When many of us think of “exercise” we envision long stints of strenuous activity such as running and weight-lifting. For many of us, that sort of fitness regimen conflicts with the daily demands of modern life, so we do nothing. According to the Centers for Disease Control and Prevention (CDC), however, we can all realize health benefits from even modest levels of physical activity.

Most adults need about 30 minutes of moderate physical activity at least five days a week, according to the CDC. That’s just two and one-half hours. We’re not talking hardcore gym workouts here, either. We’re talking bicycling, swimming, dancing, or perhaps the easiest: brisk walking.

For people with long histories of inactivity, walking is a great way to ease into a successful exercise program. Start slowly, be consistent, maintain your speed and pace, and before long you should realize the benefits identified by the American Podiatric Medical Association (APMA), such as:

• Stronger lungs and heart and improved circulation.
• Lower chance of heart attacks and strokes.
• Reduced chance of obesity.
• Lower blood pressure.
• Higher metabolic rate.
• Safer cholesterol levels.
• Improved muscle tone in the legs and abdomen.
• Reduced stress.
• Less arthritis pain.
• Reduced bone decay.

Here’s another great finding: You don’t need to burn those walking minutes all at one time. 10 minutes of walking at a time is fine, so long as you walk with moderate to vigorous effort.

Convinced? Ready to get started?

First things first, talk to your doctor to make sure there are no physical barriers to your walking program.

Next, set some goals. Short-term, you might want to start out slow, walking maybe 10 minutes a day five days a week. Mid-term, you might shoot for 150 minutes of total walk time over five days a week. You could make your long-term goal to exceed this minimum. Higher levels of activity recommended by the CDC include:

• Two and one-half hours of moderate-intensity aerobic activity (such as brisk walking) five days a week plus muscle-strengthening activities two or more days a week. Your muscle workout should include the legs, hips, back, abdomen, chest,  shoulders and arms. Or …
• One hour and 15 minutes of vigorous aerobic activity weekly (such as jogging or running) plus muscle-strengthening activities on two or more days a week. Or …
• A combination of moderate and vigorous aerobic activity five days a week plus muscle-strengthening activities two or more days a week.

You might find that achieving your short- and mid-term goals is easier if you don’t have to set aside specific times to “exercise.” To work your 10-minute walking stints into normal daily activities, for example, you might:

• Park your car farther out in the parking lot.
• Take the stairs instead of the elevator.
• Visit a friend or co-worker instead of calling or emailing them.
• Mow your lawn.
• Walk briskly through the shopping mall.
• Walk in the park.
• Walk your children to and from school.
• Walk your dog.
• Talk an after dinner stroll with family or friends.

To see how quickly even short walks add up, get a pedometer to count your steps. First, figure out how many steps you take in a normal day. Then, try to add 300-500 steps to your routine each day. Work toward a moderate goal of 2,000-2,500 more steps a day. As a long-term goal, you might aim for 10,000 steps a day - that’s about 5 miles!

To make your walks as safe and healthful as possible, the APMA and others recommend that you:

• Breathe deeply and move at a brisk, steady pace that makes your heart beat faster. 
• Walk with your head erect, your back straight, your abdomen flat, and your arms swinging freely.
• Land on the heel of your foot, then roll forward to push off on the ball of your foot.
• Wear comfortable, good-quality shoes and socks that breathe and cushion your feet.
• Take a water bottle with you, and drink plenty of water as you walk.
• Try to confine your walks to level stretches of flat surfaces. Use sidewalks and paths.
• Walk in a well-lighted, safe, and familiar places. If you’re walking in the evening, wear reflective clothing.
• Carry a cell phone for emergencies.
• Cool down and stretch after a long walk.

To help stay motivated to meet your goals, keep a log of your activity. This will strengthen your routine, show you how far you have come, and encourage you to work harder to achieve more in the future.

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For years, many of us have heard the oft-repeated advice of various experts: Drink at least eight glasses of water, eight ounces each, daily. Commonly referred to as the “8X8″ rule, this advice is well-intentioned. Upon closer examination, however, it would appear that consuming only 64 ounces of water might not actually be enough.

Your body is composed of between from 55 percent and 78 water, depending on your size. Water helps you maintain a normal body temperature, lubricate your joints, and eliminate wastes through sweat, urination, and bowel movements. When dehydrated, you can experience muscle weakness, cramping, lack of coordination - and potentially - heat stroke. While people can survive weeks without food, most only last a few days without water.

Water is lost from our systems through sweat, urination, sweating, and even breathing. Excessively warm weather, vigorous physical activity, or illnesses that involve vomiting or diarrhea can increase this normal loss. So, to be healthy, we all need to replenish water at a baseline rate and increase water consumption to compensate for above average depletion. For many years, that baseline was defined uniformly with the 8X8 rule at about 64 ounces, or two liters, a day for everybody. While the rule is widely accepted, however, it has proven hard to verify.

In his American Journal of Physiology article Drink at least eight glasses of water a day. Really? Is there scientific evidence for 8 × 8?, Heinz Valtin of Dartmouth Medical School states:

“Despite the seemingly ubiquitous admonition to ‘drink at least eight 8-oz glasses of water a day’ (with an accompanying reminder that beverages containing caffeine and alcohol do not count), rigorous proof for this counsel appears to be lacking. This review sought to find the origin of this advice (called ‘8 × 8′ for short) and to examine the scientific evidence, if any, that might support it. The search included not only electronic modes but also a cursory examination of the older literature that is not covered in electronic databases and, most importantly and fruitfully, extensive consultation with several nutritionists who specialize in the field of thirst and drinking fluids. No scientific studies were found in support of 8 × 8.”

How Much Water Is Enough?

So, if the 8X8 rule is unproven, how much water should we really be drinking? The answer depends on the source, but most seem to agree that the answer is more than 64 ounces a day.

According to a 2004 recommendation by the Institute of Medicine’s Food and Nutrition Board, women should actually consume 91 ounces of water daily and men should consume 125 ounces. This finding agrees with the United States National Research Council, which identifies the Reference Daily Intake (RDI) for water as 2.7 liters daily for female adults and 3.7 litres daily for male adults.

That might seem like a lot of water to drink every day, but bear in mind you can consume water in other ways besides drinking it. Food, for example, contributes from one-half to one liter to your daily intake. The metabolism of protein, fat, and carbohydrates adds another one-fourth to about one-half a liter.

The newest commonly accepted guideline for how much water you should drink takes into account your body’s size. Simply stated:

Daily Consumption = .5 to 1 ounce water X 1 pound body weight

So, if you weigh 120 pounds you would want to consume between 60 and 120 ounces of water daily. If you weigh 200 pounds, 110 to as much as 220 ounces. Obviously, that’s a big range. What should determine how much you actually consume within that range is how warm the weather is, how physically active you are, and whether or not you are losing additional water through sickness.

If in doubt, trust your own body. If you find yourself thirsty, drink more! Also pay attention to your urine. It should be light yellow in color and have little odor.

Water and Weight Loss

One of the benefits of drinking sufficient amounts of water is that doing so makes your metabolism run more efficiently, and therefore burn more fat. Sufficient stores of water also improve your kidney functions. According to various studies, some other ways in which water can help you lose weight include:

• Grabbing a glass of water instead of a snack. Your body can’t always tell the difference between hunger and thirst, so when you first feel hungry, try drinking water first.
• Drinking a glass of ice water before a meal. Studies have shown that this makes people feel more full and therefore consume fewer calories.

Water and Working Out

When you work out, you water consumption needs increase dramatically as you lose water through sweat and heavier breathing. Symptoms of workout-related dehydration include dizziness, lethargy, muscle fatigue, muscle cramping, and a loss of mental clarity. In contrast, if you consume sufficient water your workouts might seem easier. This is because your heart will not have to work as hard to pump blood and can more efficiently distribute oxygen and nutrients to your muscles.

Many sport authorities agree that drinking water before, during, and after a workout is essential to exercising effectively.

How Much Additional Consumption is Too Much?

It is not easy to do, but you can drink too much water, creating a condition called hyponatremia. In this case, the blood becomes excessively diluted, causing sodium levels drop. This might lead to confusion, fatigue, headache, and nausea. In rare and extreme cases it can result in coma and death. You would have to drink gallons of water to face this risk, however. To avoid it, simply make sure you drink small amounts of water throughout the day rather than all at once.

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With a climate that is arguably the best in the world, Spain’s Gran Canaria is rapidly establishing itself as one of world’s leading wellness and medical tourism destinations. After hearing about the local government’s new initiative to cater to this industry, we decided to pay the island a visit.

Photo: All2Well Wellness Advocate Becky walks the beaches of Las Palmas.

“Medical tourism” refers to obtaining health care and other wellness-related services across international borders. To date, more than 50 countries identify medical tourism as a national industry. Spain, with a mild climate and the seventh best health care system in Europe according to the World Health Organization (WHO), is particularly well suited to this industry.

Medical tourism is growing ever more popular among Americans. As many as 750,000 Americans travelled abroad for health care in 2007, according to a 2008 report by Deloitte Consulting. The firm estimates that medical tourism originating in the U.S. could increase by a factor of ten over the next decade. Among the factors contributing to this growth include the high cost of U.S. health care and the relative low cost of international travel.

The idea of medical tourism is not particularly new. The ancient Greeks, for example, used to travel to the small Saronic Gulf territory of Epidauria to seek out the healing god Asklepios.

Neither is the idea of medical tourism new to Gran Canaria. The first writings on the existence of medical spring water on the island date back to the 17th Century, noting that the local inhabitants drank a slightly carbonated liquid of rich mineral content that was beneficial to their health.

In the 19th century, the north of Gran Canaria became a destination for wealthy tourists of northern and central Europe who frequented the resorts of Azuaje and Los Berrazales. Although now in disuse, therapeutic water still flows in the Doramas forest surrounding Azuaje and the Los Berrazales ravine near Agaete. These iron-rich springs are said to be of great benefit for those suffering rheumatism and stomach and lung ailments.

In the 1960s, Italian Eduardo Filiputti built a heliotherapy centre in the Maspalomas Dunes. It was torn down in the 1990s, but Filiputti is still well regarded for promoting the dual benefits of sun and sand.

Today, Gran Canaria hosts many therapeutic destinations, including the following:

Corallium Thalasso Villa del Conde Hotel

With a thalassotherapy circuit surrounding modern spaces and seawater pools, this center offers a range of health and beauty treatments applied with background music and chromotherapy. There are open-air facilities and exclusive Ocean View Suites with private seawater pools, jacuzzis and sun terraces just yards from the ocean. Other amenities include a pavilion for seawater inhalations - equipped with heated beds and a reflexology pool for cold water stepping, a pavilion with oil showers, and a vitality circuit offering crystal and herbal steam baths with eucalyptus, lavender, lemon, and other aromas. There is also an ice fountain with showers of different water pressures and temperatures. For more information, call +34 928 563 232.

Seaside Hotel Palm Beach. This hotel boasts a modern, luxury wellness area among a palm grove. Services include thalassotherapy, aromatherapy, massage, cosmetics, Rasul, ozonotherapy, thymotherapy and serumtherapy services, saunas and relaxation areas. The Spa and Wellness Center offers 11 treatment rooms with views on a Japanese garden. For more information, call +34 928 721 032.

Seaside Grand Hotel Residencia. Among this hotel’s features are an indoor fitness studio, outdoor gym, and private salt water pool with jets designed to massage every part of your body. There is also a sauna and Turkish bath. Taichi, Yoga and aqua gymnastics are offered free of charge various times during the week. Other programs under the supervision of a medical specialist include those for general and internal medicine, anti-aging, physiotherapy and Chinese traditional therapies.

Sheraton Salobre Golf Resort & Spa. Arguably the biggest draw of this hotel is the Aloe Spa in which one can obtain a natural treatment of body wrapping with Aloe Vera taken from nearby gardens. The relaxing 50-minute treatment moisturizes and softens the skin. Other amenities include a 24-hour gym, hairdresser, vitality pool, Turkish bath, sauna, indoor pool, and various indoor and outdoor relaxation zones. For more information, call +34 928 943 000.

For a more complete listing of all Gran Canaria has to offer, visit the Gran Canaria Spa, Wellness & Health Association web site.

Impressions 
From a personal perspective, I found Gran Canaria’s climate very pleasant, its people friendly and helpful, and its dining opportunities numerous and diverse. If there was a downside, it was the euro-to-dollar exchange rate that had me paying 50 percent more on every transaction than I would at home. Because of the relative quality of the goods and services I purchased, however, I did not feel cheated. I would definately visit the Canary Islands again.

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Tobacco use kills at least 5 million people annually, according to a World Health Organization (WHO) report released December, 2009.

The leading cause of preventable death, tobacco use could kill as many as 8 million people yearly by 2030, the WHO estimates. The report also noted that second hand smoke kills about 600,000 people every year.

The Centers for Disease Control and Prevention (CDC) estimates there were about 43 million smokers in the U.S. in 2007. Although smoking-related diseases kill about 443,000 Americans annually and costs the U.S. about $193 billion a year in health care costs, the number of American smokers fell about 15 percent in the last decade. The growth of tobacco use noted in the WHO report is concentrated outside the U.S., particularly in developing countries.

Disturbingly, however, the last five years have seen the declines in American smoking slowing after being halved since 1965, according to the CDC’s November, 2009, study. “The difference between the states making the most progress and the states not making progress is really stark and shows that government policies make a difference,” Thomas Frieden, head of the CDC, told Bloomberg News. “It’s ironic that when we spend more than $7,500 per person, per year, on clinical curative care, we’re struggling to try to spend $10 a year on prevention.”

Effects on the Body

When people smoke, their heartbeats increase from 10 to 20 beats per minute and their blood pressure increases from five to 10 points as blood vessels constrict. With all that blood rushing to the heart, skin temperatures drop by six degrees Fahrenheit. Adding to all that, the body’s stress reaction causes blood sugar levels to drop.

Long time smokers are subject to some or all of the following:

• Loss of concentration and/or patience.
• Dizziness.
• Tingling in the arms and legs.
• Coughing.
• Craving.
• Tension.
• Irritability.
• Restlessness.
• Depression.

Smoking takes an average of seven years off every smoker’s life. That works out to five-and-one-half minutes per cigarette. If you are a smoker and that statistic isn’t enough to compel you to quit, perhaps some of the following information from the American Lung Association, Environmental Protection Agency (EPA) and various Surgeon Generals will.

Nicotine

Nicotine sits at the top of the CDC’s list of the world’s most addictive substances. Heroin only makes fifth. In tobacco plants, nicotine is a poison used as a natural defense against insects.

Smoking and Women

Women who smoke more than half a pack a day might have irregular menstrual cycles or suffer infertility. In addition, menopause might occur earlier in women who smoke.

Smoking while pregnant increases the chance of miscarriage, stillbirth or premature labor. Babies born to women smokers are more likely to have birth defects or abnormalities and to develop colds, bronchitis, asthma, or other respiratory diseases. On average, babies born of women who smoke frequently while pregnant weight seven ounces less than other babies.

Secondhand Smoke

About 3,000 non-smoking Americans die of diseases caused by exposure to secondhand smoke annually, according to the EPA. Classified as a carcinogen since 1992, secondhand smoke contains more than 4,800 chemical compounds including carbon monoxide, ammonia and formaldehyde, according to the CDC. Many chemicals found in secondhand smoke, such as benzene, 2-naphthylamine, 4-aminobiphenyl, and polonium-210, are classified as known cancer-causing agents. Cigarette smoke contains 69 cancer causing chemicals in all, according to the CDC. Even if it doesn’t give you cancer, secondhand smoke can still cause coughing, phlegm production, chest discomfort and reduced lung function.

24 states ban smoking in all enclosed public places, including bars and restaurants. As of November, 2009, these states are Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Maine, Maryland, Massachusetts, Minnesota, Montana, Nebraska, New Jersey, New Mexico, New York, Ohio, Oregon, Rhode Island, Utah, Vermont, Washington and Wisconsin (effective 2010).

The Good News

Even long-time smokers can regain their health if they quit in time. According to the American Cancer Society, when people quit smoking they experience the following:

• Blood pressure drops to normal in about 20 minutes.
• The carbon monoxide level in the blood drops to normal in about eight hours.
• Nerve endings start regrowing and the senses of smell and taste return to normal in about 48 hours.
• Coughing, sinus congestion, fatigue, and shortness of breath decrease and cilia regrow in the lungs in about nine months.
• The chance of dying from lung cancer decreases by about half in five years.
• The risk of heart disease becomes equal to that of a non-smoker while the risk of dying from lung cancer becomes only slightly higher than that of a non-smoker in 15 years.

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As many as 225,000 Americans die every year as a result of medical treatments, making our health care system the third biggest killer after heart disease and cancer.

This is one conclusion of the Journal of the American Medical Association (JAMA) report Is US health really the best in the world? by Barbara Starfield, MD, MPH. The report cites several studies in estimating the following number of deaths attributable to medical treatments:

• 106,000 deaths annually due to negative drugs effects.
• 80,000 deaths annually due to infections acquired while in hospitals.
• 20,000 deaths annually due to errors made by hospitals.
• 12,000 deaths annually due to unnecessary surgery.
• 7,000 deaths annually due to medication errors in hospitals.

By way of comparison, heart disease kills about 632,000 Americans annually and cancer about 560,000, according to the Centers for Disease Control and Prevention (CDC). After that comes cerebrovascular diseases (strokes), which kill 137,119 annually.

The report challenges the perception that, while expensive, the American health care system is the best in the world. In fact, according to several studies including one by the World Health Organization (WHO), our system doesn’t even make the top 10 when compared to such countries as Canada, France, Japan and Sweden.

We can argue back and forth about the merits of various health care systems. We can also pour over the statistics to draw conclusions about why medical treatment is so risky. It is a lot easier to close with one inarguable conclusion, however. If you keep yourself healthy, you’ll have a much smaller risk of being subjected to the health care system at all.

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