Fitness & Health with Dr. Gabe Mirkin

New Vitamin D Recommendations

2009-11-23T19:57:00.001-05:00

At the University of Toronto School of Medicine's "Diagnosis and Treatment of Vitamin D Deficiency" conference on November 3, 2009, thirty of the world's leading researchers on vitamin D recommended 2,000 IU of vitamin D daily (the current recommendation is 600 IU). Vitamin D3 blood levels should be 100-150 nmol/L (40-60 ng/ml); the existing recommendation is 30-50 nmol/L.

Vitamin D pioneer Dr. Cedric Garland presented data showing that raising vitamin D levels to 200 nmol/L decreased breast cancer risk more than 77 percent. He said: "Breast cancer is a disease so directly related to vitamin D deficiency that a woman's risk of contracting the disease can be virtually eradicated by elevating her vitamin D status to near that level." Recent work has shown that all cells in the body have "vitamin D receptors" to control normal cell growth. Garland presented new evidence that low vitamin D status compromises the integrity of calcium-based cellular bonding within tissues, which allows rogue cancer cells to spread more readily.

Vitamin D deficiency is associated with at least 24 cancers, diabetes, multiple sclerosis, heart disease, falls and fractures, psoriasis and many other health problems.
More on Vitamin D

Will avoiding dietary sugar prolong life?

2009-11-18T09:33:00.001-05:00

Nobody has yet shown any way to extend the life span of humans. However, both exercise and calorie restriction (with adequate nutrients) have been shown to extend the life span of animals. Both of these measures apparently extend life by increasing the number and size of mitochondria in cells and making them turn food into energy more efficiently. Each cell in your body contains up to several hundred mitochondria which provide the most efficient chemical reactions in your body for converting food into energy.

An exciting new study on worms offers a potential method for you to prolong life and good health. When blood sugar levels rise too high, sugar enters cells in large amounts. An earlier study showed that adding sugar to the diet of the worm, C. Elegans, shortens its life (Cell Metabolism, October 2007). Now the researchers have found that preventing sugar from entering cells by altering the genes for DAF-2, DAF-16 and Heat Shock Factor-1 causes the same changes as avoiding sugar and extends the worms' life span up to 20 percent (Cell Metabolism, November 2009). These benefits could also occur in humans because we have the same three genes that control sugar entry into cells as those of the worms.

Calorie restriction and exercise probably prolong life by the same mechanism: they enlarge and activate mitochondria in cells that turn food to energy. This helps mitochondria to clear free radicals much more rapidly from the body. Free radicals can damage cells and therefore shorten life. The worms' cells responded to the absence of sugar inside cells by increasing their ability to clear free radicals from their bodies which prolonged their lives. Indeed, when sugar was allowed to again enter their cells, they still could clear free radicals faster and live longer because their enlarged mitochondria were more efficient in removing free radicals.

This research on worms questions the way doctors treat type II diabetes when they prescribe drugs to lower blood sugar levels by driving sugar into cells. The best treatment may be to develop diets and drugs that prevent blood sugar from entering cells in the first place.

For now, we know that you will shorten your life and increase risk for many diseases by allowing blood sugar levels to rise too high after meals. A diet that keeps sugar from rising too high after meals (and reduces the entry of sugar into cells) can prevent diabetes, help control all the side effects of diabetes (JAMA, December 16, 2008), cause the most weight loss, and allow many type II diabetics to safely stop their medications (Nutrition and Metabolism, January 2009). Avoid foods that cause the highest rise in blood sugar levels: sugar in liquid form (sugared drinks, fruit juices, and adding sugar to any drink); foods made from flour (bread, spaghetti, macaroni, pretzels, bagels and so forth); and foods with added sugar.

You should also exercise every day. Exercise causes muscles to remove sugar from the bloodstream at a very rapid rate and this effect lasts maximally for about half hour after you stop exercising, then tapers off until it stops completely after about 17 hours. Furthermore, since lack of vitamin D causes high blood sugar levels, you should make sure that your blood level of vitamin D3 is above 75 nmol/L. New vitamin D recommendations

Just Getting Old Does Not Cause Diabetes

2009-11-16T20:33:00.001-05:00

A study from the University of Pittsburgh shows that the marked increase in diabetes in older people is caused by obesity and lack of exercise, not by aging alone (Diabetes Care, August 2009). Most cases of diabetes are caused by cells not being able to respond to insulin, rather than by lack of insulin. Inability to respond adequately to insulin is caused by being overweight, not exercising, lacking vitamin D and/or eating too many refined carbohydrates.

In this study, the same insulin responses were found in young and old endurance-trained athletes, young and old normal-weight subjects, and young and old obese subjects. Regardless of age, athletes had better insulin responses than normal-weight sedentary subjects, who had better insulin responses than overweight people.

If you are overweight, try to lose the extra weight. Check with your doctor and start or continue an exercise program. Get a blood test called vitamin D3. If it is below 75 nmol/L, you need more sunlight or vitamin D pills. When you are not exercising, avoid sugar water and flour.
More on diabetes prevention and treatment

No Evidence Cycling Weakens Bones

2009-11-09T11:59:00.001-05:00

No data exists in the scientific literature showing that any type of exercise weakens bones. Bone growth depends on the forces exerted on them by gravity and contracting muscles. So any activity or exercise that causes you to contract your muscles will strengthen bones (Medicine & Science in Sports & Exercise, November 2009).

Previous studies showed that world class cyclists had reduced bone densities in their spines. However, bone density tests do not measure bones strength. They measure how much bones block X-rays that try to pass through them. The only way to measure bone strength is to see how much force it takes to break a bone.

The most likely explanations for broken bones in cyclists are high-impact crashes and/or lack of vitamin D. I recommend that all cyclists get a blood test called Vitamin D3 in December or January. If it is below 75 nmol/L, they are deficient in vitamin D and at increased risk for breaking bones. To prevent fractures, they should do winter training in the southern sunbelt or take at least 800 IU of Vitamin D3 per day.

A recent review of 12 blinded, controlled scientific studies showed that oral vitamin D reduced non-vertebral and hip fractures in patients over 65 years of age (Evidence-Based Medicine, October 2009). Blood levels of vitamin D below 75 nmol/L cause parathyroid hormone levels to rise too high, which causes osteoporosis. A main function of vitamin D is to increase calcium absorption from the intestines into the bloodstream. When blood levels of vitamin D fall below 75 nmol/L, levels of ionizable calcium drop. This causes the parathyroid gland to produce large amounts of its hormone. Higher than normal blood parathyroid hormone levels take calcium out of bones to cause osteoporosis.

Fasting Does Not Increase Endurance

2009-11-02T08:59:00.002-05:00

Some people think (incorrectly) that fasting before a race or competition will increase their endurance. Fasting weakens and tires you. How long you can exercise a muscle depends on how much sugar, called glycogen, you can store in that muscle and how long you can keep it there. When a muscle runs out of its stored glycogen, it slows down because it requires more oxygen to burn more fat. It also accumulates more lactic acid to become acidic which causes a burning pain, and it becomes more difficult to coordinate.

Every time you move a muscle, some of the stored glycogen is used up. Every time you eat, some of the food can be stored as glycogen in that muscle. When you go for more than an hour without eating, you use up glycogen without replacing it. If you don't eat before you compete, you start with reduced stores of glycogen in your muscles and you will not be able to compete at your best.

It is nonsensical to claim that fasting increases endurance by causing muscles to burn more fat and less glycogen so muscles can retain their stored glycogen longer. When you start with less glycogen, you still use it up faster and run out of fuel earlier. You can increase endurance by cutting back on exercise four days before your competition and eating as much or more than usual. Eat one to three hours before competing. If your event lasts more than an hour, take fluid, sugar and protein (whole grain bars, sugared drinks, etc.) during your event.

Chronic Fatigue Syndrome - a new explanation

2009-10-30T22:02:00.001-04:00

Sixty-seven percent of 101 patients diagnosed with Chronic Fatigue Syndrome (CFS) were found to be infected with a retrovirus called XMRV (Science, published online October 8, 2009). One hundred percent of those with CFS who subsequently developed lymphomas or leukemias were infected with the XMRV virus. If further studies confirm this finding, doctors will soon have a test to diagnose this horrible condition and possibly a vaccine to prevent it.

More than a million Americans are seriously ill with Chronic Fatigue Syndrome, also known as Myalgic encephalomyelitis. CFS symptoms include severe weakness, exhaustion after any activity, loss of memory, and chronic recurrent infections. Patients rarely recover.

The retrovirus XMRV was first found in humans in 2006, in prostate cancer cells. It has been shown to cause nerve damage, immune deficiency, lymphoma and leukemia in animals. Retroviruses do not have their own DNA; they use the DNA of the host cells they invade. Retroviruses include HIV that causes AIDS, and Human Lymphotropic Viruses that cause leukemia and lymphoma. Just as some people infected with HIV do not develop AIDS, not everyone infected with XMRV will develop CFS. XMRV has been found in 3.7 percent of healthy Americans tested, adding up to an estimated 10 million Americans carrying this virus.

Although not proven yet, there is every reason to believe that XMRV is spread by exposure to body fluids (saliva, blood, semen). Having an infection with one of these retroviruses impairs your immunity so that you are more likely to become infected when exposured to any other germ.

The Potassium Deficiency Myth

2009-10-25T21:26:00.001-04:00

Sports drink promoters have convinced many athletes that they need special drinks to replace potassium during exercise. A recent study of female soccer players confirms that this is a myth (International Journal of Sports Medicine, June 2009). When body levels of potassium are low, the kidneys and sweat glands conserve potassium so effectively that potassium deficiency rarely occurs.

Tiredness in healthy athletes can have many causes, but low potassium is not one of them. Many years ago, Dave Costill of Ball State University tried to create potassium deficiency in healthy national champion runners. He couldn't do it because potassium is found in all foods except refined sugar, and his athletes would not stay on a diet that consisted only of hard candy. Even with prolonged exercise in very hot weather, potassium needs can be met by eating virtually any food.

Potassium deficiency CAN be caused by certain drugs, such as diuretics or corticosteroids, or by severe diarrhea or repeated vomiting. One of the best female long-distance runners in the country came to me to find a cause for her sudden drop in performance. All tests I ordered were normal except for a low blood level of potassium. I knew that hard exercise does not cause potassium deficiency and that the most common cause of potassium deficiency is vomiting, but she repeatedly denied doing this. I then requested that she collect her urine for one day and the laboratory reported that it contained three times as much potassium as normal. This proved that she was bulemic. To control her weight, she was sticking her finger down her throat to makie herself throw up. After she was able to accept the diagnosis, she got help, stopped vomiting and went on to win several national long distance running titles.

With vomiting, you throw up the stomach's acid (hydrogen) and the blood becomes alkaline. This causes the kidneys to retain hydrogen and consequently lose huge amounts of potassium in the urine. In both athletes and non-athletes, the most common cause of low potassium blood levels and high potassium urine levels is vomiting.

Metabolic Syndrome and Diabetes

2009-10-22T11:11:00.001-04:00

As the standard of living in a country increases, so does the incidence of Metabolic Syndrome. Today, one of three North Americans will suffer premature death from the consequences of Metabolic Syndrome, which is caused too little activity and too much food (The Journal of Clinical Hypertension, September 2009). Warning signs include: abdominal obesity, high triglycerides, low good HDL cholesterol, overweight, high blood sugar and high HBA1C. (HBA1C is a blood test that measures sugar stuck on cells. An HBA1C greater than 5.7 shows that you have Metabolic Syndrome).

Metabolic Syndrome means that you are in the early stages of diabetes. If you store fat primarily in your belly, you probably have high blood insulin levels, a sign that your body cannot respond adequately to insulin. High insulin levels are caused by high blood sugar levels that cause blood sugar to stick to the surface of cell membranes. Once there, sugar can never get off. It is eventually converted to sorbitol which destroys the cell to cause all the side effects of diabetes. As long as your pancreas still makes insulin, you can reverse metabolic syndrome and diabetes. However, once your pancreas dies you cannot make insulin and your diabetes is not curable.

Read my recommendations on preventing diatetes, and for treating it if you have already been diagnosed. In summary:

• Exercise
• Don't be overweight
• Avoid refined carbohydrates except during exercise
• Make sure you have enough vitamin D
• Don't smoke
• Limit alcohol to no more than two drinks per day
• Eat a healthful diet with plenty of vegetables, beans, whole grains, nuts and other seeds.

Preventing Muscle Cramps

2009-10-16T11:26:00.001-04:00

Most older textbooks explain that muscle cramps are caused by lack of water (dehydration) and lack of salt. However, studies on endurance athletes show that athletes who cramp do not have less body water or sodium than those who do not cramp (British Journal of Sports Medicine, June 2009). So the current explanation for muscle cramps in conditioned athletes is that prolonged, intense exercise damages muscles, which can cause sustained contractions or cramps.

Cramps may occur as a side effect of drugs used to treat high cholesterol, high blood pressure or diabetes. Oral contraceptives, various other drugs or alcohol can also cause muscle cramps. If you suffer from recurrent muscle cramps that cannot be explained, check with your doctor. Possible causes include pinched nerves, Parkinson's disease, hypothyroidism, diabetes, narrowed arteries, low blood mineral levels, or metabolic diseases that cause muscle damage. However, these diseases are rarely the cause of cramps in athletes.

Cramps can often be prevented by slowing down when a muscle starts to feel tight. However, athletes usually are not willing to do this during competition or hard training, so they will continue to suffer from occasional cramps and work them out as they occur. You can help to prevent cramps with a training program that includes both hard days and recovery days. We do this by cycling at 18-20 mph pace on Tuesdays, Thursdays and Saturdays and 10-12 mph pace on the other four days.

New Rules for Sunscreens

2009-10-10T07:47:00.001-04:00

If you use sunscreens, be sure to reapply them frequently. Many sunscreens contain the filters octylmethoxycinnamate, benzophenone-3 or octocrylene, which reflect ultra violet rays away from your skin to protect it only when they are on the surface of the skin. However, when these sunscreens are absorbed and the skin is not re-coated, they increase skin production of harmful oxidants that can cause skin aging and cancer (Free Radical Biology & Medicine, September 2009). Reapplying the sun screen so some remains on the skin's surface can prevent this damage.

• Before you go out in the sun, apply sunscreens to the areas with the most exposure to sunlight over your lifetime: the top of your ears, your face, the back of your neck, and your arms and hands. It is the cumulative exposure to UV light that increases skin cancer and aging.

• To meet your daily vitamin D requirements from sunlight, expose your legs or other areas of your body that have received little cumulative sun exposure over your lifetime. Take care to avoid sunburn.

• Reapply sunscreens every hour or two, particularly when you are swimming or sweating.

• Some sunscreens contain stronger UVA filters (avobenzone, mexoryl, titanium dioxide or zinc) that are less likely to be absorbed into the skin. You do not need to reapply these if they leave a visible white paste on your skin. Check the list of ingredients.

A comprehensive review of more than 1000 sunscreens was conducted by the Environmental Working Group in summer of 2009. Their findings, with brand name listings and recommendations, are available at http://www.ewg.org/cosmetics/report/sunscreen09/investigation/summary-of-findings

Large Thighs are Good

2009-10-03T18:31:00.003-04:00

Large thighs appear to confer health benefits, not risks. A study reported this month shows that people who have small thigh muscles, independent of how much fat they have in their bellies, are at increased risk for premature death, particularly from heart attacks (British Medical Journal, September 2009). 2800 men and women aged 35 to 65 had their thighs measured and were followed for ten years. Those whose thigh circumference was below 24 inches (60 cm) were at increased risk for death from heart attacks.

Other studies show that having very low body fat is also associated with early death, as are being overfat or storing fat primarily in the belly. If you store most of your fat in your belly and have very small thighs or buttocks, you are probably already diabetic or prediabetic and at significant risk for a heart attack.
Another interesting study on benefits of thigh fat
Why belly fat is risky

CRP Better Predictor of Heart Attacks than Cholesterol

2009-10-01T11:04:00.002-04:00

Blood tests for cholesterol and C-reactive protein (CRP) both help to measure heart attack risk, but CRP may be more important. CRP measures inflammation which indicates an overactive immunity, while cholesterol measures a type of fat in your blood. Having a high CRP blood test increases your risk of suffering a heart attack or stroke by twice as much as having a high cholesterol (New England Journal of Medicine, November 2002). Everything that activates your immunity can increase risk for heart attacks and everything that damages your body turns on your immunity. Inflammation is part of the immune reaction that protects you from infection. It causes redness, pain and swelling, and can damage the inner lining of arteries or break off clots from arteries to block the flow of blood which can cause strokes and heart attacks.

If you have a high CRP, try to correct the known causes: any type of infection such as chronic gum disease, high blood pressure, alcohol use, smoking, low levels of physical activity, chronic fatigue, eating a high protein/high meat diet, or having elevated triglycerides, insulin resistance or diabetes. People with sleep disturbances, depression, or any of the "auto-immune" diseases such as rheumatiod arthritis or psoriasis are also likely to have a high CRP and are at increased risk for heart attacks. More

Osteoarthritis: Treat with Exercise

2009-09-27T22:41:00.001-04:00

A review article from the University of British Columbia in Vancouver shows that exercise does not increase the rate of knee damage in people with osteoarthritis, and usually reduces knee pain and disability (Canadian Family Physician, September 2009).

If you develop pain in your knee that was not caused by an accident or trauma, your doctor will usually check you for known causes of joint damage. If he finds no cause, he will tell you that you have osteoarthritis, which means that he doesn't know why your knee hurts. Most people with osteoarthritis (not associated with trauma) are overweight, do not exercise, and/or have weak muscles that support knee movements.

Osteoarthritis causes a higher incidence of disability than any other chronic condition. It makes exercise difficult, and not exercising increases risk for heart attacks. One in three North Americans over 60 have X ray evidence of osteoarthritis.

People with osteoarthritis should avoid contact sports, but exercise is more effective than any medication to treat this condition. The best activities include swimming and other water- based exercises, stationary cycling or cycling on the road, and muscle strengthening exercises using Nautilus machines or similar equipment at a gym. People with knee osteoarthritis should avoid sports that involve sudden shocks to the knee, such as when the foot hits the ground during running. Inactivity and overweight increase your chances of further knee damage and often lead to a joint replacement. More on arthritis

Preventing Loss of Muscle Strength with Aging

2009-09-23T19:44:00.001-04:00

As you age, you lose muscle size and strength much faster than you lose endurance or coordination. Researchers at the University of Nottingham in England show that a major cause of loss of muscle is that aging prevents muscles from responding to insulin and that exercising helps to slow this loss of muscle size and strength (The American Journal of Clinical Nutrition, September 2009).

Insulin drives amino acids into muscles to help them recover from exercise and maintain their size. Researchers traced radioactive amino acids and showed that insulin drives the amino acids into muscles much more effectively in 25-year-olds than in 60-year-olds. They also showed that the blood flow in younger people's legs is much greater and supplies far more nutrients and hormones. However, three exercise sessions per week over 20 weeks markedly increased blood flow in the legs of the older subjects, enough to reverse muscle wasting.

People of all ages can use this information to help themselves become stronger. Athletes in all sports train by stressing and recovering. They take a hard workout, damage their muscles, feel sore the next morning, and then take easy workouts until the muscles heal and the soreness goes away. The athlete who can recover the fastest can do the most intense workouts and gain the most strength.

Eating a high carbohydrate-high protein meal within half an hour after finishing a workout raises insulin levels, increases amino acid absorption into muscle and hastens recovery (Journal of Applied Physiology, May 2009). The carbohydrates cause a high rise in blood sugar that causes the pancreas to release insulin. Insulin drives the protein building blocks (amino acids) in the meal into muscle cells to hasten healing from intense workouts. Muscles are extraordinarily sensitive to insulin during exercise and for up to a half hour after finishing exercise, so the fastest way to recover is to eat protein- and carbohydrate-rich foods during the last part of your workout or within half an hour after you finish.

Here's how Diana and I (ages 67 and 74) use this information on insulin sensitivity. We ride hard and fast for about 20 miles on Tuesdays, Thursdays and Saturdays. On our recovery days, we ride slowly for one to three hours. Mid-day we go to a buffet restaurant and eat a large meal with fish, shrimp, vegetables and other sources of protein and carbohydrates. After eating, we ride slowly for one or two more hours. Riding before we eat makes our muscles very sensitive to insulin. This causes insulin to drive amino acids rapidly into our muscles and help them recover faster. Riding after we eat helps us to avoid a high rise in blood sugar that damages cells. You can use either plant or animal sources of protein; both contain all of the essential amino acids necessary for cell growth.
More on principles of training

What Causes Prostate Cancer?

2009-09-17T11:30:00.001-04:00

We don't know what causes prostate cancer, but a study from Harvard School of Public Health shows an association between the common sexually transmitted infection, Trichomonas vaginalis, and risk of the type of prostate cancer that kills (Journal of the National Cancer Institute, September 9, 2009). Researchers analyzed blood samples collected in 1982 from 673 men who were diagnosed with prostate cancer more than ten years later. Trichomonas vaginalis infection was associated with a more than triple risk for the type of prostate cancer that kills.

Trichomonas vaginalis infects about 174 million people each year and is the most common non-viral sexually transmitted infection. Up to three-quarters of men infected with Trichomonas vaginalis may have no symptoms at all. Trichomanes can usually be cured just by having all sexual contacts take metronidazole for five to ten days.

Several other cancers are caused by bacterial infections. For example, the bacterium Helicobacter pylori is the most common cause of stomach cancer. Bacteroides fragilis, a bacterium that causes diarrhea, has been associated with colon cancer (Nature Medicine, September, 2009). Chronic infections activate your immune system to cause inflammation, which can block apoptosis to cause cancer.

More than 90 percent of prostate cancers probably should not be treated because they cause no harm. A study in the Journal of the American Medical Association (September 15, 2009) followed men with early stage prostate cancer who were cared for without surgery or radiation. Ten years later, only six percent had died from prostate cancer. The average time from diagnosis to death for untreated prostate cancer is more than 22 years. However, five percent of prostate cancers may need immediate treatment as they grow rapidly and can kill. A reliable test that tells which prostate cancers are likely to kill would save anxiety, potency and continence for a lot of men. Such a test is not available at this time. The authors of this study recommend that doctors and patients reconsider the watch and wait option. More on prostate cancer

Use Lactate Threshold instead of Maximum Heart Rate

2009-09-11T23:37:00.001-04:00

My report on the unreliable Maximum Heart Rate formula brought many questions on how heart rate SHOULD be used for training. Competitive athletes often use a guide called lactate threshold (LT). When you exercise, your muscles require oxygen to convert food to energy. If you exercise so intensely that you cannot get enough oxygen, lactic acid accumulates in your muscles and spills over into your bloodstream. This makes your muscles more acidic which causes terrible burning, and you to become short of breath and slow down as you struggle to get more oxygen. Your lactate threshold occurs when you exercise at the highest average heart rate you can maintain for 45-60 minutes. RoadBikeRider.com offers the following guidelines for cyclists; the same principles can be used in any other endurance sport.

"A good way to find your LT is to ride a fairly flat 15-mile course at a hard pace. Use a heart monitor that averages heart rate for the distance or just check it occasionally to see where HR settles.

You'll quickly find that you can maintain a certain high HR, but if you go a few beats higher you'll start panting and be unable to control your breathing. Trial and error will reveal the highest HR you can maintain for the distance. That's your LT.

Three simple exercise zones based on your LT heart rate are sufficient. These guidelines should work for most riders:
Recovery takes place about 40 beats below LT
Endurance is built on rides about 25 beats below LT
Breakthrough training is done from 10 beats below LT to about 5 beats above LT
No heart monitor? You can do just as well by monitoring your perceived exertion. For instance, recovery rides should be so easy that you barely feel the pedals. The idea is to take a 'walk' on the bike. Hard efforts, such as intervals and climbing, should be at the limit separating steady-but-labored breathing from panting and gasping. By experimenting you'll find this LT boundary."

Whatever your sport, I recommend subscribing to RBR's free newsletter; it's full of useful information for exercisers.

NSAIDs Interfere with Proper Training

2009-09-10T20:23:00.002-04:00

Ibuprofen and other NSAIDs (Non Steroidal Anti-Inflammatory Drugs - Motrin, Advil, Alleve and so forth), taken before or after exercise, interfere with the benefits of training for fitness and athletic competition because they delay healing of damaged muscles (British Journal of Sports Medicine, August 2009). You train for sports by taking a hard workout that damages muscles and makes them feel sore. You then take easy, less intense workouts for as long as it takes for the soreness to go away. Only then should you take intense workouts again. Swimmers take hard and easy workouts every day, but athletes in virtually all other sports allow at least 48 hours between intense workouts.

Biopsies done the day after a hard workout show bleeding into the muscle fibers and disruption of the Z-bands that hold muscle fibers together. Injured muscles release healing prostaglandins that cause collagen to be laid down in muscle fibers to make them larger and stronger. They also cause pain. NSAIDs block the training effect by blocking healing prostaglandins, thus delaying recovery and collagen production. They prevent bones, muscles, tendon and ligaments from thickening and becoming stronger.

Athletes taking NSAIDs during competition are at increased risk for bleeding into their kidneys, and for intestinal bacteria to enter their bloodstreams (Brain, Behavior and Immunity, November 2006). An estimated 60 percent of athletes competing in triathlons and other endurance events take NSAIDs because they think that it will block the pain of competition. NSAIDs have not been shown to block the pain and fatigue of competing in athletic events that require endurance.

Ordinary aspirin delays muscle healing by blocking many of the same healing prostaglandins that are blocked by NSAIDs. Aspirin also increases risk for
bleeding if you should have an accident.

Your Appendix is Not Useless

2009-09-01T20:00:00.002-04:00

You may have had your appendix removed because doctors believed that it was a useless vestigial organ. Now researchers have found that it serves as a storage tank for healthful germs that live in your intestines. These good bacteria help to break down food so you can absorb its nutrients. They also prime your immune system to recognize harmful germs and prevent them from invading your body, prevent your immune system from attacking your own body to cause auto-immune disease, and produce immune factors that may prevent colon cancer (Microbiology, February 9, 2009).

When you have diarrhea, bad bacteria can remove the good bacteria in the intestines and colon. A study from Duke University shows that the bad bacteria cannot dislodge the good bacteria from the appendix because its inner lining is covered with a thicker and far more potent biofilm (a layer of bacteria, mucous and immune system cells) than is found in the intestines (Journal of Evolutionary Biology, August 2009). No matter how severe the diarrhea or how extensively the bad bacteria drive out the good bacteria from the intestines, the good bacteria persist in the appendix and eventually re-colonize the rest of the intestines. More on good bacteria

Tennis Elbow: New Treatment

2009-08-31T09:26:00.001-04:00

Physical therapists at the Nicholas Institute of Sports Medicine and Athletic Trauma in New York City report that eccentric exercises offer a simple and effective cure for tennis elbow (July 2009 annual meeting of the American Orthopedic Society for Sports Medicine). The researchers prescribed standard physical therapy for tennis elbow to 10 patients, and physical therapy plus special eccentric exercises to 11 others. In less than two months the eccentric group reported an 81 percent improvement in pain and a 72 percent improvement in strength, while the control group had not improved.

(Eccentric contractions occur during a biceps curl when you lower the weight and your biceps lengthens. Concentric contractions occur when you raise the weight and your biceps muscle shortens.)

You don't have to play tennis to develop tennis elbow. It can be due to any movement that puts excessive force on the wrist muscles. Tennis elbow refers to elbow pain as the result of an injury to the elbow tendons that bend and straighten the wrist. Hold your hand down with your thumb on the outside (lateral to your hand) and your elbow straight. Pain on the lateral (outside) part of your elbow is called backhand tennis elbow. Pain on the medial (inside) part is called forehand tennis elbow.

The exercise is done with an inexpensive piece of equipment called the Thera-Band Flexbar, available at www.Amazon.com. Hold the bar upright with your hand of the affected side. With your hand of the healthy side, grasp the bar near the top and twist it in front of the body. Then use the sore elbow-side hand to slowly untwist the bar by flexing the wrist. Video of the exercise

Burning on Urination May be STD Infection

2009-08-29T16:25:00.002-04:00

One in three single, sexually-active Americans who have more than one partner carry a sexually transmitted disease that may not respond to treatment. These people may have no symptoms at all, or they may have pain during sexual relations, burning on urination, discomfort when the bladder is full, frequency, urgency and night-time urination, vaginal discomfort, difficulty starting the urinary stream, or discomfort in the pelvis. These people go from doctor to doctor, get lots of tests which fail to yield a diagnosis, and continue in their misery and spreading of disease.

This month, researchers in Greece showed that many of these people suffer from infections with intracellular bacteria: mycoplasma, chlamydia or ureaplasma (Urology, July 2009). Most cultures done in medical laboratories fail to pick up these infections. 153 patients had some of the above symptoms and had either failed a course of antibiotics or had negative routine cultures. The patients had cultures taken from their urine, urinary tube, vagina, and cervix. Fifty-three percent of these "incurable" patients were infected with ureaplasma urealyticum. Eighty-two percent of patients positive for ureaplasma urealyticum had other pathogens. A single dose of one gram of azithromycin was given to all culture-positive patients and their sexual partners. Those with a positive culture one month after therapy (4.9 percent) were successfully treated with seven days of doxycycline 100mg twice daily. All of the patients improved, but many continued to suffer pain in the pelvis.

Faster Runners Have Longer Strides

2009-08-23T21:10:00.000-04:00

When most experienced runners go as fast as they can, they run at close to the same stride rate. For example, a video at the New York City Marathon showed that the top 150 runners had the same cadence, taking 92 to 94 steps a minute. The difference between the top runners and the others is that the best runners took longer strides.

However, you cannot run faster by consciously trying to increase your stride length. When you try to take longer strides than what feels natural to you, you lose energy and run more slowly.

Your heel hits the ground with great force. The tendons in your legs absorb some of this energy and then contract forcibly after the heel strikes the ground so you regain about 60 to 75 percent of that stored energy. When you try to take a stride that is longer than your natural one, you lose a great deal of this stored energy, tire much earlier and move your legs at a slower rate.

The key to running faster in races is to make your leg muscles stronger so you can contract them with greater force so they drive you forward with a longer stride. Competitive runners strengthen their legs by running very fast in practice two or three times a week, and by running up and down hills once or twice a week.

New Explanation for DASH Diet Success

2009-08-20T21:23:00.001-04:00

If your systolic (heart contraction) blood pressure is above 120 mm/hg before you go to bed at night, you have high blood pressure and are at increased risk for heart attacks, strokes and premature death. You can protect yourself from premature death caused by high blood pressure with the DASH diet, exercising, avoiding overweight, and getting adequate amounts of vitamin D.

The DASH diet is based on fruits, vegetables, whole grains, fish, poultry, nuts and legumes, and low-fat dairy. Several studies have shown that the DASH diet lowers high blood pressure as effectively as most blood pressure drugs, prolongs life, and prevents heart attacks and strokes. The most common explanation for this success has been the high potassium, magnesium and fiber content of vegetables. However, a study from Medical University of South Carolina in Charleston (Journal of Human Hypertension, August 2009) shows that the DASH diet lowers blood pressure better than a diet supplemented with extra potassium, magnesium and fiber, so there must be other factors.

Now a study of 4706 men and women aged 40-59 in the United States, the United Kingdom, China, and Japan suggests that glutamic acid, an amino acid that relaxes blood vessels, may explain why a high-vegetable diet treats high blood pressure. (Circulation, August 2009.) A vegetable-based diet has five percent more glutamic acid than a diet rich in meat and prepared foods.

Calories do count; the DASH diet may not lower high blood pressure if you eat too much food. More on the DASH diet

Getting Rid of Belly Fat

2009-07-23T14:37:00.001-04:00

Sit-ups will not get rid of belly fat because you cannot get rid of fat in a certain area just by exercising the muscles underneath that fat. You will lose the most belly fat by exercising intensely in any sport (Medicine and Science in Sports and Exercise, November 2008). Three groups of overweight, middle-aged women who suffered from Metabolic Syndrome completed 16-week programs of: (1) continuing their existing levels of activity with no change; (2) low-intensity exercise training five times a week at a level that did not cause breathing hard; and (3) high-intensity exercise training with three days a week hard enough to become short of breath and two days a week at an intensity not becoming short of breath. Cat scan X rays and air displacement plethysmography studies showed that the high intensity exercisers lost belly fat, both underneath their skin and inside their bellies. The low-intensity exercisers lost no measurable belly fat.

Storing extra fat in the belly causes people to become diabetic. Full fat cells produce hormones that prevent the body from responding to insulin so that blood sugar rises too high, causing sugar to stick to cells and damaging cells anywhere in the body. Those who store fat primarily in the belly are the ones most likely to suffer high rises in blood sugar. If you store fat primarily in your belly, have high blood levels of triglycerides and sugar, and low levels of the good HDL cholesterol, you meet the definition of Metabolic Syndrome and the odds are that you are diabetic, or will become diabetic soon. You are likely to suffer a premature death unless you make major lifestyle changes: lose weight, exercise, avoid refined carbohydrates (except during exercise), and make sure you get enough vitamin D.

Exercise can cause heart attacks in people with blocked arteries, and intense exercise increases the risk. Almost 80 percent of diabetics die of heart attacks. Check with your doctor before starting a new exercise program or increasing the intensity of your existing program.

Caffeine May Help to Prevent Alzheimer's

2009-07-12T09:14:00.000-04:00

Two studies in the July 2009 issue of Journal of Alzheimer's Disease show that the equivalent of five cups of coffee a day reverses memory loss in mice with Alzheimer's disease. The coffee also reduced blood and brain levels of beta-amyloid,the abnormal protein that may cause Alzheimer's disease in mice and people. Other studies by the same researchers at the University of Florida show that caffeine lowers blood levels of beta-amyloid in elderly non-demented humans, and when given in early adulthood, prevents memory loss in mice bred to develop Alzheimer's disease in old age. Previous studies on rabbits also showed that caffeine may help to prevent Alzheimer's.

Researchers at the Florida Alzheimer's Disease Research Committee plan to start studies in humans to evaluate whether caffeine can prevent memory loss of early Alzheimer's disease. Other experiments by the same group show that caffeine may prevent memory loss by blocking the enzymes that make beta amyloid.

The amount of caffeine in two to five cups of coffee (200 to 500 milligrams) is probably safe, but more than five cups a day may cause insomnia, nervousness, irritability, nausea, anxiety, a fast or irregular heartbeat, headaches, breast pain or muscle tremors. People who have high blood pressure or narrowed arteries leading to the heart may be advised to restrict caffeine. However, the Nurse's Study showed that heavy coffee drinking is not associated with increased risk for high blood pressure. Unfiltered coffee raises blood levels of the bad LDL cholesterol and blood sugar levels after eating. Pregnant women are advised to restrict caffeine since it may cause miscarriage or low birth weight.

Many studies show that caffeine can improve mood, alertness and energy, prevent diabetes, Parkinson's disease, and liver cancer, decrease the risk of stroke and may help prevent skin cancer. It also increases endurance in athletes.

Protein for Muscle Recovery and Growth

2009-06-30T21:33:00.001-04:00

Many athletes believe that they can grow larger muscles by taking protein supplements rather than by eating protein in ordinary foods. However, protein powders come from food, and extracts cannot be more efficient than the foods from which they are extracted.

All athletes train by stressing and recovering. They take a hard workout, damage their muscles, feel sore the next morning, and then take easy workouts until the muscles heal and the soreness goes away. The athlete who can recover the fastest can do the most intense workouts. Eating a high carbohydrate-high protein meal within a half hour after finishing an intense workout raises insulin levels and hastens recovery (Journal of Applied Physiology, May 2009). Another breakthrough study reported in the same issue shows that taking the high protein-carbohydrate meal before lifting weights does not hasten recovery.

Carbohydrate in the meal causes a high rise in blood sugar that causes the pancreas to release insulin. Insulin drives the protein building blocks (amino acids) in the meal into muscle cells to hasten healing from intense workouts. Muscles are extraordinarily sensitive to insulin during exercise and for up to a half hour after finishing exercise, so the fastest way to recover is to eat a protein- and carbohydrate-rich meal during the last part of your workout or within half an hour after you finish.

You can use either plant or animal sources of protein; both contain all of the essential amino acids necessary for cell growth.

There is also good data that creatine loading helps muscles recover faster. You get creatine from fish, poultry or meat, or creatine supplements. Your body can also make creatine from three amino acids found in both plants and animals: methionine, arginine and glycine. However, you get higher blood levels from supplements or animal protein sources. We do not know if taking the larger amounts of creatine in supplements is better than the amount found in meat, poultry or seafood.