Tuesday, June 30, 2009

Protein for Muscle Recovery and Growth

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.

Thursday, June 25, 2009

Hip Fracture Usually Requires Hip Replacement

The most-feared injury among serious bicyclists is a broken hip. The femur hip bone is shaped like a shepherd's crook. The blood supply to the ball at the top of the hip bone comes in through the neck just below the ball. If the neck or ball are broken, the blood supply is usually shut off and the top of the hip bone dies. To prevent this from happening, fractures of the ball or neck of the hip bone are usually treated with immediate hip replacement. Try to avoid this drastic surgery by keeping your bones as strong as possible.

1) All exercise strengthens bones. Bicycling strengthens bones, but not as much as sports that exert greater forces on bones such as running or lifting weights. (Medicine & Science in Sports & Exercise, March 2009).

2) Exercise increases calcium absorption, which is necessary for strong bones. As I reported last week, even non-impact exercises such as swimming and cycling increase calcium absorption from the intestines by upregulating the calcium transporter genes. (American Journal of Physiology, Endocrinology and Metabolism, April 2009).

3) Those most likely to suffer broken bones during exercise are people who have low levels of vitamin D (Journal of Bone and Mineral Research, September 2006). When you lack vitamin D, ionizible calcium drops. This causes the parathyroid glands to put out large amounts of parathyroid hormone which takes calcium out of bones to weaken them and increase fracture risk.

4) High blood levels of parathyroid hormone (from vitamin D deficiency or any other cause) are a major risk factor for bone fractures during exercise (Bone, August 2005).

If you ever are unable to expose a few inches of skin to sunlight for at least 20 minutes four or five times a week, get a blood test called vitamin D3. If it is below 75 nmol/L, you need to take a vacation in a sunny place, or take at least 3000 IU of vitamin D per day until you can get some sunlight.

Monday, June 22, 2009

The Hygeine Hypothesis: Hot Debate

The Hygiene Hypothesis proposes that you need to have certain infections to have a healthy immune system. If you are not infected with various common germs, your immunity does not have the chance to practice killing germs and learning the difference between invading organisms and your own cells. For example, does Helicobacter pylori, the bacteria that causes stomach ulcers, also prevent diseases such as eczema? Nobody knows. Being infected with Helicobacter is associated with decreased risk for eczema (Journal of Epidemiology & Community Health, July 2007), but it is also associated with an increased risk for asthma (Gut, May 22, 2008).

Your immunity protects you from certain infections by searching out and killing foreign germs in your body. It does this by attacking surface proteins on invading bacteria and viruses. However, your immunity is not supposed to attack your own cells, so it does not attack cells that have the same surface proteins that your cells have. It may attack your lungs and cause asthma instead of attacking the bacteria that causes stomach ulcers. Your immunity may get so active with Helicobacter infections that it may attack your own skin to cause eczema.

The Hygiene Hypothesis has not been proven. It is just a hotly debated theory among doctors; only time will sort out the conflict and tell us if Helicobacter stomach infections help your immunity protect you from other infections. More on Helicobacter pylori

Wednesday, June 17, 2009

Surgery for Blocked Arteries Questioned

What should you do if your doctor tells you that you have blocked coronary arteries? A recent study shows that in people who have blocked arteries and diabetes, the chances of dying or having a major heart attack are the same whether they undergo surgical procedures (bypass or stents) or just take medication to treat cholesterol, blood pressure and diabetes. Death rate was also the same whether or not they took insulin (BARI 2D study, New England Journal of Medicine, June 10, 2009).

Patients who had bypass procedures had fewer heart attacks than those who had stents, even though both had the same chances of dying (also reported in the BARI-1 trial). I think that stents are less effective in preventing heat attacks because stents are foreign bodies placed in arteries that can increase chances of clotting, a major precipitating cause of heart attacks. That is why people with stents are given drugs to prevent clotting. Also, type 2 diabetics who were not given insulin had fewer blockages than those given insulin. I think that this is because high insulin levels constricts coronary arteries.

This is a very important study because the most common cause of a sudden heart attack is diabetes, and 80 percent of diabetics die of heart disease. More than one third of Americans will become diabetic and that number is projected to double by 2030.

If you have diabetes and blocked arteries, try to avoid surgery. If you need surgery, you may gain better protection from a bypass than from a stent. I also believe that you should try to control type II diabetes without insulin. Get a blood test called C peptide (which measures insulin production). If it is above one, try to avoid insulin. If it is below one, or you cannot get your HBA1C blood test (which measures cellular damage from diabetes) below 6.5, you may need insulin.

For everyone, I recommend: 1) A diet rich in fruits, vegetables, whole grains, beans, seeds and nuts. Restrict meat from mammals, and eat refined carbohydrates (sugar water and flour) only when exercising. 2) Exercise every day, and avoid overweight, smoking and more than two alcoholic drinks a day. 3) Keep blood levels of vitamin D3 above 75 nmol/L.
What should you do if your doctor tells you that you have blocked coronary arteries? A recent study shows that in people who have blocked arteries and diabetes, the chances of dying or having a major heart attack are the same whether they undergo surgical procedures (bypass or stents) or just take medication to treat cholesterol, blood pressure and diabetes. Death rate was also the same whether or not they took insulin (BARI 2D study, New England Journal of Medicine, June 10, 2009).

Patients who had bypass procedures had fewer heart attacks than those who had stents, even though both had the same chances of dying (also reported in the BARI-1 trial). I think that stents are less effective in preventing heat attacks because stents are foreign bodies placed in arteries that can increase chances of clotting, a major precipitating cause of heart attacks. That is why people with stents are given drugs to prevent clotting. Also, type 2 diabetics who were not given insulin had fewer blockages than those given insulin. I think that this is because high insulin levels constricts coronary arteries.

This is a very important study because the most common cause of a sudden heart attack is diabetes, and 80 percent of diabetics die of heart disease. More than one third of Americans will become diabetic and that number is projected to double by 2030.

If you have diabetes and blocked arteries, try to avoid surgery. If you need surgery, you may gain better protection from a bypass than from a stent. I also believe that you should try to control type II diabetes without insulin. Get a blood test called C peptide (which measures insulin production). If it is above one, try to avoid insulin. If it is below one, or you cannot get your HBA1C blood test (which measures cellular damage from diabetes) below 6.5, you may need insulin.

For everyone, I recommend: 1) A diet rich in fruits, vegetables, whole grains, beans, seeds and nuts. Restrict meat from mammals, and eat refined carbohydrates (sugar water and flour) only when exercising. 2) Exercise every day, and avoid overweight, smoking and more than two alcoholic drinks a day. 3) Keep blood levels of vitamin D3 above 75 nmol/L.

Thursday, June 11, 2009

Burning During Exercise Differs from Muscle Pain After Exercise

The burning you feel in muscles during intense exercise is different from the burning and pain you feel after exercising. Burning during intense exercise is caused by the acidity from accumulation of lactic acid. When your muscles cannot get all the oxygen they need to convert food to energy during intense exercise, lactic acid accumulates in muscles, makes them more acidic, and the acidity causes a burning feeling. Excess lactic acid is cleared from the muscles within seconds after stopping exercise.

Lactic acid is good because it is the most efficient fuel for muscles during exercise. It requires less oxygen for energy than virtually all other fuels. Sodium bicarbonate (baking soda) neutralize lactic acid in muscles during intense exercise and helps athletes to exercise longer (Medicine & Science in Sports & Exercise, October 2006). Caffeine (the amount in four cups of coffee) reduces muscle burning during intense exercise (International Journal of Sport Nutrition and Exercise Metabolism, April 2009). More on lactic acid

Burning or pain eight to 24 hours after exercising is usually caused by damage to the muscles themselves. The longer you stay in the burn during exercise and the greater the force on your muscles during exercise, the greater the muscle damage. Most athletes train by taking a hard workout on one day, damaging their muscles and feeling sore on the next, and then going at low intensity for as many days as it takes for the soreness to disappear. When muscles heal from hard force on them, they become stronger. Athletes recover from hard exercise actively by exercising at low intensity. They rarely take days off. Exercising at low intensity during recovery makes muscles more fibrous which protects them from injury when they are stressed again.

Sunday, June 07, 2009

Which Blood Pressure Number is More Important?

The higher number (systolic) measures pressure when your heart contracts, and the lower (diastolic) reading measures the pressure when your heart relaxes. A recent study followed people with high blood pressure to see which people developed heart attacks (Hypertension, May 26, 2009). The authors found that the best predictors for future heart attacks are the systolic (heart contraction) blood pressure and pulse pressure (the difference between systolic and diastolic blood pressures). Evidently the higher your blood pressure rises when your heart contracts, the more likely you are to have a heart attack. Normally, the aorta is supposed to widen when the heart contracts to send a large amount of blood to your arteries. Those with the stiffest arteries that do not widen with each heart contraction are the ones most likely to suffer heart attacks. More on interpreting your blood pressure numbers

Monday, June 01, 2009

Older People Need More Sunshine

A study from the University of Warwick in England shows that more time in the sun can help older people avoid diabetes and heart attacks (Diabetes Care, July 2009). They evaluated 3,262 people aged 50-70 years old in Beijing and Shanghai, China, and found that 94 percent were low in vitamin D and 42 percent of those had metabolic syndrome: abdominal obesity, high triglycerides, low HDL and high blood sugar levels. This is consistent with world- wide studies that show that as people age their skin atrophies, reducing their ability to make vitamin D from sunlight. Seniors also usually exercise less so they do not go outside as often. Since they are more susceptible to cold, they usually wear more clothing when they do go outside. Inadequate vitamin D increases risk for heart attacks, strokes, certain cancers, arthritis, auto-immune diseases and many other health problems.

A major function of vitamin D is to increase absorption of calcium from food. When vitamin D levels are low, body levels of ionized calcioum drop. This forces the parathyroid glands to increase production of parathyroid hormone that blocks insulin receptors, to raise blood sugar levels markedly and increase production of insulin. High levels of insulin constrict coronary arteries to cause heart attacks.

Vitamin D deficiency occurs when the concentration of D3 (25-hydroxy-vitamin D) is less than 75 nmol/L. If you are deficient, you need to expose skin to more sunlight or take at least 2000 IU of vitamin D3 per day. To address skin cancer concerns, protect the most frequently exposed areas, since it is cumulative life-long exposure to sunlight that increases risk for skin cancer. For most people, this means you should use sunscreen or wear clothing to cover your face, scalp, neck, tops of the ears, forearms and hands whenever you will be in the sun for more than 30 minutes.
More on vitamin D