Category Archives: Uncategorized

School is back in session in our area, marking the unofficial end of summer, but the summer weather is still with us. High temperatures and humidity make it feel like summer hasn’t ended. Aside from being unpleasant, these conditions can be dangerous for people who are active outdoors for work or exercise, something that is especially important for youth sports and other outdoor activities. This is the topic of my Health & Fitness column in the Aiken Standard this week.

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When I write about health I routinely use terms like exercise, activity, and fitness. I often get asked why I use these different words since they all have a similar meaning. That is an excellent question, since these terms are related they have different applications for health and wellness. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Physical activity (PA) is defined as any movement produced by muscles that expends energy. Physical activity can be classified as occupational, what you do at work, and leisure-time, what you do in your free time. Occupational PA can vary greatly depending on the job, but it is low for most of us who spend much of our work day sitting. Leisure-time PA is all activity outside of work. This is of great interest to researchers since it reflects how we chose to spend our discretionary time. Physical activity can be measured by questionnaires or using devices such as pedometers, which count the steps you take, or motion sensors, which measure how much you move.

Exercise is a type of physical activity that involves planned, structured, and repetitive movement to improve or maintain physical fitness. Physical fitness, then, is a set of attributes that relate to the ability to perform physical activity and exercise. The components of physical fitness include endurance, strength, and flexibility. Basically, participation in physical activity and exercise improves your fitness and the greater your fitness, the better able you are to participate in physical activity. This is true for completing occupational tasks as well as traditional exercise, such as jogging or lifting weights.

The good news is that both physical activity and exercise have health and fitness benefits. Physical activity can vary in intensity, from light (slow walking), moderate (brisk walking), or vigorous (exercise like running). The 2018 U.S. Physical Activity Guidelines recommend that, at a minimum, all adults participate in moderate-intensity physical activity for 2 hours and 30 minutes per week or vigorous activity for 1 hour and 15 minutes per week along with strengthening exercises at least 2 days per week. You can meet this recommendation by going for a brisk walk for 30 minutes on 5 days per week or running for 25 minutes on 2 days per week or some combination of the two. Additional benefits come from doing more, either higher intensity or longer duration activity.

Vigorous exercise is the best way to improve fitness while moderate-intensity activity is strongly linked to health benefits. Fitness benefits result from adaptations in the heart and muscles, which get stronger and become better able to resist fatigue. These changes also lead to health benefits including lower blood pressure, cholesterol, and glucose as well as helping with weight loss and weight control.

Research suggests that health and fitness benefits also result from light-intensity or intermittent activity, especially if it replaces sitting. At home or at work, the more time you spend sitting, the poorer your health, even if you exercise every day. One study shows that getting off the couch and stepping in place during TV commercials results in nearly 25 minutes of activity per hour and burns about 150 calories, compared to 80 calories just sitting the entire time. You won’t get in great shape doing this, but it will increase your overall activity.

With this is mind, a good recommendation is to reduce sitting time in favor of light activity—stand while you read the paper or walk around while you talk on the phone—and participate in moderate or vigorous activity each day by going for a brisk walk or doing other exercises, including strength training.

Muscle cramps are a common condition experienced during endurance exercise and many sports. Known as exercise-associated muscle cramps (EAMC), these sustained and painful muscle contractions tend to occur during prolonged exertion including exercise and physical labor that results in fatigue. Despite their frequency, the cause and treatment for muscle cramps is not well understood by many recreational and competitive athletes.

Muscle cramps that occur during exercise are widely thought to be caused by dehydration and electrolyte imbalances in the muscle. This makes sense, as muscle cramps seem to be more likely during prolonged exercise in a hot, humid environment in which sweat loss could cause a loss of both water and salt from sweat. Sometimes, EAMC are erroneously referred to as “heat cramps,” even though they can occur in cooler conditions. Furthermore, dehydration and electrolyte imbalances would affect the entire body, whereas muscle cramps occur only in the working muscles, typically the gastrocnemius in the lower leg. It is also worth noting that the most effective treatment for muscle cramps—stretching the affected muscle—does not replace fluid or electrolytes. These observations suggest that EAMC have a cause other than fluid and electrolyte loss during exercise.

 Research also does not support the notion that dehydration or electrolyte abnormalities are the cause of muscle cramps that occur during exercise. For example, in one study of competitors in an Ironman triathlon, there were no significant differences between those who experienced muscle cramps and those who did not in blood electrolyte concentrations or body weight changes (an indicator of dehydration). The development of EAMC was related to faster race times and a history of cramping. Other studies in a laboratory setting show that muscle cramps still occur even when electrolyte balance and fluid replacement is maintained. These findings and other research led to the development of an alternate theory of the cause of muscle cramps during exercise.

Understanding the cause of EAMC requires a brief primer in muscle physiology. Muscle contraction occurs when nerves, from the spinal cord, called motor neurons, stimulate the muscles to shorten and produce force. The force production by the muscle is controlled by a host of receptors that either stimulate or inhibit the muscle. One of these, the muscle spindle, responds to stretch and causes muscle excitation. Another, the Golgi tendon organ (GTO), inhibits muscle activation and causes relaxation. Working together, the muscle spindle and GTO regulate force production during exercise.

Just as repeated muscle contraction over time can lead to muscle fatigue, the pattern of the motor neurons stimulating the muscle can also be altered during prolonged, intense exercise. This causes an excessive stimulation of the muscle spindle and decreased activation of the GTO, resulting in uncontrolled muscle contraction—a cramp. This also explains why stretching is an effective treatment for muscle cramps. By engaging the GTO, the muscle relaxes and the cramp is eventually relieved.

The prevention of muscle cramps is obviously of great interest, especially for athletes who are prone to develop them. Given that muscle fatigue is a condition underlying most cramps, adequate training and conditioning to increase endurance is important. There are a number of popular preventive strategies, including increasing fluid and electrolyte intake, consuming specific foods and beverages like pickle juice and bananas prior to exercise, and taking substances like quinine. However, experimental evidence for these strategies to reduce EAMC is lacking and their effectiveness is based mostly on anecdotal reports.

For now, the best way to prevent muscle cramps is to prepare yourself through training and nutrition for both the environmental conditions and exercise itself. And if you get a muscle cramp during exercise, immediate stretching is the best way to relieve it.

The last day of summer was over a week ago, but the summer weather is still sticking around. At least in our area, temperatures in the 90s and high humidity make it feel like summer hasn’t ended and many of us are ready for some cooler weather.

Aside from being unpleasant, these high temperatures can actually be dangerous, especially at a time of year when we expect it to be cooler. This is the topic of my Health & Fitness column in the Aiken Standard this week.

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Living a healthy lifestyle requires making smart choices about what to eat, what to do for activity, not smoking, and getting enough sleep. The simple answer for why some people can do this so well is willpower—they have the power to say no to unhealthy options no matter how tempting they may be.

This isn’t to say that poor willpower is to blame for poor health. Making healthy decisions is difficult under the best circumstances, but in an environment that encourages poor choices, it is even more difficult. But having the mindset to take control and say no when necessary is essential for adopting healthy habits.

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This is Thanksgiving week, and people throughout the country are planning a feast that includes traditional dishes and family favorites. Even though many of these are not the healthiest choices, they make an appearance on the table each year. For many, Thanksgiving dinner is a day marked by overindulgence and poor nutrition choices.

In an effort to make Thanksgiving dinner healthier, recommendations for modifying or replacing traditional dishes are a common theme in magazines, on the morning TV shows, and on the web. While these suggestions are meant to be helpful, I’m not sure they actually serve to make a significant impact on health. In fact, the foods we eat and the way we eat them may be the healthiest part of a traditional Thanksgiving dinner. This is the topic of my Health & Fitness column in the Aiken Standard this week.

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The term “toxic environment” was popularized years ago to refer to conditions that promote the consumption of high-calorie, unhealthy food and encourage being physically inactive. This combination is thought to be a major factor that contributes to obesity and other chronic diseases, so understanding both aspects is important. For now, lets focus on our toxic food environment, which I do in my Health & Fitness column in the Aiken Standard this week.

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When I write about health I routinely use terms like exercise, activity, and fitness. I often get asked why I use these different words since they all have a similar meaning. That is an excellent question, since these terms are related they have different applications for health and wellness. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Physical activity (PA) is defined as any movement produced by muscles that expends energy. Physical activity can be classified as occupational, what you do at work, and leisure-time, what you do in your free time. Occupational PA can vary greatly depending on the job, but it is low for most of us who spend much of our work day sitting. Leisure-time PA is all activity outside of work. This is of great interest to researchers since it reflects how we chose to spend our discretionary time. Physical activity can be measured by questionnaires or using devices such as pedometers, which count the steps you take, or accelerometers, which measure how much you move.

Exercise is a type of physical activity that involves planned, structured, and repetitive movement to improve or maintain physical fitness. Physical fitness, then, is a set of attributes that relate to the ability to perform physical activity and exercise. The components of physical fitness include endurance, strength, and flexibility. Basically, participation in physical activity and exercise improves your fitness and the greater your fitness, the better able you are to participate in physical activity. This is true for completing occupational tasks as well as traditional exercise, such as jogging or lifting weights.

The good news is that both physical activity and exercise have health and fitness benefits. Physical activity can vary in intensity, from light (slow walking), moderate (brisk walking), or vigorous (exercise like running). The 2008 U.S. Physical Activity Guidelines recommend that, at a minimum, all adults participate in moderate-intensity physical activity for 2 hours and 30 minutes per week or vigorous activity for 1 hour and 15 minutes per week along with strengthening exercises at least 2 days per week. You can meet this recommendation by going for a brisk walk for 30 minutes on 5 days per week or running for 25 minutes on 2 days per week or some combination of the two. Additional benefits come from doing more, either higher intensity or longer duration activity.

Vigorous exercise is the best way to improve fitness while moderate-intensity activity is strongly linked to health benefits. Fitness benefits result from adaptations in the heart and muscles, which get stronger and become better able to resist fatigue. These changes also lead to health benefits including lower blood pressure, cholesterol, and glucose as well as helping with weight loss and weight control.

Research suggests that health and fitness benefits also result from light-intensity or intermittent activity, especially if it replaces sitting. At home or at work, the more time you spend sitting, the poorer your health, even if you exercise every day. One study shows that getting off the couch and stepping in place during TV commercials results in nearly 25 minutes of activity per hour and burns about 150 calories, compared to 80 calories just sitting the entire time. You won’t get in great shape doing this, but it will increase your overall activity.

With this is mind, a good recommendation is to reduce sitting time in favor of light activity—stand while you read the paper or walk around while you talk on the phone—and participate in moderate or vigorous activity each day by going for a brisk walk or doing other exercises, including strength training.

If you are confused or frustrated by the conflicting claims about whether a low-fat or low-carbohydrate diet is the best for promoting weight loss, you are forgiven. First, we were told that eating a low-fat diet was the best way to lose weight and improve heart health. Then, research suggested that low-carbohydrate diets were better.

Although there are hundreds of diets and weight loss plans you can follow, most fit into one of these two broad categories, reducing calories by cutting back on fats or by restricting carbohydrates.

A recently published study in the Journal of the American Medical Association compared low-fat and low-carbohydrate diets for promoting weight loss. The results say a lot about diets and weight loss in general and I interpret them to suggest that you should focus on food, not nutrients, to achieve your weight loss goal.

This is the topic of my Health & Fitness column in the Aiken Standard this week.

This study was a bit complicated, but it basically compared a low-carbohydrate diet with a low-fat diet for weight loss. After one year, both groups lost about the same amount of weight, showing that both diets were equally effective. This shows that restricting fat or carbohydrates didn’t seem to make a difference for promoting weight loss.

But it might be better to consider that what the two diets had in common is what made them both effective. In addition to the emphasis on fats or carbohydrates, both groups were encouraged to eat less added sugar, more vegetables, and fewer processed foods. It is likely that these factors played such major role in promoting weight loss that they outweighed the effect of which nutrients were restricted.

This isn’t much of a surprise, since eating less added sugar, more vegetables, and fewer processed foods are the three recommendations almost all diets and eating plans have in common. They are also among the very few things everyone seems to agree on when it comes to nutrition recommendations.

When it comes to picking the perfect diet, we should stop thinking on how they differ from one another and focus on what they all have in common. By faithfully following those key recommendations, it almost doesn’t matter what the rest of the diet includes. Avoiding processed foods and added sugar and making vegetables a major part of each meal will lead to healthier choices than simply cutting back on either fats or carbohydrates. In this way, food matters more than nutrients.

This study also demonstrates an important truth about weight loss. The average weight loss wasn’t impressive, only 6 kg in one year, or just a bit over 1 pound per month. I think that most people would be disappointed with this weight change after a year of effort. There was also a big range in weight loss, with some subjects losing over 60 pounds and some gaining about 20 pounds.

Modest average weight loss with some people losing significant weight and others losing very little or even gaining weight is typical for most weight loss programs. What you tend to hear about weight loss programs is the highest expected weight loss—”you can lose up to 40 pounds!” for example, but they don’t tell you what you should really expect. Be skeptical of promises of rapid, significant weight loss. Also be wary of diets that require you to avoid or emphasize certain nutrients like fats or carbohydrates, and remember that the real key to weight loss seems to be food, not nutrients.