By Brett Goldhawk

UBC professor Dr. Michael Koehle explains why it’s important to adapt your exercise routine to the weather conditions

For many people, summer is an opportunity to bring their exercise routine out of the gym and into the great outdoors.

But as heat waves, wildfires and smoke-choked skies become commonplace for more communities, it’s important to safely adjust your outdoor exercise to the new realities of climate change.

Dr. Michael Koehle, a professor of sport and exercise medicine at the UBC faculty of medicine, discusses how to tell if it’s safe to exercise outside and what to do when conditions become extreme.

What are the health risks of exercising in extreme heat or forest fire smoke?

Exercising in hot conditions can put us at risk of exertional heat illnesses, including heat exhaustion at the mild end of the spectrum, or the more severe variant, heatstroke, which can be life-threatening.

By contrast, living in areas affected by wildfire smoke—whether we’re resting or exercising—exposes us to long periods of very high levels of particulate matter in the air. This can lead to long-term consequences such as heart and lung disease, as well as diabetes and dementia. The harmful effects of air pollution may be compounded during exercise, because the rate and depth of our breathing increases.

Some people are more at risk than others, and this includes older adults, pregnant people, young children, and people with pre-existing health concerns like lung or heart conditions, cancer, diabetes and mental illness.

How do you know if it’s safe to exercise outdoors?

In Canada, we have helpful tools that give us an indication of the environmental conditions outdoors. For temperature, it’s important to consider the humidex, since we have more difficulty managing our body temperature on hot days that are also humid. People will experience discomfort with a humidex above 30 and should be particularly careful with a humidex above 40.

For air pollution, in Canada we use a scale called the Air Quality Health Index (AQHI), which gives an estimate of the air quality health risk on a one-to-10 scale, and can be checked on apps like Plume Labs and AQHI Canada. Environment Canada has reasonable guidance on when it is safe to exercise, but generally speaking, people should consider modifying outdoor activities when the AQHI is above four for at-risk populations, seven for the general population, or if you experience symptoms such as coughing or throat irritation.

What precautions can people take to stay safe when exercising outdoors in these conditions?

The most important strategy is to monitor current conditions and forecasts for both weather and air quality. This allows us to choose the better times of day and locations for physical activity and exercise. Often early morning can be lower-risk for both heat and smoke, and locations like parks that benefit from optimal wind, shade and distance from smoke sources can lead to lower heat and air quality risk.

For more detailed guidance, the Canadian Academy of Sport and Exercise Medicine has helpful recommendations on exercising in air pollution. The Government of Canada also has information and advice for heat and humidity.

Why is it important to continue exercising, even during environmental extremes?

We know that in the long term, a physically active lifestyle is important in preventing and treating many chronic diseases, including those that make people more susceptible to the effects of extreme heat and smoke, so avoiding activity altogether is not a solution.

Instead, using strategies like exercising in the early morning or indoors depending on the weather conditions, can help us to stay active, even when the AQHI or humidex are particularly high.

Although we can acclimate somewhat to high heat and humidity over a period of days to weeks, there is no indication that we can acclimate to the air pollution that comes from wildfires. So repeated exposure to wildfire smoke—during rest and exercise—only leads to increased risk of long-term health consequences. Everyone needs to assess the conditions and adapt our activities accordingly.

Interview language(s): English

Featured Researcher

Michael Koehle, PhD

Professor, Department of Family Practice, Division of Sport & Exercise Medicine

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Previously Published on ubc.ca with Creative Commons License

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By Kate Wells, Michigan Public

The first time Tammy and Jordan Myers held their twins, the premature babies were so fragile that their tiny faces were mostly covered by oxygen masks and tubing. Their little hands rested gently on Tammy’s chest as the machines keeping them alive in a neonatal intensive care unit in Grand Rapids, Michigan, beeped and hummed around them.

It was an incredible moment, but also a terrifying one. A court had just denied the Myers’ parental rights to the twins, who were born via surrogate using embryos made from Jordan’s sperm and Tammy’s eggs. (Tammy’s eggs had been frozen before she underwent treatment for breast cancer.)

“In the early hours of their lives, we had no lifesaving medical decision-making power for their care,” Tammy Myers told lawmakers at a Michigan Senate committee hearing in March.

Instead, the state’s surrogacy restrictions required the Myers to legally adopt their biological twins, Eames and Ellison.

“Despite finally being granted legal parenthood of our twins almost two years after they were born, our wounds from this situation remain raw, casting a long shadow over the cherished memories that we missed,” Myers told lawmakers, her voice catching.

Until this spring, Michigan was the only state that had a broad criminal ban on surrogacy. Many families say that ban left them in legal limbo: They were compelled to leave the state to have children; find strangers on Facebook who would carry their child; or, like the Myers, be forced to legally adopt their own biological children.

Gov. Gretchen Whitmer of Michigan signed legislation in April repealing the 1988 criminal ban, legalizing surrogacy contracts and compensated surrogacy after more than three decades. But the legalization is raising fears among conservatives and religious groups, who echo Pope Francis’ concerns that surrogacy exploits women and makes children “the basis of a commercial contract.”

As reproductive technology advanced in recent decades, most states passed laws permitting and regulating surrogacy. But Michigan did not, said Courtney Joslin, a professor at the University of California-Davis School of Law who specializes in family law. Still, those restrictions didn’t prevent Michiganders from having children via surrogacy.

“Criminal bans, or even civil bans, don’t end the practice,” Joslin said. “People are still engaged in surrogacy, and it’s becoming more clear that the effect of a ban is just to leave the parties without any protection. And that includes the person acting as a surrogate.”

In 2009, a couple in western Michigan had to surrender custody of twins after their surrogate decided to keep the babies. The surrogate claimed that she hadn’t been aware of an arrest and a mental health issue in the intended mother’s past. In 2013, a surrogate from Connecticut fled to Michigan to give birth, knowing state law would give her parental rights. She and the intended parents had disagreed over whether to terminate the pregnancy following the discovery of major fetal abnormalities.

The Myers family, however, thought they would be able to avoid any protracted legal fights. They had the full support of their surrogate, Lauren Vermilye, a stranger who’d volunteered to be their surrogate after seeing Tammy’s posts on Facebook. Yet even with Vermilye and her husband, Jonathan, saying that the twins belonged to the Myers, Michigan judges denied the Myers’ request for a prebirth order giving them parental rights.

“As a devoted family already raising our kind, inclusive and gentle-hearted 8-year-old daughter, Corryn, we were forced to prove our worthiness through invasive psychological testing, home visits, and endless meetings to discuss our parenting plan to prove that we were fit to raise our twins, Eames and Ellison,” Tammy Myers told lawmakers in March.

Opponents of Michigan’s repeal of its surrogacy ban distinguish altruistic surrogacy — in which the surrogate mother does not receive any compensation, including for her medical and legal expenses — from a contract for a child.

Legislators in Michigan’s House of Representatives passed bills late last year to allow courts to recognize and enforce surrogacy contracts. These bills allowed parents to compensate surrogates, including for medical and legal expenses. But as the legislation moved forward early this year, religious and conservative groups, and some Republican lawmakers, continued voicing their opposition.

Michigan’s surrogacy laws were not preventing altruistic surrogacy in the state, argued Genevieve Marnon, the legislative director of Right to Life of Michigan, at a state Senate committee hearing in March.

“However, current law does require a legal adoption of a child who is born of one woman and then given to another person,” Marnon said. “That practice is child-protective, to prevent the buying and selling of children, and to ensure children are going to a safe home.”

Michigan’s ban on surrogacy is “in keeping with much of the rest of the world,” Marnon said in March. Several European countries ban or restrict surrogacy, including Italy, which is cracking down on international surrogacy, an arrangement involving a surrogate mother who lives in a different country than the biological parents.

“India, Thailand, and Cambodia had laws similar to those contemplated in these bills, but due to exploitation of their women caused by surrogacy tourism, they changed their laws to stop that,” Marnon told the senators in March.

In January, Pope Francis called for a universal ban on surrogacy, “which represents a grave violation of the dignity of the woman and the child, based on the exploitation of situations of the mother’s material needs,” he said.

Rebecca Mastee, a policy advocate with the Michigan Catholic Conference, told lawmakers that while she acknowledged the suffering of people with infertility, surrogacy can exploit women and treat babies like commodities.

“At the core of such agreements is a contract for a human being,” she said.

“That made my blood boil, hearing that,” said Eric Portenga. He and his husband, Kevin O’Neill, had traveled from their home in Ann Arbor to the Capitol in Lansing to attend the hearings in March.

If you’ve been through the surrogacy process “you know there’s no commodification at all,” Portenga said. “You want a family because you have love to give. And you want to build the love that you have, with your family.”

When Portenga and O’Neill were trying to become fathers, they reached out to surrogacy agencies in other states but were told the process would cost $200,000. “We would have had to have sold the house,” O’Neill said.

Like the Myers, the couple turned to Facebook and social media, “just putting our story out there that we wanted to become dads,” O’Neill said. A friend of a friend, Maureen Farris, reached out to the couple: She’d been wanting to help a family through surrogacy for years, she said. And Farris lived just a few hours south in Ohio, where surrogacy contracts and compensation are legal.

Farris’ contract with Portenga and O’Neill was fairly standard. Both sides had to undergo psychological background checks and have legal representation. The contract also set compensation for Farris, which covered medical and legal fees. The contract stipulated Farris couldn’t travel to Michigan beyond a certain point in her pregnancy because if she’d gone into labor and given birth in the state, she would be considered the legal parent of the child.

That contract, Portenga and O’Neill said, gave Farris more protection and agency than she would have had in Michigan at the time. “They’re carrying a human life inside of them,” O’Neill said of surrogates. “They’re not able to work. Their bodies will be changed forever. They’re getting compensated for the amazing gift they’re giving people.”

After the embryo transfer was successful, Portenga and O’Neill learned Farris was pregnant — with identical triplet girls.

“They came out and just unraveled this huge string of ultrasound photographs and, and that’s when we knew our life had changed,” Portenga said, sitting at home in the family’s kitchen. The girls were born in Ohio — where the dads could be legally named their parents — and then the family of five returned to Michigan.

Today, Sylvie, Parker, and Robin O’Neill are 2 years old, and very busy. Parker is the “leader of the pack,” while Robin is the “brains of the operation” — she can count to 10 but likes to skip the number five. Sylvie is “the most affectionate, the most sensitive, of the three of them,” O’Neill said. “But their bond is so amazing to watch. And we’re so lucky to be their dads.”

This article is from a partnership that includes Michigan Public, NPR, and KFF Health News.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

Subscribe to KFF Health News’ free Morning Briefing.

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Previously Published on kffhealthnews.org

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Photo credit: unsplash

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Packed with hidden veggies and sweetened with banana and mango, my rich and creamy broccoli smoothie is the perfect nutritious and delicious way to kickstart your day! Made with just a handful of basic ingredients, it takes just 5 minutes to make, and it also happens to be super kid-friendly too!

If you’re looking for a quick and easy pick-me-up for a healthy breakfast or post-workout snack, my broccoli smoothie with banana and mango is just what you need. It’s one of my favorite ways to sneak in some extra greens!

Now, I know what you’re thinking – a smoothie with broccoli and banana!? It sounds unusual, but trust me, you’ll be pleasantly surprised. While broccoli might not be as common in smoothies as kale or spinach, it blends beautifully with the other ingredients, creating a creamy, thick, and rich treat.

(And if you’re looking for different ways to mix things up in the morning, be sure to also try some of my other smoothie recipes! Some favorites are my arugula smoothie, tomato smoothie, and apple carrot smoothie!)

Latest Recipe Video!

🥘 Ingredients

My healthy broccoli smoothie calls for just 6 simple ingredients, all of which can be found at your local grocery store. Scroll down to the recipe card at the bottom of the post for the exact measurements and nutritional info.

Broccoli: This veggie forms the base of my superfood smoothie. You can use either raw broccoli florets or cooked broccoli. You can even make a frozen broccoli smoothie, and it will come out just as well.

Mango: Mango adds some sweetness and is naturally loaded with Vitamin C (source). I recommend using unsweetened frozen mango chunks to save prep time. Frozen ingredients also mean you don’t have to add ice.

Banana: Rich in potassium and nutrients (source), I include frozen ripe banana to add some sweetness and creaminess.

Milk: I used unsweetened almond milk, but any type of milk will work. Other plant-based options include unsweetened coconut milk, oat milk, flax milk, and rice milk. If you’re not vegan, low-fat milk or skim milk are great choices. If you don’t want to use milk, you can also use coconut water. I don’t recommend using fruit juices like orange juice or pineapple juice as that would increase the sugar content of this recipe.

Vanilla Extract: Just a pinch of vanilla extract adds natural sweetness. I like to use it instead of adding extra sugar.

Yogurt: Greek yogurt gives the smoothie its creamy texture and a good dose of calcium and protein (source). Feel free to use dairy-free yogurt (like unsweetened coconut yogurt) as a vegan option.

🔪 How To Make A Broccoli Smoothie

My simple broccoli smoothie recipe is so easy, that you’ll wonder why you haven’t been making homemade smoothies all along! It’s a 2-step process that anyone can master.

Watch my video below to see how quickly this smoothie comes together in just minutes.

Blend Ingredients: First, I place all the smoothie ingredients in a high speed blender and puree until smooth. Then I give the broccoli shake a taste and adjust the sweetness if needed.

Serve: I enjoy my smoothie immediately!

📖 Variations

Vegan: To make this banana broccoli smoothie vegan I use unsweetened coconut yogurt in place of the Greek yogurt. Any type of vegan yogurt will work; just keep in mind that thinner yogurt will produce a thinner consistency, so you may want to add a little less.

Mix-Ins: Make my already healthy broccoli and fruit smoothie even more nutritious by mixing in some omega-3 fatty acids like chia seeds, hemp hearts, flax seeds, or even nuts and nut butter. 

Other Fruits: You can also change up the fruits. Instead of mango and banana, feel free to use other fruits like pears, apples, dates, and berries. Both fresh and frozen fruit work, but I do recommend freezing the fruit before making your smoothie.

Kid-Friendly Version: If your kids are sensitive to the taste of broccoli, try adding a bit more fruit to mask the flavor instead of adding sweeteners or sugar. This makes a great broccoli smoothie for toddlers.

Raw Broccoli Spinach Smoothie: If you want to add even more greens make a raw broccoli smoothie with a handful of spinach. Any leafy greens can be added. I love tossing in whatever greens happen to be in my fridge.

Additional Protein: To turn my recipe into a broccoli protein shake by adding a scoop of your favorite regular or vegan protein powder or 1 tablespoon of peanut butter or almond butter. 

Broccoli Pineapple Smoothie: Instead of the mango, add ½ to ¾ cup chopped pineapple to make a broccoli banana smoothie with pineapple! My kids love this version. 

Broccoli Milkshake: To make it even creamier and almost like a dessert, use some regular or vegan vanilla ice cream in place of the Greek yogurt.

Smoothie Bowl: Turn this into a smoothie bowl recipe! Pour the blended smoothie into a bowl and then top it with some of my healthy low calorie granola, nuts, and coconut. You can add any toppings you like. 

🍽 Serving Suggestions

My broccoli mango smoothie with banana is delicious alone but it’s also a great accompaniment to a bigger breakfast, healthy snack, or lunch. These are just a few of my favorites.

With Breakfast: Enjoy it alongside a bowl of my cornmeal porridge or high protein overnight oats. Another great option is to pair it with my gluten-free chocolate chip banana muffins, blueberry sourdough muffins, or healthy bran muffins for a quick and easy on-the-go breakfast.  

With Snacks: You can also enjoy your smoothie with snacks like my air fryer banana chips, healthy flapjacks, or no bake peanut butter bliss balls. It’s also perfect with some fresh veggies and my no garlic hummus or a piece of honey avocado toast. 

With Lunch: For lunch, pair your smoothie with my vegan hummus avocado wrap or kale and caramelized onion veggie panini.

🧊 Storage Directions

Fridge: Smoothies are best enjoyed fresh, but if I have any leftovers, I pour them into an airtight container and store them in the fridge. They will stay fresh for about 24 hours. Before enjoying it again, I give it a good stir.

Freezer: Freezing will change the texture and possibly the taste, but smoothies will keep for up to 3 months when frozen. What I do is pour the smoothie into a freezer-safe container or ice cube trays. Once frozen, I put the frozen smoothie cubes in a ziplock bag. When ready to enjoy, I toss the ice cubes into my blender and puree.

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