Thursday, December 30, 2010

why should you stay in shape?

we all know why you should get in shape, why you should be healthy, fit, etc. we all make our best efforts to do so with the least amount of negative impact on our lives. that is, take the least amount of time away from the other things in our lives - work, play, family, friends, etc - and the least amount of financial and to some extent bodily impact. for many, we even do our investing in fitness at one phase of life- youth, middle age, whatever - and hope it pays dividends later in life...like now. in other words, we often refer to what we used to/could have done and pretend to live off those glory years - or months, in some cases - as if somehow those hard-earned capabilities would persist beyond that phase of training.

wrong!!!!

the truth is, we de-condition much faster than we get in condition, and while we often retain some extended benefits from a training period - for ex, strength declines slowly largely because the nervous system, which is the first and most persistent adapter to a strength training routine, has "memory" (some would say, muscle memory) that enables muscle recruitment even when hypertrophy withers.

other benefits, such as aerobic or anaerobic capacity, fade, too. since the complex biochemical changes, not just the gross anatomical ones (like heart ventricle size), reverse engines to their previous state of dormancy or half-use, our capacity to perform for long periods of time (aerobic) or in short bursts of higher intensity (anaerobic) diminish, too.

the magic question for years has been, how little do i need to get in shape? and how little do i need to do to stay there? and while there is no precise answer to those questions, there is at least one caveat that persists beyond all the research studies: if you don't use it, you lose it. furthermore, if you do use it, and stop using it, it won't be there when you want it again. and this article discusses this issue a bit deeper: http://well.blogs.nytimes.com/2010/12/29/phys-ed-if-you-are-fit-you-can-take-it-easy/?ref=health

so, whatcha waitin' on; get up and start exercising...again.

oh, and happy new year, too.

Saturday, December 25, 2010

workouts that work

it's christmas morning and all through my house, not a creature was stirring, except me. hopefully the mouse that's been meandering on the counter near my home-made bread - he/she never did get any but keeps leaving droppings as proof of intent - has died from the poison i planted there for him. but my kids - 16.5 and near-18 - are with their mom's family; my girlfriend is with her kids and family in memphis; and needless to say the gym is quiet today - so i'm solo. not an issue for a non-practicing jew but it does afford me the opportunity to write this blog.

the title - workouts that work - is not new nor is it intended to be profoundly enlightening, so if you're seeking the ultimate in workout tips, look elsewhere. rather, as i oft do on this blog, i'm bringing to light the 'research' that's been reported in the ny times on fitness; in this case, on the afterglow of an exercise session. what is it? why do people feel - no, not good - that's endorphins or some such sense of accomplishment - HOT for extended periods of time after a good hard workout.

now, i've never studied this phenomenon and i'll take the word of the contributors to the article that no one really knows why, but i do know the feeling. in fact, against almost all advice, i am a late night worker-outer; that is, i usually do my cardio (stationary bikes, now that running or even ellipticals hurts my knee) after 930, 10 P.M. that's right, i come home, eat, read, lolligag, then decide, on the spur of the moment, if i have enough energy to get on the bike for 20-30 minutes. if i do - one could say i'm lucky bc i'm lean, fit looking, and after 40+ yrs of being a fitness aficionado, i don't need to do cardio as intently as competitors or out of shape folks- i will do some low intensity with reading or some version of intervals (with reading only during the warm up). then i shower and hit the rack with a book or journal...but only for a short while since sleep usually overcomes me quite quickly at that point. no, i do not get invigorated enough to stay awake, so don't ask. but then again, this is a 40 yr old habit of sorts - i used to do my tae kwon do exercises and calisthenics late at nite when i was a competitor - and it's never kept me awake. and yes, some people do get invigorated but i suspect it's a smaller number than the advisers might suggest when they warn against late-night exercise. (here's where i go personal: how many of you engage in sexual behavior before bedtime and get so invigorated you can't fall asleep afterward? unless the sex act goes unrequited in some form or another, most folks are usually calmed if not soon then immediately afterward, and sleep often intervenes before the parties separate. exercise is exercise regardless of the format, and good exercise is akin to good, even bad, sex in that one is often spent afterward. a hot shower is all that's needed to cap off the evening.)

having diverged, let me return to the point. here's the article: http://www.nytimes.com/2010/12/21/health/nutrition/21best.html?ref=nutrition

now, in winter, when i keep the house around 66-67 degrees, it's cool enough that i need a light jacket to sit around, esp downstairs, where the kitchen and the tv room/bike rooms are. but after my ride, i'm warm if not sweaty. i can move around without a shirt for a while before the chill hits but am usually on my way back upstairs to shower. i am comfortable as i hit the bed but enjoy getting under the blankets after a few more minutes of cooling down, and sleep befalls me. and tho i am not sweating or steaming as you might suspect based on my thermostatic environment, my internal thermostat does run warm. and to the point of the article - i don't care why. it's nice to know, and some grad students need to study it, but the warmth i feel after a workout is my body's attempt to reset its internal thermostat from hi to lower, to re-align blood flow from the legs and skin to the gut from whence it was shunted, and to initiate the adaptations that will enable the workout to yield health and physique results. one can get overwhelmed by articles such as this and if you're in the exercise sciences, maybe even get inspired to read on. but if you're simply trying to find a way or reason to exercise, esp in the winter months, there's nothing bad one can say about exercise but there is one more good reason to consider it: it warms the cockles of your heart and body.

and on this white, wintry, snowy christmas morning, alone in my den looking out at the dusted trees and bushes, all i can say is i'm warm. and i hope you are too. merry christmas.

Wednesday, December 1, 2010

on vitamin D: changing standards?

the other day, i got my tufts nutrition newsletter. there was a small piece in there about the need to take more vitamin d and how many are getting this message. the same day, the ny times and wall street journal reported on an institute of medicine committee that reviewed hundreds of articles and came up with some revisions to the D controversy. interestingly, each paper had a different spin despite covering the same exact literature. (liberal vs conservative? not in this situation....)

the times emphasized the lowered standard for prescribing supplementation from 30 ng/ml to 20 ng/ml of blood as there is no consensus on what the lowest level is to prevent any number of diseases associated with D deficiency: bones, cardiovascular, cancer, etc. but the journal emphasized the tripling of the baseline daily needs from 200 IU to 600 IU, with the appropriate aging considerations. it also highlighted how older men don't need 1200 units of calcium and can get by on 1000. in other words, the report is shaking up the medical world.

several docs opposed the lowered blood level marker as studies and experience have shown that higher blood levels tend to support safer bones. some docs even suggest that D supplementation up to 2000 units is safe and more effective than traditional levels of supplementation. both papers did address the economics of D supplements as there are many manufacturers and vendors who will be hurt if docs stop pushing D hard.

all this is to say that medicine is fluid. one problem with evidence based medicine is that the evidence is often not good enough to make firm standards on most everything there is to test or treat. as such, as we attempt to drive our medico-economics on a national scale with such evidence based medicine, some folks will get short-shrifted as cost becomes the measure of application. i don't have the answer and neither private nor public insurers have the means to provide all any one person needs, but i do know it is not a pretty picture. what i can offer, however, is my humblest opinion based on the literature i read and the material tossed out for public consumption. and to offer you the option of at least making informed decisions.

read on: http://online.wsj.com/article_email/SB20001424052748704584804575645023841631864-lMyQjAyMTAwMDAwMTEwNDEyWj.html

http://www.nytimes.com/2010/11/30/health/30vitamin.html?_r=1&nl=todaysheadlines&emc=a23

Tuesday, November 30, 2010

too much time, not enough activity

as i've reported in the past, sedentary behavior, of which we are all guilty in the modern society of advanced economies, is killing us. (disclosure: while you sit and read this, i'm typing it standing up at my new upright computer desk. it feels good to be standing.) i'm not going to dwell any further on it other than to say this is the future of exercise prescription: stop sitting. so long as we can impose that institutionally, as in school or work sites, we might be able redirect the downward spiral of health, and the upward spiral of healthcare costs, in our country. if i had the power, i'd outlaw TV; that would improve kids' grades, all our health, and our political discourse. but i don't, so here's my blog today:

http://www.nytimes.com/2010/11/23/health/23brody.html?_r=1&emc=eta1

Wednesday, November 17, 2010

Just a pint full of water makes the calories go down, the calories go dooown

i read this in another place and now in the ny times, of a study, and other supporting studies, that showed overwt folks told to drink 2 cups of water before meals lost more wt over a 3 month period than did the controls. there are many reasons this may be true: water fills the gut, telling the brain not to eat so much; carbs, when they meet water, expand, puff up, stretching the gut, which then tells the brain it's full; and that much water - for those who've had to prep for a colonoscopy - is damned uncomfortable and makes you sloshy inside. whatever the reason, it seems to work: http://www.nytimes.com/2010/11/16/health/16really.html?ref=health

now, there are many good, tried and true ways to cut calories and lose wt. unfortunately, as i've written before, cutting wt is hard to sustain. eating breakfast; exercising at least one hr/day; eating mostly fresh produce - fruits and veggies, and whole grains; eating lots of low fat protein - all these, esp combined almost surely guarantees wt loss. but there's more to wt loss than meets the scale. there's emotion.

many people gain wt for any number of reasons but most if not all fail to lose it for one of three main reasons (my opinion): unwillingness to sacrifice what they deem lifestyle joys; inability to make the choices necessary because of socio-cultural environment; or inability to allow themselves the power to fend off forces outside themselves that impel them to behave against their better, more knowledgeable selves. it's the latter i want to address here.

we all have our emotional baggage. for some -the overwt/obese - some of that baggage is body-shape dependent. having suffered the slings and arrows of some emotional charge, be it parental, familial, schooling, or whatnot, many o/o are damaged goods. they feel bad about themselves, feel less than attractive, less than healthy - and therefore less than what they would like to be. so food, or shall i say, eating, is a refuge of first resort. in other words, even before you can go to the store yourself let alone make enough money to find other 'drugs' - be they real drugs or gambling, or sex, or whatever else people might use to satisfy some inner longing - there's always some food nearby.

for others, it may not be body dependent; it could be self-esteem dependent. that is, for whatever reason, again, these folks use food - excess amounts or the wrong kind - for self medication.

when such people look in the mirror, they simply don't like the person they see. we all tend to look at ourselves the way we think others look at us. we can often justify things by glancing at the wall behind our desk at our diplomas, awards, etc, or maybe at our grandparents' pictures if they somehow bring honor and status to our name if not our selves. but in the end, the mirror of society still pierces the armor and the sadness or the anger manifest in self-destructive food consumption.

now, before you go off the handle here, let me state the obvious. not all o/o people are sad, angry, or low-self-esteemed. it's only in the past 50 yrs that thin took precedence over zaftig - meaty. there's always been chunky, fat, blubbery, etc but today it's so prevalent and so much a national shame and drain, it's no wonder there's so much written and studied about o/o. but the truth is, not everyone can be, nor should be, lean let alone thin. studies have shown that the elderly need to have extra pounds on them in case they get a debilitating disease like cancer. nonetheless, there are many folks out there who neither live in their body's image nor feel any shame about their bodies because they truly have known love from the important people in their lives, and truly love themselves non-narcissistically.

however, 25 yrs in the business of training people, many of whom have at some point discussed their excess wt and even tried over and over again to tame it, has taught me that there's some major emotional distress at not being lean. even if the wt has not contributed to illness or risk of illness, even if the wt does not make them look bad in clothing, even if their signif other does not change the way he/she feels as a result of wt - still, it bugs them so. and when it does, i try to veer them off from their shame and give them sound advice about how they can manage their wt for health, not appearance. as such, drinking two glasses of water, tho it is not that difficult to incorporate, seems to me a drastic alternative to the many other, more healthful ways to cut calories. and not necessarily healthier.

Wednesday, November 10, 2010

protein for cardio

in blogs past i've discussed the value of protein for muscle building and muscle training. but there's now a movement afoot to add protein to drinks otherwise reserved for aerobic athletes. based on a few studies that have shown benefits, one needs to look at the quality of these to determine veracity and validity. this ny times piece refers to an article that does and that tests the possibility of adding protein to a beverage for cyclers. the findings are interesting. the conclusion, tho still not yet confirmed, is not unreasonable. but before i take a stand on it, let me say, i'm not a nutritionist, a dietician, nor a biochemist. but i try to look at sports science objectively. as such, i will say this: for most if not all cardio athletes consuming appropriate amounts of calories relative to their athletic and basic needs, adding more protein to a drink WHILE riding or running is not helpful and could be detrimental. since it takes more energy for the body to break it down, and while running or biking you want to spare your energy for your legs, it makes little sense to pay extra for a less-than-pleasant tasting drink that, for the most part, provides the calories you need to keep from bonking. gatorade may be coming out with a product and others will follow, but save protein supplementation for afterwards and for the weight training.

read on: http://well.blogs.nytimes.com/2010/11/10/do-protein-sports-drinks-improve-performance/?ref=health

Tuesday, October 26, 2010

aging and 'physiologic reserve'

maybe you think i'm afraid of aging because i cover it so often. the reality is, we're all doing it so i find its processes and progressions quite fascinating. kinda like following my newborns' progressions via the many books my wives (two divorces, so i credit each of them) had bought so we could benchmark their lives. also, much of my work with clients is with those who are experiencing age-related changes.

this piece in the ny times - http://www.nytimes.com/2010/10/26/health/26brody.html?_r=1&emc=eta1 - discusses the concept of physiologic reserve, a cool term i thought i'd share for those wondering why they no longer can do what they usta/coulda done. it refers to the extensive network of organic functions we have at our disposal that we rarely tap into. for ex, we use very few of the billions of brain cells we possess. this allows us to keep learning things, including new movements. we also have a lot of muscle fibers we hardly ever engage - except at the highest levels of training and conditioning. this is why even as we age and lose them we can still function relatively well into our later years.

but there is a tipping point for all systems. once that point is reached, declines occur, or at least become noticeable. without thinking too hard about it, we can readily note the memory lapses or physical deficiencies that plague those of us over 50, even those of us who stayed in shape most of our lives. this is natural aging and we can only do so much to keep it at bay. but i use this concept - now that i have a name for it, i'll use it more, just to sound smarter - when i explain to new clients why resistance training is so important.

personal example: when i was young and training hard, real hard, i topped out on push ups at 60. at 50, i'd start feeling tired. by 60 i was done. pretty good overall, compared to others, but it wasn't til i got over 40 that i realized how much of a wimp i was.

i had my second child, lydia, shortly after turning 40. so i set a goal for myself- i'd add one push up per week for her first year of life. it was easy at first but got hard at 90. so, when i had sophia 16 months later, i set a goal of 1/month. thus, sometime around my 42nd birthday i was able to do over 100 push ups. (today i can still pull off 80, but it's a very hard effort.) this proved to me that i had been undertraining while i was young and injury free for all those years i was stuck at 60. i had reserves but hadn't topped out on them when i needed them most.

nonetheless, the message i give new clients is this: if you can do 10 push ups at 30, and do them daily til you are 60, while it's a feat relative to your peers, because you've been losing muscle fibers all those years, you're now working at a much higher percentage of your overall capacity. so building up now - at WHATEVER age - will enhance your ability to maintain higher levels of function as your body starts to decline. you can always get stronger, at any age, but you have to work on it harder now while you can - at whatever age you begin. so, get started; start getting stronger; that way, your physiologic reserves are greater for that time in life when not enough is not an option.

Monday, October 25, 2010

the doctor-patient wt management plan

it's on everyone's mind, whether you're lean and fit or obese and diseased: why can't i/they/he/she lose weight? well, if you're a doctor administering to a patient whose health can be dramatically altered by losing wt, you have several options: talk nice, give orders, don't say anything, or present the data. this article in the Times addressing a recent bit of work that shows what any fitness professional knows...but many do not practice: http://www.nytimes.com/2010/10/26/health/26weight.html?ref=health


now, this is my take on the issue, just my philosophy, so it does not have any more power than my experiences over the 20 plus years i've been doing training. first, my clientele - bright, educated, wealthy, primarily caucasian. second, my personality - all of the former except for wealthy, plus a former philosophy major, liberal, caring. why do i mention the latter aspects? because they factor in on how i deal with clients for whom wt loss is an issue; esp how i deal with those over long periods of time for whom advice, guidance, support, education, and training don't have any measurable benefit.

as a philosophy major, i spend many years thinking about the human condition. while i have no profound answers to offer, the one thing i learned over time is that most people won't change. they can, but most won't. neither threats of impending doom nor promises of 72 virgins in heaven will change one's behavior....until the person really wants to change. this works for individuals, societies, cultures, and nations, so you can fret the small stuff but there's no need to fret the big stuff; we just have to deal with that which presents itself.

as a liberal, however, i believe mankind, and each individual, is responsible for his/her life and decisions as to how it's lived, but that there are mechanisms, or at least should be, that will enable us to find the 'right' way to live. but, go back to the previous paragraph and you will appreciate the fact that liberalism, tho well intended, does not often work. for one thing, 'right' differs from person to person. for another, it's complicated.

for example, it's 'right' to exercise. but it's wrong to over-exercise or mis-exercise to the point of injury. raise your hand if you're an athlete who's never suffered from either overtraining or injury. good - no hands showing. well, we espouse the principle of paying for our lifestyle sins - that the obese should pay more for insurance commensurate with their risks, but then shouldn't athletes? of course, our injuries don't cost as much - now - but it was 15 yrs after my tae kwon do career ended that i needed my hip replaced; and will be a few more til i need my knee replaced. you'll say there are fewer and less severe and less costly medical conditions that sprout from being chronically active but the reality is, not all obese people will cost the system and not all athletes will save the system from costs. so, taken individually, not all of us should be hard core athletes but neither should all of us be obese. there's got to be a mid point somewhere, but who is to say where that is. there is no right level of fitness nor mechanism for getting there.

that said, as a liberal, i do believe society can facilitate the approximation of right at the expense of neglecting it. in other words, government, acting on behalf of society, should spend more money helping us to get fit, be healthy, and live more productively. i just don't know how to do that....

finally, i really do care. i want my clients to be healthy, get fitter, and enjoy their bodies and their minds. i love what i do and do it with love. those who have tried to lose wt, tho, are difficult to manage beyond their first 20-100 sessions - i say this jokingly but when someone's been trying to lose wt for 3 months or years, then there's absolutely nothing i can do to help. i don't give up but i do resort to less accommodating coaching. after reviewing one's behaviors that repetitively sabotage their stated goals, i resort to supportive questioning: that is, regardless of their answer or offered statements about dietary or exercise patterns, i find a positive spin to apply but direct them back to the 'better' method or choices. by this point, i know them fairly well so i can play this game. the one thing i never ever do is put someone down for their choices. but i have, on occasion, let them know that their choice speaks loudly for their real intentions. most of the time, this goes without saying, so i don't.

now, back to the article. docs don't have these kinds of close relations with clients like trainers. they have minutes, tens of minutes at best. reminds me of a cardiologist i met 20 yrs ago. after the movie, he asked what kind of advice i offer for wt loss. after expressing my philosophy so as to avoid sounding like a know it all - i knew a lot less back then- he shared his. he told of how he sits next to the bed of a patient who had a cardiac event, or surgery, and discussed diet. years after spending half an hour with patient after patient, sometimes the same person a couple years apart, he boiled it down to three words: greens, beans and grains. then he walks, figuratively speaking. his point is clear: he cared, he cares, he shares...then he leaves, leaves it up to the person to make a choice. it may not be the right choice. if it isn't right, he'll see him/her again, maybe. but it's all he could do.

that's why the data is not strong enough to change the way docs talk to patients. most simply don't want to listen. be nice, anyway.

Wednesday, October 13, 2010

knees, arthritis, running: are they connected?

i've probably written on this before but this article in the ny times inspired tonite's blog: http://well.blogs.nytimes.com/2010/10/13/phys-ed-do-marathons-wreck-your-knees/?src=un&feedurl=http%3A%2F%2Fjson8.nytimes.com%2Fpages%2Fmagazine%2Findex.jsonp

i alert you to the concluding line: ‘There’s no strong evidence,’’ he said, that, if your knees are healthy to start with, ‘‘running a marathon will hurt them.’’

i think it's fair to say, as i've long held, that there are no wrong exercises for everyone but there are wrong exercisers for some exercisers. in other words, using myself as an example, having done tae kwon do nearly every day of the year for about 15 years, that my knee (only my pivot leg) is shot because i must have either trained wrong or had a propensity toward arthritis. (i also have a new hip on the same side and the knee will someday need replacing.) my friend, same age, same duration of youthful training, is still teaching, running, and sparring (gently, because we are, after all, old men) and is free of knee problems. (tho he's had both his hips re-surfaced. it's a tough sport...) my point is, some suffer consequences, others don't. same for knees and running.

the studies reported in this article are noteworthy for their longevity. rather than a cross sectional study of runners and non-runners, or runners and former runners, some of these in this piece followed runners over a period of time. what they generally found was that running did not cause arthritis, but it did alter the 'matrix' of the cartilage. however, that may be one of the many ways our body adapts to the stresses of long distance long-term running. obviously, some runners had to give it up because their knees did not adapt well. others are still running. thus, i think it's fair to conclude that, much as that last line says, running does not cause arthritis unless your knees are prone to arthritis.

now, many things can make you prone: genetics, previous injury, untreated training or footwear conditions (running on the same side of the street, or in the wrong shoes - old or inappropriate for your foot), or any number of nutritional or extra-activity variables that can't be determined. (for example, is my knee shot because i also tried to be a distance athlete? or because i worked out on tile floors 3 hrs/day? or because i needed orthotics for running but trained barefoot? who knows????)

so, in conclusion, let me state clearly my position and highlight that of the news piece: exercise however you wish. pay attention to your body. treat it like a living machine, providing it the elements of success under duress - fluids, nutrients, and rest. and maybe just maybe you will not be one of those who suffers cartilage damage from your activity of choice.

but maybe you will regardless.
bummer....

Sunday, October 10, 2010

supplements, free radicals, and anti-oxidants

i have colleagues who, as trainers, wish to help their clients and friends by also supplementing their incomes passively. so they sell or market supplements, either muscle building or immunity-enhancing or disease-reducing "proprietary blends" that have an ounce of science and a ton of marketing behind them. just the other day, a close associate was discussing with me the prospect of getting involved in a multi-level marketing scheme of scientific-sounding anti-oxidants but was rightfully investigating its authenticity before jumping in. he wanted my opinion. that was before i read this article: http://well.blogs.nytimes.com/2010/10/06/phys-ed-free-the-free-radicals/?src=un&feedurl=http%3A%2F%2Fjson8.nytimes.com%2Fpages%2Fmagazine%2Findex.jsonp

my opinion was this: maybe it works but science has a way of isolating out of natural products or foods items or components of items believed to be the reason the natural products or foods are thought to be healthful. that is, take the C and E out of fruits and veggies, compress them into pills with megadoses way beyond those you can eat, and hope for miracle cures. but, studies just don't support most of these claims. in fact as i've reported previously, the latest data, based on multiple studies and combined data from multiple studies, shows that a multi-vitamin pill confers no health benefits vis a vis cancer or heart disease. (the only caveat here is, of course, when people eat restricted diets - vegetarians, for ex, need iron, zinc, and B12 from pills. and there are other limiters that might require supplementation.)

the article link above confirms that our bodies are pretty good at taking care of business. exercise, which produces tons of free radicals, that otherwise would be destructive, actually enhances our body's ability to manage them via internal mechanisms. and when you over supply the body with exogenous (outside the body) anti-oxidants, guess what happens: you become less adept at removing these by-products and also less adaptive to the benefits of the exercise itself.

it also confirms what those stodgy old dietitians have been claiming for eons: food is the best medicine. not supplements - which cannot be 'natural' because natural is food, and pills are super-concentrated versions of only one or a few elements contained in food.

so, once again, the age-old, 5 food group recipe stands firm: eat your fruits, eat your veggies, get your calcium from dairy - and don't try to tell me mankind can't get the nutrients from cows - we've been doing it since the first time a thirsty ancestor went up to a cow or camel and drank from its teat. very few of us are truly lactose intolerant and even fewer are allergic but the rest of us can handle it just fine. (in fact, low fact chocolate milk is now the premier post-workout beverage for strength athletes...and some would contend for cardio athletes, too.)

one last note. don't be surprised if you hear, soon, about the necessity if not the recommendation to eat more saturated fats. it's all aristotlean: everything in moderation. why is it we americans keep taking things to the extreme?

Wednesday, September 29, 2010

ACLs, knees, and genes

a provocative article in the NY Times projects the possibility that genetics predisposes some - esp women - to NON-CONTACT anterior cruciate ligament (ACL) tears. http://well.blogs.nytimes.com/2010/09/29/phys-ed-are-bad-knees-in-our-genes/?ref=health

tim hewett, of cincinnati children's hospital, a prominent researcher on ACL injury and prevention, reports that one set of twin girls tore their knees up within a year. their older sister also tore her ACL. another set of twin sisters had incurred torn ACLs in high school, as did their dad...and his two triplet brothers!!!! scary huh? suggesting that you can look at your family's knees and see your risk profile in scar tissue.

studies in south africa have found a gene sequence that alters the customary elasticity of ligamentous collagen. interestingly, more women had this aberration whereas males who had had ACL injuries did not have this variant and women who had not torn their ACLs also did not have it.

so, we can now add to the list of predisposing factors - weak, easily-fatiguing, and late-firing hamstrings; weak and delayed-firing gluteus medii; possible femoral notch anatomical variations; and poor training/jumping/cutting technique - genetics. like many things genetics, this does not mean you WILL have an ACL tear if other family members have had one. but it does mean you might want to train properly with more closed chain- squats and lunges - and plyometric - jumping/hopping - and agility - cutting, changing direction - exercises. see a pro who's studied this syndrome, not just one who knows how to build bigger muscles. you need better ones, not bigger ones.

Thursday, September 23, 2010

sugar, hi fructose corn syrup

the corn growers of america want you to not be afraid of hi fructose corn syrup, so they're changing the name: corn sugar!!! that should allay any fears of consuming too many wasted calories now that its name has changed, right?

wrong.

there are unwarranted fears about the correlational link of hi fructose corn syrup (HFCS) to the burgeoning girths of americans, and people all around the world. (see: http://economix.blogs.nytimes.com/2010/09/23/the-world-is-fat/?ref=business) but the science of sugar suggests there are no substantial differences bw table sugar and HFCS. many health foodies still hold onto their faith-based prejudice against HFCS but the evidence is pretty clear on at least one thing: those who consume hi sugar foods/drinks tend toward obesity more than those who get their sugars in the foods from which they come naturally - fruits, veggies, and complex carbs.

in another blog on the NY Times website today, the issue of HFCS vs sugar is well analyzed so that even the non-scientist can understand it. both sides of the argument are presented but the one thing that stands out clearly is the commentary of the main researcher whose 2004 study showed the correlation of obesity to the ever-increasing amount of HFCS in our diet. he contends that it's the sugar, not the type of sugar, that matters. and that alone should cause you to pause as you shop, for HFCS, and now the soon-to-be-renamed "corn sugar" that's in the processed foods you buy are not making you any healthier. in fact, sugar, being sugar, is, if consumed to too large a degree in your diet, you put yourself at risk not just for cavities but for diabetes, heart disease, overweight/obesity, and nothing positive unless consumed right before a hard workout. in other words, cut the sugar, eat the fruit: http://well.blogs.nytimes.com/2010/09/20/in-worries-about-sweeteners-think-of-all-sugars/?ref=health

Tuesday, September 21, 2010

stability balls at work

much has been done by exercise pros over the past 20 yrs to elevate the formerly known "swiss ball" (SB) to near-olympian levels of wonder results. what was originally a ball used in neurological therapy for newborns with developmental issues, once the ball hit america, like many other things that had intrinsic value and utility unto their own, the SB took on a mind of its own, with claims that only now are being fully investigated for veracity. but let me give some history here....

about 18 yrs ago, my colleague, who had received treatment for chronic low back issues, came to the gym with a new-fangled exercise toy - the SB. she knew two exercises, as prescribed by her PT: the crunch and the bridge (feet on ball, lying supine on floor, raising hips.) both were good enough for most people's needs but the story doesn't end there. within a few years, every gym and trainer had a SB and new exercises were being created a mile a minute. within a few years, some jokers - you know them, and they know who they are - were even promoting the SB for doing squats - no, not against a wall or with a partner; doing squats ON the ball. like the dogs in the circus, or even the elephants. only stupider - because presumably these were bright human beings doing stupid human tricks...of absolutely no legitimate value whatsoever.

claims such as improving balance, stability, and core strength overwhelmed the media and trade mags. but there was still no research to back it up until the late 90s. at first, the reports looked good - SB crunches engaged the ab muscles better than regular ones tho not as well as other - in particular, the bicycle - exercises. still, it had value now. and the new concepts of spinal stability especially of the smaller interspinous muscles - rotatores and multifidi - were supportive of unstable surfaces for performing exercises to benefit these mini muscles that normally atrophy post injury. from there, tho, it was a stretch to make other claims such as get stronger, get better core stability for athletics, and get better posture. thus far, none of these claims have been verified.

having been an instructor for Exercise ETC, Inc, out of Ft lauderdale, i had to confront these issues head on with participants who bought into such claims. many a time i sat on a SB with lousy posture mimicking that which they themselves were sitting to demonstrate that it's feasible to sit on a ball and get no inherent benefit to posture. likewise, many studies have been done demonstrating that more strength is gained by doing exercises on stable surfaces than on unstable ones. furthermore, once basic stability of the spine is intact, further challenges via the SB probably don't offer any functional benefits. after all, how many life activities take place on a 65 cm spherical surface? no great athlete in pre-modern or modern history has gotten there with such a tool and all great athletes who use them were great before they used them; the SB may simply be another of many tools in their training arsenals, one likely to be more a waste of time than anything else.

so here comes an article in the Times discussing claims that sitting on a ball at work increases calorie burn and posture. and one study did indeed show an increase of 4 - read: FOUR - extra calories per hour of sitting. let's put that in perspective: get up and get a drink of water, talk with a co-worker for a few minutes - and you'll burn more calories, hydrate yourself, and derive social benefits far beyond sitting those extra few minutes on a ball. besides, for a full 32 extra calories/day, why not take a 1/3 mile walk and get cardiovascular benefits that far exceed those of sitting anywhere let alone a ball.

btw the studies do not support improved posture. in fact, not only can people slouch on a ball; not only might you sit straighter whether on a ball or in a chair; but posture is nearly impossible to train without conscious decisions made throughout the day to exert oneself into a proper posture. so it ain't the ball, per se. in fact, if anything, the new science of sedentary behavior suggests that sitting on anything is less valuable to health and body composition than standing, so SB sitting is actually bad for you, and no better than sitting on a good chair.

read on: http://www.nytimes.com/2010/09/21/health/21really.html?ref=health

Wednesday, September 1, 2010

stretching

another article sums up the latest professional spin on stretching. done on runners, many many runners, of all ages, some of whom were assigned a 5 mins stretching routine, others who were asked not to - it took two years to find enough who would not stretch - the study found that 16% of stretchers and 16% of non-stretchers got injured over the course of the study. thus, stretching's a wash.

but is it? they also found that 23% of former stretchers who stopped stretching for the study got injured. the researchers concluded that the change of training habits likely contributed to their injuries and warned that “sudden changes are probably not a good idea.” i hate to say 'duh' but there's more to this than meets the eye.

i've written before on the lack of benefits of stretching and the value of dynamic warm ups instead. and i stand by the research both professionally and personally, from experience. but i do want to clarify something here: stretching passively may indeed be necessary for those who have conditions or muscle imbalances that do contribute to injury, such as ITB syndromeor patellofemoral pain. i would also add that for many, static stretching is essential even compared to dynamic stretching. older adults, those with known pathologies, and those for whom balance may be an issue benefit from slow, long-held stretches. of course, a dynamic warm up of even light walking loosens up the intended muscles and gets blood flowing deeper into the tissue to be stretched, so don't forget that part PRIOR to your stretches. nonetheless, there is still merit here.

what makes this study interesting was the data on previous stretchers' injuries. what we did not hear, tho, is a breakdown of the nature of the injuries incurred. it is very possible that the non-stretchers suffered injuries that would indeed have been mitigated if not prevented had they stretched. it's also possible that the stretchers, feeling like they'd warmed up enough, went out too fast and furious and thus injured themselves for reasons totally different than those related to stretching. as such, we still do not know whether or not stretching is beneficial or possibly hurtful. though large-subject pool studies have shown no benefits, like this study, it's not unreasonable to think that stretchers get injured as much as non-stretchers, just with different types of injuries. therefore, stretchers may not need to stretch and non-stretchers need to stretch but we'll never know til a study looks at the nature of the injuries within each group. til then:

http://well.blogs.nytimes.com/2010/09/01/phys-ed-does-stretching-before-running-prevent-injuries/?ref=health

Saturday, August 21, 2010

obesity

yes, it's what you do or don't do with your time, money, and mouth. yes, there are many options available and many influences that often direct your time, money, and mouth away from healthier choices. but...can society, politics, and the private sector work together to reverse the trend toward obesity in america effectively? can it, or should it? two separate questions. of course, if you believe as i do, that we're all in this together - we healthy people pay for the choices of others even by our own private health insurance, and even life insurance, policy premiums because of demographic statistics that are actuarialized to determine rates. furthermore, any public health costs are escalated to bank-busting levels by choices made, and fostered, by the many systems in our society.

this article in the Times addresses the possibility that the public and private sectors could re-tool themselves to improve our diet and our physical activity habits. it's by no means comprehensive in this endeavor but it's a start in getting folks thinking that maybe there are things that can, someday, be done to reverse the slide into obesification: http://www.nytimes.com/2010/08/22/business/22stream.html?ref=health

Tuesday, August 17, 2010

type 2 diabetes drugs and bone breaks

there are many drugs for almost any disease, but none are risk free. type 2 diabetes (t2d) is a disease prevalent in the aging populations of industrial/developed nations largely due to lifestyle patterns of excess food intake and sedentary behaviors. some of the common drugs used to manage this disease have been shown to increase risk for bone fractures in women more than men, and some warnings are being posted to docs to consider to whom these drugs are prescribed: post menopausal women are at higher risk for both diseases (osteoporosis). read: http://www.healthcanal.com/female-reproductive/10086-Diabetes-drugs-linked-with-higher-risk-fractures-postmenopausal-women.html?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+healthnewshc%2FOxfp+%28Health+News+from+HealthCanal.com%29

my view on the matter is the infamous Desiderata: ....change those things you can. we can't change aging, except by dying. we can change some of the effects of aging, esp if we start young, such as with proper diet and appropriate exercise/activity. but we can indeed change our risk for and need for meds for T2D, simply by, well, proper diet and appropriate exercise. even if you have the diagnosis, you can, esp early on, reverse it by simply losing weight through, well, proper diet and appropriate exercise. and you don't have to lose tons of it. but the choice, unlike that of living, dying or aging, is easier than the latter, and proper diet and appropriate exercise results in nearly-immediate changes in blood sugar levels that, in due, but short, time could reduce the need for meds and put you back in the game of life....which is, after all, what it's all about.

Monday, August 9, 2010

weight management/loss

the age-old debate - less carbs vs less fat - has been undergoing much new study since dr. atkins first proposed a lo carb diet back when my mom was trying to drop pounds for my bar mitzvah. (yes, for a couple years there, she was doing that yo yo thing simply to look hot for my and my brother's bar mitzvahs. when i look at the photos of those events, it's clear she, too, was a by product of an era when thin was beginning to be in. shame - some things have only gotten worse with time.)

most good research on wt loss has concluded that (1) most other studies are too short to be of value; (2) most long term studies show significant wt loss early with substantial wt re-gain later, esp for the more extreme diets; and (3) calories in, calories out is the only way to reduce wt effectively.

and here's a new study, reported in the ny times, that demonstrates no superiority between diets: http://www.nytimes.com/2010/08/10/health/research/10diet.html?ref=health

now, you might be thinking that hi pro/low carb diets are better because they raise HDL. maybe so, but the article here does not tell us to what extent. we know that simply losing wt lowers LDL and in some cases raises HDL. so the actual difference b/w the two diets may be "significant" but not a lot, that is, not enough to be clinically significant. we just can't tell from this piece of news.

however, there are better and more effective ways to raise HDL, and to lower wt. it's called exercise and balanced eating. we know all about exercise, right? but do we really know what balanced eating is; my guess is, no.

balanced eating is any form of eating that includes those bedeviling foods that one can't help but call - carbs. yes, carbs - fruits, veggies, and whole grains. hundreds of studies show the vast benefits of diets hi in these items. yet, any low carb diet restricts these - esp the grains- early and even throughout the diet period. thus, the diets are boring and eventually unsustainable.

now, one does not need to go to the full lengths of the books to achieve favorable results. in fact, most hi pro diets start feeding you more veggies and some 'special' fruits after a while. but, if carbs are kept to below 40% of your caloric needs, not only are you risking some nutritional deficiencies - esp if you're eating low enough calories to continue losing wt- but maybe even risking losing out on some very well-proportioned and as yet undetected phytonutrients that will help you fight off all kinds of diseases. and they may even help your bad breath.

balanced eating; balanced exercise; balanced living.
what a concept!!!!

Wednesday, August 4, 2010

obesity, again

another article on rising obesity rates - http://www.nytimes.com/2010/08/04/health/nutrition/04fat.html?_r=1&ref=us.

what's a country to do?

for one thing, some soon-to-be unfolded efforts to tag foods in the stores based on a 0-100 scale (100 being excellent for health) may help folks make better dietary choices. and if that weren't enough, there's now more discussion on making developments - neighborhoods - more activity friendly, tho that's a way in the future dream. for the most part, getting mother nature to drop the temperature below 90 would be helpful but the reality is, no matter the outdoor temps, most americans simply don't move enough.

so, what's a country to do?

well, yesterday the voters of missouri resoundingly voted against the federal health plan that mandates purchasing a health insurance plan. that will be the crux of the many lawsuits aiming to gut the program. and i'm sure there are good, and bad, arguments for and against it. but i'm not so sure it's one that law alone should manage. of course, being a nation of laws, that's not an option unless this blog can convince my fellow americans to reconsider their opposition to a plan that will help keep costs down by providing some measure of health care prior to the end stages of disease, maybe mitigating the need for extreme measures. let me expound.

joe eats too much junk food, drinks too much beer, and sits around watching too much tv. joe's formerly fit athletic body is now fat and plaque-laden. he is totally entitled to his choices, his lifestyle, and i don't begrudge him that...until he goes to the doctor. whether or not he is insured, the drug, insurance, and medical conglomerates will prosper on his life choices, driving up the costs for all of us who may or may not be choosing similarly disease oriented lifestyles. why? because of basic economics: supply and demand. you see, joe has to have more and better drugs to manage his deteriorating body; his insurance is paying out more than he can afford to put into it monthly; and the medical community, short of hours and long on modalities, will make a killing on his conditions. thus, the costs are shared by those of us who hardly use or abuse the system both in drug development, costs, distribution, and reimbursement; in insurance premiums; and in the ever-constant struggle by docs to get reimbursed by the insurance industry, and to prevent lawsuits by providing best of care vs best of prevention, which combined drive up costs for all.

now i know the argument - and concur in its rationality - that ever since medicare and medicaid, government subsidization has driven the cost of health care beyond previous amounts. so, in the 1960s, your doc lived next door; today, he lives in the finest of mansions in the best of neighborhoods, regardless of his clientele. and that's one of those unintended consequences of good programs and bad policies. but here we are, and going back to the way it was - when docs took $10 for an office visit - is not an option. neither the docs nor their technologies can be bought for 1960s prices. so, what's all this have to do with obesity? wellllllll

we have a choice in this country: we can allow individuals to choose to live unhealthfully, or we can encourage and SUPPORT healthy living, as a nation. there are costs all along either path, so let's face that reality. if 25 states opt out of the mandate for health insurance, then, should someone from that state travel to my state and have an attack or injury or event requiring health care, which state is going to cover the costs? for all intents and purposes, even a citizen of missouri would be like an illegal mexican when it comes to health care: no contribution, my costs.

it behooves us all to be patriotic in our observance of healthy lifestyles. it behooves our leaders to consider rewarding such lifestyles and even punishing unhealthy ones. there are rational ways, dollar-ways, to make folks understand that their choices affect not just them but us. and that there are valid reasons as to why we can make reciprocal demands upon them to comply more with what are generally considered hallmarks of a healthy lifestyle. as such, we can demand that junk foods not be included in school lunches, at work site eateries, or interspersed in aisles and media so that the attraction is harder to avoid. (i say this knowing full well that the marketplace will think i'm a socialist. i counter by saying the nation's wellbeing should not be subjugated to the financial interests of a few any more than its security should be subjugated to the religious fanatacism of a few.)

and let's reward movement - encourage it in kids (how about neighborhood schools again?), in neighborhoods (sidewalks anyone? police walking the beat?), and in adults (workplace supports). and discourage sedentary behavior with financial and workplace disincentives. (what would you be willing to sacrifice in your lifestyle for a paid vacation day? better yet, would you be willing to engage in healthy choices for an extra few days off?)

this is not the answer to all questions in this issue. it's really just a provocation for you the reader to think about how we're going to handle this epidemic. i'm going to do a 15 minute indoor bike ride now. good nite.

Sunday, July 25, 2010

feet revisited - shoes, no shoes or the right shoes

the issue of running shod or barefoot still crops up in a variety of formats. but a most interesting article in the NY Times yesterday brought up a whole different way of considering the issue: special shoes for special feet vs no special shoes.

this is prompted by the long-held belief that motion-control shoes prevent overpronators (flat-footed people) from excessive rotation of the ankle, lower leg, and knee, and thus prevents problems up the kinetic chain. obversely, supinators- those with high arches - tend to not be able to absorb shock upon foot strike, so cushioned shoes were deemed appropriate for this population. however, as the studies referred to in the article suggest, maybe the degree of shock absorption is not the cause of knee problems in runners. this is novel.

whenever a client comes in to ask my advice re an injury or ache, i sometimes garner a guess. but if it's painful and chronic, i more often refer to a sports med doc who's better capable of making a diagnosis based not only on his best guess but on proper evaluation of the patient. even if the client has seen an alternative doc - chiropractor, massage therapist, etc - or even if he's seen an orthopedist (many of whom are better at diagnosing surgically-necessary problems but not necessarily causes), i refer to a diagnostician who is not a surgeon. why? because he is more apt to consider the entire person, not just the injury site itself. if he can find a cause that does not need surgical repair, he will refer back to me or to a physical therapist if the injury warrants it. but he will also quickly refer to surgery if necessary.

the point is, without an accurate diagnosis of the cause, no matter the repair, it is likely to crop back up if the same activities resume. (on a personal note, i went yesterday to a Muscle Activation Therapist (MAT) to see if i could get some help on a problem. he did a thorough review of my whole body, not just my hip, and found some 'weak' areas of segments of muscles, and even whole muscles, that were not firing well. he treated them, sent me some exercises for them, and we'll have to see how it goes. but, despite my capacity to do many exercises for the muscles he identified as problematic, the neurological firing patterns were dysfunctional. hence, problems await.)

so, if you are a runner, and you are experiencing problems, yes, sure, please do look at the feet first. they hit the ground with lots of force many times. a podiatrist, esp a sports podiatrist, is a good first measure - tho my sports med doc is not a believer in orthotics, the ones i had made for me in 1976 still work - but don't stop there. skip the shoes- like the many articles on barefoot suggest, shoes may only hide the problem, and like this article suggests, shoes may actually create the problem - but then see a sports med specialist - and some personal trainers and p.t.'s are good sources for this kind of info. but first, and foremost, take time off the perpetrating activity. otherwise, compensations take over and new problems will arise.

http://well.blogs.nytimes.com/2010/07/21/phys-ed-do-certain-types-of-sneakers-prevent-injuries/

Monday, July 19, 2010

core exercise

so, i've been traveling a lot lately, some pleasure - like to panama city beach with my girlfriend during the july fourth weekend, some paternal -like to los angeles and seattle with my daughter checking out colleges, some work - like to kansas city to teach other trainers for exercise etc, and most recently, some pure play - to crested butte, colorado with six of my old philadelphia neighborhood. seven old men - all of us now over 56, up to 58 yrs of age, who've known each other for over 50 years. pretty amazing. what's also amazing is how healthy and fit we all were - we did a 10 mile hike at over 11,000 ft climbing 2200 ft and no one had to stop for medical reasons; even our knees held up pretty well. the next day we ventured forth on a 4 mile trek around the top of a mountain at 11,600 ft, but the trail was covered with scree, fallen rocks, that sometimes narrowed to 1.5 ft in width with a near vertical drop of hundreds of feet. three of us chose to forgo this trek - two for knees (me included) and one for vertigo. we had a nice time just hanging out at the trail head in the sun, with the breeze and a small, very warm for a high-altitude lake lake where we dipped our not-so-tired feet....because we could.

but the reason for the blog is not my personal life. one of my buddies, an avid exerciser, very knowledgeable for a layperson, asked about the TRX, suspended training system. he contended that it was the 'best' core exercise his friend has ever had and was wondering about getting involved in it. my response was characteristically....me. you see, i'm skeptical. i'm not so sure it's all it's cracked up to be. here's why.

first, many of the exercises are suspended by arms to allow large lower body movements such as squats, lunges, lateral lunges, cross over lunges, etc. these are hi rep exercises with load essentially reduced by arm suspension and thus become a form of cardiovascular exercise. with added resistance you could get more muscle building with less time investment.

second, many of the core exercises, tho creative and dynamic, are in prone or supine positions. while good semi-isolating exercises, they are less than functional. after all, they are prone or supine. core exercise, by definition, is an exercise that engages many of the trunk-lumbar spine-pelvic-upper thigh musculature. these can be done in any position....but we really live in an upright state, even if sitting. so i emphasize - except for those with spine issues - core exercises in sitting or standing positions. while not as isolating, they allow for the core to be engaged in ways it will have to stabilize the spine during sport, recreation, or ADL. as such, i would argue that the best core exercises are those that apply to life. however, i do appreciate the development of core strength and endurance via more isolating exercises, esp the planks and bridges. TRX moves can enhance said isolating exercises. but, i would still say these are not the best core exercises simply because they are isolated in non-functional positions.

finally, TRX and other toys of the trade- Bosu balls, stability balls, etc - may or may not be better than the traditional tools of the trade - free weights - until otherwise tested. like a said earlier, a squat with added load will engage more core muscles in more functional patterns of movement than the TRX. and it will help build bone density! in other words, for the time, and the effort, you'll get more bang from your buck using traditional tools.

remember, the TRX was designed to allow Navy SEALS to train where equipment did not exist. it served its purpose. but what do SEALS actually do to get in shape to do their job: run, swim, climb, jump, carry, push ups, sit ups, and other equipment-less activities. add some resistance to these and you have a much more beneficial and less taxing program....for life.

Thursday, June 24, 2010

healthy-er junk food

nanny state-ism is, like it or not. we share in each others' pain, illness, and wellness if not by intent at least by infrastructure. from private to public health insurance plans, the means of operational success comes from sharing the burden of illness with those who are healthy. in fact, we've seen much from the recent health care debates that demonstrate that the cost of any insurance plan is increased as healthier (read: younger) people opt out, leaving the more costly sicker people, or people at risk of becoming sicker (read: older) remain in the pool. hence, requiring everyone to pay into the pool, young and old, healthy and unhealthy, rich and poor (read: subsidized by government) is the only way to reduce premiums to all.

thus, the question at hand: does the state have the right or responsibility to watch how we eat?

well, since government has to approve food production methods and ingredients, one could argue that it already is watching over us. but it should not tell us what or how much to eat.

the other side suggests that, with small changes in oversight, substantially large changes in individual and public health can reap great benefits with minimal loss of either corporate profits or personal tastes. here's an article of a discussion in england, a real nanny state, that addresses such small changes in food production: less sodium, less or no trans fats: http://www.healthcanal.com/public-health-safety/8800-Cut-salt-and-saturated-fat-levels-processed-food-save-thousands-lives-says-NICE.html?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+healthnewshc%2FOxfp+%28Health+News+from+HealthCanal.com%29

whether or not you believe the state should be a nanny, there can be little argument for allowing the state to cooperate in the profiteering of corporate foods (what some might call, Food, Inc.) at the expense of both private and public health since we're all paying.

Saturday, June 19, 2010

exercise and the brain

much has been written and discussed and debated about the role of exercise, and fitness, in mental, and academic function. i recall when i was in grad school - late 1970s-mid 1980s - reading on the usefulness of cardio conditioning in treating depression and addiction. so, when i got an anonymous posting in regards to one of my posts suggesting i look at the work of john ratey re the value of exercise in regards to alzheimers, i did. obviously i did not research all his work nor even read all the articles about his work. what i saw, tho, was more corroboration of that which i've been reading about for over 30 yrs. at least, so far as education and mood states are concerned. when studies are done on those with deteriorative diseases such as alzheimers, and when they show correlations with exercise prior to or after those diseases, i can only bring up some methodological issues, the first of which is causation.

as great as western medicine is at finding the complex variables that relate to any one disease or even disorder (small diff but real), after 10 yrs of human genomic study, a recent health-related article (the Times? Health News?) headlined that so far no definitive singular genes have been identified to allow for any specific treatment of any one disease. makes sense to me: genes interface with environment to prosecute their potential. as such, fit, health, lean, well-nutriented people still get sick, diseased, and die...sometimes sooner than their polar opposite unfit, unhealthy, overweight, poorly nutriented comrades. could it be the environment in which they were raised from day one? or maybe that job they held in high school? we'll never quite know.

so, when a study shows that staying or even getting aerobically fit delays progression of an extant disease such as alzheimers, keep in mind that we have absolutely NO idea as to how fast or slow it would have progressed had the subjects not done any exercise at all. the data has to be accumulated over large numbers of patients over long periods of time factoring out for medications and other environmental effectors - such as type of care, socioeconomic and health care opportunities - yes, poor people won't have as good an outcome as rich people; unfair but that's how it is and scientists can't factor in too many variables all at once - and even then can only come up with correlations, not causations.

in conclusion, dr ratey's research on the value of fitness on brain function and health is sound when looking at non-diseased people. once we venture into the realm of brain diseased people, all we can offer are co-related suggestions. and exercise is and should always be related to favorable future outcomes if only for quality of life matters. so get your early-diagnosed alzheimer patient out and about, performing complex movements in the gym and especially outside the gym, playfully, enjoyably, and socially. it may not extend function or life but will provide a host of pleasurable moments and memories for those left behind.

Wednesday, June 16, 2010

strength train yourself flexible

studies have been showing over the past decade or so that resistance training (RT) improves flexibility. furthermore, it reduces your risk of lengthening injuries - like a hamstring tear during running, or back strain from bending - by not only increasing the ability of the muscle to pull more load but also resisting a load that's pulling it. in other words, when a force is greater than the tension of the muscle, the joint will move as the muscle lengthens, rather than shortens. think of bending over to tie your shoes - your hamstrings, glutes, and low back muscles lengthen to allow gravity to lower your upper body down. when they contract to raise you back to vertical, they shorten.

why the science lesson? because, if you do RT through a large range of motion, muscle will get stronger even at the extremes of it's range. muscle gets stronger by three mechanisms: first, neurological; then collagen deposition which makes it tougher; finally, hypertrophy, or protein accretion. when you stretch, you get some of the first two but little of the third. when you do RT you get them all. therefore, when you stretch to tie your shoe, your muscles have learned to go through that range but have the collagenous strength to withstand the load at that angle, and the strength to pull you back up safely.

bottom line - strength train throughout a joint's range of motion.
http://www.webmd.com/fitness-exercise/news/20100604/resistance-training-improves-flexibility-too?src=RSS_PUBLIC

Saturday, June 12, 2010

core training in the vertical world

this morning i got an email from a former colleague/trainer from belmont university's physical therapy department, emily. she finished her degree a year or more ago and is living in virginia i think. she wanted some info on core training for athletes - h.s. jocks - to whom she's giving a presentation.

now, this is how things work: you go to school, learn a lot, focus in one or two areas, go out and practice what you learn, focus in one or two areas....and next thing you know, you lost whatever it is you once knew. so, as a trainer she learned, from me and the relevant literature, what and how to train the core. as a therapist, she learned again some of the same but less expansive material since p.t. is treating unhealthy folks just enough to get them out of the clinic. what to do from there - distinguishes trainers from therapists. but my grips is for both.

in reviewing literature to send her, on line, i went to the NSCA's site and got one from stuart mcgill - a prominent researcher in the area of core function, and another from someone who though he was. i say this because mcgill emphasized the ludicrousness - if there is such a word- of the navel drawing in maneuver whereas the other guy made a special emphasis on doing so before doing any core work.

now i'm a fan of the navel drawing in maneuver - you know, pull the belly button into the floor. it was developed as a way to retrain the transverse abdominus - the innermost abdominal muscle that does not in any way move the torso but does stabilize it at its weakest level. i say this not to demean its value. but it really only does its job as a stabilizer when the spine/vertebrae themselves are out of alignment - when you have a spondylolisthesis, slippage of one vertebra over the one below it. but what stabilizes the spine when you have to move beyond static stability of the vertebrae? that is where trainers lose sight of the forest thru the trees.

without going too far and deep, let me share my thoughts on this. name 3 professions where you have to lie on your back and raise your upper torso toward the sky/ceiling?......time's up. how about: michaelangelo painting the sistene chapel; a coal miner; and a hooker - ok, she doesn't have to raise her upper body up but she has to do a pelvic tuck....several times a day. for the most part, we operate vertically. and generally in a rotational, not back and forth, manner. therefore, let's think about training the core both "in line" and in rotation. so, planks are starters - my bow to mcgill - but then progress to upright versions of a plank - hmmm? well, how about a tubing or cable chest press with two hands? you have to resist being bent into extension, just as a plank is resistance against the belly moving into the floor. and you're getting upper body work, too. and you're vertical, pushing as tho: pushing a carriage, shopping cart, defensive linemen, etc. likewise, a row of tubing or cable forces the lumbar extensors to stabilize against forward bending. then moving to one arm chest press and one arm row - now you have a rotational force to resist. change legs; different hip rotator actions at play now. then add rotation; then add lunge and rotate while pressing or rowing.

in other words, build on core control with core stability to core endurance to core strength to core power (adding speed). but do so in positions that matter...unless you intend to paint the next sistene chapel, that is.

Wednesday, June 9, 2010

social media

there are many new ways to communicate and blogging and Facebook are two i've decided to venture into. based on the suggestions of a marketing study at Vanderbilt on behalf of STEPS, i thought, what the hell? so here it is.

it was also suggested i start twittering - a 140-character way of sharing quickie info. since i read a lot, this would be an easy way to share lots of snippets of quality facts. however, why should i recreate the wheel when a good friend and colleague, Guy Andrews, of Exercise ETC, is doing so. please sign onto his blog for up to date by the minute exercise and health news-bits: http://twitter.com/ExerciseETC

i believe you will find his quick-twits easier to digest than my expositions, but don't stop reading here. the info i offer is able to fill in the meat of the studies others refer to in snippets.

like did you hear about.....

Tuesday, June 8, 2010

ACSM Annual meeting thoughts

last week i attended the ACSM annual meeting in beautiful baltimore. i kid you not; it is a beautiful convention center/inner harbor/down town area with good restaurants - my cousin took me to an afghani restaurant (owned, incidentally, by pres. karzai's brother) - and clubs and things to do and see (like the first george washington monument in the center of a square near the george peabody conservatory.) the convention, well organized and attended - i heard the biggest yet, with over 90 countries represented - had much to offer the geeks and practicing geeks, like me. i really enjoy hearing the researchers' research and others' opinions/suggestions that so make science a wonderfully energetic endeavor. whilst i would not consider myself one, the value is invaluable. i love taking the info, processing it into terms i can employ in my capacity as trainer and educator, and implementing it into programs for my clientele. much of what i learn is self-affirming but there's some that i learn in greater detail such that now i can understand what i've read elsewhere. for example...

obesity. we all learn and think that obesity increases your risk for heart disease, diabetes, and early mortality. and yes, the BMI data does show this. but that's like saying "all..... look alike": to the untrained eye, to the biased viewer, they really might...but really aren't. in other words, as steven blair (cooper center, dallas) and glenn gaesser noted in their symposium on the topic, the reality is that obese folks have as good a cardio risk profile as lean people...if the former are fit. thus, lean unfit people were worse off than obese fit people. furthermore, while reducing wt is good - we assume - one must ask at what expense? gaesser pointed out that chronic wt loss - cycling - actually increases your morbidity each time you regain the wt. and it's not just large amounts of flux that create this effect; it may be more related to how many times one has tried to lose it. cycling may actually BE the problem with the obese trying to lose wt, usually to no avail and often to negative effect. perhaps, and the evidence is clear and strong here, all we need to do is focus on helping the obese get fitter - not marathon fit, just fitter. and, for you trainers out there, resistance training is sufficiently effective even compared to aerobic conditioning. why? read on....

it is suggested that cycling causes loss of lean tissue - muscle. we've known that elderly folks have worse outcomes if they lose too much muscle mass. it makes sense then that losing wt, esp fast wt loss as most diets offer, also takes a toll on the lean tissue. hence, repetitive wt loss in the obese has been shown to increase risk of disease.

furthermore, studies have shown that short term fitness training - as short as 3 weeks - which is too short to have demonstrated substantial wt loss, has reduced blood pressure, blood lipid values, and get this - risk of type 2 diabetes. some folks have even been able to get off their metformin (a treatment drug for type 2).

oh, there's more, but my fingers are tired. ok, try this on: sretching - most studies show excessively long - over 2 mins - static stretching reduces power/strength. however, as i brought up in the q&a, most athletes don't stretch immediately prior to performing a power lift/bout. hence, no need to worry, but static stretching is also shown not to be effective in producing reduction of injury nor improvement of performance....except in events that need it, like dance, diving, etc. and even there, dynamic stretching may be better than static stretching at all levels. why stretch, then? if an injury or posture has the ability to alter your mechanics, stretch; if you had surgery or any injury that minimizes mobility, stretching is necessary to restore proper muscle balance and function, and static, early on, is safest. the other reason: it feels good, and relaxes you.

stop reading, go stretch, and feel good.

Wednesday, June 2, 2010

disease prevention/management

fitness = wellness, or so it would seem. however, genetics, culture, and luck, can impact one's wellness, too. fortunately, tho, goals set a decade ago by a government health initiative, to get more people tested and treated for high blood pressure, is working: http://www.nytimes.com/2010/06/01/health/research/01pressure.html?ref=health

obviously it would be better to prevent it than treat it, and that's the mission of those in the exercise world: to get more folks moving more. getting folks to take more STEPS - sorry about the plug but that's why i chose the name of my biz 20+ yrs ago - is worth it for those who do: http://www.usatoday.com/news/health/weightloss/2010-05-23-walking-metabolic-syndrome_N.htm

but why just talk about it? sitting at this computer, reading what i read, it strikes me ironic that my sit time affects my life more than my exercise time. one study, in MSSE, june 2010, notes in the conclusion, that women who lost wt during an 8-wk program did so by moving more than they had before the study began, and more than the designed exercise program implemented. those who did not lose wt, however, even with the 150-mins/wk program, did so by reducing the amount of movement they did almost as a compensation for the exercise they did. in other words, with no change in diet, some were "responders" = lost wt by continuing or adding movement; some were "non-responders" - gained wt by stopping extra movement in their lives.

so i'm going to get up and move around. why don't you?

Friday, May 28, 2010

clarification and addition

in an earlier post this evening, i referred to a study mentioned in the Tufts Nutrition Letter re calcium supplements not being beneficial to prevent heart disease. however, a Swedish study did show that calcium intake did correlate with reduced risk of heart disease in men. it was a very large epidemiological study which gives it lots of oomph. in fact, those eating the most calcium products were 25% less likely to die of all causes, cancer included. my correction, however, is to the issue of supplements - which do help manage bone loss - but, again, do not reduce heart disease risk. i wanted to make that clear. the study did show, however, that vitamin D supplements did improve one's risk against said disease.

and for you coffee addicts, many studies have lately come out showing its benefits. four new ones came out recently to show its benefits in controlling blood sugar. most interestingly, a French study found that only coffee at LUNCH really made a difference. another study also found that contrary to popular belief, 4 or more coffees a day - not sweetened, mind you - may actually reduce heart rhythm disturbances.

this is why i love to read up on this stuff. it's always surprising....

on matters pertaining to food

one of the many hang ups our society...of people and of trainers, is food. supplements have always been with us ever since the days primitive warriors ate the hearts of their victims to garner their strength and prowess. fortunately, it's only the supplement industry that's eating our hearts...and wallets, but caveat emptor is the phrase of choice.

now, how should we eat? what should we eat? how much should we eat? when should we eat? hell....why should we eat what we eat when we eat it? confusing but science, sports and medical science alike, are homing in on the answers to many of these questions. nonetheless, tomorrow another article will come out displacing everything we believed yesterday and it's time to start anew.

for example, there is a lot of noise coming out about a major study in europe - a meta-analysis, where data from several similar studies is compiled to give greater impact to the results - that showed that fruits and veggies do NOT confer resistance to cancer. something like 2 servings/day reduces your risk of a variety of cancers by 3% only. that means even the rx of 5-9 servings would only give you about 15% reduction of risk. that's a lot but statistically not much. what with all the studies showing that vitamins or even antioxidants don't confer any risk reductions, it almost makes sense to avoid supplements. esp since fruits and veggies do show great value in reducing your risk of cardiac problems. is it the fruits and veggies...or the healthy lifestyle those who eat fruits and veggies tend to live? hmmmmm

another new research in ACSM's flagship journal, MSSE, had 20 women do a wt training program for 12 weeks. half drank a glass of skim milk after their workouts and an hour later another serving. the other 10 drank equal calories of carbs. both drinks were flavored to taste similar to avoid any placebo effect of knowing which drink was which. at the end of the study, milkers were stronger in the upper body and had lost more fat despite both groups not having changed total body mass. moral of story: as we've said before, drink milk after your workouts - it enhances protein accretion. little did we know, tho, that it also helps you lose body fat.

the june issue of the Tufts Nutrition letter headlines an article, a repeat of others i've seen, that suggest calcium from pills is pretty useless when it comes to longevity (not bone density.) calcium in the diet, on the other hand, does have protective benefits for the heart.

finally, annual hi-dose vitamin D, oft recommended for post menopausal women as a way to ensure adherence to D requirements, actually INCREASED the rate of fractures and somehow even falls. in other words, if you're going to take D, take it in frequent and smaller doses.

what's this all mean? well, nearly everything i read on health and diet suggests that eating real food - and i've not heard much legit research to say that organic is more real than mass-farmed - is the way to go for health benefits. the other thing that keeps cropping up is that only ONE lifestyle choice, done right, benefits not just bones, muscles, heart, and over -all health, not to mention brain and mental function, but has very few if any negative side effects: EXERCISE. and even there, the dosages are now being reduced to smaller and less intense measures making it almost inexcusable to avoid exercise...unless you're reading this entire blog. get outa here....

Sunday, May 23, 2010

aging skin

yesterday i met a once/yr client, a 50+ very fit, self-motivated to do cardio and resistance training (RT) on her own, who takes great pride in her petite, toned shape. she calls in every so oft for a new regimen, a new program, usually to get to her legs w/o building them up. her wt has been steady for years upon years. but now, hormones changing and hormone replacements being manipulated, she has discovered some - OMG - belly tissue. i hesitate to refer to the extra as fat as her subcutaneous skinfold, which i tested and will share with you, was 5 - slightly better than 99% of people, even male athletes. (confession: when i was in my best of shape, at about 3% fat, i had a 4 mm read there.) also, she's concerned that her legs, which she'd built up again with a great video routine she'd been doing, were now flabby since she scaled back. why did she scale back? to get into her size 0. what to do????

ok, so i did check her body fat after discussing aging skin. she knew about aging muscle but felt she'd stayed ahead of the curve on that. her body fat - for those who've done skinfolds, you know how some women can be hard to pinch; well she was a charpe (sp?) dog, easy to peel, even at the thigh - was 17.9%. i showed her a chart that compared athlete types, male and female, and she ranks better than most college athletes, and in some sports, better than male athletes. in other words, her belly fat, and her thigh wobble, was really nothing more than whatever fat she may have plus sagging skin.

today, while helping the woman whose house i'm keeping get the pool ready for summer, i got a question: ok, irv, what can i do to prevent...and then she showed me....her skin from sagging? hence i felt i was getting a universal message, deal with sag.

we have several types of collagen in our bodies - a molecule that is tough, elastic, and when all is right in the world, lined up in parallel to ensure smoothness, as in muscle fibers. as we age, however, the collagen that makes up most of our skin changes to another type that is less elastic, less tough. hence, older people - you pick the age but generally over 65, 70 - have thinner skin that droops more when lined up perpendicular to gravity. now, what does that mean?

well, stand up and look in the mirror. if you think your face is saggy now, try placing a mirror on the bathroom counter top and lean forward for a few seconds - it sags even more...toward the floor, i.e. perpendicular to gravity's pull. thus, when you raise your upper arm- in abduction - and flex the elbow - a la making a biceps muscle - the back of your arm is perpendicular to gravity...and, unless you're young, muscular, and lean - helps to be a male - your triceps sag. that's life....

so, what can i tell folks who are concerned about sag? well, for one thing, don't make love on top....ok, you might be appalled by the idea but you should see what the person on the bottom sees! likewise, expect the skin on your belly to pooch, esp while doing push ups or planks, even if your abs are totally flat; you could suck in but the skin will eventually sag. don't raise your arms and wave - teachers learn this early on but blackboards force the situation; computer writing will help their self esteem. finally, unless you want to get fatter - which essentially fills the void of lean tissue and skin - or are able to build bigger muscle -which is what i told my client for her legs - as you age, your skin will sag.

anecdotally, i've seen this more in WASP-y people than in darker skinned, esp olive skinned, people. for those who have reached that magic age, for whom it's too late to have avoided sunlight (remember, boomers, being tanned was healthy in our youth), and for those who've either lost tons of wt or have less ability to bulk up with lean tissue, your skin will sag as you age. gravity, i always say, will win, til you are flat on your back- in the coffin - but for now, you must learn to get comfortable in your, yes, your sagging skin. so keep doing RT and cardio for health and function, but it's too late to order new grandparents. sorry.

Sunday, May 16, 2010

aging fitness

yesterday i met with a 61 y/o attorney with whom i'd met two years ago to help with his knee problems. he stays active and is fit tho a bit paunchier than he'd like to be...because he also enjoys drinking a few in the evening. so, while his wt hasn't really changed, and he does exercise vigorously several times a week, he is now recognizing that he needs to take care of his body better, and more efficiently. hence, he came to see me again.

several years ago, a wise gentleman in his late 60s with whom i was training at least once/wk but who was actively training at home, requested that i provide him a de minimus workout - one that he could do quick and easy anywhere that would keep him healthy enough to be able to do anything and any activities with a reduced risk of pain or injury. so i gave him about a 7-10 min workout, with some core exercises and basic upper and lower body exercises, virtually all body wt, some with tubes. he still does many of these after all these years.

now, could or should anyone do more? yes, in an ideal world, we are physically active more hours/day than we are sedentary. but that world is third, and we live in a modern, industrialized, mechanized, computerized, sedentary world. so how much do we need, and of what?

for the fellow who came to see me yesterday, with a bad left shoulder and knee, much of what i offered him was a deletion of unnecessary if not dangerous exercises, plus a few compressions of unnecessary amounts of particular exercises- like the 10 minute planks he was doing in a class environment, plus a few rehab type exercises so that he could get his shoulder in a place where he could do more safely. i offered that he start doing a few days/wk of tabata sprints - 20 sec work/10 sec recovery x 4, building up to 8; two sets, interspersed with a few minutes of gentle recovery; making up a total of less than 20 mins of cardio that would give him significant aerobic, anaerobic, and metabolic benefits.

and he was happy.

my point is, one could work out long, hard, or long, easy, or not at all. but the long is the killer - it's the main excuse for not doing anything fitness-wise: time. so coming up with short, hard for those who are fit, or short, easy for those who are not, should be the aim of all fitness pros. after all, aging is tough enough. why waste valuable time trying to fight it when in fact it may actually hasten it.

Tuesday, April 27, 2010

how to organize an exercise session

every trainer has his or her opinion on this matter, and every athlete still wonders: which exercises should i do first, and in what order do you plan your routine? typically, the novice goes with the flow - whatever's available in the gym, or whatever muscle group he wants to build, regardless of what he did yesterday or the previous workout, whichever came last. the more experienced typically follow some fuzzy order based on the most recent article in the body building mag or some pseudo-health/fitness magazine. trainers, i've noticed, have their preferred exercises - i have mine, too - and often put them in early in the routine without much consideration, if at all, to what the client needs let alone wants. i know i usually do an upper-lower, or lower-upper routine although i do have some clients with specific needs and goals for whom i'm more precise in my planning. however, the issue i often take seriously is whether or not to go big muscle group to little, or other way around.

much research has been done on this and an abstract from the NSCA annual meeting in july 2009 adds weight to the accepted norm: if you want to build big, start large and go down. if you want to supplement building big, occasionally go small to large.

Influence of Exercise Order on Maximum Strength and Muscle Volume in Nonlinear Periodized Resistance Training
Roberto Simão, et al.

The purpose of this study was to examine the influence of exercise order on strength and muscle volume after 12 weeks of nonlinear periodized resistance training. The participants were randomly assigned into three groups. One group began with large and progressed toward small muscle group exercises (LG-SM) while another started with small muscle group exercises and advanced to large muscle group exercises (SM-LG). The exercise order for LG-SM was bench press (BP), machine lat pull-down (LPD), triceps extension (TE), and biceps curl (BC). The order for the SM-LG was BC, TE, LPD and BP. The third group did not exercise and served as a control group (CG). Training frequency was two sessions per week with at least 72 hours of rest between sessions. Muscle volume (MV) was accessed at baseline, after six weeks and 12 weeks of training by ultrasound techniques. One repetition maximum strength (1RM) for all exercises was accessed at baseline and after 12 weeks of training. After 12 weeks both trained groups showed significant improvements in all exercises (1RM) as well triceps and biceps muscle volume improvement in relation to the control group; however, differences were not see between the training groups. Effect size data demonstrated that differences in strength and muscle volume were exhibited based on exercise order. Both training groups demonstrated greater strength improvements than the control group, but only bench press strength increased to a greater magnitude in the LG-SM group (ES=1.74 ) as compared to the SM-LG (ES=0.90). In all other strength measures (LP, TE, and BC), the SM-LG group showed larger effect sizes. Triceps MV increased greater in the SM-LG group; however, biceps MV did not differ significantly between the training groups. In conclusion, if an exercise is important for the training goals of a program, then it should be placed at the beginning of the training session, whether or not it is a large or a small muscle group exercise. In this approach, the immediate need of the client receives greater emphasis in program design than the traditional large to small muscle exercise sequence. Because weaknesses in smaller supportive muscles can limit the performance of more complex exercises, increased focus on those smaller muscles (if they are found to be a limiting factor) early in an exercise session would be expected to have a positive impact on the performance of complex exercises over time.]


it's almost a no brainer but for most of my clients, it's important to consider seriously.  since most are here for pure health and simple function - that is, not for getting cut or performing at hi levels competitively - going large to small makes more sense on a variety of levels. for one thing, you burn more calories, bumping up the metabolic rate both during and after the session. that's important. for another, esp for post menopausal women and all older (you define older) folk, building big muscle groups adds to bone density to those areas often measured - hips, spine, wrist. furthermore, the exercises that do this, esp the lower bod exercises, improve balance. third, the neurological benefit of moving multiple joints and muscles leads to better transfer to activities of daily living. finally, tho i'm sure there's more, few can show the benefits of toned arms or legs because most have too much subcutaneous fat, so why bother. this is not to say some exercises of these smaller groups are not necessary. it's simply to suggest that, as a priority, go big to small, but include at least one set of the smalls to ensure better bigs....just as the article suggests.

Wednesday, April 21, 2010

more healthy news

this article discusses research that shows wt loss reduces pro-inflammatory events and substances that contribute to heart disease: http://www.healthcanal.com/immune-system/7192.html

what's cool about the study is that it also demonstrates that fat, your personal body fat, may be a better predictor of how well you'll lose wt if you have bariatric surgery, but who knows? maybe even just basic wt loss measures such as eating less and exercising more: “We also showed that the activation status of immune cells found in fat predicted how much weight people would lose following a calorie restricted diet and bariatric surgery. Those with more activated immune cells lost less weight. It’s the first time this has been described and is important because it helps us understand why some people lose weight more easily than others...."


this suggests the possibility that wt loss alone may be sufficient to alter one's inflammatory milieu thereby affecting one's overall health status, and hints at the possibility that exercise without wt loss may be insufficient to alter one's health status.

it hints, too, at what is more and more becoming truer and truer - wt loss is healthier than being, note i said, BEING overwt. in other words, don't try lose just to lower inflammation, only if you have lots of excess wt. as to how - well, bariatrics is one possibility but there are easier, safer, and healthier ways to go.

Monday, April 12, 2010

vertical core exercise

now why didn't i think of this name? damn it - i've been promoting it since 1992 when i first got hold of a newfangled exercise toy, the elastic band with handles. i call it the torso rotation when you hold one end in your clasped hands directly in front of the sternum and rotate at the hips away from the anchor at the other end of the tube (the tube is the elastic implement). this works the obliques, the glutes on the side opposite the direction of turn, and the lumbar erectors and rotators on the side to which you are turning. it can be done in all kinds of stances, sitting, kneeling, on balance devices, even lying down; isometrically, isotonically (technically tubing can't be isotonic but let's use that term to imply dynamic), and even ballistically (like a plyometric); and it can be done at all angles of pull. but all i could do was name it torso rotation; what a dummy. at the recent fitness conference of the ACSM, someone came up with vertical core exercise and i hand it to that person. now you can read more about it here: http://www.healthcanal.com/life-style-and-fitness/6990.html

the only thing this article doesn't do is explain the movements it describes in enough detail to be able to replicate them. if you figure it out, please let me know. thanks.

Wednesday, April 7, 2010

wt loss in older adults

traditionally, physicians have been reluctant to encourage older adults - those over 75, for example - to lose weight since studies have shown that older adults who lose weight tend to have unnoticed medical problems. in other words, wt loss that occurs in this population is often due to disease, not desire. a recent study demonstrated that intentional wt loss via exercise and diet more than doubles your chance of survival over the next decade compared to your old-age peers: http://www.healthcanal.com/life-style-and-fitness/6856.html


why is this such big news? because wt management, esp wt loss if obese, is beneficial at all stages of life. we've discussed these issues from many directions since i started this blog and can honestly state that there's no one perfect way to change your wt without 2, no, 3 things: eating fewer calories; exercising; and most of all, motivation. if you think you can do it for a few weeks or months and get to your goal wt, you're kidding yourself. once you establish a new set point - a wt achieved by making these lifestyle changes - your body adapts by needing fewer calories. therefore, to continue losing you must buckle down and not only stick to what you've been doing but also do more of it - caloric restraint and physical activity. it's not until you've achieved a very low body fat - not body wt, can you let up a bit and eat.

so, tell your parents or grandparents that it's now ok to start living healthfully and to cut wt. that way, they'll more likely be here to see what 2020 looks like.

Sunday, April 4, 2010

when or if to see a doctor

if you're an athlete, or even a weekender, or even an around-the-house piddler, and you incur a new or recurrent ache or pain, you might dismiss it for a few hours....but then get concerned when you try to get back into whatever it is you have to do. the ache or pain increases, or simply does not subside, and you start thinking maybe you should see a doctor. but, as this article points out, quoting doctors, this may not be a good idea. besides the fact it's going to cost you time and money - and getting a red flag for your future insurer to tag you with - some of these may simply go away with that time-honored time-related thing called "relative rest." what is relative rest? it's that which takes you away from what it is that is causing the pain but not from other, generally less intense, activities. so, if your knees hurt from jogging these past few beautiful spring days, maybe you simply did too much too soon - the usual script. all you may need to do is take a bike ride or walk on a treadmill instead of pound the pavement. if the knees still hurt by the end of the week, you could conclude that running's not good for you...or that you just jumped into it too fast....or your shoes, the ones you wore last fall, need to be replaced. HOWEVER, if the knee is keeping you from doing ADLs - your activities of daily living, like sitting at a desk or walking down the corridor - and if it's causing swelling or weakness or instability, then go to your sports med doc ASAP. this article gives you some insight as to how to make the determinations, and why, but i can tell you this from my experience: most docs, esp general practitioners, don't know much about sports injuries and will generally prescribe a pain killer, anti-inflammatory, and rest. the pain killer is often overkill; the anti-inflammatory is sometimes counterproductive to the healing process, and rest is, well, rest is something you can do for yourself, so give it a try:  http://www.nytimes.com/2010/04/01/fashion/01best.html?ref=nutrition

Thursday, March 25, 2010

Exercise and wt control in aging women (and men, too....)

on wednesday, march 24, an article about a research project hit the news big time. a continuing study, as a sub group of the women's health study (by Dr. I Min Lee), found that women who were middle age (avg. 54), followed for 13 yrs on their diet, exercise, and wt, were able to maintain wt if they exercised 60 minutes a day. SIXTY MINUTES A DAY!!!! that's too much, we all say, and we are correct. with distress in their voices and sadness in their eyes, women are now throwing up their hands in defeat and failure as 60 minutes is more than twice as hard to get in daily as the previously-recommended 30 minutes. what's a person supposed to do?

well, here's the skinny on this data - it's no different than it's always been. the conclusion wraps it up but more on that in a moment. the reality is, 30 mins/day of moderate exercise, even in 10 minute segments, is for better HEALTH, primarily cardiovascular health. to maintain wt requires 60 minutes; for those already obese, NINETY minutes!!!! why? because our metabolism slows with age. if you eat the same exact amounts and types of foods in ten years as you are eating today, you will gain weight...unless you're like 12 years old. so, for those over 25, to maintain wt, or to lose, you have to EAT LESS!!!!! what a surprise! or exercise more than you have time or inclination to do. this has not changed; what's changed is the way it's being reinforced in the research world and emphasized to the average reader/listener.

bottom line: eat less calories, move more to burn more calories and you can keep your wt under control. to lose it, you have to be even more diligent on both ends of the calorie spectrum.

one more point: the best way, safest way, most beneficial way to maintain metabolic rate is thru muscle building - that is, resistance training.

so, nothing really new here, huh?