Hiking is a growing activity that can cost nothing, is right in your backyard and can burn up as many calories as jogging (with less injury to joints). One added benefit, intentionally getting back to the sound of nature (nature's "prozac"). DrRic Saguil will help the beginner get aquainted with the sport.

1. Hiking for Health?!? “The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet, and in the cause and prevention of disease.” ~Thomas Edison We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

2. Sedona

3. Enrique Saguil, MD Family Medicine West Suburban Sports Medicine St Joseph Medical Acupuncture UCLA Integrative Medicine AZCIM Yoga Teacher The Chopra Center No affiliations with REI or Whole Foods Market In Private Practice in Arlington Heights, IL Author of Running Behind (release date 8/2012)

4. Take a Hike!!! Q: What is the usual thing to look forward to with a doctor visit? A: Praise or scolding, then a suggestion to lose weight, and follow up for another visit. (Note: like a Mercedes dealership, with enough visits, we will eventually find something major, only problem is you can’t trade in your body!)

5. The First Health Approach We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

6. Your Team Ric Saguil, MD Jason Gruss, MD Tom Jordan, RD Katrina Christie, LCPC Jennifer Green, ND Joe Musolino, DC Amy Iaquinta, DC Nick Nowicki, DC Emery Paredes, PT Courtney Day, EP Yu Zhu, MD China Mike Blumberg, LCPC Aimee Weber, EP You

7. First Health Associates 2010 S. Arlington Heights Rd LL Suites Arlington Heights, IL nutrition movement RicSaguil, MD We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

8. Now look at exercise/prevention. NOT COVERED ON INSURANCE Your on your own (run/bike/swim) Most of us -“school knowledge” of exercise, (which could be dangerous) ….“leagues?” If it was so good, why didn’t we stick with it last new years resolution? No place that’s close enough, cheap enough, new enough or fast enough….but what about your neighborhood?....or backyard!!

9. Elk Grove

10. Swimming Excellent for joints, Good for lung capacity Limited by place and climate Watch skin conditions Watch asthma Watch shoulder injury

11. Biking Good for joints Good nature contact Good to help “green living” Watch back/neck Watch wallet Watch speed/coasting

12. Running Long developed community activity Can be done by any age Addictive (positively-chi running) Watch the lower extremities (Shoes!)

13. Yoga! Ancient art Popularity high, lots of places Low injury risk Excellent at cultivating relaxation response Excellent flexibility/power/balance Detoxing Still Growing with multiple styles

14. El Junque

15. Exercise Myths You have to work up a sweat You have to work up to 4 minute miles You have to see gains fast Shoes are all the same Drink when you get thirsty You can have a heart attack….+/-!!!

16. Walking Stats and “gettin sweaty” MET’s (cal/kg/hr): Sitting for this lecture=1 MET Hiking= 6-7 MET Jogging 12min/mile 8 MET Bike 10-16 mph 6-10 MET Swimming fast 6-10 MET 4 min mile=15mph 5 min mile=12mph 10min mile=6mph 12min mile=5mph 15min mile=4mph 20min mile=3mph 25min mile=2.5m/h Adapted from Compendium of Physical Activities. Ainsworth, BE et al. Medicine and Science in Sports and Exercise. Vol 25, Pg 713 (1993) and Vol 32, S498 (2000).

17. Hiking Forest Preserves are tax supported The fastest hikers burn as much as the slowest joggers Slowing down can bring awareness to the rhythm of nature Moving away from technology cultivates the relaxation response (kids!) Less chances for strain and overuse injury Watch solitude (injury, dehydration, disorientation) Watch animals

18. Equipment Shoes/Clothing Packs Map Poles Protection (think kids)

19. Shoes/Clothing Know your feet (pronator/supinator) Get some assistance (foot doc, sports doc, ex phys, running store, REI team member) Choose shoes to match the foot and plan Add an orthotic but plan on break-in Choose clothing that wicks moisture and protect from seasonal elements and the type of hiking you will be encountering….

20. Feet Pronators Neutral Supinators

21. Word of caution Break them in………..if you find “hot spots” as you were them at home, co-op member get to return without question or hassle! (Try that at Dicks Sports) Minimus running…..adapt slowly please!!

22. A Quicky with DrRic Having flat feet is ok (check out kids at a pool) Adults get flatter with time and weight Heel strikes on pavement can send shocks back up the spine especially with poor posture Proper shoes can dissipate the shock “Gellin” can make cheaper shoes comfy Proper socks for cushion, comfort and absorption

23. Sundance

24. Poles and Packs Poles and arms take advantage of more muscle for work Poles good for heavy packs or arthritic knees/backs

25. A Quicky with DrRic Poles can “extend” your distance 90 degrees at the elbow Choke down as you go up I like to “crutch it” as I go down Keep your back straight! Pack or “Bare-Back” Please tell the kids to use their back packs properly or get combo backpack/coasters

26. Clothes to keep core temp stable Vents/pit zips Moisture wicking Detachable extremity Light Compressible (if long trips) Flexible but durable

27. A Quicky with DrRic Shoes/socks- Jacket - shirt - pants – underwear (in descending order of importance) Or for just starting – shoes/socks and a light jacket Hats More advanced – a puffy, windbreaker, rain proof, pants to match, gators for brush, cover for the backpack, balaclava.

28. Spring Valley Nature Sanctuary

29. Shade and Air (just as important as clothing!!) right wrong right wrong

30. Sweat rate Depends on environmental condition (ambient temp, humidity, wind velocity) Clothing (insulation and moisture permeability) Intensity of physical activity Usually about 1.0-1.5/h (about 2% decrease in body water/h if 150lb) At 5%, gastric emptying reduced 20-25% Sunburn retards skins ability to dissipate heat

31. Dehydration Athlete sweats 1-2 L per hour (33-66oz) 2% water loss can impair fine motor skill and judgement At 104*-105*, altered cognition. At 106*-107*, delerium,stupor, coma. (Marathon, Ironman) Suggestions are: carry 4 liters per day but it varies…

32. “That’s Hot…….

33. Carriers

34. Volume ½ gallon or 1.89L 2L 0.6L 0.35L 0.24L 0.5L 4L= +/- 8.8lbs Multiday trips??? That’s heavy baby!

35. Don’t forget the salt

36. A Quicky with DrRic 4-6 ounces(0.11-0.18L) every 20 minutes or ½ Liter/hour Can’t trust thirst sensation (unless 2% fine motor skill/judgement not important for the hike) Timing important for deep forest preserve or national park (ie Half Dome=14hours)

37. Starved Rock

38. Protection

39. A Quicky with DrRic DANGEROUS!!! Check shoe/clothes for hitch hikers!

40. Aron Ralston -127 hours

41. Timing of hikes Weather.com Weather.gov Sunrise/sunset 1-3 times a week for 30-60 minutes (30+minutes to achieve RR) Or add resistance to burn more calories (depending on your indiviresting metabolrate) Diabetics can increase to 5x week for glucose control Hypertensives can use breathwork twice a day

42. A Quicky with DrRic IN IN OUT OUT Inhale/Exhale hiking exercise to cultivate “The Relaxation Response”

43. Devils Lake

44. RR My ultimate reason for hiking it using nature to lower blood pressure, clear the mind, increase serotonin and encourage positive gene expression

45. Looking for the next level? Pick a spot that’s calling to you Research the terrain and the challenges Prepare local, add resistance, time your “summits” to dovetail your schedule Work on flexibility and region specific strength Cross train/cross fit/personal programs Nutritional assessment to “sync” with training Seek guidance on how to develop a personal training regime from knowledgeable people

46. Research Price Time away Seasonality Difficulty level and goal setting

47. One Way Loop Trail

48. Advanced training Increase in speed or resistance Cross training (endurance and altitude work) Flexibility is a universal improvement any sport

49. Nutritional enhancement Standard American Diet is lacking in nutrient In all cases of disease, poor nutrition is a contribution In many cases of performance plateau, nutritional depletion is a contribution See a registered dietician/sports nutritionist

50. Keeping Healthy = Think outside the BOX Maintaining low BMI Hiking Eating properly (Andy Weil’s “Antiinflammatory Diet”) Cultivating the Relaxation Response Hiking Exercising Hiking Sleeping 6-8 hours Hiking Community/group tx (Dean Ornish says it helps) ….if you need help with the above, just ask my team at FHA!

51. First Health Associates Protection (long-term) is ultimately making a lifestyle change with education/guidance in ………..diet/movement/neutralizing stress. Not one size fits all, sometimes “Steps” are necessary to improve outcome while under the care of a qualifiedteam. We pride ourselves on developing a personal program with a multidisciplinary approach to a sustainable lifestyle change.

52. FHA’s Steps of “Kaizen” In making a change, everyone starts and ends at a different step, we help you get to the next one….. ………Hiking is another way to step up! Starved Rock

53. 2013 10/1/11

54. QUESTIONS? Take a Hike!!!! COMMENTS? CONCERNS? Next Lecture: Whole Foods Market Schaumburg Initiating the First Steps to a Lifetime of Change September 24th, 2:00 pm Call WFM We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.