Nutrition, Exercise, Health - What to worry about next ?

Nutrition, Exercise, health - Worry Thursday


You are so busted !

Roy and Carole had just walked into the bar-restaurant and spotted me with a glass of beer. Even worse, my wife and I were sharing a plate of french fries.

The couple, a few years older than me, are clients and we'd often talked about sensible nutrition. How to keep saturated fat down for heart health; how to get enough protein to make sure as older citizens that muscles get maximum benefit from exercise.

So why was I doing this ?

In my defence - it was early July and this was just the third plate of french fries we'd dipped into this year. I ended up talking to Roy and Carole about what my wife and I feel we are doing right and what we've stopped worrying about.

1. Food Combining. Most of the time we follow Food Combining rules. The major part is not to mix meat or fish with carbs. For instance: no mash with beef; no pasta with meat balls. Overall this has worked very well for us.
   
2. OMEGA 3 intake at about 1 to 2 gram per day. We eat salmon and tuna every week, sometimes other fish as well. I also take Ultimate Omega fish oil capsules ( 1 in the morning and 1 in the evening).


3. High Fiber intake. I bake my own whole grain bread and make my own humous. This is because I'm somewhat distrustful of food labelling and if I can make it then I know exactly what it is.

"Of course you take a multi-vitamin every day ?" Carole said.

"No." I used to take vitamin's every day but no more. When I traveled on business a lot ( Platinum on Delta), missed meals, eating on the run, then I took vitamins as a cheap insurance. But no more. Now I have my nutrition under control, vitamin's are a waste of money and they might do some harm.

The problem with multi-vitamins is that they usually also come with minerals included. I worry about mineral balance. If you take too much of one mineral, it's likely to reduce the absorbtion of other minerals. On balance, it's OK for women to take calcium to try to get bones as strong as possible but it's a god idea to spread the calcium across the day rather than taking it all a one go.

What about those french fries?

Delicious.

I love 5 Season's food with their commitment to organic. I'm not going to worry about a once in a blue moon plate of french fries.

Balance - essential part of Fitness Workout

Wednesday Workout - Balance Training

Just about all my over 40 clients agree that improving their balance is an important part of fitness.

It's not just about increasing leg strength - even though leg strength is important. The brain and central nervous system are all vital to good balance. So you have to practice.

Smile at this picture.

This is me balancing on a foam roller.

Try it !

It's a hard foam, about 8 inches diameter and tricky to balance on. It moves back and fore under the feet. That is the idea - you have to keep adjusting to the movement in the roller. My clients' find it easier to do with bare feet. You can do it with shoes on but shoes don't wrap around the roller the way bare feet do.


Now for the next balance exercise.

This one uses a half-round foam roller i.e. it has a curved side and a flat side. Stand with one foot on the flat side and feel the foam roller wobble under-neath your foot.

Then try the other leg.


I have lots of balance exercises for use with clients but these two are to start you trying to add balance to your workouts.

I bought my foam rollers from Power Systems but they are available from many suppliers. My full round one has a hard plastic core to keep it's shape and a washable cover to help keep it clean.

The half-round is just naked !

Yes, these are the same foam rollers used for myofascial release.
More about my use of myofascial release another day.

Healthy Chocolate ?

Tuesday's Healthy News - Healthy Chocolate


Is it possible that chocolate could be healthy ?

My friend Lee Salino firmly believes this because of the difference to her health, her husband's health and that of several close friends, all improved dramatically after starting to eat healthy chocolate every day.

I'm going to try Healthy Chocolate for a month to find out if it makes a difference to me.

At the moment I'm trying the nuggets and the squares.

The nutritional advantage of chocolate revolves around the ORAC value of dark chocolate. I warn you - this 36 page report is somewhat undigestible !

There are also ORAC watchers.

I'll report on my own personal non-scientific results.

Is dark chocolate something to add to my diet ?

Working out - How to adjust for Multiple Sclerosis

FITNESS - Malady Monday

Fitness and Multiple Sclerosis

Finding a personal trainer or physical therapist that you can trust and work with long term is a critical first step.

The nerve sheaths lose some of the myelin protecting the nerve.Then plaque forms like small scars.This stops or interferes with messages passing from brain to muscle. So the brain sends out a control message to a muscle but the message does not arrive or arrives garbled. Result no movement or the wrong movement.


What next ?

• Do not work out to the point of fatigue, It is a bad idea with MS to push to exhaustion. Before MS this might have been the way you worked out but pushing too hard brings up body temperature and high body temperature makes the symptoms worse.
• Stay cool. So find a cool or even cold place to work out. Preventing body temperature going up to far too fast means that you'll be able to workout effectively for longer.
• Use cold packs or even cold vests to keep muscle temperatures down.
• Do not overload a joint as the potential for injury is obviously always present.
• However joints need to be worked through a complete (almost complete) range of motion.
• At the end of range of motion in an exercise, hold the position for a second or two before coming back to the start position.
• Try to use rotational motions as much as possible (over straight in and out movements).
• Try to include exercises which directly relate to everyday tasks like getting in and out of a shower.

Leg muscles can get tight and spastic but you need to find a way to get around these issues:

• Sometimes stroking the muscle opposite the tight muscle (the tight muscle is often called the agonist muscle and the opposite muscle is the antagonist) helps loosen the tight muscle. So if the Quad muscles at the front of the thigh are very tight and unresponsive then stroking gently the muscles at the back of the thigh (the Hamstring muscles) can free up the Quad muscles.
• Gently stretch each leg joint in all directions. This means the ankles up, down and around; knee forward and back; hip forward, back and around. This is to stop a joint gradually losing range of motion and a week at a time getting tighter.
• Use leg kicking motions (as if kicking a ball but not actually using a ball) but curve the leg movements from outside to inside. Make sure you are safely holding on before trying a kick.

Lastly, MS is not the same all the time. It gets better and gets worse.
Use the up time to best advantage.

I laughed out loud at this piece in Real Simple magazine.

Click to make it easier to read.

Why Breast Milk is better than Formula

"Due to its benefits, health authorities recommend breast feeding exclusively for the first six months of a baby's life, followed by breastfeeding in addition to solid food until children are at least a year old. Yet in the US, just 11 per cent of babies are exclusively breastfed up to the age of six months. In the UK, the figure is just 3 per cent. Despite all the public-health campaigns encouraging new mothers to breast feed, tens of millions of babies worldwide are raised on infant formula rather than breast milk."

To make the chart bigger and easier to read just click on it.

The above quote and the chart to the left are from an article in the New Scientist of July 12, 2008 "Winning formula?" To get the full article a subscription to New Scientist is needed but you can look at an abstract without a subscription.

I have New Scientist mailed to be every week - a big favorite.

Quite a number of my clients have worked out with me both before and after baby, so I have a natural interest in all things related to children's health. The really sad thing is that many people believe that formula is actually better than breast milk. Nothing could be further from the truth.

Exercise; easy, every day or hard and alternate days ?

How do you work out ? How often ? Every day. For me just about every day is a workout day of some sort but is this the best way. Particularly if Metabolic Syndrome is something that you have to worry about.

The major alternatives are working out fairly easily every day just like Ellen Pompeo of Gray's Anatomy fame. Here she is treating her aerobic exercise pretty cheerfully.

Exercising at a moderate level 5 or more days a week is the present recommendation of the American Heart Association but this new study, albeit small scale and preliminary, puts a question mark against the standard advice.








The alternative is to really get your heart rate up like this guy doing leg exercises with a stool. This is a simple, do anywhere exercise but very strenuous.

This month Circulation, the American Heart Association journal published the early results of a study comparing exercise at 90% of maximum heart rate against exercise at 70% of maximum. They made sure that people in both groups used up the same number of calories on exercise whether they worked out 3 times a week in tough 90% maximum group or the easier 70% group who worked out 5 times a week.

Overall the 90% maximum group working out 3 times a week had a bigger impact metabolic syndrome issues than the easier working group.

The 90% group had a bigger impact on blood pressure, insulin sensitivity, HDL cholesterol and improved ability to exercise.

There might be a downside as pointed out by the American Heart Association: However the added benefits must be weighed against the potential for increased musculoskeletal and cardiovascular complications."

The exercise prescription used in the study for the hard charging 90% group was:

• walk or run uphill on a treadmill
• 40 minutes per session
• 10 minutes warm up to 70% maximum heart rate (this should feel comfortable but only just so)
• 4 hard 'intervals' of 4 minutes each at 90% maximum
• 3 'recovery intervals' of down to 70% in between the hard intervals
• 5 minutes cool down (this is important - do not just stop).
  

Disease, illness, genes and your genome

Do you feel good after a morning coffee or totally jittery ?

Whether your body metabolizes coffee quickly, leaving that good feeling, or processes the caffeine in the coffee slowly, leaving you feeling jittery for hours depends upon one gene. The gene comes in a fast and a slow version. If you have the fast version - coffee is good. If you have the slow version - coffee is bad.

This starts to explain why in some medical research coffee is linked to heart attacks but other research completely exonerates coffee. It depends upon the genetics of the people selected for the research project and usually the genetics of the research subjects are not tested prior to starting the tests.

More than a dozen companies now offer to test your DNA and tell you what to worry about.

The Human Genome Project was the first to decipher the complete (or close to complete) DNA for human beings. The results from this project were not for a specific individual but now the capability to analyse the complete DNA for one individual is with us. But expensive - very expensive.

KNOME is offering to sequence, for a fee, the DNA of any individual.

NAVIGENICS is linking decoding your DNA to genetic counseling. Most people willing to shell out $25,000 to have their DNA sequenced have a reason or at least a big worry. Do I have a big health issue looming up !

23andme and deCodeMe have more limited ambitions - to identify any nasty genes in your DNA and let you know about them. These two do not sequence your whole DNA - just go looking for the unpleasant truths. This is why these two are charging around $1,000 to $2,000.

Any new field of science is going to have 'entrepreneurial' entrants. California last month sent out letter to 13 companies offering genetic testing telling them to stop offering their services in California. This audio report gives more information.

The Economist says in essence "not yet worth the money'.

However genetic testing is starting to enter main-stream medicine - look at this position statement from the gastroenterologists. 

There is a whole profusion of organizations trying to be the lead in creating an ethical DNA testing industry.

Genetic testing is probably within a decade of being an every day activity but you need a good reason to shell out $1,000 this year. Anybody offering DNA analysis for under $100 is going to provide just that amount of useful information!

10 years younger ?

How hard is to get 10 years younger ?




For best fitness, or even some reasonable health and independence, does walking make a difference ?

Should you walk steadily for quite a long time, say an hour, or walk hard for a few minutes, ease off to get your breath back and then go at it hard again ?

As we get older our body's ability to take in and use oxygen gets less and less. We can't work as hard for as long. Pretty obvious ! Dr Roy Shepherd based at the University of Toronto has been trying to get more precise about this.

Is there a point when one is so unfit that you just cannot look after yourself ?

The answer seems to be threshold of 18 ml/[kg.min] in men, and 15 ml/[kg.min] in women, reached at 80-85 years. This is saying that when your body gets down to only being able to handle 15 milliliters of oxygen per kilogram of body weight in the case of a woman [1kilo = 2.2 pounds] then you really are in a bad shape.

A 40 year old in good health but not actually doing any specific exercise might be able to handle 40 ml/[kg.min] ( men) and around 35 ml/[kg.min] in a woman.

So a man at 40 might have a buffer of exercise capacity of around 22 ml/[kg.min] and a woman of the same age maybe 20 ml/[kg.min].

What if you say 60 and already are going down that slippery slope to losing independence ! Say you have not been exercising and your oxygen numbers are around 28 to 30 ml/[kg.min] - a bit too close to that 18 ml/[kg.min] threshold for not being independent. Can you make up for lost time ?

Dr Shepherd thinks so.

He found that a vigorous walking program 5 days a week made a big difference. Within a couple of months improvements were measurable.

• after 2 months a 13% improvement
• after 6 months a 17% improvement

This is like getting 10 years younger.

After a year you could 12 years younger.

However it has to be vigorous walking - just strolling is nice, will slow the decline but will not make you younger.

Hyaluronic Acid to lubricate Osteoarthritic Knees

I've blog'd about having my knees lubricated with Hyaluronic Acid and said that the results were less than stellar.

The August issue of the Johns Hopkins Medical Letter "Health After 50" is also somewhat dismissive of the effectiveness of Hyaluronic Acid for the treatment of osteoarthritis.

It quotes Dr. John Flynn, a Johns Hopkins Arthritis expert "Hyaluronic Acid is a synthetic lubricant. 'Oiling' the joints makes sense in theory, but Hyaluronic Acid is probably not any more effective than conventional therapies that have been proven definitely to help relieve the painful symptoms of osteoarthritis."

In 2003 the Journal of the American Medical Association reported that over a total of 2,584 treated knees, Hyaluronic Acid was only slightly better than a placebo. The Cochrane Database summary is that Hyaluronic Acid is about the same as taking asprin (or any other non-steroidal anti-inflammatory [NSAID]).

As for me, I'm running again - albeit slowly and not very far. I've designed my own recovery regime - no research to support it.

The plan to run again (such as it is):

1. Only run on a treadmill for 6 months
2. When I start running outside only once a week and on a track for the next 3 months
3. Two complete days between runs i.e. say I run on Tuesday then no running on Wednesday and Thursday
4. Indoor cycle (Spin) on one of the non-running days
5. Each week add 1/4 mile to distance run
6. Walk for 1/4 mile before running and walk for 3 minutes when I'm finished
7. Maximum run speed in first 6 months is 7.5mph.

Next week I'll run 2 miles each running day.

Not much and still a long way to 13 miles for a Half-Marathon.

Nutrition and Resistance (strength) Exercise

During hard exercise the muscles burn up some of their own muscle protein. How do you make sure that after exercise is over you rebuild the burnt up protein and incorporate some additional protein so that on balance the exercise has made you stronger and bigger ?

This is a very important consideration if you are recovering from injury, serious illness, getting on in years and particularly if sarcopenia (muscle loss) is one of you big health issues.

How should you eat to make the most out of strength and resistance training ? During strength and resistance training your muscles are working against a heavy load - at or close to the maximum weight or resistance the muscles can move. Glycogen in the muscles is used to power the exercise. If the exercise is really hard, the muscles burn up (oxidize) muscle protein to fuel the exercise.  The amount of muscle protein burnt is about proportional to how hard the exercise is - harder then more protein is burnt. You need to work out hard to make big gains in strength. 

Taking in some carbohydrate in the hour after exercise is a must - even better in the 15 minutes after exercise stops because the highest rate of glycogen storage is in the hour after exercise.

How much carbs ? It depends on your body weight:

• 40 kilograms   (88 pounds)    40 to    48 grams (about 1.5 ounces)
• 80 kilograms   (176 pounds)  80 to    96 grams (about 3 ounces)
• 120 kilograms  (264 pounds)  120 to 144 grams (about 4.5 ounces).

How much protein ? Surprisingly little is needed to get muscles back to where they were and then growing some more - at least 6 grams and 15 grams ( 1/4 to 1/2 ounce) is plenty. You need to get this small amount of protein into yourself fairly quickly after exercise. Within 4 hours more protein is needed - another  30 grams (about 1 ounce).

Taking carbs and protein together helps because the carbs help get the protein (after digestion in the form of amino acids) into the muscles. 

Protein is built up out of amino acids. Most amino acids can be made by our bodies but 8 need to be gained from food - the essential amino acids. Nutrition stores will sell you essential amino acids in tablet form. Trying to feed oneself with tablets is usually a waste of time but taking essential amino acids just before training seems to help build muscle. 

Eating normally just before training is likely to create a insulin rush - you could throw up or feel nauseous and possibly light headed. However taking 6 grams of essential amino acids in tablet form just before training by-passes the worry about generating an insulin rush.