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Stretch it out.

My Health & Fitness column in the Aiken Standard this week is about stretching and flexibility. This is one aspect of  a comprehensive exercise program that you might be missing. Here’s why that is a problem and what you can do to start improving your flexibility.


 

The benefits of regular exercise include increased endurance, strength, and flexibility along with increased energy expenditure for weight loss and weight maintenance. These benefits will vary depending on the type of exercise you perform.

Endurance (aerobic) exercise will improve your cardiorespiratory fitness and endurance. These improvements allow you to exercise at a higher intensity or for a longer duration. Aerobic exercise like walking or jogging is also the most effective at burning calories.

Resistance training (weight lifting) will improve your muscular strength. The practical benefit is that you will have an easier time completing physical tasks at work or at home, something that is increasingly important as you get older.

Ideally, your exercise program will include a combination of endurance and resistance training. But there is another type of exercise that you should also include—stretching.

Stretching is an important and often overlooked part of an exercise program. Stretching exercises improve your flexibility and range of motion. This can help reduce back pain and muscle stiffness, improve your posture, and may reduce your risk of injury when you are active.

Here are some key points to keep in mind as you add stretching to your exercise routine:

  • Target major muscle groups. When you’re stretching, focus on your calves, thighs, hips, lower back, neck and shoulders. Also stretch muscles and joints that you routinely use at work or play.
  • Warm up first. The idea that stretching is a good warm-up before exercise is outdated. Stretching muscles when they’re cold increases your risk of injury, including pulled muscles. Warm up first by exercising at low intensity for five minutes or, better yet, stretch after you work out.
  • Hold each stretch for at least 15 seconds. It takes time for the muscles to stretch and lengthen. That can seem like a long time, so keep an eye on the clock or your watch. Then repeat the stretch on the other side. For most muscle groups, a single stretch is often sufficient if you hold it long enough.
  • Don’t bounce. While it might seem that bouncing would give you a better stretch, the opposite can be true. In extreme cases you could even damage the muscle making you less flexible and more prone to pain.
  • Focus on a pain-free stretch. You should expect to feel the stretch, but it shouldn’t cause pain. If it hurts, you’ve gone too far. Back off to the point where you don’t feel any pain, then hold the stretch.
  • Relax and breathe freely. Don’t hold your breath while you’re stretching. This is especially important if you are doing a workout that emphasizes stretching, like yoga.

Yoga is one example of an exercise that results in improved flexibility as well as promoting stress relief. There are different types of yoga, some of which improve strength and endurance along with flexibility. Yoga classes can be modified to accommodate even the least flexible participants, so don’t be afraid to try it.

You may want to start by stretching at two to three times a week to improve and maintain flexibility. Exercises that target the major muscle groups should take less that 10 minutes to complete, so this can easily fit into other activities.

As with any exercise, doing more can yield better results. If you have a problem area, such as tightness in the back of your leg, you might want to stretch more often. And keep in mind that you can stretch anytime, anywhere — in your home, at work, or when you’re traveling.

 

 

Feeling the pressure

May is National High Blood Pressure Education Month, a time to raise awareness about the diagnosis, health effects, and treatment of high blood pressure, also called hypertension. This is important because approximately 70 million U.S. adults have hypertension. Of those, almost 40% don’t even know it, which means they are not seeking treatment.

Another 30% have prehypertension, blood pressure that is above normal but does not meet the criteria for hypertension. Prehypertension is appropriately named since most people with this diagnosis eventually develop hypertension—unless they take steps to lower their blood pressure.

High blood pressure is a contributing factor to many heart attacks and strokes and is associated with type 2 diabetes, heart failure, and kidney disease. Hypertension is called the “silent killer” because it often has no symptoms yet it leads to serious health outcomes.

Here are some steps to help you celebrate National High Blood Pressure Education Month:

1. Know your numbers

Your blood pressure includes two numbers, both measured in millimeters of mercury (mmHg). The top number, systolic, is the pressure in your arteries while your heart is contracting and pumping blood. The bottom number is the diastolic pressure, which occurs between beats when the heart is relaxed. Both numbers are important for assessing your risk of health problems.

Normal blood pressure is less than 120 mmHg systolic and less than 80 mmHg diastolic. Blood pressure that is 140 mmHg and higher or 90 mmHg and higher is considered hypertension. If your blood pressure is between 120–139 mmHg systolic or 80–89 mmHg diastolic, you have prehypertension.

2. Get it down

If your blood pressure is above normal you should take treatment seriously. Lifestyle changes including eating a healthy diet, regular physical activity, weight control, and quitting smoking are all effective and essential for lowering blood pressure.

There are also several good medications that your doctor can prescribe to lower your blood pressure. Take them as directed and don’t forget that they are designed to work with healthy lifestyle habits.

3. Keep it down

The aim, of course, isn’t simply to reduce your blood pressure using drugs. Your ultimate goal should be to keep your blood pressure low without relying on medications, all of which have at least some negative side effects.

The best way to maintain a normal blood pressure is through daily exercise, eating a healthy diet, losing weight if you are overweight, and quitting smoking. A good place to start is the DASH diet, which is high in fruits, vegetables, and fiber and low in sodium and added sugar.

The DASH diet has been shown to lower blood pressure and lead to weight loss. It is also consistent with recommendations to prevent and treat many other health problems, including diabetes and high cholesterol.

Since blood pressure tends to increase with age, even if you have normal blood pressure you should take steps to prevent high blood pressure in the future. Adopting a lifestyle that includes daily physical activity, healthy eating habits, managing stress, and not smoking is essential for preventing high blood pressure.

Additionally, these same health habits will help you prevent most other chronic disease including diabetes, heart disease, and many cancers. It turns out that celebrating National High Blood Pressure Education Month can also help you celebrate good health in general.

The physical activity report card is in. We pretty much failed.

The spring semester just ended at the university where I teach. Which means my colleagues and I have been busy evaluating our student’s progress and submitting grades.

About this time, another report card came in from the National Physical Activity Plan evaluating physical activity in U.S. children. The results aren’t good. In fact, we pretty much failed! This is the topic of my Health & Fitness column in the Aiken Standard this week.


 

It’s probably no surprise that the majority of Americans are not active enough. Only about half of adults meet even the minimum recommendation for physical activity of 30 minutes per day, five days per week. Compounding this problem is the fact that many people spend much of their time at work and home being sedentary—some spend over 12 hours per day sitting!

Low levels of physical activity is associated with an increased risk of heart disease, stroke, some cancers, and, of course, obesity in adults. Becoming more active is probably the most important change a sedentary person can make to improve their health. The impact is similar to a smoker who quits.

What may be surprising is that this is a problem for children, too. Less than half of children ages 6–11 are active for 60 minutes per day. Among teenagers, it is less than 10%! The health effects of too little activity in kids is similar to that of adults.

The combination of inactivity and obesity can lead to “adult” diseases such as type 2 diabetes in young people. For this reason, some experts predict that this generation of children may be the first ever to die at a younger age than their parents.

Current recommendations call for children under the age of 18 to attain at least 60 minutes of moderate-to-vigorous activity at least five days per week. In younger kids this can be achieved through active play. In teens it is more likely to include organized sports and games.

The National Physical Activity Plan is a set of recommendations, programs, and initiatives designed to promote an active lifestyle at work, school, and home for all Americans. It was established by an alliance of health professionals and researchers.

This group recently released a report card on physical activity for children and youth that graded the success of efforts to promote activity in several areas. The results show that we are failing to meet even minimum goals and recommendations. Here is a summary of that report card:

Overall physical activity: D-Only 42% of 6–11 year old children and just 8% of kids ages 12–15 meet the 60 minutes per day activity goal.

Sedentary behaviors: D. About half of all children spend more than the recommended upper limit of two hours of screen time, which includes TV, computer, and video games, per day.

Active transportation: F. Just over 10% of children walk or bike to school regularly.

Physical education in school: C-Only about half of children attend at least one PE class per week.

Based on these grades, American children are not getting enough physical activity. But it isn’t fair to say that our children are earning these grades—it’s the adults who are failing! Most children are at the mercy of parents, teachers, and other adults who decide how they will spend their time at school and at home.

The report card shows that we are either not allowing our kids to be active enough or limiting opportunities for them to move and play. This isn’t necessarily a conscious effort, but is likely a consequence of the physical activity habits of adults that our children adopt.

Given the importance of regular activity for growth, development, health, and even academic success, getting our kids to be more active should be among our highest priorities. This requires both individual action and organized community efforts to make physical activity and exercise a part of every child’s day.

And while we are at it, we (the adults) should make this same effort. Perhaps the failing grades on the recent report card will motivate us.

Stealthy Healthy Eating

My Health & Fitness column in the Aiken Standard this week is about the many processed foods that include added nutrients, primarily vitamins, minerals, and fiber, to make them healthier. While this seems like a good thing—helping people get enough essential nutrients, even if they eat a poor diet—there are drawbacks to using these foods instead of eating actual food that contains these nutrients.


What if there was a way to get the benefits of eating vegetables without having to eat any vegetables? This may be a dream for millions of American children and adults who don’t eat enough vegetables.

Thanks to creative food processing, the healthy components of vegetables can be added to many foods, including soda, candy bars, and other sweets. Books and websites contain recipes for adding pureed vegetables to brownies and other baked goods. There is even a new line of prepackaged pureed vegetables to use!

The recommended intake of vegetables ranges from one cup per day for young children to 3 cups for adults. A simpler guideline is to fill half of your plate with fruits and vegetables at each meal. The goal should be to eat a variety of vegetables throughout the week.

There are plenty of good reasons for people to eat vegetables. Most vegetables are a low-calorie source of essential vitamins and minerals. The dietary fiber found in vegetables (and fruits and whole grains) plays a role in maintaining a healthy body weight, lowering cholesterol, and reducing the risk of some cancers.

Fiber is increasingly added to processed foods including granola bars and energy bars. It is possible to get up to half of your daily recommended intake of fiber by eating a single Fiber One bar. That is the equivalent of a cup or more of most vegetables! Considering that many of these snacks are essentially candy bars, they are a tasty way to get fiber.

Vitamins and minerals have long been available as supplements and added to certain foods, including products made from grains like pasta and bread. But now you can get vitamins in many soft drinks, many of which have as much sugar as soda. And calcium is added to a variety of foods from breakfast cereals to snacks.

There are, of course, some benefits of doing this. People who don’t eat a healthy diet can get enough essential nutrients through these products. Some of these foods are low in calories so they can help people who are trying to lose weight.

While these “hidden” nutrients may seem like a good solution for people who don’t eat enough vegetables, this form of stealthy healthy eating may have some negative consequences.

These processed foods may be high in sugar, fat, and calories which could contribute to weight gain. The fact that these foods are designed to taste good—many include chocolate—may lead people to overeat. Aside from excess calories, eating far too much fiber could cause GI discomfort or other health problems.

More concerning, though, is the fact that these foods set an expectation that healthy foods should be sweet. This is particularly problematic in children, who may avoid eating vegetables (and other healthy foods) in favor of sweet drinks and snacks that contain the same nutrients.

Additionally, getting vitamins, minerals, and fiber through processed foods keeps people from learning how to make healthy choices and prepare real food. This has consequences for developing healthy eating habits in both children and adults.

Focusing on getting individual nutrients over eating a variety of healthy foods is thought to be an important cause of the current obesity epidemic. Relying on processed foods with added vitamins, minerals, and fiber may be doing more harm than good to your health.

The bottom line is that you should get your nutrients from real food and balance what you eat with daily physical activity. Remember, good health comes from making smart choices, not from a bottle or a box!

How to win at losing: What to do when your diet ends.

In the past few weeks several community and fitness center-based weight loss programs have ended. Since many diets and exercise programs last 12–15 weeks, this time of year marks the end of many programs. During this time many people have met personal weight loss goals through individual diets and “biggest loser” type programs. (I have written about competition-type weight loss programs in the past here and elsewhere.)

One of these is the Team Lean program at the Y. This year over 1,600 people from the Aiken and Augusta area participated in this 12-week program that included weekly education sessions and weigh-ins, a strong group dynamic, and monitoring to prevent rapid, unhealthy weight loss. The average participant lost almost 10% of their body weight, which is sufficient to promote improvements in blood pressure, cholesterol, and diabetes.

This level of weight loss is common among people who participate in individual or group programs. But the real challenge is to maintain that weight loss after the program ends. Many people have successfully met their weight loss goal only to gain the weight back later. In fact, some people do it every year, losing and regaining the same 10 (or 20 or 30) pounds over and over.

Losing weight is challenging, to be sure. But maintaining weight loss can be even more challenging. Many people think that they are finished once their diet or weight loss program ends. The truth is that the end of the diet marks the beginning of the next phase: keeping the weight off. This is the topic of my Health & Fitness column in the Aiken Standard this week.

There is a practical reason why this happens. In order to lose weight and keep it off people need to learn a whole new lifestyle involving what, when, why, and how they eat as well as daily exercise. These lifestyle changes are difficult to make and can take months or years to fully adopt. In many cases, the weight loss program ends before people make lasting behavior changes and revert to their old habits.

While there are literally hundreds of diets and weight loss programs to choose from, “weight maintenance” programs are far less common. The good news is that following the advice of people who are successful at losing weight and keeping it off can help you maintain your weight loss.

The National Weight Control Registry (NWCR) is a collection of information submitted by individuals who have succeeded at long-term weight loss. These “successful losers” have lost an average of 66 pounds and kept it off for over five years, with some losing as much as 300 pounds! Best of all, they share the secrets of their success.

It turns out that they lost weight through a variety of diets and programs. Nearly half lost weight on their own and the other the other half followed of some type of program. Regardless, almost all of them increased their physical activity and modified their diet, suggesting that diet and exercise together are important for successful weight loss.

There is also variety in how NWCR members keep the weight off. Most report continuing to maintain a low-calorie, low-fat diet and doing high levels of activity. Almost 80% eat breakfast every day, 75% weigh themselves at least once a week, over 60% watch less than 10 hours of TV per week, and 90% exercise, on average, about 1 hour per day.

Many people worry whether they are following the “best” diet or weight loss program. The specific diet may not be as important as what you do when it ends. Notice that the majority of successful losers still control what they eat and nearly all exercise each day. This suggests that going back to the way you ate before you lost weight is unrealistic. And if you aren’t exercising, at least walking, every day already, now is a good time to start.

Go outside and play!

If you are like most people, you have probably spent much of the day indoors, probably sitting. In fact, this is likely how you spend most days. According to one survey, the average American may spend up to 15 hours per day sitting at work or at home. If you subtract sleeping, this accounts for nearly the entire day!

Prolonged sitting has been linked to negative health effects that are similar to those of not exercising. Even among people who do exercise, those who spend more time sitting tend to have more health problems than those who are more active during the day. Consider yourself lucky if you have a job that keeps you active.

The good news is that you can offset the health effects of sitting too much. Taking short breaks at work can improve attention and productivity. In fact, many time management and productivity techniques include periods of focused work separated by breaks. Using these breaks to get up and move is good for your body and your mind. The same is true at home—getting off the couch during TV commercials can have the same benefits.

Even greater benefits can be gained from dedicating more time to be active, especially regular exercise. A lower risk of weight gain, diabetes, heart disease, and some cancers are among a long list of positive health effects of physical activity. Lesser known benefits include improved mental health, cognitive function, and greater feelings of wellbeing.

Being active in a natural environment seems to have an even bigger impact on mental health. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Indeed, activity 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. This is mostly due to the fact that you will likely walk or run faster outdoors, but other factors like wind resistance add to your effort. Research shows that even though people tend to exercise at a higher intensity outside, they don’t necessarily feel it. In fact, ratings of effort are lower outdoors for the same exercise.

This because the pleasant visual stimuli outdoors distracts you from unpleasant sensations of effort during exercise. This is the same reason that listening to music makes exercise more enjoyable and why fitness centers have televisions on the walls or built into exercise equipment. Think of the outdoors as a really big TV screen!

Almost any indoor exercise can be moved outdoors. While walking, running, and cycling are most obvious, resistance training exercises using body weight and many high-intensity interval training workouts can be modified for outdoors. Yoga and aerobics classes in the park are also great ways to promote both the physical and psychological benefits of exercise.

Much of the psychological benefit of outdoor exercise occurs in the first five minutes, so even short bouts of activity are meaningful. It also means that going for a short walk outside when you have a break at work or walking instead of driving short distances can have positive effects. At home, taking the dog for a walk, playing outside with the kids, or doing yard work are good ways to be active and reap the benefits of being outdoors.

Every little bit of activity you do outdoors will have both physical and psychological benefits to help you become and feel healthier. So, go outside and play!

That’s NOT fruit!

Making healthy food choices is never easy. It is made more challenging by the fact that some foods that appear to be a smart choice may be less healthy than you think.

This is the topic of my Health & Fitness column in the Aiken Standard this week. It is a topic I have addressed in the past that is still relevant today. Specifically, regarding what my kids picked for breakfast this morning! This shouldn’t be a surprise, since many foods that look healthy, but aren’t are breakfast foods marketed to children.

Often, prepackaged fruits and vegetables contain added sugar, fat, or salt, making them less healthy than eating them fresh. Consumption these foods can also make it less likely that people—especially children—will eat fresh fruits and vegetables when they are available.

The problem is that these foods may look like fruit. They may even contain real fruit juice. But many drinks and snacks–especially for kids– that look like fruit are really candy in disguise.

Here are a couple of examples of foods that may appear to be healthy but, upon closer examination, turn out to be less nutritious than we might think.

Fruit snacks: These gummy fruit treats are a favorite among kids. If you check the package you will probably see that they contain real fruit or fruit juice, so they must be healthy, right? While there is variation among different brands, in most cases these snacks contain little, if any, actual fruit. If you read the ingredients you will see that they do contain lots of added sugar, meaning that many of these snacks are essentially candy. In fact, if you compare some brands of fruit snacks with something that is easily recognized as candy, such as gummy bears, you will see that they have a similar sugar content.

Fruit drinks: Not everything that looks like fruit juice is actually juice. Take Sunny D for example. This popular orange drink contains mostly sugar and water—and only 5% juice. By contrast, real orange juice contains fewer calories and more vitamins per serving. In fact, if you compare the ingredients and nutrition information, Sunny D is essentially orange soda without the bubbles!

There are two problems with this. First, some foods that appear to be healthy because they either claim to or actually do contain fruit are actually less healthy than we might believe. Considering that fruit snacks and fruit drinks are likely to be consumed as alternatives to real fruit juice or a piece of fruit as a snack, these foods could lead to poor nutrition. This is especially true in children.

Second, sweetness is one of the most important tastes we respond to. Consuming food and beverages that are flavored like fruit but are actually much sweeter may make real fruit less palatable. Again, this is especially true for children who may develop an expectation that strawberries should taste like strawberry-flavored fruit snacks or that orange juice should taste as sweet as Sunny D. These kids are likely to prefer the sugar-sweetened version over the real fruit. Since these sugar-sweetened “fruits” tend to be higher in calories, consumption of these foods is one contributor to childhood obesity.

This isn’t just the case with fruit. Adding salt and sauces to vegetables makes them more flavorful, to the point that many of us don’t eat plain vegetables very often. The majority of potatoes are consumed in the form of French fries, loaded with both fat and salt. This has changed how we expect potatoes to taste so that now we typically eat baked potatoes “loaded” with butter, sour cream, cheese or bacon. When was the last time you ate a plain baked potato?

But there are some simple steps you can take to get back to eating real fruit and vegetables. Look for 100% fruit juice or, better yet, a piece of fruit instead of fruit-flavored drinks. Instead of sugar-sweetened fruit snacks, try dehydrated fruit. Cut back on the salt, butter, and other toppings you add to vegetables or purchase frozen vegetables without added sauces.

HIIT me, again!

The next time you are at the gym sweating through an hour on the elliptical machine or going for a long run to improve your fitness, think about this: you may be able to get the same benefits with just a few minutes of exercise. It’s not as easy as it sounds, though. The exercise has to done at a very high intensity, often in short intervals.

This type of exercise is called high-intensity interval training (HIIT), which involves multiple bouts of very intense exercise separated by periods of rest or light exercise. I have written about this type of training previously, but new research and the popularity of HIIT training programs warrant revisiting this topic in my Health & Fitness column in the Aiken Standard this week. And although high-intensity training is effective for improving fitness and burning calories, it may not be right for you.

Exercise to improve cardiorespiratory fitness typically involves 20–60 minutes of moderate to vigorous exercise done 3–5 days per week. This type of exercise is common for people who are training for an event like a 10k run since it leads to improvements in maximal exercise capacity (called VO2max) and endurance by increasing heart function and promoting changes in the muscle. This type of training is also followed by most people who are interested in losing weight or getting in shape, even if they don’t plan to compete in a race.

Research and practical experience have shown that shorter HIIT sessions can be effective, too. The length and intensity of the intervals vary both in the research and in practice. For example, in one study these intervals were as short as 30 seconds of all-out, maximal exercise separated by rest periods, for a total of just six minutes of exercise per day. Other studies employ slightly less intense (still 90% of maximal heart rate) intervals for a total of 20 minutes of exercise per session. The results show that HIIT leads to adaptations in the muscle and improvements in VO2max that are greater than that of more traditional, lower intensity exercise.

A study published last month showed that even one bout of high-intensity exercise can promote changes in the muscle that lead to improved endurance. This study compared the effect of four 30-second bursts of very intense exercise separated by four minutes of recovery with a single 4-minute bout of vigorous exercise. Both promoted a similar effect on blood and muscle markers that lead to improvements in fitness. This suggests that both sustained and interval exercise can be effective, as long as the intensity is high enough.

Does this mean that high-intensity training is right for you? It depends on several factors. First, the risk of injury during intense exercise is greater than during more moderate exercise. At the very least, exercise of this intensity is likely to be uncomfortable. Second, exercising at a high intensity may not be a good idea if you are not already in good shape or have other health problems like diabetes or high blood pressure. Third, HIIT may not be the best way for you to meet your exercise goals. If you exercise to lose weight your emphasis should be on duration, not intensity, to burn calories. If you are trying to build endurance for a marathon or long distance bike ride, you really do need to focus on longer duration exercise.

For most people, there is little harm in trying some higher-intensity exercise, even just one day per week. In fact, many group exercise classes are designed to be a high-intensity workout, so this might be a good way to add more intense training sessions to your exercise routine.

 

Subway’s identity problem (and why it matters).

If you are looking for a healthy place to eat lunch, chances are you will think of Subway. More than any other fast food restaurant, Subway has developed a reputation for being a healthy choice, consistent with losing weight and an active lifestyle. While you can get healthy food at Subway, you may end up eating a meal that is similar to traditional fast food in terms of calories, fat, and sodium.

This “identity problem” — Is it a healthy option to regular fast food? Or just an alternative to fast food? —  is the topic of my Health & Fitness column in the Aiken Standard this week.  This matters, of course, because you may well be fooling yourself into thinking you are making healthy choices when you aren’t.

Subway has long been thought of a healthy alternative to traditional fast food. This is largely due to a menu that has fresh-looking sandwiches rather than burgers and fries. Food at Subway looks healthy. This image is enhanced by a marketing strategy that associates Subway with health and wellness, something they seem to do better than any other fast food chain. Advertisements featuring former Olympians were abundant during the winter Olympics television broadcasts and the continuing association with Jared Fogle, who lost nearly 250 pounds by drastically changing his diet—including eating at Subway—and becoming more active strengthen this image.

The Subway menu does include several sandwiches designated as Fresh Fit choices that are low in fat and calories and could contain a full serving of vegetables. If you read the fine print you will see that this is true if you order a 6-inch sandwich on plain bread with meat and veggies, but no condiments or cheese. Adding mayo, sauces, and cheese or substituting another bread will increase the calories and fat in the sandwich. But, if you make smart choices, select a healthy side such as apple slices, and have water, unsweet tea, or another calorie-free drink, you can get a healthy, low-calorie meal.

However, that does not mean that all of the sandwiches at Subway are good choices if you want limit calories or fat. One of the sandwiches featured currently is the Fritos chicken enchilada sandwich, which is served exactly as it sounds: shredded chicken topped with enchilada sauce and Fritos chips. But if it comes from Subway it must be healthy, right?

Wrong! If you look at the nutrition information you will find that this sandwich has 580 calories, 26 grams of fat (which account for 40% of the calories), and 1170 milligrams of sodium (nearly half of what you should get in a whole day). The best traditional fast food comparison is the Big Mac at McDonald’s, which has 550 calories, 29 grams of fat, and 970 milligrams of sodium. Considering that many people eat at Subway in an effort to avoid the fat and calories of fast food, this would not be a good choice.

The point is that while you can get a healthy meal at Subway, many menus items are as high in fat, calories, and sodium as food at other fast food restaurants. The image that Subway has carefully cultivated likely conceals this fact, leading people to think they are eating a healthy meal when, in reality, they are not. It is also possible to get a meal at McDonald’s and many other fast food restaurants that is nutritionally similar to the healthier sandwiches at Subway.

This is a good lesson, since menus at many restaurants include a “healthy choices” section. Keep in mind that food that appears to be healthy may not be and that a restaurant typically thought of as a poor choice may have healthy menu items. The trick is to check out the nutrition information and make smart choices.

Sports Science at the Winter Olympics

So, the 2014 Winter Olympics wrapped up with the closing ceremony yesterday. If you have been watching the Olympics you have seen some incredible performances. The competitors are among the fittest and most highly trained athletes in the world, both in terms of laboratory measures of fitness and in subjective evaluations of skill. Competing in the Olympics requires years of focused, intense training and some good luck.

In my Health & Fitness column in the Aiken Standard this week I take a look at the  physiology that goes in to training for and competing in the Olympics.

First, let’s look at the fitness. This is most evident in the endurance events like cross-country skiing and speed skating. The key to performance in long-duration events like these is for the muscle to contract repeatedly and forcefully without fatigue. In order to do so, the muscle must have a steady supply of oxygen and nutrients. These nutrients are delivered through the blood, which is pumped to the muscle by the heart. The muscle takes up and uses these nutrients to produce ATP, the form of energy used by the muscle.

After months and years of endurance training the heart gets bigger resulting in the ejection of more blood to the muscle. Within the muscle there is an increase in the number of capillaries, the small blood vessels that deliver blood to the muscle, and mitochondria, the part of the cell that produces most of the ATP. Together, these adaptations allow the muscle to produce more ATP without fatigue, allowing the athlete to sustain a higher intensity (skiing speed, for example) for a longer time without fatigue.

How fit are these athletes? In the laboratory we measure VO2max, the maximal rate at which oxygen can be used by the muscle to power exercise, during intense exercise. While we don’t have test data on most Olympic athletes, cross-country skiers tend to have the highest VO2max values, followed closely by distance runners and cyclists.

While all Olympic athletes are all very physically fit, other events rely more heavily on skill including figure skating and freestyle snow boarding. For example, in figure skating completing a triple axel involves leaping into the air, spinning three and a half times, and landing backwards. On a 4 mm wide blade. On ice. Or think about the triple cork 1440, a snowboarding trick that involves flipping three times in the air while doing four 360-degree turns.

The athletes who are able to successfully complete these maneuvers have practiced for years to develop the skill and confidence needed to perform them consistently in competition. These are some of the most obvious displays of athletic skill, but all events require good technique. The development of skill in addition to fitness is the main reason why athletes specialize in one area and you don’t see people competing in both downhill skiing and speed skating, for example.

Of course, there is a psychological aspect to Olympic performances. The motivation to put in the training time alone is remarkable. Even more impressive is the ability to focus on an event despite the distractions of the crowds, media, and pressure of competition. This combination of physical and mental preparation is rare—as rare as Olympic gold medalists!

The training and preparation followed by bobsledders provides a good model for what goes into creating an Olympic athlete.

But is training alone sufficient for Olympic-level performance? Could anyone who trains enough make it to the Olympics? The answer is no, because there is another important factor in athletic performance—luck. Luck refers to genetics, which determine potential for attributes like heart size and muscle characteristics. As much as 50% of performance in some events is attributed to genetics. One sports physiologist famously answered the question, “How do I become an Olympic champion?” with “pick the right parents!”

There is more that I am missing (on purpose, because I have a word limit in my column). One additional key factor is nutrition. Despite what Subway would have you believe, Olympic athletes don’t really eat a lot of sandwiches with Fritos on them. In fact, this is a good overview of what US Olympians eat to fuel their training and competition.

Even though most of us will never become Olympic champions we can still experience many of the same benefits of training. All athletes train to develop strength, endurance, and flexibility, which is exactly what we should do, too. And those attributes will help us perform better at work (and play) and help us live a longer healthier life. It will also help us appreciate the training, dedication, and good luck that the athletes bring to the Olympic games.