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Posts Tagged ‘Exercise’

Some sobering news about diet soda has come to light which should give people pause before consuming such beverages.

Julie Lin MD, MPH, FASN and Gary Curhan, MD, ScD, FASN of Brigham and Women’s Hospital studied more than 3,000 women participating in the Nurses’ Health Study to identify the impact of sodium and sweetened drinks on kidney function.

The information from the participating women, whose median age is 67, was from 1984, 1986, and 1990 and included data about kidney function. Over the course of the years from 1989 – 2000, the shocking data revealed that over 11% of the women suffered a decline of over 30% in their kidney function.

“Thirty percent is considered significant,” says researcher Julie Lin, MD, MPH, assistant professor of medicine at Harvard Medical School and a staff physician at Brigham and Women’s Hospital in Boston. That’s especially true, she says, because most study participants had well-preserved kidney function at the start of the study.

What those women had in common was a thirst for artificially sweetened sodas which exceeded two per day. Other factors were ruled out in reaching that conclusion, including age, caloric intake, obesity, high blood pressure, diabetes, cigarette smoking, physical activity, and cardiovascular disease.

Put another way: the women who drank two or more diet sodas a day had a decline in their glomerular filtration rate, a measure of kidney function, of 3 milliliters per minute per year. ”With natural aging, kidney function declines about 1 mL per minute per year after age 40,” Lin says. No link was found with the other beverages. And less than two sodas a day didn’t seem to hurt. “We didn’t see any association up to two artificially sweetened beverages a day,” Lin says.

”A serving was reported as either a glass, a can, or a bottle of a beverage,” Lin tells WebMD. ”It was not more specific than that.”

”The mechanisms aren’t clear,” Lin says of the association she found. In another study she presented at the meeting, she found higher salt intake is also associated with faster kidney function decline.

Understanding the mechanisms are important because it can help evaluate with certainty whether these results are applicable to men as well.

Unsurprisingly, an industry group remains skeptical of these findings:

Asked to review the study findings, Maureen Storey, senior vice president of science policy for the American Beverage Association, says in a prepared statement: “It’s important to remember that this is an abstract presented at an annual meeting.” She notes that the research needs further scrutiny by researchers.

She acknowledges that kidney disease is serious but that diabetes and high blood pressure account for the majority of kidney disease cases, ”not consumption of diet soda.”

When it comes to dieting and exercise there are no short cuts. Diet soda may help satisfy a craving for a sugary beverage without the caloric penalty, but there may be unintended consequences. For example, what if the body recognizes a discrepancy between the information sent by the tongue, “sugar incoming”, and the message processed by the other parts of the metabolism, “no sugar received”? Logically, if the discrepancy is processed, the body will increase the hunger drive as a way of compensating for the missing sugar, which may cause the person to consume more calories than they would have otherwise.

Even for those people who take the excellent first step towards getting healthy by exercising need to be keenly aware of the law of unintended consequences, because exercise can make you fatter.

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Here is a “dog bites man” story from researchers at Columbia University Medical Center and Massachusetts General Hospital.

It is no secret that anabolic steroids have all sorts of nasty side effects.

Anabolic steroids can cause many adverse effects. Most of these side effects are dose-dependent, the most common being elevated blood pressure, especially in those with pre-existing hypertension, and harmful changes in cholesterol levels: some steroids cause an increase in LDL cholesterol and a decrease in HDL cholesterol. Anabolic steroids have been shown to alter fasting blood sugar and glucose tolerance tests. Anabolic steroids such as testosterone also increase the risk of cardiovascular disease or coronary artery disease. Acne is fairly common among anabolic steroid users, mostly due to stimulation of the sebaceous glands by increased testosterone levels. Conversion of testosterone to dihydrotestosterone (DHT) can accelerate the rate of premature baldness for males who are genetically predisposed, but testosterone itself can produce baldness in females.

There is a whole bunch more (we left out some of the nastier bits) where that came from. Now we can include damage to kidneys as a side effect of abusing anabolic steroids too. In fact, the damage incurred is worse than what is seen in the kidneys of morbidly obese individuals.

The investigators studied a group of 10 bodybuilders who used steroids for many years and developed protein leakage into the urine and severe reductions in kidney function. Kidney tests revealed that nine of the ten bodybuilders developed a condition called focal segmental glomerulosclerosis, a type of scarring within the kidneys. This disease typically occurs when the kidneys are overworked. The kidney damage in the bodybuilders has similarities to that seen in morbidly obese patients, but appears to be even more severe.

However, some good news also comes from this study:

When the bodybuilders discontinued steroid use their kidney abnormalities improved, with the exception of one individual with advanced kidney disease who developed end-stage kidney failure and required dialysis. Also, one of the bodybuilders started taking steroids again and suffered a relapse of severe kidney dysfunction.

If stopped in time, kidney function can improve enough for daily functioning. Kidneys in particular are so vulnerable to the effects of anabolic steroids because they are affected both directly and indirectly:

The researchers propose that extreme increases in muscle mass require the kidneys to increase their filtration rate, placing harmful levels of stress on these organs. It’s also likely that steroids have direct toxic effects on the kidneys. “Athletes who use anabolic steroids and the doctors caring for them need to be aware of the potentially serious risks to the kidney,” said Dr. Herlitz.

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Video Games: Good For The Heart & Body

Parents would greatly prefer if their children engaged in plenty of outdoor exercise. Unfortunately for some parents, their children actually lead almost completely sedentary lives. Those children are at a high risk for health complications, especially if a lack of exercise is combined with poor dietary choices.

Even if you are fortunate and have children who are physically active there are still reasons to moderate their activities during their time in front of the television. There are real skills which can be gained from interactive media, beneficial to boys and girls alike, which they simply will not gain from hours of passive television consumption.

An active video game system like the Nintendo Wii can be beneficial to kids who otherwise get no exercise at all, according to recent research published in Pediatrics.

Scientists at the University of Oklahoma Health Sciences Center found that playing active video games like the Wii can be an effective substitute for moderate exercise.   No one is saying children should stop playing outside or doing real exercise but active video games can be a suitable alternative at times.  Basically, if an obese child is going to sit around and play video games instead of exercising, something is better than nothing.

Here are the detailed finding of the research:

  • Children use similar amounts of energy playing Wii boxing, doing DDR at Level 2 and walking 2.6 mph. They burned about three times as many calories doing these activities as they did while watching television, about 3 calories a minute playing the games compared with 1 calorie a minute lounging in front of the TV.
  • Kids used about two to 2½ times more energy playing Wii bowling and doing the beginner level of DDR as they did watching TV. They burned 2 to 2½ calories a minute during the activity.
  • Boys used more energy than girls when playing DDR and bowling, but both boys and girls used about the same amount of energy walking and playing Wii boxing.

DDR2 is referring to the game Dance Dance Revolution 2. Boxing, tennis, and bowling are part of Wii Sports, the game that comes bundled with a new Wii. There are other fun fitness related games from Nintendo, such as Wii Sports Resort and the Wii Fit (which has games incorporating a unique balancing board).

Amazon.com has a special notice up:

Celebrate Sunday’s Wii Price Drop with Savings
If you are considering a Wii, you might like to know that the price of the Wii console will drop to just $199.99 starting at 12 AM PST, Sunday, September 27, 2009. Come back when it does and celebrate your purchase with surprise savings on some of our best games and accessories for Wii!

We recommend marking your calendar.

UPDATE: The notice is no longer up at Amazon, but the discounted price of $199.99 is still in effect.

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Tennis elbow, characterized by pain, weakness and inflammation or degeneration of the wrist-extensor tendon that connects to the elbow, is one of those intractable overuse injures that, until recently, yielded very reluctantly to treatment.

Tennis players are not the only people who might suffer from tennis elbow. Golfers, plumbers, and even people who lug around heavy briefcases can get it.

Treatments range from acupuncture to corticosteroids to surgery, usually with limited — if any — long-term success.

Muscles and ligaments work in two possible ways. Concentric contractions are when the fibers tighten and get shorter, like doing a bicep curl. Eccentric movements are in the other direction, when the muscle fibers are lengthening. A new technique was developed which focused on eccentric exercises.

“We couldn’t believe” how fast and well the therapy worked, says Timothy Tyler, PT, ATC, a clinical research associate at the Nicholas Institute and one of the authors of the study. “We were seeing improvements in five weeks, even three. It was crazy.”

Here’s the treatment exercise they developed:

He and his colleagues realized that a single, unhurried exercise using a tensile bar that looks like an oversized licorice stick could create an eccentric contraction all along the forearm. In the exercise, a person holds the bar upright at his or her side using the hand connected to the sore elbow, then grasps it near the top with the good hand. The top hand twists as the bar is brought around in front of the body and positioned perpendicular to the ground; the sore hand then takes over, slowly untwisting the bar by flexing the wrist. “Afterward, you should be sore,” Tyler says. “That’s how we know it’s effective.”

Dr. Tyler goes on to explain precisely why eccentric movements work better:

Eccentric contractions require the muscle to work against a force, in this case the coiled bar. “You can load a tendon so much more eccentrically” than with concentric exercises, Tyler says. “So we think the process may be remodeling the tendon.” Ultrasound studies by other researchers, including the group in Belgium, have shown that damaged tendons typically become less thick, indicating they are less damaged, after a course of strenuous eccentric exercise.

The rubber bar used by Dr. Tyler to treat tennis elbow, the Thera-Band Flexbar, is available for under $20. Yes, this is one of those unique cases where “cheap” and “effective” can be combined together in a legitimate way. Although it shouldn’t take too long to perform this exercise, its effectiveness depends on the commitment level of the patient.

“It’s not a difficult exercise but it is unique, so I would advise people to be taught by a physical therapist, if possible,” Tyler says. If not, proceed on your own — after, of course, an examination by a doctor; elbow pain can have many causes, not just tennis elbow. “In my opinion, you’re not going to hurt yourself,” Tyler continues, although you should be prepared for a commitment. His patients did three sets of fifteen repetitions every day. Beginners should start with three sets of five repetitions, adding more as the repetitions get easier, Tyler says.

Images demonstrating the technique are available at the source.

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Can Exercise Make You Fatter?

Consider this an exercise on the laws of unintended consequences.

Vigorous physical activity for at least 45 minutes will strengthen a person’s cardiovascular system and burn calories. It will also make that person hungry. When combined with the general tendency to overestimate calories burned during exercise and to underestimate calories in food defeat is all but guaranteed.

For example, burning 300 calories during an hour’s worth of exercising and eating a delicious 600 calorie muffin as a post workout reward is a net gain. On an average day in which a person exercises more, they eat more.

Weight training builds muscle, and a pound of muscle consumes more calories than a pound of fat but not enough to make much of a difference.

According to calculations published in the journal Obesity Research by a Columbia University team in 2001, a pound of muscle burns approximately six calories a day in a resting body, compared with the two calories that a pound of fat burns. Which means that after you work out hard enough to convert, say, 10 lb. of fat to muscle — a major achievement — you would be able to eat only an extra 40 calories per day, about the amount in a teaspoon of butter, before beginning to gain weight.

The human body is an exquisitely regulated machine which has certain homeostatic goals in mind and works ruthlessly to achieve them. To truly win this war an individual needs to fight against themselves and it is very difficult to do so.

Arm yourself with data about how many calories are really being burned for various types of workout  routines and durations. Know the approximate caloric count of your favorite snack foods, like those sugar free muffins at the local bakery.

Plan ahead and be aware of your body’s inclinations. If you are going to be hungry after an energetic workout be sure and have a low calorie and healthy snack immediately available. For a post exercise meal, choose your dining partners carefully.

Good luck.

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You can’t be a runner past the age of 40, as I am, without hearing that running will ruin your knees, by which doomsayers usually mean that we’ll develop “degeneration of the cartilage in the kneecap, which ­reduces its shock-absorbing capacity,” says Ross Tucker, a physiologist in South Africa and co-author of the new book “The Runner’s Body: How the Latest Exercise Science Can Help You Run Stronger, Longer and Faster.” In other words, we’ll be afflicted with arthritis.

It seems to be common knowledge that certain sports and exercises such as distance running are bad because of the eventual suffering in the knees by participants. A long term study of runners has found that there is no particular reason for that to be the case simply because the knees are being used more often and in a tougher fashion than walking or other milder exercises.

In fact the opposite is true:

Instead, recent evidence suggests that running may actually shield somewhat against arthritis, in part because the knee develops a kind of motion groove. A group of engineers and doctors at Stanford published a study in the February issue of The Journal of Bone and Joint Surgery that showed that by moving and loading your knee joint, as you do when walking or running, you “condition” your cartilage to the load. It grows accustomed to those particular movements. You can run for miles, decades, a lifetime, without harming it. But if this exquisite balance is disturbed, usually by an injury, the loading mechanisms shift, the moving parts of the knee are no longer in their accustomed alignment and a “degenerative pathway” seems to open. The cartilage, like an unbalanced tire, wears away. Pain, tissue disintegration and, eventually, arthritis can follow.

The key factor is injury. Preventing an injury by strengthening the muscles involved in running is a good start. Once an injury has been sustained, it is likely to lead to another and possibly cause even more damage, so always consult with a doctor before resuming a normal running regimen.

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Speaking at APA’s 117th Annual Convention, Steven Blair, PED, called Americans’ physical inactivity “the biggest public health problem of the 21st century.”

Quick, raise your hand if you snickered when you read the word biggest because you were picturing just how big and fat Americans are. Now take your raised hand and slap yourself across the face for being so insensitive.

We kid.

Really though, there are surely much bigger global problems relating to health, especially in regards to disease control, access to clean water, nutritional deficiencies, etc.

Research has shown approximately 25 percent to 35 percent of American adults are inactive, Blair said, meaning that they have sedentary jobs, no regular physical activity program and are generally inactive around the house or yard. “This amounts to 40 million to 50 million people exposed to the hazard of inactivity,” Blair said in an interview.

Putting the hyperbole aside, it is an often accepted and mistaken bit of common knowledge that weight can determine a person’s health. Many young men and women diet and exercise with the goal of changing their weight to a particular amount, and are occasionally briefly successful. Others do not exercise, or do so rarely, but are not considered overweight so it is assumed that they are healthy.

One follow-up study of 40,842 longitudinal study participants showed poor fitness level accounted for about 16 percent of all deaths in both men and women. The percentage was calculated by estimating the number of deaths that would have been avoided if people had spent 30 minutes a day walking.

The reality is that everyone should make it a goal to be physically active to at least a moderate level. Cardiovascular exercises in particular seem to be strongly correlated with longevity and better health, physical and mental,  well into old age. Most people should stay away from exercise extremes such as marathon running because the damage incurred (to the joints, for example) and risk of injury are not worth the health benefits.

Blair also highlighted the benefits of exercise on the mind, referring to recent emerging evidence that activity delays the mind’s decline and is good for brain health overall.

Diet alone cannot make a person healthy. Appetite control is regulated in a complex way by the body, and is very difficult to fight against for any reasonable period of time. Should you be one of those people with a slow metabolism and a hearty appetite, make sure you put extra time and effort into exercising.

Obviously, since this was presented at an APA function there was a role in all this for psychologists.

“I believe psychologists can help develop better lifestyle change interventions to help people be more active via the Internet and other technological methods.”

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