Friday, September 29, 2006

Prepare for skiing

If you plan to ski this winter, start getting ready now. The best way to train for skiing is to ski, but snow isn't always available. To prepare for a skiing vacation, you need to strengthen both your heart muscles and your skeletal muscles. You can strengthen your heart for skiing with any exercise that will raise your heart rate for at least 10 minutes, three times a week. However, to prepare your muscles for skiing, you have to use activities that use your upper legs, such as skating or riding a bicycle. The average bicycle rider is far better prepared for skiing than the average runner. Many joggers who can easily run ten miles find that they can't ski very long because their upper leg muscles tire and hurt after just a few minutes of skiing.

You drive yourself forward in skiing with the muscles in your upper legs. Running stresses primarily the muscles in your lower legs. It does not strengthen the muscles in the upper legs enough to allow the average person to ski for any length of time. Running stresses your upper leg muscles only when you use them to lift you up when you run hard up hills. Since you ski by bouncing up and down on your knees and shushing forward from your hips, the best sports to prepare for skiing are those that stress primarily your thigh and upper leg muscles. You can use the popular indoor exercise machines that mimic cross-country skiing motions, or ski on dry roads with roller-skis. In-line skating or cycling are good choices for outdoor preparation, particularly if you climb lots of hills. Add a weight training program to strengthen your upper body and arms as well as your legs, and you’ll be ready for the snow.

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Wednesday, September 27, 2006

Recurrent sore throats

If you have recurrent throat infections with staph or strep bacteria, check your toothbrush, your nose and your mate. One study showed that beta strep, which causes rheumatic fever, was grown from toothbrushes of 30 percent of children who were infected with that germ. Beta strep can persist in unwashed toothbrushes for 15 days and in washed toothbrushes for 3 days. Another bacteria called staph aureus can persist in the noses of people even after they have taken the appropriate antibiotic. Having staph in your nose also prevents simple cuts from healing.

Staph grows so luxuriously in the wet nasal membranes that it is difficult to cure by taking oral antibiotics. You can also be re-infected by a mate who has no symptoms at all. If you suffer recurrent staph or strep infections, get a new toothbrush and ask your doctor to culture your nose. If you have a staph aureus infection, apply an over-the-counter antibiotic ointment such as Bacitracin in your nostrils nightly for several weeks.

Tuesday, September 26, 2006

Will vinegar help me lose weight?

Vinegar is an excellent preservative and a good household cleaner, but it is not a medicine or a weight-loss drug. Several popular books claim that vinegar prevents cancer and heart disease, lowers high blood pressure and helps you to lose weight, but here is no evidence to support any of these claims. One of the books explains that vinegar helps you to lose weight because oil and vinegar don't mix, so vinegar and your fat won't either.

Vinegar is nothing more than a mixture of 95 percent water and around 5 percent acetic acid, made from grapes, apples, rice, potatoes or other fermented plants. It is very low in calories, but the only way vinegar could possibly help you to lose weight is by causing you to eat lots of salads while you cut back on other sources of calories.

Monday, September 25, 2006

Push-Ups: Train to do the most

If you want to be able to do 100 pushups in a row, do not try to do as many pushups as possible every day. You'll probably injure yourself and end up unable to do any pushups at all. Training for competition requires an understanding of the stress-and-recover rule and the interval-sets rule.

The best way to improve any athletic skill is to stress your body on one day and then allow enough time for your body to recover before you stress it again. On one day, take a hard workout. On the next morning, your muscles feel sore. Take easy workouts until the soreness disappears and then take a hard workout again.

For your hard workouts, you can do far more work by exercising in sets, rather than continuously. If you can do six continuous pushups, you can probably do ten sets of two with twenty-second rests between each set. Do repeat sets of two until your muscles feel sore. Try to take workouts that are hard enough to make your muscles feel sore for no more than 48 hours. An ideal training program would consist of sets of three until you feel sore on the first day, take off the second day, do sets of five on the third day until you feel soreness, and rest on the fourth day. Repeat these four-day cycles, and you'll soon be ready to compete.

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Friday, September 22, 2006

Know when to change sports

If your favorite sport causes chronic pain or an injury that does not heal, you should probably switch to another sport. Two recent studies from the Argentine Tennis Association followed players with knee and shoulder problems (British Journal of Sports Medicine, May 2006). In the first study, men who had anterior cruciate ligament (ACL) tears showed a great drop in their tennis performance. The knee is just two sticks held together by four bands, called ligaments. Two ligaments are located on the outside of the knee and two ligaments cross in the middle of the knee joint. The ACL runs from the bottom of the upper bone of the knee joint forward to the top of the lower bone of the knee joint. It prevents the upper bone of the knee joint from slipping backward when your knee hits the ground. When this ligament is torn, each foot strike causes the upper bone to slide backward over the lower bone, shears off cartilage in the process and hastens a knee replacement. It is downright dangerous for a person with a torn ACL to play tennis or run until the ligament is replaced. Even then the surgical replacement is not as strong as the original ACL and that person risks joint damage every time he runs, jumps and turns on his knee joint.

The second study followed older men who had played tennis for many years and had no shoulder pain, surgery or trauma to their shoulders. Even with no symptoms, thirty-three percent of these men had significant x-ray findings of joint damage called osteoarthritis in their dominant shoulder, and the older they were, the more likely they were to have this damage. X rays showed increased incidence of joint space narrowing, joint cysts, bone fragments, flattening of the joint cartilage, displacement of the upper arm bone and erosion of the joint cup. If you are a long-time tennis player and have shoulder pain, your doctor will probably recommend that you stop playing tennis.

The good news is that switching to a new sport is much easier than starting from inactivity. Training principles are the same for all sports. Give yourself time to learn new skills and build up the muscles you have not used before.

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Thursday, September 21, 2006

Statins and muscle pain

Some patients with high cholesterol levels are afraid to take statins because off fear of developing side effects such as muscle pain. A study from Scripps Mercy Hospital in San Diego reviews the latest data on side effects of statins (The American Journal of Medicine, May 2006). This review found that statin- induced muscle damage is more common in Asians, people who exercise, have had recent surgery, have kidney, liver or thyroid disease, or have high triglycerides. The incidence of muscle pain and damage from statins is extremely low in non- exercisers, three to ten percent in those who exercise, and very high in competitive athletes.

Most athletes refuse to take statin drugs because they train by taking a hard workout that damages their muscles. Then they must take easy workouts until the soreness disappears and muscles heal. When statins prevent this muscle healing, the athlete must train at reduced intensity for a much longer period of time. Brand names of statins include: Altoprev, Crestor, Lipitor, Mevacor, Pravachol and Zocor.

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Wednesday, September 20, 2006

Are any weight loss drugs safe and effective for teenagers?

Researchers from St. Christopher's Hospital for Children in Philadelphia recently reported that metformin, a drug used to treat diabetes, can help obese, non-diabetic teenagers lose weight (Endocrine Society Annual Meeting, June 2006). Many previous studies show that short-term use of metformin can help people lose weight.

Metformin prevents the liver from releasing sugar into the bloodstream. When taken before eating, it markedly reduces the rise in blood sugar. A high rise in blood sugar after eating causes the pancreas to release large amounts of insulin which acts on the brain to make you hungry, on the liver to make more fat, and on the fat cells in your belly to fill with fat. This study shows that metformin along with a low-refined-carbohydrate diet lowers weight for years. It also lowers high blood sugar and cholesterol, decreases insulin resistance and helps get rid of acne in obese teenagers. More on glucophage for weight loss

Tuesday, September 19, 2006

What should I eat after a hard workout?

Eating a protein-rich meal as soon as possible after this hard workout hastens muscle recovery. Intelligently-increased workloads make an athlete stronger, and anything that helps you recover faster allows you to do more work. When you feel the burn during intense exercise, you are damaging your muscle fibers. The pain that you feel 8 to 24 hours after a hard workout is due to muscle damage. It is now fairly well established that your muscles recover faster if you eat protein as soon as possible after a hard workout or competition.

You’ll be happy to know that a study from Indiana University in Bloomington shows that chocolate milk helps athletes to recover faster from hard exercise than drinks that replaced only carbohydrates or fluid (International Journal of Sports Nutrition and Exercise Metabolism, February 2006). Milk is full of protein, but so are, fish, shellfish, meat, chicken, whole grains and beans, and so forth. Eat any source of protein that tastes good to you.

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Monday, September 18, 2006

Stand still or keep moving between bursts of hard exercise?

If you compete in sports that require repeated short bursts of very fast running, such as in basketball, soccer, or football, will you recover faster by standing still or by continuing to move at a slower pace? A study from Brooklyn College in New York showed that it doesn’t make any difference (International Journal of Sport Nutrition and Exercise Metabolism, February 2006). Researchers asked fit athletes to perform multiple bouts of exercising to exhaustion. Between the bouts of vigorous exercise, one group spent 12 minutes staying completely still, while the other group continued to exercise at less than 20 percent of their maximum workload. Athletes in both groups showed equal recoveries and performances.

However, those who stayed still between all-out efforts had blood that was more acidic than those who continued to exercise. Many athletes believe that lactic acid buildup in muscles hinders their performance, but this study shows that blood acidity has little to do with recovery from hard exercise. When you exercise so intensely that you cannot get all the oxygen you need, lactic acid starts to accumulate in your muscles and spills out into your bloodstream to make your blood more acidic. This can make your muscles burn and hurt, but it will not delay your recovery for your next bout of all-out effort.

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Sunday, September 17, 2006

Is exercise before sleeping harmful?

Many fitness instructors give you bad advice when they tell you not to exercise within three hours of going to sleep. The old argument was that vigorous exercise causes your body to produce large amounts of its own stimulants, adrenalin and noradrenalin, that make your heart beat rapidly, raise body temperature and prevent you from feeling tired. More recent research shows that exercising vigorously before going to bed does not interfere with sleep. We also know that exercise helps to prevent disease, prolong life and make you feel good. So it is better to exercise whenever you can, even if it's just before you go to bed.

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Saturday, September 16, 2006

If I replace salt after exercise; won't this cause osteoporosis?

Athletes must eat large amounts of foods to take in enough calories to fuel their muscles during exercise. A high salt intake in athletes does not cause osteoporosis because they eat so much food that contains calcium and potassium that the amount of salt they take does not cause blood calcium levels to drop, so calcium does not leach out of bones.

As a general rule, taking extra salt causes the body to retain extra fluid, which expands blood volume and increases blood flow to the kidneys to increase loss of calcium in the urine. This lowers blood calcium levels, so calcium has to be taken from bones for replacement. Sodium salt also causes the kidney tubules to lose more calcium. However, potassium blocks the exchange of sodium for calcium in the kidneys and prevents calcium loss. Eating calcium also prevents blood calcium levels from dropping so there is no need for the bones to release extra calcium into the bloodstream (Journal of the American College of Nutrition, June 2006). All fruits, vegetables, whole grains, beans and other seeds are loaded with potassium. Most varied diets contain adequate calcium, but if you decide to take a calcium supplement, be sure you are also getting plenty of vitamin D. Because calcium blocks the conversion of inactive vitamin D to active vitamin D, extra calcium increases your needs for vitamin D.

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Friday, September 15, 2006

Do protein drinks increase speed during competition?

Adding protein to a sports drink does not help athletes cycle faster in a 50-mile time trial, according to a study from McMaster University in Ontario (Medicine and Science in Sports and Exercise, August, 2006). Many studies show that taking in a carbohydrate drink helps improve performances in athletic events lasting more than an hour. Two recent studies showed that adding protein to a carbohydrate drink improves performance even more. However, in these studies, cyclists worked at a fixed rate of effort, rather than using spurts of energy as athletes do in competition.

When you compete in an athletic event lasting more than an hour, you need fluids and calories. In events lasting more than three hours, you also need salt. Calories come from carbohydrates, fats, and proteins. During highly-intense exercise, your muscles use carbohydrates more efficiently than proteins or fats. So carbohydrates are the calorie source of choice during intense exercise. Furthermore, drinks containing protein often taste bad and are not as refreshing as water, soda or sports drinks, so you don’t drink as much.

High-protein meals eaten immediately after hard exercise have been shown to help athletes recover faster, but the data that taking protein during exercise improves an athlete’s performance is extremely weak. In competitions lasting more than an hour, athletes should take drinks that contain carbohydrates, or water plus food. In events lasting more than two hours, they also need to replace salt, either with salted drinks or with salty foods such as salted peanuts.

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Wednesday, September 13, 2006

Knee cartilage does not grow back

When all the cartilage in your knee is gone, the only effective treatment is to replace the whole knee. Knee replacements are now lasting for twelve to twenty years or more, and most remain pain-free. The ends of bones are soft, so they must be covered with a thick white gristle called cartilage. Once damaged, cartilage can never heal. An affected person spends the rest of his life losing cartilage until the cartilage is completely gone and the knee hurts 24 hours a day. The only effective treatment at that time is to replace the entire knee. However, the artificial knee can become dislodged from the bones and may need to be replaced after several years. The area will be so full of scar tissue that a second surgery is far more difficult than the first. If you have damaged cartilage in your knee, you should protect that knee for the rest of your life. Running, fast walking and jumping cause further damage, while pedaling and swimming usually do not. When the knee hurts all the time, your doctor will check to see how much cartilage is left. If it's gone, you probably need a knee replacement.

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Monday, September 11, 2006

Bleeding gums need attention

One in 10 people suffers from periodontal diseases, characterized by bleeding in the gums when you brush your teeth, loosening of the teeth and damage to the structures that help the teeth stay in place.

They are caused most commonly by infections by three Gram-negative bacteria: Porphyromonas gingivalis, Bacteroides forsythus and Actinobacillus actinomycetemcomitans. The body responds to these infections by producing various cytokines (IL-1, IL-6, IL-8, TNF-alpha), inflammatory mediators (PGE2), and matrix metalloproteinases (MMP-2, MMP-3, MMP-8, MMP-9). Viruses, such as cytomegalovirus and Epstein-Barr virus) can also cause periodontitis. Conventional treatments for periodontitis aim to eliminate bacterial plaque by scrubbing, cleaning and prescribing antibiotics. Recently dentists have also been prescribing anti-inflammatory drugs to decrease inflammation.

If your gums bleed when you brush your teeth or you have lose teeth unexplained osteoporosis, ask your doctor or dentist to prescribe a combination of metronidazole 250 mg four times a day, and Biaxin 500 mg twice a day for one week. Also see my report on the link between gum disease and heart attacks.

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Wednesday, September 06, 2006

Belly fat is worse than hip fat

Storing fat primarily in your belly increases your chances of suffering heart attacks and diabetes.

When you take in more calories than your body needs, your liver turns them into fat. Fat cells in your belly are different from those in your hips. The blood that flows from belly fat goes directly to your liver, whereas the blood that flows from your hips goes into your general circulation. The livers of those who store fat in their bellies are blocked from removing insulin by the extra fat and therefore do not remove insulin from the bloodstream as effectively as the livers of those who store fat in their hips and have less fat in their livers.

People who store fat primarily in their bellies are called apples, while those who store fat primarily in their hips are called pears. The apples have higher blood insulin and sugar levels (2) that raise levels of the bad LDL cholesterol that causes heart attacks, and lower levels of the good HDL cholesterol that prevents heart attacks. See my report on Insulin Resistance.

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Tuesday, September 05, 2006

Maximum heart rate: Is it harmful to exceed it during exercise?

Some people enjoy using a heart rate monitor and find that it helps to motivate them, but you don’t need one. You can tell how fast your heart is beating just by paying attention to how you breathe. The only heart rate that you need to know is the training heart rate that makes your heart stronger. To strengthen your heart, you have to exercise vigorously enough to increase your heart rate at least 20 beats a minute beyond your resting heart rate.

You can tell when your heart rate is high enough to strengthen your heart because your body will require more oxygen than it does at rest, and you will start to breathe deeply and more rapidly. You should still feel comfortable and be able to talk. If you exercise so slowly that you never breathe more deeply or rapidly than your resting rate, you are not strengthening your heart. However, you don’t have to exercise at your maximum heart rate to become fit.

When you have been exercising for several months and your exercise program feels easy, you can decide whether you want to improve. If you would like to compete or just want to increase your level of fitness, a heart rate monitor can help you plan your training sessions, set goals, and measure your progress.

Instructions that accompany most heart rate monitors are based on a mythical maximim heart rate formula that predicts the fastest your heart can beat and still pump blood through your body. Although this formula is the gold standard used today, it is not based on science. In 1970, Sam Fox was the director of the United States Public Health Service Program to Prevent Heart Disease, and one of the most respected heart specialists in the world. He and a young researcher named William Haskell were flying to a meeting. They put together several studies comparing maximum heart rate and age. Sam Fox took out a pencil and plotted a graph of age verses maximum heart rate and said it looks like maximum heart rate is equal to 220 minus a person's age. For the last 30 years, this formula has been taught in physical education and heart function course and has been used to test heart function and athletic fitness.

The formula is wrong because your legs drive your heart; your heart does not drive your legs. Maximum heart rate depends on the strength of your legs, not the strength of your heart. When you contract your leg muscles, they squeeze against the blood vessels near them to pump blood from your leg veins toward your heart. When your leg muscle relax, your leg veins fill with blood. So your leg muscles pump increased amounts of blood toward your heart. This increased blood fills the heart and causes your heart to be faster and with more force. This is called the Bainbridge reflex that doctors are taught in their first year of medical school. The stronger your legs are, the more blood they can pump, which causes your heart to beat faster.

A pencil mark plotted on a graph during an airplane flight more than 30 years ago has been the accepted formula for maximum heart rate for more than 30 years and the fitness community has accepted this dogma for more than 30 years.

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Saturday, September 02, 2006

Are total-body scans worth the money?

I never recommend the full body CAT scans for healthy people. You've seen the advertisements. They tell you to come in, get a scan of your entire body, pay your thousand dollars and find out what's wrong with you before you have symptoms.

CAT scans of the body are high-speed, highly sensitive X-rays that can find tiny tumors, weak spots on blood vessels that make them bulge out like balloons, and calcified areas that may be indicative of heart disease. As a result of intense competition, prices are dropping, from $1,000 or more to a few hundred dollars. New centers are springing up in cities and strip malls across the country. They advertise in newspapers, on the radio, on billboards and in fliers sent by mail. There are even mobile units that travel from state to state in huge buses, make contacts with churches and other groups and then charge a reduced price of $200 to scan any of three regions of the body, or $500 for all three.

However, most of the radiologists that I know, who have no interest in making money from these scans and are not influenced by personal gain, tell me that they are a waste of money and time. They tell me that a careful look at most CAT scans shows that almost everyone will have some abnormality. Scanners can find lumps smaller than a millimeter, or four-hundredths of an inch, and most of these lumps are harmless. So you follow up the cat scan with several thousand dollars worth of other tests only to find out that you are normal and you have been upset for the sole reason that you took a test that picked up an a normal finding in most healthy people.

Furthermore, many people are fooled by the medical profession into thinking that early treatment results in cures for everything, when the truth is that early treatment often offers nothing but worry. For some cancers, early treatment has not been proved to have any effect on their course. "We've sold ourselves the myth that getting everything early is always good," said Dr. Larry Kessler, the director of the office of surveillance and biometrics at the Food and Drug Administration.

CAT scans are relatively safe, however. Since these CAT scan tests are usually not covered by insurance, you will have to pay for them and the odds are overwhelming that they will find nothing or that they will find something that is harmless. They then may cost you more money for many other tests, and loss of sleep before you find out that you do not have a tumor or any other serious disease.

On the other hand, those who provide the scans say they are a real service. The radiologists who do them are delighted with them. They offer a huge rate of profit. Since the patients pay out of pocket, there are no insurance companies to haggle with. What would you say if you had a CAT scan and they found nodules in your liver, kidneys and lungs. Your family practitioner will tell you that half of all normal people over 50 have cysts in their liver or kidneys. However, an abnormal full body CAT scan upsets your doctor who knows that if he misses a cancer, you will sue him. So against his better judgment, he orders a liver biopsy and another doctor sticks a needle into your liver, removes a piece of your liver, and finally tells you that you are normal and have nothing to worry about. Total body scans can pick up hidden cancers, ballooning blood vessels and plaques in your arteries, but they will also pick up a host of things that will cost you thousands of dollars and lots of worry before you find out that most healthy people have these abnormalities.

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