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No pain, no gain? The truth about muscle soreness and what to do about it.

If you exercise, especially if you lift weights, you have probably heard the adage, “No pain, no gain.” This may serve as motivation for some people, but the belief that exercise results in pain might be a good reason not to work out for others. If you are one of those people, you should know that idea that exercise should hurt is simply wrong—muscle pain during or following exercise usually suggests an injury. However, some muscle soreness is unavoidable, especially if you are new to exercise.

The cause of this type of muscle soreness—and what you can do to prevent and treat it—is the topic of my Health & Fitness column in the Aiken Standard this week.

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This soreness is called DOMS—delayed onset muscle soreness—and it typically occurs 24 to 48 hours after exercise. It can range from a mild reminder that you worked out to more severe soreness, weakness, and tenderness. DOMS can occur after any type of exercise, but is more common following weight training, especially if it is your first session or a particularly intense workout.

A common belief is that lactic acid build-up in the muscle causes muscle soreness. This is based on the fact that during intense exercise like weight training the muscles make energy for contraction anaerobically (without oxygen), which leads to lactic acid production. This is in contrast to aerobic exercises like walking or jogging that produce energy using oxygen, with little lactic acid build-up. This belief that lactic acid causes DOMS has been shown to be false since any lactic acid that is produced during exercise is cleared shortly after you finish, long before muscle soreness begins. This is one of several commonly held myths about exercise that just won’t go away.

So what causes DOMS? It turns out that strenuous exercise leads to microscopic tears in the muscle, which leads to inflammation and soreness. This sounds bad, but the muscle damage is an important step in the muscle getting bigger and stronger. Your muscles are made up of protein filaments that shorten, leading to a contraction. When you lift weights your muscles respond by creating more protein filaments, allowing you to generate more force and causing the muscle to grow in size, called hypertrophy. The mechanism that leads to creating more muscle protein is stimulated by the damage that occurs during exercise. Without that stimulus, muscle growth wouldn’t occur. This is why weight training programs call for increasing the resistance over time to overload the muscle. Without increasing the weight, you wouldn’t get much stronger.

While the muscle adaptations that are associated with DOMS are beneficial, you may wish to avoid or limit the soreness aspect. You can do this by beginning your exercise program slowly. Resist the temptation to do too much too soon! Build up your time and intensity slowly over several weeks and start weight training with lighter weights. Remember, your goal is to begin an exercise program that you will sustain. Many people have quit working out because they started off with exercise that was too intense. While your goal should be to exercise every day, there is nothing wrong with taking a day off between workouts early on.

If you do experience DOMS you should rest those muscles until the soreness subsides. You can also try an over-the-counter pain reliever or applying ice to the sore muscles. If the soreness isn’t too severe, you can still exercise, but keep the intensity low. Weight training sessions should be scheduled a few days apart to allow for muscle recovery, but aerobic exercise can usually be done every day. If your arms are sore from lifting weights, you can always go for a walk!

Go green for Earth Day

As Earth Day approaches we should 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. Did you know that the food items that make up a typical meal travel 22,000 miles 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.

Skip the smoothie, have a burger? Fast food for exercise recovery.

Many athletes use specialized supplements before, during, and after exercise to improve performance and enhance strength and endurance gains from training. Many non-athletes also use similar supplements, even though they may not need them. And a recent study suggests that fast food, literally meals from McDonald’s, can work as well as more expensive sports supplements for promoting muscle recovery following intense exercise. I try to make sense of all of this in my Health & Fitness column in the Aiken Standard this week.



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After exercise, many athletes consume specialized beverages and foods that supply nutrients to help their muscles recover. These recovery drinks generally contain some combination of carbohydrates (sugar) and protein and come in liquid, shake, or smoothie form. There are also energy bars specifically formulated for use after exercise. Research shows that these carbohydrate-protein recovery drinks and foods enhance muscle recovery and adaptations to training in some athletes. Even if you aren’t an athlete, you may consume these products after you work out. Let’s explore when and for whom these recovery products might be useful.

Intense endurance exercise—think of a distance runner, cyclist, or triathlete—uses muscle glycogen as a fuel. Muscle glycogen is a storage form of glucose, sugar that the muscle converts into energy. During prolonged exercise sessions that last at least 60–90 minutes, muscle glycogen levels can be severely depleted. Resynthesizing that muscle glycogen is a priority following exercise.

Athletes who are engaging in intense resistance training to build muscle and strength may also benefit from a recovery drink. Weight training stimulates protein synthesis in the muscle, so it makes sense that consuming additional protein would be beneficial. As new muscle protein is formed, both strength and muscle size are increased.

It has also been shown that combining the carbohydrates with protein results in more rapid muscle glycogen replenishment and increases muscle protein synthesis. This is why many specialized recovery drinks and foods include a combination of carbohydrates and protein. The best time to consume carbohydrates to restore muscle glycogen levels is immediately following exercise. Similarly, the muscle is most responsive to extra protein immediately after a resistance training session.

Perhaps these recovery drinks, bars, and shakes aren’t even necessary. Sports nutritionists have long recommended conventional foods and beverages for athletes after exercise. Research shows that chocolate milk is just as effective as more expensive supplements for replenishing muscle glycogen and promoting muscle protein synthesis. Remarkably, according to a study published last week, fast food may work just as well!

In this study cyclists were fed either commercial recovery aids or food from McDonald’s including pancakes, sausage, juice, a burger, fries, and soda after they completed an intense exercise session. Importantly, the meals contained equal amount of calories and nutrients. It turns out that there was no significant difference in how quickly muscle glycogen was replenished or in performance in a subsequent exercise bout between the two conditions. While the authors don’t recommend eating more fast food, this study suggests that foods not typically thought of as sports nutrition products can be effective for muscle recovery following vigorous exercise.

But what about people who engage in regular exercise to improve fitness or lose weight? The benefits of recovery drinks in athletes exist because the intense training causes changes in the muscle that allow the extra carbohydrates and protein to have a positive effect. Training at a lower intensity is unlikely to create this stimulus in the muscle, so these nutrients would not have a significant benefit. Simply put, most people don’t train hard enough to need a recovery drink.

The bottom line is that these recovery aids are not always necessary and you can get the same benefits from regular food. Something else to keep in mind is that these supplements, especially in shake or smoothie form, can be high in calories. It is entirely possible to consume more calories in a recovery beverage than you burn during exercise. This could diminish the effect of exercise on weight loss and may actually lead to weight gain. For most of us, a sensible diet with regular exercise is the key to meeting fitness and weight loss goals.

When it comes to making good food choices, knowledge is power.

My Health & Fitness column in the Aiken Standard this week is about making smart food choices and how the nutrition information we are provided with can complicate that process.


Making smart decisions about what you eat is an important step in losing weight, feeling better, and preventing and treating a host of health conditions. But doing so requires that you have the knowledge to make those healthy decisions. Unfortunately, most people don’t have a good education in nutrition, forcing them to rely on information provided to them.

Some of this information comes from reputable sources and is based on research and experience. More often, though, nutrition information is provided by food manufacturers whose interests may not be consistent with providing smart recommendations. The end result is that consumers (that’s us) may not understand the information they get or know how to use it to make healthy choices.

A good example is the health claims about whole grains found on many food packages, including breakfast cereals. “A good source of whole grains,” is a common claim. Most people would reasonably interpret as a sign that the food inside is healthy, or at least is healthier than similar foods that don’t contain whole grains.

These types of claims are allowed by the FDA, but they refer only to what is in the food, not whether it is healthy or not. Many of the foods bearing this claim probably are healthy choices, but this isn’t always the case.

For example, Lucky Charms cereal contains whole grains. In fact, whole grains are the first ingredient, as the claim on the box indicates. Sounds good, right? But, when you read the Nutrition Facts panel on the side of the box you will find that the second ingredient is marshmallows! Does that sound like a healthy breakfast? (Hint: It’s not!)

Lucky_Charms package

 

This is the problem. If you are like most people, you won’t take the time to read the ingredients or the nutrition information on the back of the package. And even if you do, you may find that information to be confusing. Even if you wanted to make healthy choices, you might not have the knowledge to interpret and apply the available nutrition information.

This general lack of knowledge we have about nutrition has led to situations in which some foods are restricted or banned. Recently, the city of Berkeley, California voted to impose a tax on soda and other sugary drinks in an effort to keep people from consuming too much sugar and too many calories.

This effort, and others like it, have contributed to a vigorous debate about personal choice and freedom for people to make their own decisions about what to eat and drink. One argument against these types of restrictions is that if people have the nutrition information about soda (or any other food) they can make informed choices.

This is a nice idea, but it simply isn’t fair to expect people to make good decisions if the information isn’t available or is not easy to understand. Worse, misleading information can lead to making bad decisions.

Help may be on the way. The FDA is working on a redesigned Nutrition Facts panel that should help us make better food choices. In particular, the amount of sugar added to foods will be listed. This change alone will help identify foods that may appear to be healthy, like Lucky Charms which contain whole grains, but are actually high in added sugar. Additional changes include more realistic serving sizes and better information about fat content.

It is unclear when the updated nutrition facts panel will be implemented. In the meantime, do your best to read labels and use common sense as your guide: The addition of marshmallows does not make any food any healthier, no matter how much whole grain it contains!

Much ado about nothing: Supplement-free dietary supplements

Dietary supplements, including vitamins, minerals, and herbs, are used by millions of people every day. In fact, over 50% of Americans regularly take dietary supplements. Maybe you are one of them. If so, you should be aware of some recent news that once again raises concerns about supplement use.

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


 

Miracle cure pill bottle

The most common reason people report taking dietary supplements is to improve or maintain their health in general, but many take them for specific reasons such as bone health or weight loss. Anecdotal evidence suggests that people who take supplements are healthier than people who don’t. However, supplement users are more likely to eat better, exercise, and not smoke, all of which contribute to good health. [more details here.]

Given the claims made by supplement manufacturers, you may be surprised to learn that there is very little evidence to suggest that taking dietary supplements can improve your health. In fact, no scientific organization recommends the routine use of dietary supplements. Among the few exceptions is folic acid supplementation for women who are or who may become pregnant to prevent neural tube defects in the developing fetus. There aren’t many others.

While there is support for using vitamin or mineral supplements to address individual deficiencies, there is no reason to believe that taking supplements will do much to make a healthy person healthier. The fact that all supplements contain the statement, “This product is not intended to diagnose, treat, cure, or prevent any disease,” should tell you something. At best, taking dietary supplements will cause few, if any, benefits; at worst, they may do harm.

There have long been concerns about the safety and efficacy of dietary supplements. Ironically, this is by design. According to the 1994 Dietary Supplement Health and Education Act (DSHEA) manufacturers do not need to prove that their products are effective, only that they are safe. That said, there are instances in which the safety of dietary supplements has been questioned. [you can find tips for using dietary supplements safely here] Some can interfere with the way that other prescription and over-the-counter drugs work. Others may make certain health problems, like high blood pressure or diabetes, worse. And there is a concern that people might use dietary supplements to treat a condition rather than seeking medical help.

You may have seen in the news recently that the New York Attorney General is taking action against four major chain retailers for selling fraudulent and contaminated dietary supplements. DNA analysis showed that many of the supplements examined were completely lacking the active ingredient and contained other ingredients not listed on the label. In one case, a sample of St. John’s Wort contained no actual St. John’s Wort extract, but did contain the extract of a common house plant!

Some supplements undergo quality testing by independent labs, including U.S. Pharmacopeia and NSF International, and have labels which suggest that you are purchasing the actual substance. Keep in mind that this does not guarantee that the supplement will be safe or effective, just that it has been tested for purity.

Despite these questions about supplement purity, safety, and health benefits, there is nothing necessarily wrong with taking dietary supplements. If you choose to take supplements be aware of potential health risks, know that you may not be getting what you pay for, and don’t expect any miracles. And always make sure you tell your doctor which supplements you take to avoid any adverse reactions with other medications.

Finally, remember that no amount of dietary supplements can match the health benefits of good nutrition and regular physical activity.

Is chocolate healthy? The depends on what you mean by chocolate. And what you mean by healthy.

With Valentine’s Day quickly approaching, you may be planning to get something sweet for someone special. Traditionally, this typically includes a box of chocolates. While candy isn’t really a healthy option, eating certain types of chocolate has been linked to some health benefits.

The idea that chocolate may be healthy is no doubt welcome news for chocoholics. But it may leave you wondering if eating chocolate really is healthy. The answer depends on what you mean by chocolate and what you mean by healthy.

ChocolateA

First, it is worth understanding what it is about chocolate that may promote health. The health benefits of chocolate have to do with the fact that it comes from a plant, the cacao tree. Like many plant-based foods including fruits and vegetables, chocolate contains phytochemicals, plant-derived compounds that have health benefits. Indeed, chocolate does contain antioxidant flavonoids that have been shown to affect a variety of physiological systems. These flavonoids are also found in a wide variety of fruits and vegetables as well as coffee, tea, and wine. The beneficial effects include dilation of blood vessels, improved blood clotting, and reduced inflammation, all of which can reduce the risk of cardiovascular diseases including heart attack and stroke. Additionally, these flavonoids may lower blood pressure, regulate insulin levels, and reduce stress.

The chocolate that we eat contains two main components from the cacao plant, cocoa and cocoa butter, in addition to added sugar and other ingredients. Cocoa is the non-fat component of the cocoa bean and cocoa butter is mostly fat. The flavonoids are found in the cocoa, so chocolate that is richer in cocoa, like dark chocolate, contains more of these beneficial compounds. For example, dark chocolate may contain 70% cocoa, compared to 25% cocoa in milk chocolate. These flavonoids also give dark (sometimes called semi-sweet) chocolate more of a bitter flavor than milk or white chocolate. This is also because dark chocolate may contain less sugar than milk chocolate, but this isn’t always true.

Milk chocolate contains more of the cacao butter along with other additives, usually milk. White chocolate is made exclusively from the cocoa butter and contains no cocoa, so none of the beneficial phytochemicals. Even though the fat in cocoa butter is mostly healthier monounsaturated and saturated fats, it still contains calories. Sugar, milk, and other ingredients also add calories, so chocolate is certainly something to enjoy in moderation.

One thing to keep in mind is that some of the research into the health benefits of chocolate was conducted in animals, not humans. And some of the research in humans used isolated extracts from the cacao plant, not chocolate. And when subjects were given chocolate it was dark chocolate that is high in cacao. The point is that the evidence for chocolate being healthy was not based on eating more Hershey’s bars!

But given the potential benefits, eating dark chocolate instead of other sweets such as cakes, cookies, and other candy is probably a good idea. Simply eating more chocolate in addition to other sweets will not make you any healthier, and the extra calories could lead to weight gain. Look for chocolate that contains at least 70% cocoa (sometimes listed on the label as cacao or cocoa solids) and remember that a small amount is enough.

Also keep in mind that many fruits contain the same antioxidants as chocolate, so a serving of berries, for example, is a better choice. And finally, achieving good health requires more than simply changing one aspect of what you eat, so include dark chocolate as a part of a diet that includes real food balanced by daily physical activity.

Eat slow, then fast. How and when you eat may be as important as what you eat for weight control.

What you eat is an essential part of achieving and maintaining good health. What you may not know is that when and how you eat can be just as important. This is especially true if your goal is to lose weight.

My Health & Fitness column in the Aiken Standard this week describes  two ways that changing the way you eat can help you lose weight and keep it off. Neither of these are necessarily new ideas, but implementing them together may help you eat less.

First, eating more slowly can help you limit the amount of food you eat. Perhaps your mother admonished you to “slow down” at meals when you were young. This was good advice, for both practical and physiological reasons. In addition to controlling how much food you consume, eating more slowly is a good way to enjoy meals, both the food and the company, more fully.

You mother may also have told you to “chew your food.” too. This was probably to remind you to eat more slowly.  Almost 100 years ago Horace Fletcher recommended a process that involved chewing each bite of food 100 times. “Fletcherizing,” as it was called, was a way to reduce how much people ate, among other more dubious health claims.

There is a physiological reason to slow down, too. Your appetite is regulated by a host of factors, including the act of eating and the presence of food in your stomach. As you eat, your stomach fills. This triggers the release of hormones that signal your brain to reduce your appetite. The result is that as your stomach fills, you feel less hungry.

Once you start eating, it takes time for your stomach to release these hormones. Eating quickly, like many of us do, allows you to take in lots of calories before your brain gets the message that you are full. This is one factor that leads to overeating. But if you slow down at meals, you start to feel full before you eat as much. Research shows that this can lead to lower calorie intake during the meal.

Second, the time between meals may affect your metabolism in ways that result in less fat accumulation. Again, the concept of fasting between meals isn’t new, but recent research helps explain why eating less frequently may help prevent obesity and related conditions, including diabetes.

While this research was done using rats, the physiological concept may well apply to humans. In these studies, rats were put on a diet that included an overnight fast ranging from 8–12 hours. The researchers found that the rats that experienced a longer fasting period between meals had better insulin levels and less fat storage.

The reason for this seems to do with the gut microbiome, the bacteria that live in the intestine and play an important role in regulating metabolism. A longer period without food changes the nature of these good bacteria, promoting these benefits.

I first heard about this on Science Friday, which provides an excellent summary of this research.

It is unclear whether this same effect occurs in humans. Even without this evidence, adopting a fasting period between dinner and breakfast, which should be about 12 hours, seems prudent. At the very least, it will keep you from snacking in the evening, which almost certainly involves unhealthy choices.

An additional finding of this research is that the benefits of the 12-hour fast seem to persist, even through a day or two of more frequent eating. This is relevant, since many people do well to modify their eating habits during the week, but tend toward less restrained eating on the weekends. The fact that the benefits of an overnight fast most days of the week are maintained despite a “wild weekend” is good news!

The combination of what, when, and how you eat can make an important difference in how much you eat, the key to losing weight and keeping it off. As you try to make healthier food choices, consider eating more slowly and making dinner the end of your eating day.