Host: Murray Norton (MN)

Guests: Dr Patricia Smith (PS) and also Joanna Hall (JH)

MN: Hello and welcome to Webchats, very good of you to join us. It's that time of year when we all start pumping iron and pounding the road and getting ourselves fit and back into shape. Research by Slendertone shows that we all start off with good intentions and it all seems to disappear very, very quickly. To help us find out why, and also how we can resolve all these problems, I'm delighted to say we're joined by former cardiologist Dr Patricia Smith and also Joanna Hall, the fitness guru, it's good to have you with us. You were voted the most influential woman in fitness!

JH: Oh thank you, I thought you were going to congratulate me on my pregnancy, due next month actually. It's OK - we've got five weeks!

MN: Don't make this woman nervous for goodness sake! Stay calm. We're not equipped in the studio for that! So why is it that we all do this in January? Is it the right month to be doing this?

JH: That's a really important point, because I think it's the wrong time to be doing it. I think, just as we look at our wardrobe and change our clothes for spring and summer and winter and autumn, we need to address the same approach in our fitness and well being. So adjusting our motivations and our objectives as the months change and you'll find that you're more likely to keep motivated. You're also giving your body a cross-section of benefits, so you're looking at improvements in your flexibility, your posture, and weight loss. I think start being a little bit active, then up the tempo for February and think about addressing weight management issues in that month.

MN: So it's not a case of just jumping in and going crazy with it then. Patricia, as a cardiologist you'd say that's just the right attitude, don't go mad!

PS: I think the danger is in the run up to Christmas and certainly in December I attended so many functions and your eating too much, you're drinking too much, you're sitting around, and then all of a sudden January 1st, on with the new fitness gear, the new trainers, running down the road, and chest pain! Not feeling to great. I think the key is moderation. If you can actually motivate yourself to get up and get out and go for a brisk walk or a dance or whatever it is that you enjoy doing.

MN: A question from someone calling themselves Petrol23, talking about this kick-start in January, should we be doing all this or is it enough to be getting off the bus one stop early and having walk?

JH: Definitely, it's really important to think about lifestyle activities. There are two ways that you can address exercise, one is structured exercise which is where you put your trainers on, you're going to get hot and sweaty, it's time that you have specifically set aside to be in a training zone so to speak. You also need to think about lifestyle exercise, and that your regular residual physical activity levels. Get off the bus one stop earlier, walk up the escalators. They're small things, but if you're doing it on a consistent basis it really will make a difference. I think psychologically this is important, because when life gets busy, and we all lead busy lives, the first thing that goes is our structured exercise. So if you don't have any lifestyle activity and you cut out your structured activity you're on a pretty sticky wicket because you've e got nothing to fall back on. So if we challenge the way we think about exercise and activity and build a foundation of moderate activity that we can do on a regular basis throughout the day, then that is a fantastically strong foundation and you'll feel proud of yourself. It then acts as a catalyst to feel better about other activities.

MN: This start-stop is making us go wrong in the first place then, and it's no good for our health anyway.

PS: No, you need consistency. Small amounts of exercise, four or five times a week. Walking to the post box, taking the dog for a walk, instead of emailing your friend get up and go and walk to them. Even those small amounts.

JH: We are now becoming more aware of health, as well as the cosmetic benefits of having more toned tummy or better posture etc. It's important that the right message gets across. If you are serious about fitness, you need to be introducing an element of intensity. If you're thinking about weight loss, you need to be thinking about a combination of intensity and duration. So let's build a foundation that will look after your health. It's known to protect against twenty diseases, like heart disease, cancer, osteoporosis, depression, which at this time of year when the days are short. Being more physically active is going to be your first port of call. Sometimes people get turned off because they don't reap benefits, and we want to make sure we're encouraging people to do the right things for the right rewards so that our time is effective.

MN: Question in from Elaine, she's got three stone to lose, and hasn't done much exercise for a while, how should she go about it? If you have three stone to lose, that's going to be putting a strain on all body parts isn't it, especially the heart, so you don't want to do too much too quickly.

PS: My advice would be that if it hurts, it's not right. You do need to push yourself a little bit if you want to generate a change. You do need to be getting to a point where you are just a little bit breathless. One of the ideal things about this product that Slendertone have brought out it is has this heart rate monitor attached to it that effectively shows you what your heart rate is doing. You put in your weight and your age and it will tell you what the right heart rate range is for you. There's a little dial there so that when you're walking along, you can see it, and if your heart rate is between the two little bars recommended for you weight and range then you're doing a decent amount of exercise. Having tried it myself, I was quite shocked, I was a little bit breathless, I was having to struggle to have a normal conversation, and I looked at the monitor and I was just below where I should have been so I picked up the pace a little bit. It's a useful tool, because you need feedback while you're doing it.

MN: It's no good doing it afterwards, or thinking, well I'm pretty shattered so I must have had a good workout.

JH: How you feel about your exercise is a little bit like the stock market. You know how they say it has dips and troughs. One day when you exercise you may feel great, the following day you may feel tired, and that's relating to your hydration status and your nutrient status, so listen to your body. Having the opportunity to listen to your heart rate is very important because we know we classically tend to overestimate how hard we're working and we underestimate how much we're eating. So for Elaine, who is wanting to lose three stone, clinically, research has shown that long-term weight management is dependent on how much we move our body. ~In the short-term, the most important factor is what you're putting in your mouth.

MN: So monitor how much you're putting in your mouth, and monitor exactly how much you're moving your body.

PS: If we want to lose weight, energy in has to be less than burn. You do need to burn more than you're eating, so unfortunately there are no simple answers here.

MN: Candice has got a question, "I've only got an hour to do the exercise, should I do an hour of cardio, should I do half an hour of cardio and some strength workout, what kind of exercise is going to be good?"

JH: My first response is that is depends on what your level of fitness is today. If you haven't played squash for five year and you're two stone over weight and you head off down the gym for two hours of squash with the next-door neighbour, that's probably not going to help you feel too good at the end of it.

PS: I think the bottom line here is doing something that you enjoy doing. In terms of the balance between cardio and resistance training, if you're trying to burn calories cardio at the right heart rate is how you are going to burn the most calories in that session. Resistance training actually builds muscle, not overnight, it can take a few weeks but if you persist at it, the higher your muscle to fat ratio, the more calories you're going to burn. If you combine resistance training with cardio then you build up muscle and longer-term you'll build up more calories in a resisting format.

JH: What I would advise to Candice is to be taking more of an integral format, so you're actually taking the two together. You might intersperse it so you've got three minutes of cardio activity, whether it's on the treadmill or jogging, walking, cycling, on the Stairmaster, then come off and you can do some resistance work. And resistance work is not just necessarily doing some resistance work, think about using your whole body. So that's lunges, that's squats, what I call walk-out press-ups, where you stand up, take your arms above your head, bend down, walk your hands out and do a bent-knee press-up. So you're actually incorporating your whole body, you're getting resistance benefits, but you're also boosting the available calories that you can use up in a short time, and the great thing about that is that you can lessen your workout time. You've told us you've got 60 minutes, which is fabulous, but if we said that we could give you the same benefits in less time, then I think that's a win-win situation all-round. You'll probably then find you're more motivated to go the gym, and other aspects of your life.

MN: Where we came in, talking about motivation, I was just picking up on what you said about doing something that you enjoy doing. If you do something you hate doing, I hate going to the gym for example, I would much rather run around chasing a squash ball than even go to a gym. You've got to do what you enjoy, to get your heart rate up.

PS: One of the most common reasons for giving up your New Year's resolution of going down to this trendy gym is that it's the first thing to go when you're short of time. As Joanna said, you need to do something that you like.

MN: A lot of this research is brought out by Slendertone. Another question from Gemma, "Does the Slendertone belt actually work? Will it work for me?" So how does it work? Is it a support device?

JH: It does actually deliver results provided it's used in the right way. We need to be thinking about using the combination of cardiovascular exercise as well as toning your abdominals. What it does is give you a belt, which you put around your midriff, and through electrical muscular stimulation it encourages the muscle tissue to make the muscles contract, which means that the muscle will contract and tone and flatten and provide functional support. So it's great if you've been doing lots of sit-ups and you've been worried about neck strain or something like that. It's not a passive product, you can actually wear it while you're doing cardio-vascular exercise which is crucial and fundamental to be successful in weight loss.

MN: So when you're already doing some exercise you can work on these muscles even if they aren't the ones you're exercising? Two workouts in one! I guess you can wear it on the way top the gym and back too.

PS: You're not supposed to wear these belts while you're driving by the way, but definitely if I go to the gym, if I'm on a cross trainer I'll wear this. I think some people are actually getting confused with the older product, the Slendertone Flex that they've had on the market for a while. This is a new product that Joanna and I are talking about, a product called Slendertone Active, which incorporates the heart rate monitor.

MN: That's a very important distinction there. One question people are bound to ask, doesn't this mean we can just strap the belt on and lie down on the sofa, open a box of chocolates, watch the telly?

JH: No, no, no! Let me stop you right there. Cardio is important for our stamina, for our health, our heart and lungs. We do need to have supportive tools. Everyone is living a lifestyle where we want fast results; we don't want them tomorrow, today's good but if we had them yesterday that's even better! It's really important that we put together a routine that's effective, and that's what is so good about Slendertone Active is it's a combination of the cardiovascular exercise, and the resistance. So you can choose to go for a walk if you are new and entry-level to exercise, or if you're already exercising you could do the jog and tone programme, or you may choose to do just the tone programme. Because you can monitor your heart rate, that ensures that you can continue to exercise at the right intensity, and you know that you are getting clinical feedback on how your body is performing. So that's great motivation, and it also means that the amount of time you're investing in your exercise is going to reap you bigger rewards.

MN: Just one question about the heart rate there, if you're heart rate is at a level where you're out of fitness and you've got a couple of stone to lose, then presumably as you get fitter your heart rate will decrease slightly and you'll end up working harder to get that heart rate up?

PS: That's an important point, because the first thing you do after you've taken the product out of its box is you load in your personal data. If you're 70kg and 49 years old you put in that data and it calculates where you should be. Now hopefully in two months time, if you've got your weight down you'll change it on the product.

MN: Fay has sent in a question, she wants to know about aerobics and toning. She doesn't know whether to do aerobics or toning. What's going to be better for weight loss?

JH: For weight loss it depends on how much weight you have to lose. If you have significant amount of weight to lose you should look at it through cardiovascular activity. If you're already walking then maybe a jogging programme. Swimming is a cardiovascular activity as well, but evidence suggests that it isn't that beneficial for weight loss. You need to be thinking about weight baring activity. The other benefit about that is that you're actually enhancing your bone density. So you're going to be reducing your risk of osteoporosis. So cardio is great way to do that. If you're talking about inch loss, so would you rather slip on a pair of jeans and find you can get into them more easily or do you want to stand on the scales and see the weight drop off, because there is a slight difference. If you combine a toning programme with an actual cardiovascular programme, depending on the size of the weights and the heaviness of the weight, it could be that your weight stays the same but you actually lose the inches. So you need to ask yourself, "What am I actually trying to do?" If it's just the weight, then cardio, if it's inch loss, then a combination of the two and that's where the Slendertone is great in that sense. Of course you do also get great benefits from doing the toning exercise, so my preference is a combination of the two.

MN: Emma has been exercising, starting her New Year's resolution, but unfortunately she's hurt her knee, which does happen. You get an injury, it sets you back and then it all stops and you don't bother again. She's frightened of making the knee injury worse, would swimming help?

PS: Any exercise is good but you need to be careful. Swimming is great because it's a non-weight bearer. I have terrible problems because I'm a skier and have terrible problems with my knees and love to run but have had to pull back with that. Basically just the pounding has done more harm that good. The walking is much better as there is much less impact. And good shoes help.

JH: If you're a breast stroker and you've got a bit of a screw kick that can put more pressure on your knees. You're better off doing kicks, maybe have a board in front of you to keep you in good alignment. Knee problems can actually be quite complex. If you have inflammation of something called the bursa, between your knee bone and your thighbone, the best way to spot this is if you are walking downstairs and you get a pain that is indicative of bursitis. Now for bursitis you need to do the classic RICE, which is Rest, Ice, Compress, Elevate. So you get your peas, press it on, get your leg up to try to take away the inflammation. Now you can combine that with light non-weight bearing exercise such as swimming or a little gentle walking, but if it is an ongoing problem you do need to see somebody, and maybe look at the way you walk up and down the stairs because some people do tend to walk a little bit knock-kneed, and if that is the case then you will be putting the alignment out.

MN: I have to say that everyone's going to be testing now! I can see Patricia nodding now because we're both skiers and with skiing you're knock-kneed all the time. Swimming can be good but watch out for the breaststroke. Also you can't wear your Slendertone in the pool!

PS: No you can't!

MN: Denise is a busy mum, two toddlers, she's getting married in six months, "Can you suggest something for me to lose weight that I can stick to and fit into my routine?" Different circumstances, but the same answer more or less, no?

PS: Even pushing prams, put on the belt, put on the heart rate monitor, load in the information, even if it's fifteen minutes twice a day taking the kids to the park, playing with the kids in the garden. Getting up and getting active is the key to it all, and watching what you're eating.

JH: Think about maybe cutting out your carbohydrates in the evening. That's a great way to cut your calories down without having to think about cooking something different for you partner and your kids. Congratulations on your marriage by the way!

MN: There's a question about pregnancy here as well, can you use the Slendertone belt if you're pregnant?

JH: No, you shouldn't use it while you are pregnant, but once you have had the baby and your post-natal check-up and everything is OK, it can be a great way to help reengage those abdominal muscles, because they, and I have first hand experience here, actually expand by 18 inches. There's quite a lot to get back into place, so Slendertone Active is something I'm definitely going to be using.

MN: Thomas is 72, are your products suitable for a 72 year old?

PS: The first thing I would say is that it depends on other things, how fit he is. If you have a cardiac pacemaker or a defibrillator you need to be careful. There are very clear guidelines and safety instructions inside the box that you need to look at. For your average 72 year old who is reasonably fit and active, yes, fine. I would say that one of the benefits I have had from using the belt is that by strengthening the muscles around the lower back I have reduced my incidence of lower back pain. I haven't had that for two and half years, and I do believe that's because of core strength.

MN: What about for a 13 year old daughter?

PS: You'd have to wonder why a 13-year-old daughter wants one, usually they are busy, and they're active. I'd be a little concerned that there's an obsessive element.

JH: I'd say you need to look at yourself because the biggest message provider in the household is what mum and dad are doing. So look to yourself a little bit and think what can you do as a family to encourage yourselves to be more physically active, whether it's going to the park at weekends or doing different activities. Maybe finding older relatives in the family and going on history walks round your area or landmarks or places where you've lived, something like that. The physical message can be incorporated into fun activities as well.

MN: We're getting Peter in who tried the belt to find out how he got on as our guinea pig. First though, we've got Carina, an investment baker who has a busy work and social life, a healthy diet but unfortunately the weight is not coming off. "I'm concerned that my weight is going to go up as my work is getting more and more stressful." Can something like this belt maximise the exercise that's going on at the moment?

PS: I think the benefit for me is the motivation. There are a couple of programmes; one that we mentioned earlier was walk and tone, and also jog and tone. If you're not used to too much or maybe she's used to a fair amount already, get into the programme, it actually allots you points as you exercise so during a 30 minute walk you'll earn approximately 4 points. So I'd be aiming in a week for 20 points. Definitely be clocking these on a diary during the week, and if I miss my 30-minute w2lak during the day I think, OK, I'm four points short, where can I make them up? And inevitably you'll be able to find time to get out for 30 minutes. The other thing of course is knowing that you're exercising at the right level to get a cardiovascular benefit and also to burn more calories. You need to be at a certain level before you start to burn the fat.

JH: And also Slendertone Active is very useful because you can concentrate on building your own lifestyle activity and my experience on working with a lot of clients in the city find that you may find the time to go to the gym and take your structured exercise but outside of that, because your life is so busy, your overall foundation of physical activity is very low, so try to supplement it if you can with walking, think about which tube stations you get around London because I suspect that is where you live. I'd also say try to get a little bit more sleep. It's been shown clinically that people who are sleep deprived find it harder to lose weight. Maybe focus on quality sleep, you may find that you get better results from it. People who work night shifts do suffer from problems losing weight because it does distort the hormonal balance.

PS: Another thing is that so many people I notice in the gym can't be effectively exercising aerobically because they're just sauntering along and they not pushing themselves. They look no different from one month to the next.

MN: I have to say a lot of people have the intention, the time restraint is the problem, but this Slendertone Active belt maximises the time. Before we go Peter has joined us. How was it with the belt on?

Peter: I'm actually really impressed, I've been wearing it for the last month and the convenience factor is wonderful, I only have a limited amount of time like most people so when I can't get to the gym I can put it on, go for a run and really target those abdominal areas. I hate doing sit-up like most people probably do and I'm able to monitor my heart rate too.

MN: And the twitching of the pulse, does that put you off?

Peter: Thief first time I tried it, it was just a tickling sensation, I ran with it and I was able to turn it up to a higher intensity. The body is very comfortable with it; the belt does not feel intrusive at all.

MN: Thanks Peter, enjoy using the belt. Patricia thanks for all your help. Joanna, with one month to go we wish you all the very best. Thank you all for your questions and we'll see you again next time, on Web Chats.

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