Hunger games

One of the most powerful motivators we have is hunger. Seeking food when we are hungry is what allowed our ancestors to survive. For most of human history, finding the next meal could be arduous or even dangerous, so a strong physiological drive was necessary to make it happen. Now, though, the problem isn’t usually finding food, it’s having access to too much food. Unfortunately, the regulation of hunger in our brains hasn’t changed.

The physiology behind why and when we eat is the topic of my Health & Fitness column in the Aiken Standard this week.

hungry child


Hunger is an internal physiological drive to seek and eat food and is usually experienced as a negative sensation. When you are hungry you may be distracted when your stomach growls. Since most of us have a supply of food that is readily accessible, severe hunger is uncommon. But when people diet to lose weight, especially a restrictive diet, hunger can be a powerful signal to eat.

 

Often when we think we are hungry, it isn’t hunger at all—it’s our appetite. Appetite is a psychological, as opposed to physiological, sensation that drives us to eat. Hunger and appetite can work together, but not always. The sight or smell of food can trigger can increase our appetite even if we aren’t hungry. Appetite tends to be more specific, too. While hunger will drive you to eat pretty much any food, appetite usually pushes you to eat a certain food.

 

One of the reasons we overeat is because we confuse appetite with hunger. We may think we need to eat when we see a food advertisement on television or smell someone cooking, but we really don’t have a physiological need for nourishment. Think about eating dessert after dinner. You just ate a full meal, so you can’t possibly be hungry. But when you see the dessert tray you develop an appetite for something sweet, even though you don’t need it.

 

Satiation and satiety are two other factors that influence what you eat. Satiation is the feeling of satisfaction or fullness that signals the end of a meal. Satiety is the effect of one meal, including the amount and type of food you eat, on how much you eat later. You can use these biological factors to your advantage to help you eat less.

 

For example, if you eat quickly you will eat more food (and calories) before satiation occurs. If you eat more slowly, you may actually eat less before that same feeling of fullness occurs. Additionally, what you eat for breakfast will impact when you feel ready for lunch and how much you eat when you do. It turns out that protein has a greater effect on satiety that either carbohydrates or fat. If your breakfast is juice and a donut you are likely to feel hungry sooner compared to having something with protein, like yogurt or eggs.

 

Genetics also play an important role in what we eat. Research suggests that how much we eat and even our food preferences are controlled, at least to some extent, by genes. Of course, some of this has to do with learned behavior, too. Maybe you prefer certain foods because you have a strong positive association with them developed throughout childhood.

 

One important point to remember is that no matter how strong the effect of genetics on food preferences, eating is a behavior that you can control. Your genes give you a predisposition, not a predetermination, meaning that even though you can’t change your genes, you can make an extra effort to not let them define you.


drparrsays blog footer

 

 

A two-hour marathon is possibly possible now.

Earlier this month a runner attempted to complete a marathon (26 miles and 385 yards) in under two hours. For distance runners and sports scientists, a sub two-hour marathon is a bit like the four-minute mile once was—an arbitrary, but significant, goal. The current world record for the marathon is just under 2 hours and 3 minutes (2:02:57). To cut 3 minutes off that time would be a remarkable feat considering that it took almost 20 years to lower the record three minutes from 2:06 to 2:03. The continued quest for a sub-two hour marathon is the topic of my Health & Fitness Column in the Aiken Standard this week.

 

running feet


First, let’s put a two-hour marathon in perspective. To do it would require sustaining a running speed of over 13 miles per hour for two hours. Most runners I know would be hard pressed to complete the 385 yards at that pace…forget about the 26 miles that come before it! It is also more than twice as fast as the average marathon time of over 4 hours. If you are brave you can experience how fast this is yourself by getting on a treadmill and cranking the speed up to 13 miles per hour. Hang on, though, because you won’t last long!

 

The recent attempt to break the two-hour mark featured the accomplished Kenyan marathoner Eliud Kipchoge, whose personal record was just over 2:03. The effort was as much about running technology as it was about human performance. The shoes he wore were designed by Nike to be exceptionally light and provide extra recoil to propel the runner forward. The race was run on a Formula One track in Italy that was smooth and flat and was completed early in the morning when the weather was cool with low humidity.

 

During the race, a group of runners ran in front of Kipchoge to break the wind so he could draft much like race cars do. These runners also acted as pacers, keeping him at the right speed to break the record. There was even a pace car that projected a line on the road for the runners to follow. Water and sports drinks were provided by assistants on bikes so the Kipchoge didn’t need to slow down to replenish fluid and carbohydrates. In all, it was a perfect scenario to run a sub-two-hour marathon.

 

Despite all the preparation and efforts during the race, Kipchoge just missed the goal, finishing in 2:00:25—less than one second per mile off the mark! This suggests that breaking the two-hour barrier for a marathon is achievable, but is still a significant challenge. In fact, because of the pacing strategy used, this run is not considered a world record.

 

Other groups are also working to get a runner past the two-hour mark. One, led by sports scientist Yannis Pitsiladis, is taking the approach of enhancing training and to promote better performance. I have written about the physiological foundations of running performance related to the sub two-hour marathon previously.

 

While the two-hour marathon is still a goal for many, the sports science, technology, and training advances currently being explored exciting. Like the “shark skin” suits worn by swimmers and aerodynamic bikes used by cyclists, improvements in running technology are likely to be both beneficial and controversial. None of these advances can offset the physiological adaptations that result from years of dedicated training, so the best way to prepare for your next race is to put in time running, whether you are wearing the newest, fastest shoes or not!


drparrsays blog footer

 

Exercise musicology

There are many tools, or ergogenic aids, athletes use to improve exercise performance. These include nutrients like carbohydrates, drugs like caffeine, steroids, and techniques like blood doping. Some of these performance-enhancing substances are illegal or banned, so ergogenic aids often have a negative image. Furthermore, many only work for highly trained athletes. But there is one ergogenic aid that has been shown to enhance performance in everyone. In fact, there is a good chance you use it when you exercise. That ergogenic aid is music. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Exercise music

Music is a psychological ergogenic aid is known to affect mood, emotion, and cognition. More and more research also shows that music can also enhance exercise performance. In most gyms, there is music playing in the background and many people listening to music using headphones while they exercise. A practical reason, of course, is that listening to music makes the exercise more enjoyable by providing a mental distraction. It turns out that music has additional psychological and physiological effects that can improve exercise performance.

Not only can listening to music make exercise more enjoyable, it can also help you get a better workout. Research suggests that when exercise is coupled with motivational music, people tend to exercise at a higher intensity. They also tend to fatigue at a slower rate leading to longer exercise sessions. This is also associated with a lower rating of perceived exertion, meaning the exercise might feel easier!

Tempo is an important aspect of music that contributes to performance. People tend to prefer a tempo that matches the exercise intensity. Fast tempo music fits well with higher intensity exercise, like running, and music with a slower tempo is suited for lower intensity exercise, like yoga. But music tempo can also influence the intensity of exercise. Music with a faster tempo can promote more vigorous exercise, as measured by a higher heart rate, and a longer distance covered when running or cycling.

Listening to music before exercise can also affect performance. Studies have shown that listening to music prior to exercise can improve motivation, arousal, and focus. This is probably why you see athletes warming up before games and races wearing headphones. Research also suggests that listening to music during cool down can decrease recovery times, as measured by blood lactate levels.

While listening to music may increase exercise performance, the benefits vary based on the type of music. First of all, music that a person does not like is unlikely to elicit any positive impact on performance, so pick something you enjoy listening to. Another factor of music that can influence performance is whether it is synchronous or asynchronous. Synchronous is when a person matches their movements with the music they are listening to. This is particularly effective for running, cycling, and rhythmic exercises like aerobics. Asynchronous is when the music and the movements of a person do not match, which may still provide ergogenic benefits for certain types of exercise.

Listening to music during exercise can make your workouts more effective and enjoyable. Music you like can distract you from sensations of intensity and fatigue and lead to longer training sessions. Music played at a fast tempo can make you exercise harder and slower tempo music can help you relax. But you probably knew that already—sometimes sports science makes sense!

What if you prefer to exercise without music or other distractions? Like all ergogenic aids, the additional effect of music is small compared to the great benefits of the exercise itself, so keep doing what you are doing.


drparrsays blog footer

After the ouch: New ways to treat minor sports injuries.

If you play sports or exercise regularly you probably have experienced some sort of injury. Hopefully yours was just a minor muscle strain, joint sprain, or soreness that didn’t prevent you from continuing your exercise program. It is always best to address minor injuries before they progress to cause more lasting damage.

If you do sustain a muscle or joint injury you will probably ice the affected area to help it heal. But there are also several newer techniques that can help speed recovery. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Kinesio tape


The most common recommendation for treating a minor exercise injury is to use ice to reduce swelling and speed healing. For example, an ankle sprain might be treated by sitting with the injured leg elevated while applying ice; later the joint might be wrapped with athletic tape to provide support and further reduce inflammation. This combination is called RICE—rest, ice, compression, elevation—and makes intuitive sense.

Several other treatments for sports injuries have become more commonly used thanks in part to their use by professional and Olympic athletes. This is also due to the realization that inflammation is a key component in tissue repair and reducing it with ice therapy might actually interfere with healing. More and more sports medicine professionals are using modalities— voodoo flossing, cupping, and kinesio taping—other than (or in addition to) RICE to treat many injuries.

The benefits of compression for injury healing can be achieved by tightly wrapping an injured area with a rubber band, called “floss,” for a short time, usually less than a minute. This technique, commonly called voodoo flossing, is used to increase joint mobility and speed healing of minor injuries. Tightly wrapping a joint does has several potential effects by which it can improve movement and reduce pain. This includes allowing tissues to move more freely and increasing blood flow to the injured area.

Cupping gained much attention when swimmer Michael Phelps appeared at a race in the 2016 Olympics with large red welts on his back. He wasn’t hurt, as many feared. Rather, he was using cupping as a technique to treat injury and improve performance. Cupping literally involves the application of glass or plastic cups to the skin for several minutes, typically 5–15 minutes. Using either vacuum or heat, the cups pull the skin away from the underlying muscle tissue, increasing blood flow and improving movement. While cupping may be new to most of us, it has been used since ancient times and factors prominently in traditional Chinese medicine.

While voodoo flossing and cupping have a role in treating injuries and improving performance in the training room, there is a relatively new modality that can be used during exercise to enhance performance. Kinesio tape, also called K-tape, is applied over specific muscles to reduce pain and improve movement. The tape pulls the skin away from the underlying muscle, which increases blood flow and enhances movement, much like cupping. The difference is that kinesio tape can be used during exercise, as many people first saw on the shoulders of beach volleyball players in the 2008 Olympics.

While many sports medicine professionals still recommend RICE as a first line treatment for minor injuries, they are increasingly utilizing these alternative treatments. With a little training, people can use these techniques at home to treat some of their own minor injuries. Obviously, it is important to learn how to properly do these treatments and evaluate whether they are working. Improper treatment can delay healing and may make some injuries worse, so these treatments might be best done by trained professionals. And some injuries do require attention by sports medicine professionals. That said, if you are looking for an injury treatment beyond RICE, voodoo flossing, cupping, and kinesio tape might be worth trying.


drparrsays blog footer

Saving for when you need it most by making deposits in your fitness bank.

Saving money for emergencies is good advice and important for maintaining quality of life in the event of a lost job or other financial crisis. While this may seem like common sense, many people have been caught without enough savings when they needed it and found it difficult to meet basic needs.

This principle can also be applied to fitness. When you are healthy, you can maintain a high level of fitness. This makes your day-to-day activities easier and serves as a reserve or “bank” to draw on when you need it. Your good fitness now can get you through a health crisis just like saving money can help you through a financial crisis. This health crisis could come in the form of an injury or illness that keeps you from being active for several days or a hospitalization that keeps you in bed for a week, a month, or longer. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Patient walking in hospital


The problem with periods of inactivity, like bed rest or hospitalization, is that there are severe physiological effects that occur within days and get worse over time. You may have noticed this as weakness and fatigue after spending a few days in bed with a cold. Muscle strength declines with each day of bed rest, and can be 50% lower following as little as three weeks. That reduction in strength could limit a person who was already deconditioned to a point where he or she would have difficulty completing the most basic activities of daily living.

A person who was fit and strong when they went into the hospital would certainly be better off when released. And older adults fare worse than younger individuals. According to one study, the decline in strength seen in older men in just 10 days was equivalent to the change measured after 28 days in men 30 years younger.

It’s not just the muscles that are affected, the bones get weaker, too. In fact, 12 weeks of bed rest can reduce bone density by as much as 50%, exposing patients to a greater risk of fracture. This is due to the reduced stress on the bone from not standing and walking as well as the lack of muscle activity. Two of the most effective ways to build bone density are putting stress on bones through weight-bearing activity and the action of the muscles pulling on the bones from resistance training. Because bed rest eliminates both of these stresses, bone density declines rapidly.

One unique study from the 1960s had healthy young men complete three weeks of bed rest. They all experienced a rapid decline (over 20%) in their aerobic fitness, but recovered quickly after the experiment ended. These individuals also had their fitness tested again 30 years later. It turns out that the decline in fitness in those young men in three weeks of bed rest was greater than the decline in fitness that occurred over 30 years of aging!

The good news is that most patients are encouraged to move around as much as possible. Some receive in-patient physical therapy or rehab, even after major surgery, to help lessen the effects of prolonged bed rest. It is important to take advantage of these opportunities if you, or a loved one, are hospitalized.

There are many reasons to exercise and be fit, but the most important reason may be to develop a fitness “bank” you can draw on if you become injured or hospitalized. Since the effects of bed rest are seen in people of all ages, everyone can benefit from a good fitness foundation. Just like putting money in the bank, doing a little now can have great benefits later when you need it most.

Finally, some smart advice: First, achieve and maintain a high level of fitness now, just as you would save money for a rainy day. You never know when you will need it. Second, if you are hospitalized, take advantage of opportunities to move, whether that is limited to moving from bed to a chair or if it includes short walks or even inpatient exercise–if the medical staff approves, of course. While many well-meaning friends and family members will tell you to rest and not move, true bed rest is almost the worse thing you can do.

For example, inpatient cardiac rehabilitation targets patients who are recovering from heart attacks and even open heart surgery. The goal is to get these patients up and moving as quickly as possible to prevent long-term consequences of bed rest.


drparrsays blog footer

 

When it comes to drinks, apparently you can’t win if you try.

This is all from the New York Times this week:

I’m thirsty. I want a soda… Sugary drinks tied to accelerated brain aging

Okay, so I will drink a diet soda instead… Diet sodas tied to dementia and stroke

Fine, I’ll have a beer… Beer drinkers may develop irregular heart rhythms

I give up. I guess I’ll just have water.


drparrsays blog footer

 

 

Go green (literally) for Earth Day

As Earth Day just passed, this is a good time to think about the impact we have on our environment. We should also think about what we can do to reduce that impact. The good news is there are ways we can “go green” that are good for our health and the health of our planet, as I explain in my Health & Fitness column in the Aiken Standard this week.


Bicycle commuting

First, you can go green by replacing car trips with walking or cycling. Every mile you drive releases carbon dioxide and other pollutants into the environment. Additionally, spending more time sitting in your car can also have negative effects on your health and happiness. Walking or biking has no such effects on the environment and has important health benefits including improved fitness, weight control, and greater feelings of wellbeing. Despite the potential environmental and health benefits of replacing car trips with active transportation, 37% of Americans report not walking for transportation at all in a given week.

Obviously, walking or biking everywhere isn’t practical. But you could probably replace some car trips with active transportation. Most people commute less than five miles to work and nearly half of all car trips are less than two miles. Both are reasonable distances to bike or walk. If you have several places to go, you can always park in a central location and walk to each destination.

The second way you can go green is by eating more vegetables and fruits. Fruits and vegetables contain vitamins, minerals, and fiber and most are low in calories. At a minimum, you should eat five servings per day with an emphasis on fresh fruits and vegetables. You should also try to buy from area farmers. Eating locally grown food is good for you and the environment. Food production and delivery is second only to cars for fossil fuel use  and is the biggest contributor to greenhouse gas emissions. According to one estimate,  the food items that make up a typical meal travel about 1,500 miles each (as much as 100,000 miles for a whole meal in some places) to get to your table? Food from local farms is associated with fewer “food miles” and a lower environmental footprint.

Additionally, produce grown locally is picked at the peak of freshness, meaning it is richer in nutrients, not to mention flavor. By contrast, produce that is grown far away is picked before it is ripe, resulting in lower nutritional value. As an added benefit, the money you spend on food from local farms stays in our area, supporting farmers who live in our community.

Since you are eating more veggies, you can eat less meat. Raising animals for meat, milk, and eggs has a major impact on the environment. Over a quarter of land is dedicated to raising livestock, and almost 15% of total greenhouse gas emissions come from livestock. These animals also produce tons of manure every minute, at least some of which ends up polluting water supplies.

Finally, you can literally “go green” when you exercise. Being active outdoors leads to enhanced feelings of energy and diminished fatigue, anxiety, anger, and sadness compared to similar activity conducted indoors. Additionally, some research suggests that outdoor activity may improve attention in adults and children. Another advantage of exercising outdoors is that you might get a better workout because you will likely walk or run faster outdoors. Research shows that even though people tend to exercise at a higher intensity outside, it may feel easier. Much of the psychological benefit of outdoor exercise occurs in the first five minutes, so even short bouts of activity, like walking instead of driving a short distance, are meaningful.

So, as you celebrate Earth Day this week, think about all the ways you can go green—it’s good for you and the environment.