Database of Dietary Supplements Labels

The Dietary Supplements Labels Database offers information about ingredients in more than two thousand selected brands of dietary supplements. It enables users to determine what ingredients are in specific brands and to compare ingredients in different brands.

This information is published by the United States National Library of Medicine. However the database has copied across claims by the supplement manufacturers which have not been verified.

So this database is valuable reference but you still need care to filter out unverified claims of health benefits.

Core training

Training the "core" is an important consideration for most people wanting to improve fitness, recover after pregnancy and to generally be better equipped to deal with the stresses that life throws at us. As a result most gyms have Swiss Balls available for use and many also have "Wobble Boards" and Hard Foam Rollers to balance on. Until now it has been difficult to know when to workout on unstable surfaces like wobble boards and Swiss balls and when to simply stand on the hard stable gym floor.

The current issue of ACSM's Health and Fitness Journal (January/February 2008 Volume 12 Number 1) has an excellent analysis of when unstable surfaces help and when they hinder. Coming at the subject of core training from a medical and a scientific angle helps enormously. The chart to the right is an analysis of what exactly is in "The Core".

The analysis starts with:

• what exactly is "The Core"
• what exactly are you trying to achieve with "Core Training".

As it turns out the core muscles comprise much more than just the visible 6-pack muscles - the rectus abdominis. The core goes beyond just the abdominal muscles and the lower back which many have regarded as core muscles. The list of muscles gets rather long. Here is the ACSM view of core muscles after full consideration of human anatomy:

1. transversus abdominis
2. internal oblique abdominis
3. quadratus lumborum
4. external oblique abdominis
5. erector spinae
6. latissimus dorsi
7. rectus femoris
8. sartorius
9. iliacus
10. psoas (major and minor)
11. gluteus maximus
12. semimembranosus
13. semitendinosous
14. biceps femoris (long head)
15. multifidus
16. rotatores
17. intertransversalis
18. interspinalis

This is quite a list to which one could add a few more muscles. All of these muscles are working to some extent in all core related exercises. It turns out that "isolation" is just about impossible.

The big point from this ACSM article is the important perception about the results from training core muscles. Core exercise can emphasises one or more of :

• Endurance from core muscles
• Strength from core muscles
• Power from core muscles.

Looking at core exercise in terms of are you trying to improve endurance, strength or power means that the exercises used need to be different. If you want all three to improve then you'll need to train for endurance then strength and then power. Take a couple of weeks of exercise for your body to recover and then go around the exercise loop again but this time starting from a higher level.

Core Endure is important for everyone whether you are an older person recovering from a serious medical issue or a highly paid professional sports star. Unstable surfaces such as Swiss Balls, Bosu's and Wobble Boards all help in the development of core endurance. The technical term for an unstable surface such as a Swiss Ball is a "labile surface" Look at this article which has some nice pictures of abs exercises on a bench, on a Swiss ball and on a wobble board. However it also turns out that exactly where you place the Swiss ball makes a big difference to how hard the exercise is. Read this piece of research. It turns out that having the Swiss ball near your shoulders makes core exercise easier and having the ball at the low back makes it harder. This is important to know is you are just starting to move your core exercises onto a Swiss ball. Easier to start and then gradually increase the challenge.

Core Strength becomes important after the core muscles have sufficient endurance. To develop core strength you need to move your exercise to get off the Swiss ball, wobble board, etc and move to a stable surface i.e. the floor. However the important thing to know about this phase of core development is that one sided (unilateral) exercises become critical for strength development. Use dumbbells for one sided exercises with one or both feet firmly planted on the floor. An example would be a one-sided hip extension while holding a dumbbell (reasonably heavy) in one hand. This article reports research showing that you need a stable surface for strength development.

Core Power is the ability to generate a lot of force rapidly i.e. you can move heavy objects fast. For core power both feet have to be firmly planted and you are rotating while pushing a load well within your capabilities i.e. for core power the weight or resistance is less than you are capable of but you are moving the weight fast. For instance you might be pushing a cable row handle forward (or back) as fast as you can against a reasonable resistance.


There are many books on Core Performance. I really like the one opposite by Mark Verstegen which covers exercise from many angles.






There are also books which just describe Swiss ball exercises - of which there are a great number. The book by Goldenberg and Twist is aimed at a sports audience but is a good read for many people but it does not make any distinction between endurance, strength and power.

Core training

Training the "core" is an important consideration for most people wanting to improve fitness, recover after pregnancy and to generally be better equipped to deal with the stresses that life throws at us. As a result most gyms have Swiss Balls available for use and many also have "Wobble Boards" and Hard Foam Rollers to balance on. Until now it has been difficult to know when to workout on unstable surfaces like wobble boards and Swiss balls and when to simply stand on the hard stable gym floor.

The current issue of ACSM's Health and Fitness Journal (January/February 2008 Volume 12 Number 1) has an excellent analysis of when unstable surfaces help and when they hinder. Coming at the subject of core training from a medical and a scientific angle helps enormously. The chart to the right is an analysis of what exactly is in "The Core".

The analysis starts with:

• what exactly is "The Core"
• what exactly are you trying to achieve with "Core Training".

As it turns out the core muscles comprise much more than just the visible 6-pack muscles - the rectus abdominis. The core goes beyond just the abdominal muscles and the lower back which many have regarded as core muscles. The list of muscles gets rather long. Here is the ACSM view of core muscles after full consideration of human anatomy:

1. transversus abdominis
2. internal oblique abdominis
3. quadratus lumborum
4. external oblique abdominis
5. erector spinae
6. rectus abdominis
7. latissimus dorsi
8. rectus femoris
9. sartorius
10. iliacus
11. psoas (major and minor)
12. gluteus maximus
13. semimembranosus
14. semitendinosous
15. biceps femoris (long head)
16. multifidus
17. rotatores
18. intertransversalis
19. interspinalis

This is quite a list to which one could add a few more muscles. All of these muscles are working to some extent in all core related exercises. It turns out that "isolation" is just about impossible.

The big point from this ACSM article is the important perception about the results from training core muscles. Core exercise can emphasises one or more of :

• Endurance from core muscles
• Strength from core muscles
• Power from core muscles.

Looking at core exercise in terms of are you trying to improve endurance, strength or power means that the exercises used need to be different. If you want all three to improve then you'll need to train for endurance then strength and then power. Take a couple of weeks of exercise for your body to recover and then go around the exercise loop again but this time starting from a higher level.

Core Endure is important for everyone whether you are an older person recovering from a serious medical issue or a highly paid professional sports star. Unstable surfaces such as Swiss Balls, Bosu's and Wobble Boards all help in the development of core endurance. The technical term for an unstable surface such as a Swiss Ball is a "labile surface" Look at this article which has some nice pictures of abs exercises on a bench, on a Swiss ball and on a wobble board. However it also turns out that exactly where you place the Swiss ball makes a big difference to how hard the exercise is. Read this piece of research. It turns out that having the Swiss ball near your shoulders makes core exercise easier and having the ball at the low back makes it harder. This is important to know is you are just starting to move your core exercises onto a Swiss ball. Easier to start and then gradually increase the challenge.

Core Strength becomes important after the core muscles have sufficient endurance. To develop core strength you need to move your exercise to get off the Swiss ball, wobble board, etc and move to a stable surface i.e. the floor. However the important thing to know about this phase of core development is that one sided (unilateral) exercises become critical for strength development. Use dumbbells for one sided exercises with one or both feet firmly planted on the floor. An example would be a one-sided hip extension while holding a dumbbell (reasonably heavy) in one hand. This article reports research showing that you need a stable surface for strength development.

Core Power is the ability to generate a lot of force rapidly i.e. you can move heavy objects fast. For core power both feet have to be firmly planted and you are rotating while pushing a load well within your capabilities i.e. for core power the weight or resistance is less than you are capable of but you are moving the weight fast. For instance you might be pushing a cable row handle forward (or back) as fast as you can against a reasonable resistance.


There are many books on Core Performance. I really like the one opposite by Mark Verstegen which covers exercise from many angles.






There are also books which just describe Swiss ball exercises - of which there are a great number. The book by Goldenberg and Twist is aimed at a sports audience but is a good read for many people but it does not make any distinction between endurance, strength and power.

Sleep Apnea

Sleep Apnea is becoming an epidemic - maybe at a rate of 24% in men and 9% in women.It looks as if the rise in Sleep Anea is tracking the spread of obesity. According to an article in the Lancet, severe Sleep Apnea is correlated with a three-fold increase in the risk of a heart attack (or similar cardiac incident).

The rise of Sleep Apnea as an important health issue motivated the ACSM (American College of Sports Medicine) to devote the whole of its October-December 2007 Certified News to the topic of Sleep Apnea. The issue was headlined as "Obstructive Sleep Apnea: An Elephant in the Closet of Importance to the Exercise Professional."

So what can be done ? The answer :

• lose weight - maybe as little as 12 pounds and 10% of body weight should make a big difference
• use a sleep aid such as a CPAP.

Is there a problem ? Well yes, because Sleep Apnea makes exercise more difficult:

• heart rate does not increase the way it should in a healthy body
• blood pressure goes up more than it should during exercise.
• wearing a CPAP every night is no bed of roses and hence long-term, every night use of a CPAP is unlikely. The peaceful image of a CPAP in use at the head of this blog is just a tad idealized. Read this forum to get an idea of what it's really like.
  

Can a Personal Trainer help ?
Is there an exercise prescription for Sleep Apnea ?
At the moment the ACSM does not have any specific exercise recommendations for Sleep Apnea but the issue of Certified News referred to above is the start of defining such a prescription.

One major problem standing in the way of a simple exercise prescription is the possibility, even likelihood, that anyone with severe obstructive sleep apnea is going to have other health issues such as obesity, Type 2 Diabetes, hypertension and a variety of heart issues such as congestive heart failure, cardiac arhythmias and perhaps a stroke risk.

The bottom line is to try for 45 to 60 minutes of low intensity exercise every day (or at least 5 days) a week. Low intensity is defined by the ACSM for this purpose as being 40%to 60% of maximum heart rate. This is longer than ACSM recommendations for hypertension, Type 2 diabetes and CV diseases but at a lower intensity.

The ACSM emphasizes that exercise for anyone with severe sleep apnea should be concluded gradually with an extended cool down period of at least 15 minutes. One additional ACSM recommendation is to closely monitor blood pressure and in particular to measure blood pressure 5 to 15 minutes after the end of exercise cool down. This is to check that blood pressure has returned to baseline value. If it has not then either the exercise intensity was too high or the cool down was too short.

Prescription Sleep Aids

The Mayo Clinic Health Letter for January 2008 has a good summary of prescription drugs to aid sleep. Mayo makes the distinction between finding it difficult to get off to sleep as contrasted with the problem of staying asleep (sleep-maintenance insomnia). Older adults more commonly have sleep-maintenance insomnia.

The Health Letter has a useful summary of drugs used for helping getting off to sleep and for those that help one stay asleep.

The newest class of sleep drug are the melatonin agonists. These are related to the natural hormone melatonin. Rozerem is the brand name and it seems somewhat weak in its affect but not habit forming.

Another group of sleep aids currently being heavily promoted are from the class called non-benzodiazepine hypnotics. This includes brands such as Ambien, Ambien CR, Lunesta and Sonata. It appears that older adults can take these fairly well with little residual drowsiness. However Mayo say that there are some reports of amnesia after taking them. That said this new class of non-benzodiazepine hypnotics is much better than their predecessors, the benzodiazepine which have been used for the last 40 years.

Sonata (one of the non-benzodiazepine hypnotics) is short acting and wears off quickly.

Mayo is fairly dismissive about non-prescription medication sleep aids such as Benadryl, Somine and Unisom saying they have minimal effectiveness.

The Mayo summary is:

• Ambien - Useful for initiating sleep, sleep onset 7 to 27 minutes, low risk for dependency
• Ambien CR - Useful for initiating sleep, sleep onset 30 minutes, more chance of morning drowsiness than with Ambien
• Lunesta - Good for both initiating sleep and sleep maintence, sleep onset 10 minutes, low risk dependency.
  
• Sonata - Good for night awakening and for sleep initiation, sleep onset 30 minutes, short acting so you can take it middle of night and be OK in morning.

Remember that these are all on prescription, so listen to your doctor, take exactly as prescribed and read all the warnings.

Difficulty sleeping can reach an extreme in sleep apnea. This topic is worthy of a blog all on its own.

Bra's cause Breast Cancer ?

In yesterday's post saying that I like OnExercise Magazine, I mentioned that one of the magazine articles was on Bra's causing Breast Cancer. I also mentioned that my wife, a breast cancer survivor, said that she was not going to stop wearing a bra and overall she was not impressed by the article.

If you put any set of words into a Google search, thousands of hits will result: some interesting and valid; some off the wall; and quite a few totally irrelevant. I tried searching on "bra cancer" and no surprise lots of information came to the surface - not all of it believable. One of my motivations for this is a desire not to add to urban legends. Once a story gets started on the internet and can race off with a life of its own.

It all goes back to a book called Dressed to Kill by Sydney Ross Singer and Soma Grismaijer published in 1995. You can buy it on Amazon for about $15. By the way, there are lots of books and videos with Dressed to Kill as a title so pick up the right one.

Other sites say - don't worry - look at this one as an example.

The BBC carried a report in 2000 saying that Professor Robert Mansell (University of Wales, Cardiff) who has been researching this area said that he thought women had nothing to worry about.

However there are many who firmly believe the link.

The frequently used argument that decades ago no one believed there was a link between smoking and lung cancer, so if today (or at least 1995) no one believes there's a link from bra's to breast cancer then just wait for more evidence. After 12 years no more evidence. Your decision.