).

A systematic review of 75 different studies on Covid-19 was completed last year and the numbers showed the substantial risk for individuals with obesity:

  • 46% more likely to contract Covid-19
  • 113% more likely to be hospitalised from Covid-19
  • 74% more likely to be admitted to ICU from Covid-19
  • 48% more likely to die from Covid-19

The below illustration from a Southern California study also shows the increasing risk ratio associated to a higher BMI. Patients with a BMI measurement of 40-44 had a risk ratio of 2.68 and patients with a measurement greater than 45 had a risk ratio of 4.18. This means they were over 4 times more at risk of death compared to someone with a BMI of 18.5-24. This study also showed that obesity was a big risk factor even for younger adults. Particularly in men under the age of 60, the risk increased significantly and was the most common comorbidity. 

WHAT CAUSES THE ADDED RISK?

The fact that obesity is a risk factor for contracting Covid-19 and mortality means it can no longer be ignored. It is not about fat shaming; it is about understanding that obesity has far more implications on a persons health than how they look. The main point of this blog is for you to understand why there is an added risk, and what having excess fat can do to your immune system both short-term and long-term.

Firstly, being obese increases our risk of the majority of other comorbidities; Type 2 diabetes, hypertension, cardiovascular disease and heart disease. That increases the risk alone.

Obesity is a metabolic disease. Hormones and nutrients are not controlled appropriately. Hormones like leptin are increased and hyperglycaemia (excess blood glucose) occurs. Both of which have been shown to increase Covid-19 mortality. This lack of blood glucose control can impair immune cell function and blunt the response to a virus or disease. 

We also discussed previously that virus is shed for longer and more intense in obese individuals. The mechanisms by which excess fat affects our immune system, however, is mainly due to inflammation and ‘cytokine storms’.

Interferons (IFNs) are protein molecules and are a type of cytokine. We have anti-viral interferons in our body protecting our immune system. They quite literally “interfere” with viruses in the body and help to stop them taking over our immune cells. One of the reasons obese individuals have a decreased immune response is because they have reduced numbers of these IFN’s protecting their immune system. This coupled with them have an increased number of cytokines like IL-6, which are a pro-inflammatory cytokine (and therefore increase inflammation in cells), put them at a much higher risk of severe infection.

This increase in inflammation is happening in the lungs in particular, especially during infection of a respiratory disease. Hence why obesity is linked to a reduced lung function and chronic obstructive pulmonary disease (COPD).

Cytokine storms are an uncontrolled inflammatory reaction of the immune system to virus or infection. When a person is carrying excess fat, IL-6 cytokines and C-reactive protein levels are increased. These are both signs of inflammation in the body and cells and are very prominent in cytokine storms. If an immune system reacts to infection with these uncontrollable cytokine storms, the response to the virus is elevated and significantly more severe. With obese individuals having higher levels of both of these cytokines circulating, there is more chance of them creating a cytokine storm when they have been infected by a virus. This puts them in danger of hospitalisation and mortality.

All of this coupled with excess fat tissue can put a huge strain on the immune system and cardiovascular system, in particular. Just increasing the amount of fat stored around essential organs, such as lungs, can put the organs under increasing stress. If they are struggling to function already, the increased fat putting pressure on them can exacerbate the issue.

THE KNOCK-ON EFFECTS OF THIS ISSUE

Unfortunately, given the current situation and obesity levels rising year on year, there is no easy way out of this. We have already gone through the crippling costs on the NHS and the number of hospital visits per year due to obesity (876,000 in case you had forgotten).

Over the coming months and possibly years, we will see obesity levels worsen before there’s any chance of improving.

During the first UK lockdown of 2020, a study on 1.6 million people showed the following outcomes.

  • 29% of people increased in weight
  • 34% decreased the amount of exercise they did
  • 35% increased their amount of snacking
  • 19% were eating less healthy than before
  • 27% were drinking more alcohol
  • 29% of smokers were smoking more
  • 42% admitted to being worried about their physical and mental health

That was in a lockdown in spring/summer, I would take a guess to say these numbers have gotten worse in a winter lockdown. These changes in habits are tough to get out of if you have been doing them for months at a time. Pair that with the fact that people have consumed more processed foods during the lockdown too, and it makes a very difficult scenario to just simply snap out of it when restrictions are lifted. Many people have lost jobs and even more have had their earnings reduced. Unfortunately, this lower income is associated with a lower quality of food supply. Partly because these ultra-processed alternatives are cheaper and have a longer shelf life.

The other knock-on effect of obesity is the potential for the Covid-19 vaccines to be less effective. In influenza vaccines this is certainly the case, but hopefully Covid-19 vaccines can still be effective. The main mechanism for why they may not be as effective in obese individuals is because T cell production in response to infection is the key to the vaccines being effective. Unfortunately, T cell responses have been shown to be impaired in obese individuals.

WHAT CAN WE DO RIGHT NOW?

Again, what’s the point in writing this if we didn’t want to try and help in some way. What can we do right now to help this situation, protect our own health, our family’s health and of course our NHS?

Other than the obvious “we need to lose weight”, there are things we can start doing. But it all starts with taking responsibility for our own health.

INCREASE CARDIORESPIRATORY FITNESS (CRF)

I would love to see more research done on this side of things, but there a few studies out there. One study showed that in men who were of normal BMI, those that had a low level of CRF had a 163% higher mortality risk than men who were fit.

Other evidence points at CRF improving the inflammatory response of our immune system to Covid-19 infection, even in obese individuals. Exercise and CRF have a positive effect on lung function for starters and help to lower risk of respiratory infections. Exercise can lower chronic inflammation, and also elicit an anti-inflammatory response in the body that combats the usual pro-inflammatory markers you see with infections and viruses.

Therefore, just increasing our fitness levels can help to put our body and immune system in a better state to fight infections and viruses.

SUPPLEMENTS

We discussed this in a blog right at the start of the pandemic. There is some really promising evidence showing that higher levels of vitamin D in our bodies are associated with a greater protection against Covid-19. Having insufficient levels increased the risk of hospitalisation and mortality greatly. Why we are not doing more to encourage vitamin D intake off the back of this is beyond me. Especially with the evidence of vitamin D improving immune system function in general, but that’s another subject entirely. If you are interested in learning more about this, have a read of our previous vitamin D blog.

One thing is for sure, having sufficient levels of vitamin D along with living an active lifestyle and a good diet will put you in a far better position to fight off the majority of illnesses and viruses. Our digestive system and gut are closely linked to both our brain and immune system. The better we take care of our nutrition, the better our nutrition takes care of our brain and immune system.

STOP PULLING THE WOOL OVER EACH OTHERS’ EYES

This may be slightly controversial to discuss. We touched on it in the introduction but trying to mask this comorbidity is a very dangerous thing to do. We need to be completely open and honest about the people that are risk and encourage them to do something about it. Otherwise, this issue will only worsen.

Mainstream media are partly the culprits here, too. We often see stories of younger adults suffering in hospital with Covid-19, and the headlines will be that the patient has no comorbidities. Unfortunately, when you see the photo of the individual, more often than not that person is obese or at least overweight. This isn’t helping anyone and in fact feeds the problem further.

However, encouragement is what is needed here, not just being blunt and telling people they are at risk. Helping each other to understand that it is more than just how they look, it’s the unbearable pressure it is putting on their body and organs. Despite it being tough to lose a significant amount of weight, it is very possible when people have the right support, and truly want to do something about it.

JUST OPENING GYMS ISN’T THE ANSWER

Now for what we as a health and fitness industry can do. I’m sure this probably isn’t what you’re expecting to hear. We can shout from the rooftops about how gyms help to keep people healthy, both physically and mentally. That is absolutely true, and we are the biggest advocates of that, so please bear with me why I think we need to do more.

There are roughly 10 million people in the UK using gyms, which is around 15% of the population. 63% of the population are either overweight or obese currently, which is about 42 million people. The gym industry has boomed over the last 30 years, yet obesity levels have also soared in that time.

The easiest thing for gyms to do is to get young and fit people to attend. The emergence of budget gyms has made getting fit more affordable for everyone. However, the only ones benefitting from this gym model are generally already healthy and not overweight, they also have an idea of what to do when it comes to exercise and nutrition.

Gyms will always market their product to look cool and modern, to attract that demographic. The people that need gyms the most aren’t even in their thoughts. This is why beginners and overweight individuals feel too intimidated to even start. They feel like they don’t belong there and won’t get any support whatsoever.

Overweight or obese individuals are the ones that need to be coached through the whole process to make positive long-term changes to their health. Budget gyms and health clubs do not do that.

This is just creating a larger gulf between unhealthy, obese individuals and the regular gym-goers.

For this reason, I truly believe our industry is doing the general public a disservice. This could possibly be a reason why the government have dismissed us as part of the solution to this pandemic. All of the data is there to show why staying fit, healthy and not overweight can help to fight Covid-19 and save the NHS billions of pounds per year.

Even before the pandemic, the fitness industry has never been an integral part of a government scheme to promote keeping fit and healthy. There is a lack of trust there that is deeply ingrained.

In order to really make a difference, our industry needs to change for the better. There absolutely is a place for these types of gyms to give people cheap access to great facilities. But are they the right service for the 42 million or so people who are overweight or obese and most likely don’t like going to the gym?

Quality coaching is the answer. Supportive coaches that educate rather than just make clients sweat for an hour. Coaches that help people that don’t necessary like training, or don’t know where to start.

Health and fitness is about living the lifestyle, not about being the strongest or the fastest. It is our job to help people make these positive lifestyle changes, that they can then pass onto their children and improve the next generations health as well as their own.

We also need to make a welcoming environment to all walks of life. Something I am most proud of at GWD Performance is creating that environment to help people to excel, no matter how inexperienced, unfit or struggling mentally. Everyone is running their own race with their own obstacles.

The people that need the fitness industry the most, are the ones least likely to use gyms. We need to do everything we can to make it a positive experience for them. 

We are on a mission to help those that need it most. It is the health and fitness industry after all, it’s about time we stepped up the health side of it and made a difference.

REFERENCES

https://pubmed.ncbi.nlm.nih.gov/33034689/

https://pubmed.ncbi.nlm.nih.gov/32278670/

https://onlinelibrary.wiley.com/doi/pdf/10.1111/obr.13128

https://www.acpjournals.org/doi/full/10.7326/M20-3742

https://www.frontiersin.org/articles/10.3389/fendo.2020.556962/full#h4

https://pubmed.ncbi.nlm.nih.gov/26642906/

https://onlinelibrary.wiley.com/doi/10.1002/oby.22849

https://www.bmj.com/content/371/bmj.m4130

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6523028/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7196905/

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NAIL YOUR HYDRATION & IMPROVE YOUR DAILY POTENTIAL

by Corporate WellnessUncategorized

We have heard it all before about how important hydration is to so many aspects of life; health, body composition, performance, concentration. But for some reason it always seems to get neglected. Humans can survive weeks without food but cannot normally go without fluids for more than a few days.

The overall weight of the human body will be on average around 60% water (age & gender dependant). Yet we still underestimate the importance of hydration. In some ways it’s a similar scenario to sleep and recovery. We’ve all heard the dangers of a lack of sleep, yet we still stay up binge watching Netflix.

The purpose of this blog isn’t to scare people into glugging down 8 litres of water a day. It is to understand the basics of the importance of hydration on fat loss, general health and our brains abilities, and understand how we can make some quick improvements.

Water plays a vital role in a number of essential bodily functions. It is present in the process of most chemical reactions in the body, swallowing, lubricating joints, regulating body temperature, hormonal balance, helping the nervous system function and getting rid of waste products. And of course, we have all had a horrible headache before, then once we have some water it disappears.

If Adam Sandler has taught us anything from his movies, it’s the importance of high-quality H2O!

WHAT IS HYDRATION?

Sounds like a silly question. “Well it’s water, isn’t it?!”.

The main component in maintaining hydration levels is of course water. Water or fluid is also the craving we get when we are thirsty. But there are other components involved in maintaining a healthy hydration status. For example, we get on average around 20% of our fluid intake through food (depending on what food we eat). Many of the nutrients in our intake also have a significant effect on hydration status.

The main components involved are salt (sodium chloride and bicarbonate), potassium, magnesium and calcium. These solutes are what determine our osmolality, which is essentially the concentrations of these solutes in our intracellular and extracellular fluid.

Intracellular fluids are the fluids found inside our body’s cells, extracellular are the fluids found outside our body’s cells. We won’t get too into this detail, but the concentration levels of the solutes mentioned, or osmolality, is also a very important part of our hydration status. Too much or too little of them can also lead to dehydration of some kind.

Therefore, hydration isn’t just about drinking lots of water, it’s also about getting the appropriate amount of these nutrients. This has a vital role to play in the function of the skeletal system, and the moving of fluids and nutrients into and out of cells.

THE EFFECT OF DEHYDRATION

The human body is defined as mildly dehydrated when there is 1% or greater loss of body mass due to fluid loss. Therefore, for a 90kg person, they would be considered dehydrated if they lost 0.9kg of body weight, during exercise for example.

This may sound like quite a lot, particularly if you were trying to lose 0.9kg of fat! But research has shown that the human body can lose this 1% of mass after just 13 hours of consuming no fluids. Research has also shown that we can lose up to 2% in just 24 hours. I imagine at one point or another we have got to the end of the day and realised we have barely eaten and not even had a drink.

That 2% body mass loss from lack of fluids can have some pretty negative effects. Headaches and symptoms of fatigue begin, cognitive function is impaired, so we struggle to perform day to day tasks and concentrate on work. Physical performance begins to reduce too, which we will discuss further.

The long-term consequences of chronic dehydration have also been researched. Maintaining good hydration levels has been shown to reduce the incidence of kidney stones, coronary heart disease, asthma and hypertension. Although more research is required on the long-term effects of dehydration, particularly on certain cancers. It can also be tough to measure long term fluid intake, but the warning signs are there.

HYDRATION AND PERFORMANCE

The biggest effect we see from lack of hydration is in physical performance. The 2% drop in body mass we discussed earlier has been shown to reduce endurance performance, increase fatigue, decrease motivation and an increased perceived effort. On top of this, during exercise, just drinking when you are thirsty is not enough to stay adequately hydrated. That is why it is important to keep sipping away at fluids throughout the day prior to exercise, but also continue to drink during intense exercise, regardless of whether you feel thirsty or not. This is most relevant when it comes to training in warmer climates of course, and environments where we lose more fluids through sweat and heavy breathing.

Our cognitive performance is also compromised through dehydration. This is possibly the area that affects our day to day living most. Mild dehydration (2-3% loss) can disrupt our mood, decrease concentration, alertness and short-term memory function, particularly in the young and elderly.

HYDRATION & HEALTH

As previously mentioned, fluid has a vital role to play in many bodily functions. Did you know that having low fluid levels can even increase your chance of constipation? It is a common treatment to be recommended to those suffering. However, increasing fluid levels only helps this scenario if you are dehydrated.

There is a broad association between chronic dehydration and an increased level of the hormone angiotensin II. An increase of this hormone is linked to many chronic diseases, such as obesity, diabetes, cancer and cardiovascular disease.

Our kidney function also becomes impaired through lack of hydration. The kidney is a key component in removing waste from the body, and regulates the bodies water balance. Adequate fluid is vital for the kidney to perform its task of filtering waste from the bloodstream and excreting it from the body.

Next up, the heart. The way in which the heart may be affected by dehydration is through a decrease in blood volume. Blood volume may be lowered by a loss of body water, normally seen through exercise or lack of fluid ingestion. This, along with moving from laying down to upright, can lead to an increased heart rate and a drop in blood pressure. Fluid intake can help to alleviate this pretty quickly.

Dehydration can also have an effect on our mental health too. The main mechanism for this is the direct link to the stress hormone (cortisol), where it has been shown that even mild dehydration can increase levels in the body. The indirect repercussions of this can be just as harmful, however. This increased feeling of stress can lead to making poor decisions when it comes to nutrition, lower our motivation to exercise and eat well, and make us feel more tired in general.

HYDRATION & BODY COMPOSITION

This is something we regularly stress to clients when they start working with GWD Performance, and it is possibly the point that gets met with the most scepticism. How can consuming more water help with fat loss?

A 2014 study was conducted on overweight females. The participants were instructed to continue their food and fluid intake as normal, but to drink an extra 1.5L of water per day; 0.5L 30 minutes before breakfast, lunch and dinner.

Despite the increase in fluid intake, at the end of the 8-week study on average there was a significant reduction in body mass, body fat percentages, BMI, and there was also a reported suppression of appetite.

Another 2003 study looked at the effect of having water with a meal compared to various different beverages, including milk, juice and sugar sweetened beverages. Having the various beverages increased total energy intake by anything between 5 and 25% compared to having just water.

There are other mechanisms by which staying hydrated can help with fat loss and body composition levels. The study discussed above showed that consuming more water prior to eating can help to suppress appetite and help prevent overeating.

For someone that tends to consume calories from fluids (fizzy drinks, juice etc.), consuming more water can prevent you from doing just that. The more water you consume, the less thirst you will feel for these calorific drinks, and therefore can naturally reduce daily calorie intake, all by just making a slight change to a habit.

As discussed previously, our kidneys are vital to us removing waste from the body. Adequate hydration is very important in keeping our kidneys working effectively. The simple process of urinating is a removal of waste, and of course water intake has a huge role to play in that, too. This, combined with all of the general health benefits of staying hydrated, are going to keep the body optimal for exercise and energy levels. The more we feel motivated and energetic, the more we are going to want to train and stay active. That raised activity level can help to create a more effective energy balance for fat loss.

The healthier you are, the more your body and mind is prepared to stay active, positive and motivated.

RECOMMENDATIONS

This is a tough one because every persons fluid intake will be unique to them. But there have been a few changes to recommendations over the years, mainly due to poor guidelines previously.

US guidelines, for example, were based on the average amount of fluid intake of the population and did not take into account whether that population were dehydrated or not! We always say as a general rule of thumb, on an average day, females should consume at least 2.5L of water per day and males at least 3L per day.

If we take weight into it, I would recommend consuming 20ml per pound of body weight. So therefore, if you weigh 150lb (around 68kg), then you should be drinking 20mlx150, which equals 3L per day. This may work out a little more than our general numbers above but is a little more accurate based on a persons weight.

However, there are so many factors involved in hydration levels. Activity levels can be a factor, how much we sweat, air and body temperature, what type of foods are consumed, the list goes on.

With all the technology out there these days, the best way to self-measure hydration levels is the good old-fashioned way; urine colour! You can get colour charts to do a daily check to make sure you are hydrated, it’s not the prettiest way but it’s great instant feedback to make changes quickly if you need to.

TIPS TO STAY HYDRATED:

  1. Always have a water bottle with you. It’s so easy to not drink when you don’t have one available all the time.
  2. Try the water bottles with time markers on. They may look a bit gimmicky, but it gives you a target to aim for all the time.
  3. Keep chipping away at your daily target. Don’t rely on glugging down 1L at a time, keep sipping throughout the day.
  4. Start your day with a glass of water and get ahead of your target from the off. Sip down 500ml when you wake up, it may also help to wake you up (especially if it’s cold).
  5. Have a glass of water 30 minutes before your main meals, it may help to suppress appetite.
  6. If you’re exercising, take that into account and try to get more fluids in BEFORE you exercise, rather than trying to play catch-up after.
  7. Add some flavour. Squeeze a citrus fruit into your bottle or add some berries to add a bit of taste. Even a little bit of squash is fine if it means you drink more.
  8. Don’t forget your electrolytes. We mentioned it in the blog, these are vital to keeping hydrated too.
  9. Keep checking your urine! If it ain’t clear, it ain’t right.
  10. Caffeinated drinks and alcoholic drinks can have a slight diuretic effect. If you’re drinking them, make sure you have a glass of water along with them.
  11. Try and drink most of your fluids before the evening. Nobody wants to be getting out of bed 5 times a night!

REFERENCES

https://academic.oup.com/nutritionreviews/article/68/8/439/1841926

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/1210B6BE585E03C71A299C52B51B22F7/S0007114513004455a.pdf/effects_of_hydration_status_on_cognitive_performance_and_mood.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4901052/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2929932/

https://pubmed.ncbi.nlm.nih.gov/24684853/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4121911/

https://academic.oup.com/ajcn/article/98/2/282/4577135

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BEHIND THE SCENES OF GWD CORPORATE WELLNESS – MORE THAN JUST TRAINING SESSIONS

by Uncategorized

Corporate Wellness to us, as with health, has many different components to it. Of course, our bread and butter is fitness and training. However, so much goes on behind the scenes to keep the companies we work for fit, healthy, happy and building great relationships. So we wanted to share just what it is that we do behind the scenes.

First of all, our corporate wellness programs wouldn’t be successful without the amazing companies we work with. They all show an incredible dedication to their staff’s wellbeing, and their staff show a great appreciation to their companies for going above and beyond. You may have seen some videos of our corporate teams discussing the program, and so many of them speak of their pride for the company they work for. This stands out as probably the most prominent difference in the teams that we are lucky enough to work with.

There is no one-size-fits-all for our corporate wellness offering. Every company is different, and we appreciate that. So, throughout this blog we are going to go through some areas of our programs that we do behind the scenes. As with health and fitness, the training sessions are just the tip of the iceberg.

We have all different types of training environments with our teams, it is all about making the best of each situation. All of the participants are hugely varied in terms of age and training experience, so the environment and sessions need to be well planned and executed. We have one company that transform their meeting room into a gym and others that use local community halls and we supply them with equipment to use. We have other companies that we have designed and implemented corporate gyms for. They are fortunate to have designated spaces and we utilised that to create the best gyms we could with the best use of space. But one thing is a constant no matter what environment our teams are in; a well-structured and safe but challenging session is always had.

An example of one of the bespoke gym areas we designed for our clients.

TRAINING PROGRAMS

Whether the staff have a gym membership or not, we have them covered. Our very own GWD app has everything they need to stay fit at home or at the gym, for both beginners and experienced exercisers. With different programs designed for the gym and with no equipment, it’s a great way to complement our training sessions so they can train as often as they like.

The training programs have exercise demonstrations for every movement prescribed. It also includes guidance on the amount of sets and repetitions to perform, and how much rest to take in between sets.

NUTRITION GUIDANCE

Nutrition, the absolute minefield of losing weight and being healthy, right? Well it doesn’t have to be. We try to make our nutrition guidance as clear and simple as possible for staff. This is first of all to help them understand what “healthy eating” actually is, then give them advice and guidance on how to implement that into day to day life. Nutrition is your bodies fuel and is therefore so vital to how much energy you have throughout the day. We want our companies firing on all cylinders during their working day as much as they do!

Nutrition workshops are also provided to give that extra bit of information out to staff. We have found this a great way to deliver the information, as the staff can sit down and really digest (excuse the nutrition pun) what they are being taught.

Our GWD app also synchronises with the popular calorie tracking app “MyFitnessPal”. This enables staff to input their daily calorie intake, and we then see that information within our app. 

ACTIVITY TRACKING – FITBIT & MYZONE

Never has technology been more prominent in health & fitness, and rightly so. Wearable tech is leading the way, and we like to use 2 main pieces of equipment; FitBit and MyZone.

As you will probably know, the FitBit is worn around the wrist and it tracks daily activity, the main one being numbers of steps performed throughout the day. This allows us to keep track of staff’s daily activity and produce reports like the one showed above. We can create groups (such as departments or branches) or view individually to see who is performing the best. This creates a fun, engaging atmosphere with the added spice of a little friendly competition!

The MyZone heart rate monitor is worn as a strap around the sternum and is worn during exercise. This tracks data such as heart rate, calories burned, and what percentage of maximum heart rate the user is working at. Again, we receive data such as the above snapshot to evaluate both how often staff are training and how hard they are working in each session.

This again creates a fun and competitive environment. We also promote teamwork by often giving teams targets to reach collectively and push towards as either a company or a team. The MyZone app also has a social media element to it. Users can view each other’s workouts and comment on them. They can also view the challenges we have created for them and see a live leader board of where they stand.

GWD APP & MEMBER ACCESS SITE

This is where all of the above information comes together. Our very own GWD app allows access to training programs, nutrition information, coaching videos, progress tracking, everything we feel the staff need. The member site gives access to content on living a healthier lifestyle, live home workouts, guides to food, how to improve mindset (more of which we will come onto soon). Again, everything we feel is vital to improve the general health, fitness and mind of staff is on there.

KEEPING IN CONTACT

Aside from seeing the teams during training sessions, we keep in contact regularly with them. We set up whatsapp groups for each company (or by department if the staff numbers are high) to encourage engagement with each other and keep them up to date with sessions and what’s going on. What we do always has been and always will be about being inclusive and improving team cohesion.

We send out regular emails to the teams to update them on their activity levels and how our challenges are going. We also send out any information we feel may help them in maintaining a healthy lifestyle. With so much information being thrown around social media and search engines, it’s important that we sift through that for the staff to make sure they are only getting the correct information to help them.

MINDSET WORKSHOPS

Our Mindset Academy is something we set up at the start of the Covid-19 lockdown. At GWD Performance, we consider our mindset to be one of the three main pillars of health and wellbeing, along with fitness/training and nutrition. We felt it was a perfect time to introduce this as a positive mindset suddenly became even more important. But even at the best of times, how we approach health, fitness, life and our careers has the most significant role to play in our success.

In our mindset academy we cover modules such as goal setting, making and breaking habits, self-belief, willpower and motivation. Staff have the option to watch the workshops live so they can be interactive and ask questions, or they can watch the workshop back in their own time. Participants receive a workbook to go through in order to continually work on improving mindset, because our academy is so much more than just a lecture.

LOCKDOWN – HOW WE HAVE ADAPTED OUR SERVICE

As with most businesses, the current lockdown has meant we have had to adapt our program and service. We felt it was our duty to continue to provide quality to all staff. But we also felt we had to improve certain aspects. With a large chunk of staff working from home or furloughed during this time, the community aspect all of a sudden became more important. It has been great to see staff seeing each other over our zoom training sessions, this point of contact and continuation of doing something together has been priceless in maintain relationships between staff.

As mentioned earlier, this also prompted us to launch our very own mindset academy to develop our holistic approach to health and wellness. Development of the psychological aspect of health can help no end with the physiological aspect, they go hand-in-hand. You know the saying, healthy body, healthy mind. But an improved mindset isn’t just going to help our health, but also our career and personal lives too. What we teach in the academy can be implemented in almost any scenario in order to improve the outcome, which can only be positive for business performance.

Of course, our training sessions also became “virtual”. We use Zoom to deliver our online sessions to staff, they have access to over 20 workouts per week to choose from, to do with not one, but two of our coaches. This enables us to keep a close eye on the staff during the session to ensure they are performing each movement correctly and safely. It also gives us the opportunity to be more interactive with everyone, and one of the coaches can concentrate on the most important things like being the DJ and providing the tunes!

We also took the decision to integrate our corporate wellness clients into the same facebook group and member site as our gym clients. This was again to improve the community element of our service and allow staff to be connected with similarly likeminded individuals. This also gave staff the opportunity to have access to more material and help on their wellness journey, which we feel has really paid dividends.

We are so proud of all of the companies we work with and feel privileged to be working alongside employers that really care about their staff. If you feel that your company or the company you work for would benefit from working with us, we would love to have a chat and show you the ways in which we can help.

Sleep

WHAT HAPPENS WHEN WE SLEEP?

by with No Comment Corporate WellnessUncategorized

NEWSFLASH! A drug has been developed that can help people to focus more, train harder, improve cognitive ability, increase muscle mass and reduce body fat. Judging by the title of this blog I’m sure you can guess what I’m going to say what that drug is; Vitamin Zzzzzzzz.

It’s not often we attribute one single thing to make such a huge difference to our health and performance. In most cases it’s a combination of so many smaller aspects that equate to a healthy life. But when it comes to sleep, it’s almost the glue that holds these aspects together. Adequate sleep is our bodies opportunity to recover, repair and refresh, no matter how tough the day has been.

You would have heard the magic number of 7-9 hours per night being the key, but quality of that sleep also comes into play. How long you spend in different stages of sleep can be a good indicator of quality of sleep. However, it can be tough to measure this. There are many apps out there and wearable devices, which can provide you with an idea on sleep performance, but I am unsure on just how accurate these can be. The best indicator of how well you have slept is quite simply how you feel throughout the day.

Sleep can have a big effect on our energy levels, will power, work output, training/sport performance. Frankly, the time you are awake is always influenced by the time you are asleep.

We have barely scratched the surface when it comes to sleep research. For so many years it was just thought of as that thing that humans and animals do. It wasn’t really looked into for the majority of our existence. For many, still to this day, it is just a coma-like state that we believe the less of it we do per day, the more productive our day is as it eats up too much time. Once you have finished reading this blog, my aim is for you not to be one of those people!

DIFFERENT STAGES OF SLEEP – THE SLEEP CYCLE

Firstly, our sleep generally follows our own circadian rhythm. This is essentially our 24-hour body clock in which our sleep-wake cycle follows. The circadian rhythm is represented in the below graph by rectal temperature (don’t worry, we don’t measure this!), which is the best indicator of our core body temperature.

We have 4 main stages we go through whilst we sleep. All of these stages have a vital role to play in the function of the body and most importantly the brain. You may hear about our deep sleep and REM sleep being the most important part. This in essence is true, but every stage has a function and a reason why we go into that stage. Many cycles are completed each night, depending on the amount of sleep we get. REM sleep is maintained for a maximum of around 60 minutes each cycle, at best.

As we age, these stages can differ. We tend to be in REM sleep for less time the older we get. The below information is based on the average adult.

NREM Stage 1:

The stage where we switch from wakefulness to sleep. This is a brief period lasting a few minutes on average, with a few obvious physiological changes. Heart rates begins to lower, breathing rate reduces, your muscles begin to relax which can result in the odd twitch. Our brain waves and activity begin to slow at this point.

NREM Stage 2:

This is another stage of light sleep, where heart rate and breathing continues to lower. Muscles relax even more, and the twitches tend to stop. Interestingly, brain activity lowers further, but we are faced with sudden burst of brain wave activity called sleep spindles. The spindles actually help our brain to block out external noise, and have a key role to play in us retaining information we have learnt before we fall asleep. This is the stage at which we spend the most time in throughout the night.

NREM Stage 3 & 4:

This is where our body does its recovering and regenerating. Heart rate, breathing and muscle activity is at its lowest point at this stage, and when we are least likely to be awoken by the outside world. So burglars take note, try and time your break-in at this point.

This restorative phase is where our muscles and tissues repair, immune function improves, and our energy levels get restored. This is when growth hormone is secreted the most to aid recovery.

REM (Rapid Eye Movement):

Long been heralded as the most important part of sleep, REM sleep has a very different function to the other stages. Which is the reason why all stages of sleep are vital. This stage on average begins around 90 minutes into sleeping. Eyeballs move rapidly from side to side underneath your eyelids, which is obviously where the stage got its name. During REM, our initial physiological changes go in reverse. Heart rate and breathing increase, and our brain wave activity is at its peak.

It is at this stage where we dream the most, as our brain is most active. Due to this increased brain activity, this is also the vital stage where we process the previous days information and put it into our memory banks. If we have learnt skills, movement patterns or any other information, this is where it helps to ingrain into us.

PHYSIOLOGICAL CHANGES WHEN WE SLEEP

Our posts during sleep week have gone through the hormonal changes during sleep, so I will just touch on this subject. Our sleep cycle plays a huge role in keeping a healthy hormonal balance.

The obvious first one is melatonin. Regarded as the most important hormone to our sleep cycle and sleep quality. Melatonin is released throughout the night for a person with a normal sleep cycle. It is secreted in response to darkness and our environment is the biggest player when it comes to a healthy release of this hormone.

We touched on growth hormone being released mainly in stage 3 & 4 sleep. Studies show that growth hormone (the hormone that repairs healthy cells in the body) is produced the most at this point; as much as 70% of our nightly production is released in stage 3 & 4 sleep. This makes sleep vital to the repair and regeneration of our muscles, bones, joints and tissue.

Our sleep also has an effect on the hunger hormones, leptin and ghrelin. A 2004 study found that when sleep was restricted (2 nights of 4 hours sleep, compared to 2 nights of 10 hours sleep), big changes to each hormone occurred. Leptin, the hormone related to the feeling of satiety, decreased by 18% in the 4 hour group. And ghrelin, the hormone related to the feeling of hunger, increased by 28% in the 4 hour group.

Many other studies have shown insufficient sleep to have a negative effect on insulin and glucose tolerance. It has been shown that both reduced sleep duration and poor sleep quality have negative effects on the production of insulin and our bodies ability to control and handle glucose. These are one of the many reasons that poor sleep has time and time again shown to have a negative impact on body fat levels and weight control. Another reason for this could be the evidence that lack of sleep makes us snack more throughout the day and crave sugary foods.

SLEEP – THE BODIES VERY OWN MECHANIC

There are so many processes that occur in our body during sleep. Think of sleep as our daily service. After all of the stressors on the brain and damage to our muscles throughout the day, sleep is where the mechanic steps in. They top up all our levels to baseline, repair the bodywork and allow our engine to cool down, so that we are firing on all cylinders again the next day.

We must let our brains recover as much as our muscles, if not more so. Our brains and nervous system are in overdrive all day every day, keeping everything ticking over and sending signals all over the body. Sleep is our opportunity to calm that system down, reduce cortisol (stress) levels and like our muscles, allow everything to be raring to go again the next day. Our sympathetic nervous system (“fight or flight” mode) is also revved into overdrive when we are lacking sleep. Therefore, it is essential following a poor night sleep, our next few sleeps are improved to ensure we recover from this.

HOW SLEEP AFFECTS HEALTH & PERFORMANCE

With all of the previous information in mind, we can begin to piece together just how important sleep is to both athletic performance and performance at work.

Athletic Performance:

A 2011 study showed a distinct decrease in performance of both long-distance running, and short bursts of activity. In the study, they also found that perceived effort during exercise increased, making it feel tougher after just one night of minimal sleep.

Another study in 2014 also showed the effect lack of sleep can have on injury prevalence. The below graph shows average hours of sleep per night in a team of young athletes. The athletes that averaged 6 hours of sleep per night had more than a 70% chance of obtaining an injury throughout a season. Compare that to the athletes that averaged 9 hours + of sleep per night, who had less than 20% chance of injury.

But of course, 99.9% of us are not elite athletes, so what affect can it have on day to day life and our health? And how can it affect workplace performance?

Health:

Let’s start with health. Did you know that driving whilst tired kills 1 person per hour in the USA alone? In fact, fatigue related driving errors are responsible for more accidents than drink and drug driving combined. 

Sleep deprivation has such a profound effect on our health that it can literally alter our DNA. A study performed in Japan found that men were 500% more likely to suffer a cardiac arrest if they averaged less than 6 hours per night. Plus, adults over 45 who get less than 6 hours per night are 200% more likely to have a heart attack or stroke during their lifetime. The main mechanism behind why this is the case seems to be the link between a lack of sleep and high blood pressure (hypertension), even in young and fit individuals.

I don’t want this blog to feel morbid, so I will keep the rest of the health phase brief. Having less than 6 hours of sleep per night has also been shown to increase the chance of all of the following; heart disease, obesity, dementia, diabetes and cancer.

Workplace & Cognitive Performance:

Reductions in cognitive performance, reaction times, and mood state/emotional stability are often observed in sleep-deprived individuals.

A 2013 study looked into the effect of 6 hours sleep per night on reaction times and lapses in concentration in the average workforce. It was found that performance reduced significantly compared to workers with 8 hours of sleep, just 2 hours difference. They then gave these subjects 2 days of 10 hours sleep per night to replicate a weekend to recover, and they still found that performance did not improve even after this “recovery” period.

Research studies aside, let’s be honest with ourselves. After a bad night of sleep, how much does our will power and motivation to do even the simplest of tasks drop? This is the biggest effect I have felt both personally, and with the hundreds of clients we have worked with over the last few years. At work, we start taking shortcuts. We do the bare minimum and try to “just get through the day”. Lack of sleep creates an unproductive workforce. That isn’t because they are lazy or poor workers, it’s because they aren’t mentally or physically primed for the day. Sleep is the single most important factor in improving productivity. Lack of sleep stops us from being in a position to perform, whether that’s in kicking a football, or staying alert and on-task in the office. Sleep allows us to thrive in the day, not just survive.

No real recommendations at the end of this blog – From all of the research I have done on sleep over the years, it seems 6 hours or less is the number where everything begins to deteriorate. Aim for a minimum of 7 and find your sweet spot from there. I think the stats speak for themselves, get more sleep! The mechanism behind how we get more sleep is the tougher part, which is why we have dedicated a week to delivering information on this. As always, do your research, ask for help when needed.

REFERENCES

https://journals.lww.com/nsca-scj/FullText/2013/10000/Sleep,_Recovery,_and_Athletic_Performance___A.8.aspx

https://journals.physiology.org/doi/full/10.1152/ajpregu.00565.2004

https://journals.physiology.org/doi/full/10.1152/ajpendo.00301.2013