“Why Exercise Wont Make You Thin” – John Cloud March 30, 2010

My reactions to this TIME magazine article by John Cloud may have been similar to your reactions when you read this title: “Why Exercise Wont Make You Thin.” John Cloud, who is not an exercise physiologist or has any exercise backgroud, wrote an article in TIME magazine outlining how exercise is basically a waste of time and people should be more concentrated on diet instead. The publication of this article created an uproar among exercise physiologist across the country. In my opinion, and I do not stand alone in this view, Cloud had no right to claim that exercise is a waste of time. It is true that to see the biggest reduction in weight loss an individual must combine exercise with a healthy and reduced calorie diet. Exercise alone will not produce significant weight loss. However, the benefits of exercise are worth a 5 mile run or 45 minutes on the stationary bike. Exercise will reduce your chances for chronic diseases (such as heart disease and stroke) increase your metabolism, reduce LDL cholesterol and increase HDL cholesterol, boast your energy, reduce depression, and so much more. The benefits are almost endless!

The fact that TIME magazine allowed the publication of such a badly and ignorant article blows me away. It is common knowledge that the public is easily swayed or influenced by the media, whether it be a magazine article or TV commercial. Of course this is an over-generalized view. But still; Cloud’s article is damaging to the American public. We are dealing with an obesity and type 2 diabetes epidemic which calls for increased physical activity and a proper diet. By writing an article that says exercise is no good is very damaging to the perceptions of exercise and the general public. Perhaps Cloud just wants to go by numbers in terms of his weight, in which case he clearly isn’t getting the results he wants through his exercise routine. However, I am sure that his arteries are thanking him (though maybe not now since he is deciding to give up on physical activity). As with any scientific journal or anything presented in a magazine are on TV, you must be wary of where the information is coming from, the size of the subjects (if it is a study) and how valid the information actually is. Also, being wary of things taking out of content is very important, such as quotes.

For instance, Cloud quotes a known exercise physiologist, Eric Ravussin from Louisiana State University, saying “‘In general, for weight loss, exercise is pretty useless,’ says Eric Ravussin, chair in diabetes and metabolism at Louisiana State University and a prominent exercise researcher.” Anyone who knows the effects of exercise on the body would realize how much this quote is probably taking out of context. Ravussin most likely was explaining that exercise alone cannot yield significant weight loss. A combination of a good diet and exercise will have the best results. However, it must be stressed how beneficial exercise is to your overall health. I am sure that Ravussin was at no point in his interview with Cloud saying exercise is a waste of time.

I think it is very important to mention this TIME magazine article in regards to endurance exercise because people must be aware of how flawed this article actually is. To deem exercise as worthless is very wrong because of all the health benefits that regular exercise can provide. People need to realize that promoting weight loss does not mean that you can do 30 minutes of cardio and then eat whatever you want. You need a good balance between a healthy diet and regular physical activity. I am willing to bet that Cloud’s diet is not that healthy and his failure to actually lose weight was more due to a bad diet than his exercise routine.

http://www.time.com/time/health/article/0,8599,1914857,00.html

Endurance Exercise and Altitude March 29, 2010

If you have ever gone on vacation where the altitude is above sea level (such as at 12,000 feet) then you may notice that you are completely winded when climbing the stairs or going for a light jog. Being in New England and living at sea level, relatively, our bodies are not accustomed to the thin air that is experienced at altitude. There are many challenges and changes the body must undergo before it becomes accustomed to the new environment. When you go to altitude there is a progressive decrease in atmospheric pressure with a reducing in the partial pressure of oxygen when you inhale. Right away your body will undergo compensatory changes to compensate for the reduced oxygen in the air by increasing ventilation and cardiac output.

For many people, they start to experiences the effects of an elevated altitude at  or above 5,000 feet. Beyond this level of 5,000 feet is where you will see a gradual decrease in physical performance. However, if you are at altitude for a prolonged period of time your body will get use to the conditions and adapt. This is called altitude acclimatization and will occur after about a week of exposure to altitude.

Some people who go to altitude will experience either as acute mountain sickness (AMS), high-altitude pulmonary edema (HAPE), or high-altitude cerebral edema (HACE). AMS is the most common and less server out of these three conditions. It is characterized by headaches, nausea, fatigue, decreased appetite, and poor sleep. When this condition is very server it can cause a reduced ability to balance and slight swelling of the hands or feet. AMS typically lasts about 2-7 days and manifests within the first day of arrival to altitude.

HAPE is much more serious that AMS for it can be potentially fatal. However, this condition is less common than AMS and is only shown to occur at altitudes greater than 12,000 feet. Increased risk of this condition comes with people who quickly ascent and descent above 12,000 feet repeatedly and who undergo high-intensity exercise early on in altitude acclimatization. This condition is characterized by crackles and rales in the lungs.

HACE is also a potentially fatal condition that is even less common than HAPE and occures at altitudes over 12,000 feet as well. This condition is typically due to unresolved severe AMS in people who still experience the symptoms but continue to ascend in altitude.

In terms of exercise, especially endurance exercise, people should limit the amount they do when first reaching altitude.  The intensity of the exercise should be reduced and rest periods increased. Also, increasing the amount of fluids and carbohydrates is important for being at altitude. Increased fluids are used to prevent dehydration while increased carbohydrates are important due to the reduced oxygen. When the body burns carbohydrates for fuel it does not require the use of oxygen; while burning fat does require oxygen. Therefore, increasing the amount of carbohydrates (within reason of course) will aid in using more anaerobic metabolic pathways in the working muscles.

Altitude acclimatization will result in many changes in the body. These changes allow you to reach a maximum physical performance at the altitude you are at and to decrease the chances of developing conditions such as AMS. These adaptation involve physiological changes within your body that better adapt you to the environment. These adaptation are usually attained at 7-12 days once you reach altitude. Your body will start to produce more erythropoietin, which is a hormone secreted by the kidneys to stimulate your bones to produce more red blood cells. This increase in red blood cells  will help you transport more oxygen around your body and will also result in an increase in hemoglobin. Furthermore, you will experience an increase in cardiac output. This means that your body will be able to pump out a greater quantity of blood throughout your body with each heart beat.

I think that learning about the effects of exercising at altitude are important for understanding how the body works, especially during endurance exercise. Many athletes have been known to train at altitude in attempts to naturally increase their erythropoietin concentrations to increase their oxygen delivery capabilities.

A good site to visit that goes over the effects of exercising at altitude is:

http://www.hypoxico.com/?gclid=CPDTn-7s3qACFSFy5Qod0TuFBw

“Exercise Prescription for Healthy Populations.” ACSM’s Guidelines for Exercise Testing and Prescription. Ed. Walter R. Thompson. 8. Lippincott Williams and Wilkins, n.d. 201-203.

Exercised-Induced Asthma

A big problem with athletes and the average physically active person can be the development of exercise-induced asthma (EIA). This conditition is characterized by a difficultly in breathing about 5-20 minutes after exercise. This difficulty in breathing is due to the airways becoming very sensitive to sudden changes in temperature and humidity. When you undergo moderate to intense exercise you will switch from primarily doing nose-breathing to primarily doing mouth-breathing. During exertion you cannot possibility get enough air down to your working muscles through your nasal cavity. Therefore, you start sucking air down through your mouth. The problem with this is that the mouth bypasses the filtrating and humidifying effects of the nose.

When someone has EIA this bypassing of the nose is a real problem. Symptoms of EIA include wheezing, chest tightness and/or pain, coughing, or shortness of breath. All very unpleasant!

Many people are affected by EIA, including those who are not asthmatic. About 13% of non-asthmatic people experience symptoms of EIA, while about 40% of people with alergicrhinitis experience EIA. About 18 million people are affected by asthma, with about 90% of them experiencing EIA symptoms. Lastly about 20% of this population are athletes. However, in terms of elite athletes, there has not been a lot of studies done on how effective certain treatments are in treating the condition and not blunting athletic performance.

There are many treatments to be considered with EIA. There is no gold-standard so far. Each treatment has its potential side-effects. Currently, the perferred treatments are as follows:

Controller treatments: Inhaled Corticosteroids, Leukotriene antagonists, and Disodium Cromoglycate and Nesocromile sodium.

Reliever Treatments: Beta2-agonists, and Ipratropium Bromide.

Inhaled corticosteroids aim to reduce the bronchial hyper-responsiveness and control any disease activity. However, this treatment have systemic and local side-effects which include adrenal suppression, growth retardation in children and adolescence, and reduction of bone density.

Leukotriene antagonists (LA) come in two main categories; leukotriene synthesis inhibitors and leukotriene receptor antagonists. A single dose of LA has been shown to produce protective effects against EIA. However, it has also been shown that this positive effect can be seen in most patients but not all.

Disodium cromoglycate and nedocromile sodium (DSCG) are anti-inflammatory drugs. Based off some studies, this mode of treatment has been shown to have a protective effect on EIA when taken immediately before exercise.

Beta2-agonists were shown in the 1970s that when orally administered they will have a poor protective effect against EIA. The best effects are seen when this drug is inhaled. Therefore, this is a very common way to treat EIA. However, it must be noted that long-acting Beta2-agonists may result in tolerance to the drug and as a result, a reduction in the effectivness of the drug. Tolerance occurs when there is down-regulation of the Beta2 receptor in the mast cells of the body.

In conclusion, EIA should be considered when engaging in endurance sports or activities because it can pose a great problem in terms of performance. However, if the condition is monitored and the proper precautions and measures are taken (such as getting a physician’s assessment and prescribed a proper treatment) an individual should feel free to participate in endurance exercise.

Here is a good site for tips on what to do when exercising with EIA.

http://www.stumbleupon.com/su/2QKrvv/www.scirus.com/

Porsbjerg C, Backer V, Joos G, Kerstjens HA, Rodriguez-Roisin R. “Current and future use of the mannitol bronchial challenge in everyday clinical practice.” The Clinical Respiration Journal 3.4 (2009): 189-97.

Can Chocolate Help Reduce Your Risk for Cardiovascular Disease? March 9, 2010

Here is an interesting thought; can eating coca reduce an individuals risk for cardiovascular disease by lowering the blood pressure response to exercise. In overweight and obese individuals, exertion through physical activity will lead to an unhealthy elevation in blood pressure. This is thought to be due to a compromised endothelial vasodilatation of the blood vessel walls. This means that with the increase in blood pressure due to the physical activity and increased heart rate, the walls of the blood vessels do not expand the way they should to compensate for the increased pressure. This creates strain on the heart because it must pump harder to overcome the pressure of the arterial walls when it pumps the blood out of the left ventricle to the systemic circuit.

There are many ways to reduce this strain such as maintaining a healthy weight and regular cardiovascular exercise. However, in terms of diet, coca has been shown to reduce the elevated blood pressure response to exercise among overweight and obese individuals.

Berry et. al looked at this effect of coca consumption and blood pressure with overweight subjects. The subjects were randomly divided into 2 groups, one which consumed a high-flavanol coca beverage  and the other which consumed a low-flavanol coca beverage. Blood pressure was continuosly measured throughout the study during rest and exercise. The results showed that pre-exercise blood pressure did not change with either group. However, there was a significant reduction in the blood pressure response to exercise with the high-flavanol group. This study indicated that with increased consumption of coca flavanols, improvments in the endothelium-dependent flow-mediated dilatation of the blood vessels can be seen.

Even though this study indicated that consuming more coca in the diet will help reduce an individual’s risk for CVD, it should be noted that too much of a good thing isn’t healthy. The coca should be added to the diet in a moderate amount; meaning that piling your diet with chocolate cake, brownies, and chocolate bars is not the best idea. Having a small serving of dark chocolate a day is a better and more healthy option.

Berry NM, Davison K, Coates AM, Buckley JD, Howe PR. “Impact of cocoa flavanol consumption on blood pressure responsiveness to exercise.” The British Journal of Nutrition (2010): 1-5.

Does Positive Thinking Help Fight Against Cardiovascular Disease?

Cardiovascular disease is the number one killer of Americans today. It comes in many forms from strokes to heart attacks to pulmonary embolisms. There are many factors that contribute to the development of such diseases like high cholesterol, increased body fat percentage, hypertension, and elevated blood triglycerides. However, there is another dimension that warrants research. The idea that mental health can play a role in susceptibility and prevention of cardiovascular disease has been the topic of resent research. Stress can play a big role in the release of elevated levels of cortisol  (a stress hormone) within the blood which can lead to epithelial dysfunction, and thus plaque development. Having a positive outlook and healthy mindset that’s limited in stress has been shown to benefit an individual’s overall health and wellness.

Richman et al. looked at levels of an individual’s vitality and risk of cardiovascular disease. Vitality was defined as a having good physical and emotional health. The thought was that having positive emotions would have a protective effect against health problems. Over the course of 2 years the study used the scores of a  Mental Vatality scale as a function to the subject’s cardiovascular health. The study found that the Mental Vatality scale was both valid and reliable at measuring an individual’s health risk. Therefore, having optimal physical and mental health plays an important factor is preventing cardiovascular disease. In such a fast-paced society that we live in, we must try to include  activities that relieve the stress in our life and help fuel positive thinking.

Richman LS, Kubzansky LD, Maselko J, Ackerson LK, Bauer M. “The relationship between mental vitality and cardiovascular health.” Psychological Health 24.8 (2009): 919-931.

How Much Exercise is Enough?

How much cardiovascular exercise do you need to do to see benefits? According to the Center of Disease Control (CDC), and Surgeon General, the recommended amount of cardiovascular exercise for health benefits is 30 minutes 5 or more days a week. According to the recommendations by the American College of Sports Medicine, to see fitness benefits you must do at least 30 minutes a day, 3 or more days a week. Even though these seem to be two separate recommendations, the recommended intensities are different. The CDC and Surgeon General require a light to moderate intensity level;. Their recommendations are more focused on improving the overall health of indivisuals, such as reducing cholesterol and blood pressure to promote a decreased risk of cardiovascular diseases. ACSM’s goals are to increase the fitness level of individuals, which requires a greater intensity level of cardiovascular exercise. ACSM aims at helping indivisuals reduce their body fat percentage and improving their maximal oxygen uptake (VO2max).

So how do you know which of these two recommendations you should follow? Essentially they both even out. At lower intensities your muscles are primarily utilizing fat substrate for fuel, while at higher intensities your muscles are mainly burning carbohydrates for fuel. Moreover, at higher intensities you are burning more overall calories per minute that you would be for lower intensities. Therefore, if you worked out for an hour at a low to moderate intensity one day, then for only a half hour at a high intensity the next day; overall you would burn the same amount of calories.

With this in mind you can determine what kind of exercise you have time for in your week. However, it is important to realize that exercise has been shown to demonstrate a dose-response. This means that the more you exercise the greater the health and fitness benefits you will see. At some point, however, this positive relationship curl will level off because you’ve either reached your genetic potential and have plateau, or have overdone it and is experiencing the effects of overtraining. The latter is characterized by constant fatigue, exhaustion, and a suppress immune system. In order to counter these effects an individual should take a week or so off from their exercise routine and allow their body to recover.

In terms of the dose-response relationship, one study conducted by Church et. al domonstrated this by comparing the effects of 50%, 100%, and 150%  the recommended exercise amount. The results showed that even the subjects who worked at 50% the recommended activity amount, saw benefits. Therefore, the take home message is that even a little bit will make a difference.

Timothy S. Church, Conrad P. Earnest, James S. Skinner. “Effects of Different Doses of Physical Activity on Cardiorespiratory Fitness Among Sedentary, Overweight or Obese Postmenopausal Women With Elevated Blood Pressure: A Randomized Controolled Trial.” The Journal of the American Medical Association 297.19 (2007): 2081-2091.

Exercise Post Hip-Surgery March 2, 2010

Hip fracture is a major problem in our society. According to Casado et. al in 2003 about 310,000 older adults suffered hip fractures, with about 72% of them being women. The big issue is that about 20% of those who suffer a hip fracture will die within that year due to improper post-surgery care or blood clots. Exercise has been shown to have a dramatic effect on improving the quality of life for this population. However, due to insufficient social support, little education about exercise, or fear of hurting oneself, many older adults do not engage in regular physical activity post-hip surgery. The Baltimore Hip Study 5 looked at how social support by exercise experts can improve the self-efficacy, outcome expectations, and the motivation to implement exercise as part of their regular routine among older women. Casado et. al used the data from this study to ascertain the effects of social support from an expert in the recovery process post-surgery for hip fractures. It was found that with an exercise expert present throughout the exercise program prescribed to the subjects; self-efficacy and outcome expectations were reported to be improved than with the subjects who did not receive support from an exercise expert. The data also showed that just having the experts there along side the subjects was enough. The subjects responded positively even to the experts that offered little to no motivational talk.

This study clearly shows that little social support, from family, friends, or experts can go a long way in motivating an individual post-hip surgery in improving his or her life through regular exercise. Exercise, weather it be resistance training and/or cardiovascular training, is so important for improving an individual’s quality of life. By strengthening the muscles for better balance through resistance training and strengthening the heart through cardiovascular training, the combination of the two will help an individual recovery from a hip-surgery and try and prevent a future incident.

BANGHWA LEE CASADO, BARBARA RESNICK, SHERYL ZIMMERMAN, EUN-SHIM NAHM, DENISE ORWIG, KELLEY MACMILLAN, JAY MAGAZINER. “Social Support for Exercise by Experts in Older Women Post–Hip.” Journal of Women & Aging 21.1 (2009): 48–62.

“America the Beautiful”

I saw the film “America the Beautiful” which was a documentary on body image in the United States by Darryl Roberts. Roberts really captured America’s distorted view on what is considered ideal and “beautiful” and what is not. Reality and the ideal woman do not match up. This movie showed how our society has taken the natural female body and distorted it to become unattainable, unrealistic, and unhealthy. The average American female is about 5’4” and weighs about 140lbs, while the average model is 5’11” and weighs about 110lbs. Each year about $13 billion is spent on dieting products. I found these values startling and disturbing. Perfection has become the standard among our population through the media and social pressures. It is disgusting that there are little girls out there who haven’t even gone through puberty yet and are already obsessing about how they look and if they are too fat.

I think that everyone should have a chance to watch this documentary. It really opens the audiences eyes to this epidemic to be perfect and thin. The fact that the media can take an average beautiful young woman and brainwash her into thinking that her thighs are too big and she needs a face lift and/or liposuction is phenomenal.

I hope that more and more people can see what Darryl Roberts captures in his film and start to be more aware of the world around them in terms of what actually is beautiful. Hopefully women and little girls all over the nation will start to resculpt how they view beauty and be able to embrace what is natural beauty and not obsess over unattainable perfection.

Here is a link to a commercial from Dove that really characterized how flawed our media is. This commercial was shown in this documentary and is VERY powerful.

http://www.youtube.com/watch?v=iYhCn0jf46U