Newsletter #96 - August 2009

In this issue:

-- From me to you, Dr Paul Lam
-- Managing Diabetes with a Healthy Lifestyle, Alan Barclay
-- Tai Chi for Diabetes is Part of the Solution, Pam Kircher
-- Inaugural Tai Chi for Diabetes Workshop in Hawaii, Iliena Ferrier
-- Tai Chi for Diabetes: The 3-in-one Gym in a Box, Maureen Miller
-- Tai Chi and Women's Health, Stephanie Taylor
-- Humour, Laughter and Radiant Health, Bob McBrien

Click on the title above to read the articles, this link to read all previous newsletters and here to subscribe.

Hello Everyone,

As we age we face increasing challenges in life especially losing the quality of life we are used to from different

Dr Paul Lam in Eaglehawk Neck Tasmania during his Depth of Tai Chi for Arthritis Workshop July 2009

chronic conditions. Arthritis and diabetes are two of the major conditions which can be debilitating in the aging process. However, keeping a healthy lifestyle with exercise and diet will allow us to maintain our quality of life, reduce health risks and even help the community save health dollars.

When we conducted our Tai Chi for Diabetes study , we learned people with diabetes tend to be less interested in exercise and less coordinated. It seems to me there is a vicious circle. The less you exercise the less you will do well in exercise related sports, and the less you will be motivated to exercise. Likewise with coordination, less exercise usually amounts to being less coordinated. Is it possible that people who are genetically less coordinated also have a higher chance to develop diabetes or is it an environmental factor? These can be exciting topics for medical research.

What is encouraging in this study is we found by using the positive, stepwise progressive teaching method, people with diabetes could learn Tai Chi for Diabetes quickly and actually enjoy practising it soon after. This group gained considerable health benefits and their coordination seemed to have improved.

I firmly believe a good teaching method can make a significant difference to whether people will take up and adhere to an exercise program, thus improving health and reducing the risk of developing chronic conditions such as diabetes.

Thank you for your positive feedback regarding the inclusion of a feature video clip in the newsletter. This month I have one of Stephanie Taylor’s talk on Preventive Medicine which she gave in June during the USA one week workshop in Memphis. Click here to view. This talk is also in the form of an article in this newsletter titled “Tai Chi and Women’s Health”.

I will soon be starting my workshop tour in September. This time I will be visiting Singapore, Manchester, Barcelona and Zurich (in Europe), Florida, Colorado, Oregon and California (in the USA). Please check my website under Calendar if you are interested in attending any of the workshops. I’m certainly looking forward to be meeting with some of you.

The brochure for the Sydney January workshop is now available. It has also been posted online. If you require hard copies please email or contact my office.

Thank you for participating in the “Win a Set of the Latest Tai Chi for Arthritis DVDs” competition. I was so impressed with your wonderful experience and innovative use of the DVDs it was difficult to pick just one winner so I have settled on two. I was moved by Egalo’s motivation to manage your rheumatoid arthritis; the proactive way you used my DVD to improve the management of your condition. With JM, I was impressed with how you shared the copy with your instructors and friends and encouraged them to buy their own copy and use it while travelling. I also liked your understanding of tai chi benefits. I look forward to meeting with all of you who contributed in the near future.

In an attempt to merge the different threads, have lost the link, so some of you may not have been able to post your review. I’m giving you the correct link again and extending the competition for another two weeks.
Please go to the forum and click on this link.

Next month we will take a fresh direction, the theme will be “How to make the most of your productive time”.

In this newsletter:

Alan Barclay, an expert on diabetes management from Diabetes Australia, confirms regular physical activity and healthy diet in combination with tablets or insulin helps lower blood glucose levels.
Master Trainer and MD, Pam Kircher gives alarming statistics of how widespread diabetes is in the USA and how Tai Chi for Diabetes can be a part solution to this problem.
Iliena Ferrier, a Senior Trainer in Hawaii, puts Pam’s words into action by conducting the first Tai Chi for Diabetes workshop in Hawaii.
IDF and ADA in USA recommend aerobic and flexibility exercises to prevent Type II diabetes. Senior Trainer Maureen Miller shows how Tai Chi for Diabetes incorporates these physical activities without the trappings of the gym.
As an OBGYN, Stephanie Taylor enlightens us with her knowledge on women’s health. As a Master Trainer, she shares with us how preventive medicine for women can be achieved through the Tai Chi for Health program.

This Month’s Special:

Tai Chi for Diabetes -– Instructional DVD
Tai Chi for Diabetes – Movement Chart
Tai Chi for Diabetes: Living Well with Diabetes -- Book

Buy the Tai Chi for Diabetes DVD and Movement Chart and receive a FREE, Tai Chi for Diabetes Book valued at USD $20.95 or AUD $29.95

Limit to one order per person. Click here for more information or to place your order.

Upcoming workshops by Dr Lam:

August 22 - August 23, 2009. Sydney, Australia
Exploring the Depth of Tai Chi for Arthritis

August 29 - August 30, 2009. Moorabbin, VIC, Australia
Exploring the Depth of Tai Chi for Arthritis

September 3 - September 4, 2009. Sydney, NSW, Australia
Therapeutic Tai Chi

September 19 - September 20, 2009. Brisbane, QLD, Australia
Tai Chi for Diabetes Instructor Training

October 1 - October 2, 2009. Manchester, United Kingdom
Exploring the Depth of Tai Chi for Arthritis

October 3 - October 4, 2009. Manchester, United Kingdom
Tai Chi for Osteoporosis Instructor Training

October 10 – October 11, 2009. Barcelona, Spain
Tai Chi for Diabetes Instructor Training

October 17 - October 18, 2009. Zurich, Switzerland
Exploring the Depth of Tai Chi for Arthritis

October 24 - October 25, 2009. Kingsland, GA, United States
Tai Chi for Osteoporosis and Fall Prevention Instructor Training

October 31 - November 1, 2009. Teller County, CO, United States
Exploring the Depth of Tai Chi for Arthritis

November 7 - November 8, 2009. Sisters, OR, United States
Exploring the Depth of Tai Chi for Arthritis

November 14 - November 15, 2009. Pleasant Hill, CA, United States
Exploring the Depth of Tai Chi for Arthritis

Many other workshops conducted by my authorised master trainers are listed in the Workshop Calendar.

Yours in Tai Chi,

Paul Lam, M.D.

http://www.taichiproductions.com

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Managing Diabetes with a Healthy Lifestyle
Alan Barclay, Chief Scientific Officer at Glycemic Index Foundation, Human Nutrition Manager at Diabetes Australia.

Alan has a PhD from the University of Sydney on the association between glycemic carbohydrate (glycemic index

Alan Barclay, Chief Scientific Officer at Glycemic Index Foundation, Human Nutrition Manager at Diabetes Australia

and glycemic load) and the risk of developing lifestyle-related diseases like type 2 diabetes, heart disease and some cancers. Since 1998, Alan has worked for Diabetes Australia in both a full and part-time capacity and prior to that as Research and Development manager. Alan is the official Media Spokesperson for the Dieticians’ Association of Australia. He has appeared frequently in local newspapers, magazines, and radio and television news. Alan is also one of the co-authors of the New Glucose Revolution: Diabetes & Pre-diabetes handbook.

Rates of diabetes are increasing rapidly around the globe. The most common form, type 2 diabetes, affects around 80% of sufferers and is primarily a metabolic disease caused by a combination of poor diet and inadequate physical activity in people that are genetically susceptible like most indigenous people, and people from South-East Asia, and the Middle East. The less common form, type 1, is predominantly an autoimmune disease, and occurs in genetically susceptible individuals and is believed to be triggered primarily by viral or certain dietary factors. Common complications of both types of diabetes include kidney disease, nerve damage, retinopathy (eye damage), heart disease, stroke and damage to the circulation in the feet and lower legs. Whatever the type of diabetes, management involves following a healthy diet and regular physical activity, usually in combination with tablets or insulin to lower blood glucose levels.

One of the most important dietary considerations is to achieve and maintain a healthy body weight by matching your kilojoule intake to your physical activity level. In addition to this, your diet should also be reduced in saturated fat and low in trans fat and sodium to help reduce blood cholesterol and blood pressure, and consequently decrease the risk of heart and blood vessel diseases. Despite the current interest in high protein diets, people with diabetes should only eat a moderate amount of protein – high protein diets should be avoided as they may exacerbate kidney disease. To help achieve and maintain optimal blood glucose levels, carbohydrate-containing foods should be high in dietary fibre and preferably have a low glycemic index (GI). Low GI foods include low fat dairy foods like milk and yoghurt; most fruits with the exception of some tropical fruits and melons; beans, chickpeas and lentils; pasta, noodles and some rice (Moolgiri and Doongara); grainy breads and some breakfast cereals like rolled oats and muesli. An easy way to identify healthy low GI carbohydrates is to look for foods that carry the GI Symbol. Carbohydrate foods should also be spread out evenly throughout the day and matched to insulin/diabetes medication.

People with diabetes benefit from most types of exercise as it improve their general health as well as increases the ability of their body to use insulin. Aerobic exercises like walking, jogging, swimming, riding a bike, etc…are great for cardio-vascular fitness, whereas resistance training like lifting light weights (not body building!), calisthenics, or using a resistance band are great for toning and strengthening the body, and increasing muscle mass which will improve insulin sensitivity. Gentle exercise like Tai Chi may also provide general improvements in physical health and have been shown to improve social functioning. Whatever you choose, do something that you enjoy and do it regularly. Ideally, aim to do 30-60 minutes of exercise, at least 3-5 days a week.

It has been proven that people can prevent, or at the very least delay, the common complications of diabetes, and improve their quality of life, by following a healthy lifestyle.

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Tai Chi for Diabetes is Part of the Solution
Pam Kircher, MD, Master Trainer, Durango, CO, USA

Over the past decade there has been an alarming increase in the incidence of Diabetes in industrialized societies

Pam Kircher, MD and Master Trainer of the Tai Chi for Health Programs

and particularly in the U.S. 40% of Americans are overweight and at risk of developing Diabetes.

Diabetes is a chronic disease that not only involves the inability of the body to metabolize sugars, but also increases the incidence of heart disease and strokes, nerve damage to the feet leading to infections and falls, and decreased eye sight. It is a very debilitating and expensive chronic disease process. Type I Diabetes is not initiated by a poor lifestyle, but Type II Diabetes is. 90% of people with Diabetes have Type II Diabetes. And the incidence of Type II Diabetes is soaring. While there is some genetic component to Type II Diabetes, it is a largely a disease resulting from a poor diet, no exercise and much stress.

Lifestyle is such a huge component in the development of Diabetes that a study in the New England Journal of Medicine reported that lifestyle changes in people with an abnormal glucose tolerance test (a precursor of Diabetes) had 57% fewer conversions to Diabetes than people who took medication alone (39% decrease) when compared with controls who did not change their lifestyles. Those lifestyle changes were exercise and diet. As a further illustration of the impact of lifestyle on the development of Diabetes, after a lifetime of fast foods and video games, American teenagers are now developing Type II Diabetes for the first time ever and at an alarming rate! These trends are present in all industrialized societies, but not at the rate seen in the U.S. The U.S. story is a cautionary tale for other industrialized countries as well as developing countries.

Tai Chi for Diabetes is part of the solution to this problem. It was particularly designed by Dr. Lam and Diabetes experts to not only help to prevent Diabetes but to help to control Diabetes in those who already have the chronic disease. Like other forms of Tai Chi for Health, the slow gentle exercises help to build up strength, flexibility, aerobic capacity, and balance. The decreased stress that results from regular Tai Chi improves glucose (sugar) metabolism. The exercise improves the glucose uptake at the cellular level resulting in normalizing the blood glucose level. In addition, this particular form stimulates the meridians described in Chinese medicine that help to improve glucose control. It also is of a progressive nature so that people on Diabetes medication are less likely to encounter sudden drops in sugar than if they were doing other forms of exercise.

You can be part of the solution! If you are already a Tai Chi for Health instructor, you can get certified as a Tai Chi for Diabetes instructor at a workshop listed on this website. You can bring the Tai Chi for Diabetes program to the attention of your local health care providers including the Diabetic educators in your community. If you already know the form, volunteer to do a demonstration at a Diabetic support group meeting. Finally, continue to be a voice in your community and in your Congressman’s offices for investing in health care through Prevention and Wellness!

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Inaugural Tai Chi for Diabetes Workshop in Hawaii
Iliena Ferrier, Senior Trainer, Kapolei, HI, USA

I am happy to share that the State of Hawaii has enjoyed her first Tai Chi for Diabetes Workshop that successfully certified 12 instructors.

Our participants were from physical therapy clinics, fitness professionals, assisted living center, public school system, in-home care agency, acupuncturist, and 2 tai chi practitioners wishing to instruct in a veterans hospital (one is in a wheelchair). The varied backgrounds resulted in rich exchange of information between participants, laughter, and the promise of lasting new tai chi friendships.

As a Senior Trainer, I am very pleased to support our new instructors through continuing programs to enrich their tai chi growth and regular opportunities to share information. Everyone is inspired with their new skills and is looking forward to our first practice together as “fellow instructors”!

As a member of the Hawaii’s Diabetes Coalition, I am sharing and exchanging information on intervention programs. The response has been positive. I also serve on the State of Hawaii’s Dept. of Health’s Fall Prevention Consortium. The program proposal is to use tai chi as a theraputic exercise.

It is exciting and rewarding that I am continuing to meet new professional friends from various organizations (i.e., Kidney, Cancer, Chronic Diseases, Native Hawaiians and Education) that want to learn more about Tai Chi for Health. I believe we will continue to see future workshops in Hawaii!

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Tai Chi for Diabetes: The 3-in-one Gym in a Box
Maureen Miller, Senior Trainer, St Marys, GA, USA

“Diabetes currently affects 246 million people worldwide and is expected to affect 380 million by 2025. In the US alone, the total annual economic cost of diabetes in 2007 was estimated to be $174 billion.”

These statistics, from the International Diabetes Federation and American Diabetes Association websites, are mind-boggling. But what is even more astonishing is that up to 80% of type 2 diabetes is preventable by adopting a healthy diet and increasing physical activity. Physical activities recommended by the American Diabetes Association include aerobic exercise, strength training, and flexibility exercises.

Many folks still think this means going to the gym for a step or aerobic class, into the weight room for the strength training, and then back to the aerobic room for yoga. And to do this, you got to have a gym - or outfit your house like a gym. Unfortunately, in today’s society, this barrier, along with time and expense, become the excuses for not including physical activity into daily routines. As long as these roadblocks exist, every 10 seconds two people worldwide will develop diabetes and our medical costs will keep rising.

Fortunately, we who teach Tai Chi for Health have tools that can be used to demolish these barricades. Like a gym in a box, the Tai Chi for Diabetes DVD and classes offer 3-in-1 physical activities can be undertaken by almost everyone, almost anywhere, anytime and any place.

These programs are based on ancient exercises; ones that take into consideration the need for aerobic and flexibility exercise, along with strength training, without all the trappings of a gym.

Tai chi is a low impact aerobic activity. It is estimated that a person practicing tai chi for an hour will burn slightly more calories than she would in that same hour while walking at a brisk pace, leisurely bicycling or skiing downhill.
While performing the same activity, the tai chi player is also undergoing strength training, by practicing the tai chi principle of working against a resistance.
The same activity provides flexibility exercise as one applies the principles of moving with joints relaxed and observing weight transference.

When presented this way, how can folks possibly resist a chance to get up and get physically active with our 3-in-1 Tai Chi for Diabetes program?

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Tai Chi and Women's Health
Stephanie Taylor, MD, Ph.D., Master Trainer, Carmel, CA, USA

This talk was delivered by Stephanie at the recent USA one week workshop in Memphis, click here to see a video of her talk.

Women's health care is every one's health. Women are the primary consumers of health care and they usually decide on the health care utilisation of their husbands and children. Taking care of women means that you are taking care of the whole family. As the largest consumer of health care, women really set the tone for the nation. Women are in a position to be highly influential in the move to an improved health care system.

On June 15th, President Obama addressed the American Medical Association House of Delegates. In his speech, he stated that we, as a nation, are spending $2 Trillion a year on health care. This is 50% more than the next most expensive nation. What are we getting for that? We have the problem of the uninsured, which drives up costs for everyone and less than optimal care for those who are insured. We trail other nations in infant mortality, and overall longevity. I quote: "If we do not fix our health care system, America may go the way of GM, paying more, getting less and going broke. To say it as plainly as I can, health care reform is the single most important thing we can do for America's long term fiscal health. That is a fact".

You will be pleased to hear the two most important steps President Obama identified are:
1. Development of an electronic medical records system,
2. Investment in preventive care.

He states specifically that "Preventive care means doctors telling us what risk factors and what preventive measures we should pursue." He specifically cites: preventive screenings, eating well, and exercising.

Modern medicine can be described as building larger and faster speed boats to rescue drowning people in a fast moving river. Prevention means sending someone up river to see why people are falling in. Prevention has two aspects. The majority of the most expensive illnesses are preventable. Once the illness has established, we can prevent additional complications and their emotional and financial costs. Let us take arthritis, osteoporosis and diabetes.

Twenty seven million Americans have osteoarthritis, the most common form of arthritis. It is not just due to aging, but a lifetime of accumulated trauma. As we live longer we will see more osteoarthritis because our joints have had more interesting life experiences. Tai Chi has three beneficial effects on arthritis-fall prevention, fall management and reduction of symptoms after injury has occurred. We can prevent joint damage with good body mechanics. Tai chi is an excellent training for improved body mechanics. There is a large body of research that shows tai chi it is excellent at fall prevention. I would share with you that it is also excellent at fall management. Some of you know that I have an interest in horse back riding. I have two significant falls in the last two years. My training in tai chi allowed me to walk away uninjured from a fall that would have otherwise damaged joints or caused a fracture.

I see patients with bone loss daily in my practice. Both men and women experience bone loss, but women to a greater degree. There is a prevalent belief that once bone loss is identified on a DEXA scan that the treatment is taking a pill to strengthen bones. That is true, of course, but incomplete. Many factors contributed to the bone loss-nutrition, Vitamin D deficiency and lack of exercise. All three need to be addressed before prescribing a medication. An exercise program, including tai chi, is essential in preventing further complications of the disease.

Diabetes affects both men and women. There is increasing appreciation that diabetes is a cardiovascular disease equivalent and they should really be thought of as different aspects of a similar disease process. As such, heart disease kills ten times more women than breast cancer. Tai chi has a role in many aspects of diabetes and CV disease prevention and management. Several high quality studies are published annually.

The Tai Chi for Health Community website has a complete listing of current supporting research with abstracts: http://www.taichiforhealthcommunity.org/

What is the future?

Can you imagine a time fifty years in the future, when everyone has excellent health care. They look back at our time and remark that they find it astonishing that no one had a daily personal health maintenance practice. Can you imagine! They carried on with a stiff upper lip until they collapsed and were taken to hospital!

But what can we do right now? If we are interested in prevention, when should we initiate our intervention? If we are interested in developing excellent body mechanics, we should start in pre kindergarten, Tai Chi for Kids. If we are interested in preventing arthritis, we will change the physical education and sports programs in the public schools. Team sports need to have an injury prevention program that starts in the physical education department. This could truly live up to their name of "physical education". Instead of educating a generation to be highly skilled observers of the professional football scene, they could teach each and every individual to take care of their own physical body in any situation. If we are interested in preventing osteoporosis, we can teach real nutrition from a garden planted at every secondary school, and get those kids outside playing hopscotch and jumping rope. If we are interested in preventing cardiovascular disease, we can do all those things, and also teach them how to heal the broken heart in the gentle embrace of a loving community. And we will teach them how to create that community if they were not born to it.

We are living in a difficult, challenging and very interesting time. This is the beginning of a renaissance for health care. And we are here on the threshold. I would like to end with a blessing from my soul friend John O'Donohue:

Though your destination is not yet clear
You can trust the promise of this opening
Unfurl yourself in the grace of beginning
That is at one with your life's desire

Awaken your spirit to adventure
Hold nothing back; learn to find ease in risk
Soon you will be at home in a new rhythm
For your soul senses the world that awaits you.

From “To Bless the Space between Us” by John O'Donohue, Doubleday

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Humour, Laughter and Radiant Health
Dr Bob McBrien, Salisbury, Maryland, USA

Developing our ability to find a good laugh each day contributes to an optimistic outlook on life. I read a quote by

Dr Bob McBrien and Dr Paul Lam in tai chi pose

Mark Twain that instructs us on this point. He said, “Humour is a great thing…The minute it crops up, all our hardness yield, all our irritations and resentments flit away, and a sunny spirit takes their place.”

I find that the ability to poke fun at life is a key trait of the happiest folks taking my tai chi for health classes. Sometimes finding the laugh of the day is easy when a newspaper headline is funnier than the cartoon page. Here are a few examples of headlines that got past the editors.

Police Begin Campaign to Run Down Jaywalkers
Panda Mating Fails; Veterinarian Takes Over
War Dims Hope for Peace
Cold Wave Linked to Temperatures
Red Tape Holds Up New Bridges
New Study of Obesity Looks for Larger Test Group
Local High School Dropouts Cut in Half

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END OF NEWSLETTER
Warning: Dr. Lam does not necessarily endorse the opinion of other authors. Before practicing any program featured in this newsletter, please check with your physician or therapist. The authors and anyone involved in the production of this newsletter will not be held responsible in any way whatsoever for any injury which may arise as a result of following the instructions given in this newsletter.

Ask Dr Lam - you can ask me anything about tai chi here.

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