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Though it may seem that having more down time would free up more time for self care and heighten focus on wellness goals, for many of us the COVID 19 public health emergency has left us with feelings of sadness, confusion, and lack of focus. Despite having more time at our disposal at home, it is very difficult to stay committed when you are feeling low. For those with chronic kidney disease and other health conditions, fear of the increased risk of contracting a contagious illness itself can itself be stressful.  The circumstances surrounding us during these times of uncertainty can be daunting, and when you feel you are struggling to stay on track there are a few tips and tricks to set your mind and body on the right course. As we do our part to keep others safe by wearing our masks and avoiding unnecessary outings, now is the most important time to also take charge of our own health. Here are a few simple health tips to incorporate into your routine. Sometimes, rather than setting an "total lifestyle change" goal, it is often easier to make a few small changes every day or every week which will ultimately keep you on a wellness path where you will stay committed.

1. Cardiovascular exercise: Incorporate at least 15-20 minutes of sustained exercise into your routine daily. One of the best forms of exercise is walking. Walking around the block even for just 15 minutes can improve blood flow and circulation. Walking requires integration of strength, endurance, and balance, all of which are important to maintain as we age. For those who with limited mobility, don't let injury, disability, illness, or weight problems get in the way. The goal of cardiovascular fitness is to increase your heart rate, increase your oxygen consumption, and ultimately increase your strength and endurance. Hand ergometers are a great option for those with limited mobility and can provide a full body workout. Chair yoga, swimming, a rowing machine, and stationary bike can also provide the same cardiovascular benefit when walking is not possible. Remember that exercise causes your body to release neurotransmitter chemicals such as dopamine, norepinephrine, and serotonin which reduce your perception of pain and also trigger a pleasurable feeling in the mind and body.

2. Strength training: Often neglected in the elderly, strength training is of paramount importance for those with chronic kidney disease and in those over the age of 50, to maintain bone health and muscle strength. Patients with chronic kidney disease are at risk for mineral and bone disorders. It is well known that the morbidity and mortality is increased in patients with chronic kidney disease compared to the general population. Also, fracture risk is more than doubled in patients with chronic kidney disease when compared to the general population. In addition to being prone to nutritional vitamin D deficiency, chronic kidney disease can result in abnormal hormone levels (PTH) which cause an imbalance in calcium and phosphorous. The risk for osteoporosis as well as renal osteodystrophy is increased. Resistance exercise is necessary to build muscle and bone strength. Examples of simple exercises that you can incorporate into your routine daiy include: push ups (against a floor or wall), tricep dips, squats, resistance bands, and lifting hand weights.

3. Plant based diet: It seems obvious that diet would be one of the most important things to be mindful of as we age and are confronted with illness. Obesity and diabetes are a national pandemic. Unfortunately, for many of us, diet is the hardest aspect of our lifestyle to change. Our eating habits are often established in childhood. If we have been raised from a very young age to consume a certain type of diet, that is often the hardest aspect of our lives to change as we get older. There is robust, growing evidence in the medical literature that a plant based diet is the most beneficial diet for our health. Vegetarians (when compared to meat eaters) have a lifetime reduced risk of cardiovascular mortality, chronic kidney disease, and even cancer. If a completely vegetarian diet is not possible for you, you can find significant benefit by increasing fruit and vegetables servings by just 2-3 additional servings/day, and reducing your intake of meat by at least one meal/day. Even switching from red meat to fish or lean meat could be a small, sustainable change for you.

4. Increase consumption of micronutrients: Patients with chronic kidney disease are at particular risk for micronutrient deficiency, particularly " B " vitamins such as thiamin(b1), riboflavin(b2), niacin(b3) pantothenic acid (b5), folic acid, and vitamin b12. Deficiency in these micronutrients can be due to loss of micronutrients through dialysis, or due to prescribed medications such as diuretics which can cause urinary loss of essential vitamins and minerals. Furthermore, patients with chronic kidney disease may be prescribed restrictions in their diet, such as a low potassium, protein, and phosphorous diet, which in turn leads to nutritional deficiency. It is also common for patients with chronic kidney disease to have impaired intestinal absorption of micronutrients which can further exacerbate deficiency. Prolonged micronutrient deficiency can cause anemia, neuropathy, bone disease, cardiovascular disease, and other life threatening conditions. Unfortunately, there is no reliable way to assess micronutrient deficiency and the effects may not be seen until there is functional deficiency. It is, therefore, important, to routinely monitor your health and diet with your nephrologist and a dietician. 

5. Practice mindfulness: During these challenging times when losing track of days and losing track of self care tend to go hand in hand, taking care of your health can seem like an extra burden in an already overwhelming time. Dedicate just a few moments every day to realign and connect your mind, breath, and body.  Setting an intention for the day can change your health and wellbeing for the best. Breathwork is one extremely simple way to exercise mindfulness and clear your mind of stress and noise. When you are stressed you tend to breathe fast or hold your breath. When you are relaxed, your exhalations are usually deeper and longer. Respiration is controlled by the autonomic nervous system, which means breathing will occur unconsciously. However, for the past several decades researchers have been exploring how the nervous system can benefit from controlled, conscious breathing. Try the simple practice of taking slow, deep breaths throughout the day. Try to match the length of your inhalation with the length of your exhalation, adding a pause between inhalation and exhalation. This simple act can produce feels of calmness with the added physiological benefits of reduced blood pressure and reduced heart rate.

If you are concerned about your kidney health, and would like to learn more about dietary and lifestyle changes you can make to achieve optimal health, you can call us at 817-233-6923 to schedule a consultation.

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