In her 2024 Wellness Academy talk, Dr. Gina Lokna offered profound insights into the connections between fitness, lifestyle changes, and overall well-being. She explored the principles of lifestyle medicine, the importance of movement, and strategies for managing stress.
In this Q&A session, we dive deeper into the practical applications of her teachings, touching on topics like muscle gain, stress resilience, and the role of melatonin in sleep regulation.
About the expert: Gina Lokna, MD
Gina Lokna, MD is a dedicated sports medicine physician with a collaborative teaching style that engages patients of all fitness levels in treating musculoskeletal injuries and conditions. She emphasizes a whole-person approach to fitness and wellness, partnering with her patients to provide exercise prescriptions, injury treatment and prevention, fitness assessments, and integrative lifestyle interventions to support optimal health.
Q&A with Gina Lokna, MD
This transcript has been edited for clarity.
Q: Is it ever too late to start making lifestyle changes or exercising?
Dr. Lokna: The principles around lifestyle medicine in those pillars that I was addressing are really a framework appropriate for all ages. So it’s never too late. Our body is a resilience machine. It’s made to make changes.
It typically has an affinity towards positive changes, and it’s self-reinforcing. As you’re doing small things that add up to feeling better, having more energy, getting more rest, getting more movement.
It’s never too late to start.
Q: A follow up question then, what’s your take on an active life vs a planned exercise life?
Dr. Lokna: My first answer is that it wouldn’t be either or. It’s Yes, AND. I’ll give you a couple of examples.
I don’t think we can substitute the benefits of an exercise routine that is deliberate in terms of how high the heart rate goes and how much strength training we’re doing for muscle building.
But on the other hand, those aren’t the only times that we want to be active and moving. So we know this about blood sugar metabolism. We know this about help for sleep and restorative sleep cycles.
So here are two examples I would give to you. Most of us in offices have seen the trend towards standing desks or a walk. I have a colleague who famously uses a walking treadmill desk. These are fantastic, and what I would call active lifestyle interventions. They all count towards movement and exercise. The 5 to 10 minute walk after you eat is a great efficiency mechanism for improving blood sugar and metabolism. All examples of active lifestyles are really about moving when you can.
Q: One listener said they exercise regularly but aren’t seeing muscle growth. What could they be doing wrong?
Dr. Lokna: So, there are a couple of things about muscle. This is a big question, and we are all slightly different in terms of the way we look in terms of our ability or ease with which we can make muscle change visible.
I have two thoughts. One concern measuring to see if there really is some growth and change in skeletal muscle mass. Our office uses techniques to measure body composition. One is called the Dexa scan, which we commonly use at our C Street office. It’s a six-minute scan, and nothing touches you.
You lie on a platform, and the machine scans and tells us the percentages of body composition, lean muscle mass, skeletal muscle mass, etc. So you may be building more muscle mass than you think you are. And one way to measure this would be to to test body composition maybe once or twice a year to see where your trend is going.
The second answer, goes back to what I mentioned in the talk, progressive resistance overload. To stimulate adaptive change for muscle, the target needs to keep moving. If you begin a program that is light on resistance training and it feels effortful, that is a moving target. In order to affect change for muscle growth, there needs to be other ingredients as well.
I mentioned adequate support for protein. That’s the building block for what we’re doing in terms of improving muscle growth, hypertrophy, and strength training. All of these have different parameters around the reps and different sets. However, measuring where you are and making sure that your program is changing so the target is moving helps to give that progressive overload a chance to work.
Q: You spoke about stress in your lecture. Do you have any advice for long-term stress relief, especially for caregivers or those experiencing grief?
Dr. Lokna: Yeah, and this is a big, very important topic, I think for individuals, for groups of people, for our communities.
There is a research, and a author who’s been very helpful around stress resilience, Doctor Elissa Epel. I’ve really enjoyed her work. There are many good studies showing the importance of building into a lifestyle time for restoration so that our nervous system gets to quiet from the fight- flight, chronic stress, to a slowed response.
Even when situations contributing to chronic stress aren’t changing, simple practices like breath-work, getting time out in nature, meditation, prayer, and social connection can help regulate our nervous system. These are not intended to be quick fixes to manage stress, but they’re really intended to help co-regulate our nervous system to be able to develop more resilience and balance so that our body, mind, and emotions can handle the sustained load.
There is good data supporting practices like mindfulness, breath-work, and movement. Those would be my suggestions in terms of building it into a lifestyle.
Q: One last question: what are your thoughts on using melatonin as a sleep aid?
Dr. Lokna: Yeah, this is a big topic. Thank you for asking this. I was pretty negative about sleep aids that were over-the-counter, things that people take for sedation. I don’t put melatonin in that category. I think that individuals have different responses to melatonin. Lots of the dosing is a little bit less regulated than we’d like to see as a supplement. But for some people, it can be very helpful as a supplement to help facilitate sleep.
Again, I don’t put melatonin in the same category as other over-the-counter sleep aids that I recommend avoiding.
For more information, watch Dr. Lokna’s full lecture from the 2024 Wellness Academy.
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