Endurance Training

Endurance exercises cause us to breathe hard. Maybe you know this type of exercise as cardio or aerobics. No matter what we call it, it’s cardiovascular exercise, meaning we’re using our cardiovascular and respiratory systems, which include the heart, blood vessels, and lungs.

Doing cardio increases heart and breathing rates from resting rates, improving endurance, cardiovascular and respiratory health, and physical fitness. Key components include the mode, intensity, and frequency of endurance exercise. Some examples include walking, running, and riding a bicycle.

How do you choose which endurance exercise is best for you? Look around.

What’s available? It might be a gym, park, swimming pool, or stairs. You can run on a treadmill or elliptical machine or outside in a park. You can climb on a stair-master in the gym or run up and down the stairs.

What are you able to do and what do you enjoy? Maybe you are unable to run and you would prefer to walk. Pick up the pace and walk a bit faster. Maybe you were a dancer as a child; go to a barre class and get your heart rate up.

Maybe you really don’t like cardio. Try getting to places early and walk around to kill time. Park far away from wherever you’re going or get off the subway a stop or two early to keep your heart rate up for a little while longer.

Maybe you get bored of doing the same exercises over and over. Mix it up! Ride a bike instead of running. Try different exercise classes…sometimes this will even save you money! Gyms and studios love to give discounts to first time students.

And…what do you want and/or need to get out of endurance exercise? Maybe you want to improve your daily energy levels. As we improve our endurance, our ability to perform daily activities increases because it is easier to breathe.

Each person’s endurance training is different, so it’s important to be conscious of our bodies as we increase amount of time or intensity of endurance exercises. If you haven’t been aerobically active in a while, take time getting back into aerobic activity. Like I’ve said about other forms of activity, take baby steps. Drink plenty of fluids. Dress in appropriate layers whether you’re running outside or inside. Exercise outdoors during the day or in well lit areas at night. Warm up. Exercise. Cool down. Stretch.
Where you begin depends on initial your fitness level, age, medication, and medical conditions. Start with 10-15 minutes of walking and gradually work up to 30 minutes per day. The American College of Sports Medicine recommends 150 minutes of moderate-intensity exercise per week. Combine endurance training with flexibility, strength, and balance exercises to improve overall physical fitness. But first, consult with a doctor, physical therapist, or a well-educated personal trainer to make sure your body is up for the challenge.

Woman running. Female runner jogging, training for marathon. Fit girl fitness athlete model exercising outdoor.

How Lyme Disease Became A Blessing

I will never, ever forget the day I was diagnosed with Lyme disease in 2014.  I was only fourteen when I received the life-changing phone call telling me my blood test had come back positive for Lyme.  For years I struggled with a plethora of undiagnosed health issues and desperately searched for answers.  Little did I know how much this phone call would really impact my life (and for the better!).

Battling a chronic, debilitating disease is, to say the least, not easy.  I have a constant, excruciating headache, joint pain, stomachache, dizziness, nausea, and overwhelming fatigue.  You couldn’t guess that I’m sick by simply glancing at me or that my treatment consists of 50 pills per day (no, that’s not an exaggeration), multiple antibiotics, and weekly IVs and injections.  On the outside I may not look like I’m fighting a disease, but I battle this invisible, chronic, nasty disease every second.

Being sick has denied me of many opportunities and robbed me of activities I previously took for granted, such as functioning like a normal teenager, spending time with friends, and playing on my high school golf team.

However, I would never change this experience because of what it has developed within me— strength, perseverance, compassion, inspiration, and calling.

Lyme disease attacks the stomach as well as the entire body, so I developed food intolerances to gluten, dairy, and soy among many, many other things.  Honestly, I didn’t even understand what gluten was when I was told a few years ago that my body didn’t tolerate it well.  As a result, I had to begin learning more about nutrition and focusing on the foods I ate more than I ever had before.

I read countless articles and books about food, and the more I read, the more I became intrigued.  I realized I have a passion for health and nutrition.  This is how Health and High Heels, my blog and website, began!  Health and High Heels is a platform for me to share my love and passion for healthy living with the world and to inspire others.  I post healthy recipes I develop and write about healthy foods and restaurants I find both locally and in my travels.  And I love high heels, so of course I had to include that in the name!

Despite my struggles, I view Lyme disease as a blessing.  The key is that I’ve chosen joy despite my trials, and I’ve found great joy in educating others about nutrition, sharing my healthy recipes with the world, and hopefully pursuing a career in medicine to help others who are sick like me.


You can find Health and High Heels on Instagram (@healthandhighheels), Facebook (Health and High Heels), Twitter (@healthhighheels), Pinterest (@healthhighheels), and my website (Healthandhighheels.org)!  These social media platforms are where I share my recipes, photographs, “fun foodie facts,” and healthy product reviews.  My goal is to excite others about healthy living and to encourage them to try a recipe or two, visit the local farmer’s market for fresh, organic produce, or even come up with original recipes!  Overall, I urge everyone to begin discovering what healthy living means in his or her own life!

Diabetes and Depression

Diabetes and depression is a topic I feel strongly about, but also one that is not easy to discuss. Many people with diabetes and relatives to those with diabetes do not want to acknowledge the psychological issues one can have when living with diabetes. These issues are not only related to the fact that diabetes is a chronic disease, that one has to inject insulin to survive, and that one has to modify diet, exercise, relationships etc etc.

In fact, John McManamy, author of “Living well with depression and bipolar disorder” says that a Kaiser Permanente study of some 1,680 subjects found that those with diabetes were more likely to have been treated for depression within six months before their diabetes diagnosis. About 84% of people with diabetes reported a higher rate of earlier depressive episodes. He goes on to say that a 2004 Johns Hopkins study tracking 11,615 initially non-diabetic adults aged 48–67 over six years found that ‘depressive symptoms predicted incident Type 2 diabetes. Women, in particular are at greater risk, according to other studies; and another study shows that this risk, among both men and women, persists even after controlling weight, caloric intake, smoking, and economic factors.

It has clearly been shown that depression is higher in people living with diabetes, and that this differs from other chronic disease. It is also clear that the depressive tendencies people struggle with are exacerbated by volatility in blood sugar, and can be reduced when control is improved. I recognize this, since I know that when I was “high” I felt tired, lethargic and often hopeless. This would lead to thoughts not moving fast enough, and frustration with my own capacity as a thinker. I would be sad about small things and be emotional about events that otherwise did not bother me. The worst part of depression triggered by blood sugar volatility is the feeling of loss of control and the vicious circle triggering poor management of diabetes which makes both the physical problems and the psychological issues worse!

My recommendation is as always to try to stay in control and when you do slip, ask for help! Being alone with your disease is the worst, and the concept of peer-to-peer mentoring helps, especially with more emotional issues than with medical and physical details. It is hard for a doctor or a nurse to understand the sense of hopelessness, fear of complications and the loss of control that we feel at times when living with diabetes. This is when a friend who also has the disease can help you tremendously by bringing you up in your mood, and down from the rollercoaster of sugar.

My other piece of advice is to reduce the simple carbs in your diet– it really helps you control the volatility. As you may have seen in children without diabetes, their mood is seriously affected by high sugar meals, and the subsequent crash is hard on parents and caretakers.

Lastly, exercise creates a natural surge in anti-depressive hormones such as serotonin and endorphins so adding exercise to your daily regimen will reduce the risk of depression.

I had a pancreas transplant in 2010, and since then my HbA1c has been normal with few glucose excursions. My mood and my energy levels have improved dramatically, but yet, when I eat a carb-loaded meal (rarely!) I do feel a high in the beginning, but then I dip and I lose my mojo. I feel lost and without control. I may have solved the sugar highs, but I am still vulnerable to lows in sugar and that is still my trigger for also feeling low in my mood.

Sugar is evil and I hope that in the future children will not be fed high-sugar meals and handed candy as rewards – it kills, mutilates and makes you sad!

Image of a woman siiting curled up on the ground

Flexibility Training

Yes, some are more flexible than others; however stretching does improve everyone’s flexibility. We sell ourselves short if we don’t stretch when we exercise, whether it’s strength, balance, or endurance training. Flexibility increases the ease of muscle contractions and decreases the likelihood of muscle soreness and tension after workouts. Our range of motion improves, preventing injury. We get to know our bodies better, improving our coordination throughout the day and making other forms of exercises easier.

Maybe while stretching your body, you’ve noticed are different modes of muscle lengthening. Despite how good many of them feel, there are pros and cons and important facts to keep in mind while you’re stretching.

Young athlete preparing with warm up stretches

  • Static Stretching – This slow and sustained movement at one joint requires little energy and decreases muscle tension the possibility of injury by passing the normal range of motion. For example, when sitting on the floor with your legs straight and reaching for your toes, letting your hands fall and being still.
  • Passive Stretching – This type of static stretching requires assistance from another person or force. The person stretching must relax their muscles. For example, when a trainer puts pressure on the back when you are sitting on the floor with your legs straight and reach for your toes, letting your hands fall and being still.

  • Active Stretching – This slow stretch requires the muscle to be moved through its range of motion. For example, when sitting with your legs straight out in front of you and flex your toes towards your face, you are actively contracting the muscles on the front of you leg and stretching the muscles behind your leg.
  • Dynamic Stretching – This stretch requires controlled deliberate movement, actively moving muscles repeatedly through the range of motion, benefits functional range of motion used in daily living. For example, pointing and flexing your toes.

  • Ballistic Stretching – This shouldn’t be confused with dynamic stretching, as it refers to quick bouncing movements, for example when you bounce when reaching towards your toes. The cons far outweigh the benefits and this type of stretching should be avoided.

Where to start? First, determine the proper posture or alignment before starting the stretch. Become conscious of your breath, inhaling through your nose and exhaling through your mouth. Inhale as your prepare to stretch and exhale as you relax into the stretch to give yourself greater range of motion. Do not hold your breath. Remain conscious of your comfortable range of motion. Continue this cycle until you feel you can’t stretch any further; until discomfort increases slightly. Slowly inhale and return back to your initial position to allow your muscles to recover to their natural length.

When should a person not stretch? If there is sharp pain or uncontrolled cramping when stretching, stop. If bones at a joint limit your motion, or if you have an unhealed fracture, infection, or inflammation around the joint, or a local hematoma, don’t do it! Wait 8-12 weeks post injury to stretch site, and before that consult with your doctor to make sure your body is up for the challenge.

When I Lost My Love For Tennis

I used to play tennis every day for more than 1 hour a day – I loved the game, and I was very good at it. This was before I was diagnosed with diabetes – after that, I never won again and I lost my love for the game completely.


I don’t think diabetes is 100 percent to blame for this, but probably at least 50 percent. When I was diagnosed the summer of 1989, I had just reached the finals of a large national tournament in Sweden. I lost in the final, but overall I had done very well – especially considering I had suffered from tonsillitis three times during the spring preceding this event, and I had been seriously injured the year before.

However, after my diagnosis I lost my confidence in my body. I had never had such a failure in my life and here I was, at 17 years old (I spent my bday in the hospital getting trained on injections and glucose monitoring), feeling like I was suddenly disabled. Little did I know that the complications they warned me about during those first few weeks with diabetes would be a reality less than 20 years later and that I would go through two transplants before I turned 40!

Tennis represented so much to me as a young person, I spent most of my free time either playing tennis, getting to tournaments, working out to play better or preparing ahead of games. I loved going to my club and I even loved hanging out after tennis, relaxing and feeling the work-out in my body and if I had won, feeling strong and confident.

I guess the closest to this feeling in my current life, is when I present at conferences or when I have an important business meeting. I have the same feeling of anticipation, preparation and then during the presentation I have a high, triggered by endorphins, and I am on top of the world for the duration of the event. The problem is coming down afterwards.  Being in the zone is great and all, but afterwards I feel empty, anxious and even sad.

As a diabetic, sometimes these events could be affected by my disease. For example, if my blood sugar was running low and I had to go up on the stage for a presentation, I would need to quickly eat something to avoid the risk of passing out and the absolute certainty of presenting poorly because my brain did not have enough sugar to work with. When I was high, I could also feel it, since I would get slower in my thoughts and especially in my reasoning. I would rather be high than low, and my solution to avoiding this roller coaster was to always keep myself slightly high, but not high enough to be slow, blurry-eyed or lethargic.

After getting my pancreas transplant in January of 2010 I have not experienced any of these feelings and it is such a relief and such an advantage! I sometimes say that I did not know how hard it was living with diabetes before I got a pancreas transplant and realized what normal life is supposed to be and how good I felt. Achieving that feeling for everyone with diabetes is our goal, and while we pursue the cure, we need to identify a range of products that can help people with daily life.

I hope that I will get back to tennis one day, but for some reason, tennis more than any other sport is linked to my life before diabetes. I know that I have a new chance, and should be incorporating tennis into my life, but it is easier for me to exercise otherwise without ever feeling that diabetes, transplants and age have had a negative effect on my performance!


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