Preparing for the APFT

 

Preparing for the APFT is both a mental and physical effort. If you want to reach optimal performance, it is important to take a whole-body approach, including engaging in cardiovascular exercise and strength training; eating a healthy diet; and getting adequate and quality sleep. 

 

EXERCISE

When beginning your exercise program it is important to pace yourself and slowly increase your activity. This will help you avoid injury, achieve optimal benefits, and reach Army standards. Your standardized physical training program will always include the following elements: a warm-up, the main physical training, and a cool-down. This is the safest and most effective way to train and condition your heart for exercises and progression.

 

Warm- up

The warm-up should last approximately 15 minutes, and occur just before the activities of your physical training session. Performing consistent dynamic (moving) warm-ups can ultimately help improve performance on the APFT.  Dynamic warm-ups like walking prior to jogging and jogging prior to running, prepares the body for more vigorous conditioning activities and can decrease the risk of injury.  Soldiers should also refer to the Army Physical Readiness Training Manual FM 7-22 for the preparation drill that is a dynamic warm-up consisting of ten exercises that appropriately prepare Soldiers for physical readiness activities. 

 

Cardiorespiratory and Strength Training

Cardiorespiratory endurance refers to the body’s ability to utilize oxygen in the working muscles. The standard Army Physical Fitness Test (APFT) involves running, so activities like Ability Group Runs (AGR), speed running, foot marching, and conditioning drills per the FM 7-22, will help you prepare for this event.  Cycling and swimming are also good choices when working on cardiorespiratory fitness.  Strength training at least twice per week is important to prepare for the push-up and sit-up portion of the test.  If your APFT goal is to improve the number of repetitions of push-ups and sit-ups, it is recommended that you perform a variety of upper body and core exercises.

 Ø  Upper Body Exercises:  There are three major muscles groups involved in a push-up: Pectorals, Triceps, and Deltoids.  Maximize your workouts by varying muscles worked and super-setting exercises so that you can combine rest time for one muscle group with work time for another muscle group.  

Ø  Core Exercises: A true core strength training program not only uses your abdominals, but also activates all the muscles stabilizing the spine, hips and pelvis.  Refer back to Army HEALTH’s fitness tool for specific exercises and instructional videos for these specific areas.  Practice will help you increase your APFT scores, but remember that rest is also important.  Incorporating upper body and core exercises into your weekly workout routine will help you reach your goals. 

 

Cool down

The cool down should last approximately 10-15 minutes and should occur immediately after the activities of your standardized physical training session. You should begin the cool down by walking until your heart rate returns to less than 100 beats per minute and heavy sweating stops.  

 

NUTRITION

In addition to exercise, proper nutrition plays a major role in attaining and maintaining total fitness. Good dietary habits on the days leading up to, and including the day of your APFT can greatly enhance your ability to perform at your maximum potential. According to the Department of the Army Fitness Training manual, "Because foods eaten one to three days before an activity provide part of the fuel for that activity, it is important to eat foods every day that are rich in complex carbohydrates." 

 

The night before the test, you can benefit from drinking water and eating fruits, vegetables and lean proteins. On the day of your test, it's a good idea to eat just one light meal before the test begins. Having a light meal will help keep your energy up without feeling sluggish. Here are some ideas for staying energized and hydrated:

  • Half whole-grain bagel with light cream cheese and a cheese stick or slice of turkey breast.
  •  A piece of whole-grain toast with peanut butter.
  •  Apples, bananas or carrots with hummus or peanut butter.
  • Keep water with you at all times.
  • Several hours before your scheduled cardiovascular event, drink at least 16 ounces of water.
  • Avoid rehydrating with sports drinks (if exercising for < 1 hour).
  • Drink 20 ounces of fluid for every pound lost through sweating.

*Remember: It is possible to drink too much water. Listen to your body.   

SLEEP

Sleep is a vital component for peak physical performance, yet it is often overlooked or not prioritized. In addition to increasing energy and endurance, getting enough sleep also aids in muscle recovery, stress reduction, and increased accuracy and reaction time. Research has shown that sleep so strongly affects physical performance, such that your body declines in physical performance by 25% for every 24 hours that your body is deprived of sleep. It is important to get enough sleep all the time, not just the day before your APFT.  Here are some tips for getting more sleep:

  •  Avoid caffeine at least 6 hours prior to bedtime (including soft drinks, tea, and chocolate)
  •  Avoid eating 2-3 hours prior to bedtime
  • Keep the bedroom cool
  • Block noise and light
  • Establish a regular, relaxing bedtime routine such as taking a hot shower. 

The Bottom Line

Train the way you test. This is the best way to ensure that you will do well on your next APFT. Focusing on a whole body approach that includes diet, exercise, and sleep will also aid in preparation. Finally, here are some tips for the day of the test. Good luck! 

  • The night before the test, drink water and eat fruits, vegetables, and lean proteins. Runners also prefer the carbohydrate-boosting energy of pasta the night before a race. 
  • On the day of the test, eat a small snack that consists of a complex carbohydrate and a protein (i.e. whole grain toast with peanut butter).
  • Drink at least 16 oz. of water prior to the test. During the breaks between the tests, drink small amounts of water slowly to replenish fluids lost during sweating.
  • Wear proper running shoes with your PT uniform (i.e. no minimalist “barefoot” shoes).  Additionally, choose a running shoe that is suitable for your particular type of foot .
  • Always warm up and cool down. The warm-up should include a lighter version of your exercise activity, such as jogging before running. The cool down process allows your heart rate and breathing to return to their resting rates. 

 

References: www.active.com, www.miltary.com, http://www.militaryonesource.mil/, http://armyhealth.pbrc.edu/, and FM 7-22.   

Athletic Shoes 101

It’s important to have proper fitting footwear to protect your feet, legs, ankles, and most importantly, your back from discomfort or even injury. Chronic activity with ill fitting, or inappropriate shoes can break down joints and tissue, making it more prone to injury. 

First, it is important to choose the right shoe for the sport to protect your feet from the stresses of that sport.   Walking into a shoe store to buy athletic shoes can be confusing when it comes to buying the right shoe for your feet and your sport of interest.   Second, if you are running, it is of the utmost importance that the shoe be appropriate for your arch height (pronated, average, high arch-underpronate), body type (heavy weight, lean), and also how your foot strikes the ground. 

Here are some tips on observations you can make to help you know what to look for in your next pair of shoes: 

Know your foot

Feet come in a variety of shapes and sizes.  Your shoes should match the shape of your foot and the way your feet strike the ground.  Look at your last pair of shoes.  Notice where they show the most amount of wear.

1. Overpronation: If your shoe shows the most wear on the inside edge, it means that you have low arches or flat feet and have a tendency toward overpronation, meaning your feet roll inward.  This causes extra wear on the outside heel and inside forefoot.  Choose a shoe with high support, and possibly motion-control, depending on how overpronated you are.

2. Underpronation: If your shoes wear out mostly on the outside edge, then this means you have high arches and tend to underpronate, which means your feet roll outward.  This causes wear on the outer edge of the heel and the little toe.  Choose a cushioned shoe with a soft midsole or neural arch depending upon how underpronated you are. 

3. Neutral:  If your shoes wear out evenly on both sides, then you have a neutral arch.  You are in the majority!  Look for a neutral arch shoe or mild stability (if a little pronation) shoe, which has the right combination of cushioning and support. 

Shop around and get expert advice.  Shoe stores offer many kinds of shoes for active people.  Visit one or more stores you trust.  Try on various styles and brands.  Often, private athletic shoes stores in your area (not chain stores usually) have employees that will watch you walk with your shoes off to get an indication of what your personal needs are in a good fit and function. They can also help you choose the shoe best suited for the kind of activity you do. 

Shop toward the end of the day or after working outYour feet swell at the end of the day or after exercising.  Try on shoes when your feet are at their largest.  Be sure to have your foot measured every time you shop for shoes.  Foot size often changes with age so choose shoes that fit, not by the size that you’ve worn in the past.  

Shop with your socksTry shoes on with the kind of socks you normally wear when exercising.  If you wear orthotics, be sure the shoes fit with them inside.  The salespeople will let you replace the insole of the shoe with your orthotic if you ask so you will know how the shoe really fits you as you will wear it. This is key, particularly if you already have injuries or want to prevent any.

No need to break in!  Athletic/running shoes should be comfortable right away. Try them on and walk around. They should NOT need to “stretch out” later.  There should be one thumb’s width of space between your longest toe and the end of the shoe.  The heel should NOT pinch or slip around when you walk, and they should bend easily at the ball of your feet (just behind your toes). Run around the store if you need to make sure. 

Choose the right shoe for your sportEach sport has shoes designed for specific demands made on the feet and ankles.  Look for these features when buying a shoe for your sport:

Note* Athletic shoes should not bend anywhere other than the ball of the foot. If the shoe bends in multiple places, it is likely too flimsy for even a neutral runner and demonstrates poor quality. You would be surprised at how many “fashionable” shoes are flimsy and don’t adequately support the activity.  

 1. Running - Choose a shoe that is light, has a thick, cushioned sole, and supports the foot while moving forward.  You'll need slightly different shoes depending on whether you'll be on the road or on trails. The outsoles of road shoes have just a few grooves in a mostly flat surface. The bottoms of trail shoes have a deeper tread for better traction on dirt or mud. Trail shoes' uppers are often waterproof.  

2. Walking - Choose a shoe that allows your foot to roll and push off naturally while walking.  A walking shoe usually has a fairly rigid arch, a well-cushioned sole, and a stiff heal support for stability. 

3. Aerobics – An aerobic shoe should provide sufficient cushioning and shock absorption and should have good side-to-side stability to withstand forceful impact.  Shoes need an arch support that will compensate for these forces.  It should also have strap support to provide stability to the front of your foot and to prevent slippage.  The upper part of the shoe should be high enough to prevent irritation to your toes and nails.

 4.Cycling – The key to cycling shoes is that they have a hard, completely inflexible bottom. There should be no ability to bend the shoe. Many of the new indoor cycling shoes are very flexible. These are not ideal, particularly for outdoor cycling. The bottom of the shoe should be firm in order to prevent injury to the foot, ankle and even knee and back joints. The upper part of a cycling shoe is the most important part of the fit.  The shoe should fit tightly but not so tight that is can restrict blood flow to the feet.  

5. Cross-Training – Cross-training shoes meet the comfort, cushioning, stability and requirements of many sports and activities.  The bottom soles of cross-training shoes are wide and stable to provide side-to-side support and stability that is needed for a variety of sports.  They are the most economical choice since they allow you to buy a single pair of athletic shoes for a variety of uses.  Cross-trainers, however, are not recommended for those who are on a regular running program. They do not offer enough cushioning and flexibility for runners and are heavier than typical running shoes. 

Consider fit and comfort before priceYou don’t have to buy the most expensive shoe on the market to get the best athletic shoe.  If you want a fashionable shoe or one backed by a celebrity, you’ll probably pay more and it likely won’t be the one you need. Fashionable shoes are usually designed with a neutral foot in mind to fit the majority.  On the other hand, you don’t want an inexpensive pair of shoes that could fail you and cause injury.  Choose a high-quality shoe that fits your foot the best and make sure they are comfortable. 

Know when to replace themAccording to the American Academy of Podiatric Sports Medicine, the average pair of running shoes should be replaced after about 350 to 550 miles.  This means that you should probably replace your shoes before they show any signs of major wear.  The shoe will gradually lose its absorption capacity and stability before it shows signs of wear. If it is not a running shoe you are actually running in (average miles or replace every 6 months), a good rule of thumb is to replace your athletic shoes once per year regardless of whether they still “look good”. Sometimes the wear that could create injury is not evident to the eye.

 

Diabetes: What You Need to Know

Worldwide, 382 million people are diagnosed with diabetes.  Diabetes related deaths claim the lives of 1 American every 3 minutes and is the leading cause of blindness, kidney failure, amputations, heart failure and stroke. Besides the enormous physical and mental strain, people with diabetes face the huge cost to treat diabetes. The total cost of diagnosed diabetes has risen to $245 billion in 2012 from $174 billion in 2007 – according to the American Diabetes Association.

The Basics

All cells in the human body need energy.  When you eat or drink, food is broken down into glucose, a simple form of energy the body needs and uses.  Insulin, a hormone produced by the pancreas, helps remove glucose from the blood stream where high levels cause the symptoms of diabetes. Think of insulin as the mediator that is required to carry glucose from the blood stream to the body’s cells where it can be utilized for energy.   Diabetes occurs when there is a problem with insulin production or activity and results in high blood sugar levels. Let’s take a look at some of the differences between type I and type 2 diabetes.  For our purpose in this blog, we will further examine Type 2 diabetes below.  

*Genetics contribute to both types of diabetes

What causes type 2 Diabetes?

Although we don’t know all of the causes of type 2 diabetes, we know that it is likely a combination of genetics and lifestyle factors.  The good news is that type 2 diabetes can often prevented and reversed through changes in lifestyle habits.  In this blog, we examine the relationship between four key areas of health and type 2 diabetes.   

Physical Activity

Lack of exercise is usually correlated with higher amounts of body fat- which interfere with the body’s ability to properly utilize insulin and, therefore, remove glucose from the blood stream.  During exercise the body is forced to use stored energy as fuel for the workout.  When we don’t exercise, our body is not able to utilize its fuel (glucose) as efficiently.  A higher waist circumference (aka “belly fat”) is also highly associated with increased instances of developing diabetes.  This is because excess abdominal fat produces hormones and other substances that cause harmful effects on the body such as an increase in the production of LDL (“bad” cholesterol), heart disease, and increased insulin resistance

How can I prevent/reverse it?  Move more.  Exercise decreases body fat and promotes weight loss.  Both of which have been shown to have a positive impact on diabetes management.  Unhealthy amounts of body fat can impair the system that regulates hormones involved with diabetes. Conversely, muscle helps the body improve the process of insulin and blood glucose regulation.  The recommended amount of physical activity for those with or approaching diabetes is the same as for those without diabetes: 150 minutes of moderate to vigorous activity per week.  Taking a brisk walk, bicycling, and swimming are all good examples of ways to meet this goal. 

Dietary Intake

The typical American diet is high in white bread, pasta, soda, highly processed food, and junk food.  Foods like this which are high in carbohydrates can have a negative impact on diabetes. When too many carbohydrates are consistently eaten, blood glucose levels remain high, and over time, the body becomes less efficient at utilizing insulin to reduce blood sugar levels.  The whole process starts to malfunction and this is the beginning of insulin resistance and diabetes.

How can I prevent/reverse it?  Focus on replacing, not eliminating food groups.  Carbohydrates have a much larger impact on blood sugar levels than fats or proteins, so that’s why it’s important for people with diabetes to be mindful of carbohydrate intake.  In spite of what is commonly said, managing diabetes isn't as much about completely eliminating foods from your diet. It’s more about replacing sugary, starchy food sources like, fried food, soda, and sweets with healthier choices like protein based dishes, low carb fruits and vegetables, and water.  Portion size is a key factor.  Typical meals should consist of a protein, a healthy fat, and a whole grain carbohydrate; a small sweet treat should be reserved for special occasions only. 

Sleep

Research has demonstrated the correlation between sleep loss and risk for weight gain, insulin resistance, and type 2 diabetes.  When sleep deprived, our body’s hormones are thrown out of balance.  For example, the stress hormone cortisol is higher when sleep is inadequate.  Elevated levels of cortisol can prompt insulin resistance which interferes with the body’s metabolism and ability to properly regulate blood glucose levels.  Reduced sleep has also been shown to reduce levels of the hormone leptin which is an appetite suppressant; and increase levels of the hormone ghrelin which is an appetite stimulant.  With these two key hunger hormones out of balance, it is more difficult to regulate dietary intake and this is when we often see overall increased caloric consumption as well as increased consumption of carbohydrates, specifically. 

How can I prevent/reverse it?  Prioritize Sleep. For some, improving sleep may be a matter of prioritizing an earlier bed time.  For others, a deeper delve into personal sleep habits may be needed.  One place to start is to make sure you are maintaining a regular schedule by getting up and going to bed at the same time every day. Secondly, make sure to eliminate all sources of caffeine (soda, coffee, tea, chocolate) at least 6 hours prior to bedtime.  Lastly, make your bedroom a haven for sleep.  A bedroom that is favorable to sleep is one that is dark, quiet, cool, and comfortable. 

Mind/Body

Both mental and physical stress can have an impact on people with diabetes.  Stress hormones like the aforementioned cortisol, and epinephrine can negatively impact diabetes.  Let’s think about the fight or flight process.  When we react to an urgent, stressful situation our body releases a series of hormones that start a cascade of processes that draw energy from our stores which increases blood glucose levels and allows us to utilize energy for our fight-or-flight response.  For people with diabetes, exposure to long term stress hormones decrease insulin’s ability to remove glucose from the blood stream and blood sugar levels become more imbalanced.  It can be a viscous cycle. 

What How can I prevent/reverse it?  Being more mindful of daily lifestyle habits is a good place to start.  According to the American Diabetes Association, you can decrease your risk for type 2 diabetes by making lifestyle modifications like the ones listed below:

Overweight & Obesity Stigma: Shaming Helps No One

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Fat shaming is a form of public humiliation aimed at evoking a change in the name of “health”. It occurs every day to people of all ages, races, sizes, educational and socio-economic backgrounds. It happens at home, school, and work. At its most detrimental level, it’s precipitated by those whom we trust the most: our family members and health care providers. Often, these shameful thoughts and generalizations are internalized and eventually we become our own bullies.

The stigma associated with being overweight and obese often manifests into discrimination-which can be just as damaging as other forms of discrimination. The consequences bear devastating mental and physical health outcomes. In the past decade, the prevalence of weight discrimination in the United States has increased by 66% and is still climbing. This issue is something we can no longer avoid as a society.

The Impact of the Media

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Fat shaming can be seen just about everywhere you look. Take for example a recent Scooby-Doo movie that “cursed” Daphne with being overweight, emphasizing to children that being overweight is something to be ashamed of…a “curse”.

The “fitspo” aka “fitness inspiration” community has no doubt reinforced this message. With mantras like “if you just run 5 miles a day or do this specific workout…you will look like this” [insert picture of extremely lean and toned, shirtless guy/girl in spandex],

WeightStigma

the focus is often skewed toward appearance rather than health. What the fitspo community fails to mention is that the model in the picture doesn’t do that particular workout at all. Everyone’s body is different and will respond to a workout in its own unique way.

The idea that reaching and maintaining a healthy weight is a matter of trying hard enough is apparent in almost any infomercial and/or print media for an exercise routine, diet, or supplement. Advertisements emphasize the idea that weight loss and being healthy is a matter of calories in and out, using the right products, or engaging in the right exercise routine (which you too can partake in for the right price) and that people must be lazy if they are overweight. The diet and fitness industry capitalize off the belief that being overweight is a character flaw, evoking a demand for their product by those in need of gaining back lost virtue.

A 2008 study revealed the tendency of the media to selectively report on scientific article findings and to frame weight and health related news stories in a way that dramatizes the content and fosters individual blame. However, recent research has shown that this is not a good strategy to evoke positive public health change. For example, studies have shown that fat shaming actually has the potential to lead individuals already struggling with weight management to gain more weight in some cases, thus, the original intention of the shaming backfires. As it should- bullying, shaming and discrimination overall, have never been shown to be beneficial to anyone.

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So much of what we see in the news and in product advertisements conveys that body weight is a direct indicator of health. Although we agree that weight is an important factor in assessing health, it’s much more complicated than that and additional factors must be considered for a complete picture. Recent research indicates thin people too, can be “fat”. This is a direct message to not judge a book by its cover. Research has more than established at this point that thin does not necessarily equal healthy, and overweight does not necessarily equal unhealthy. What we see on the surface is only a small representation of what going on below the surface.

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Missing the Mark

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Take for example, the 2012 Strong4Life ad campaign which is part of Children’s Healthcare of Atlanta Pediatric Hospital’s five-year, $25 million initiative designed to curb childhood obesity in Georgia. The campaign features pictures of seemingly overweight children with a “warning” that states “it’s hard to be a little girl if you’re not” and “fat prevention begins at home…And the buffet line”. Their newest video demonstrates how a fat child, enabled by “bad” parenting, is led to have a heart attack through a series of lifelong bad habits.

It’s hard to understand why people say and do the things they do in relation to overweight people. A concerned parent of an obese child may think they are helping their child by saying something like “a minute of the lips, forever on the hips”. But in reality, these types of comments are embarrassing and will not encourage the child to make healthier choices. Instead, a more likely outcome is they’ll learn to eat alone and in shame during their next meal.

By the same token, health care providers are often uncomfortable approaching the subject and may not realize that simply telling someone to eat less and exercise more will not always help. In a recent interview, Dr. Rebecca Puhl, Deputy Director for the Rudd Center for Food Policy & Obesity at Yale, spoke about the issue of weight related bias in the health care system. “Women with obesity report that doctors are one of the most common sources of weight bias in their lives – 69% of women reported these experiences with doctors. Negative weight related attitudes and stereotypes toward patients with obesity have been documented among physicians, nurses, medical students, dietitians, psychologists, and even health professionals who specialize in obesity. Stereotypes include assumptions that patients with obesity are non-compliant with treatment, lazy, and lack willpower and motivation to improve their health.” said Puhl. This brings to light the complexity of the issue. Oftentimes health care providers may think they are helping a patient lose weight by “encouraging” them, but in all actuality, that’s not what happens. Simply put: you can’t shame people into being “healthier”.

Adverse effects

People that are exposed to more weight based discrimination are more likely to experience shame, gain weight, stop seeking medical treatment, and avoid exercise. Depression, emotional eating, and low self-esteem also play a role. Research has shown that overweight people who reported discrimination based on weight were more than twice as likely to be obese four years later than people who didn't experience such discrimination. As research has more than established, making someone feel bad about themselves does not encourage healthy behavior change.

The Need for a Shift

It’s time for a shift in the conversation- from body size, numbers, and shaming to a positive focus on individual health behavior change. As a community, we need to encourage and enable everyone to make healthier lifestyle choices. Shame does not have a place in health promotion and is not an effective motivator of change.

 

Image Sources: Daphne; Glacier; Strong4life;

Sports Drinks

Sport Drink_infographic_WITH LOGO

 

What to look for: natural sources of electrolytes like bananas & coconut water 

What to stay away from: sports drinks all together unless intensely exercising

Sports drinks are intended to maintain hydration and restore electrolyte balance lost during heavy exercise. Electrolytes are maintained in body fluids and needed for nerve impulses and muscle contractions. Electrolytes like sodium and potassium are lost through heavy sweat and must be replaced to keep the concentrations in your body fluids constant. But, buyer beware.  On average, sport drinks contain 20 grams of sugar in one 12 oz. serving.  That’s over 13 teaspoons of sugar in the average 32 ounce sport drink bottle. All of the added calories from sugar can seriously interfere with weight loss/maintenance efforts in addition to sending blood sugar levels on a roller-coaster ride of peaks and valleys. Therefore, it is important to know when sports drinks are appropriate and useful and when they are not necessary.

Sport drinks are ideally used by athletes engaged in high‐intensity workouts lasting 60 minutes or more. They are not recommended for routine consumption.  However, factors such as duration of exercise and weather conditions can affect the need for an athlete to supplement carbohydrate and electrolyte loss with a sport drink.  It is especially important to be mindful of electrolyte loss when exercising in high temperatures.

Most people exercising at a moderate-vigorous rate can stay hydrated and energized by eating a healthy meal or snack and drinking enough water prior to and during their workout. Check out the list below of electrolytes and common food sources for each.

Potassium-bananas, kiwis, green leafy vegetables, sweet potatoes

Magnesium- green leafy vegetables, whole grains, nut butters, pumpkin

Calcium- milk, yogurt, black eyed peas

Chloride- olives, tomatoes, celery

Sodium- The typical American diet is quite high in sodium, so dietary need to supplement is rare. However, nut butters are a healthy source of sodium if needed.