Happy American Heart Month

In relation to February being American Heart Month and March being National Nutrition Month, I thought I would kick off a series of posts discussing sugar. I find the topic of sugar and increased levels of consumption fascinating. One of my clients is a former nutritionist and she subscribed me to a publication known as “Nutrition Action”. It is a small, research based health letter released quarterly by the Center for Science in the Public Interest. In a recent issue, the topic of “Sugar Belly” is mentioned and examined. Several studies are mentioned which link increased intake of fructose (sugar from fruit) with higher amounts of belly fat, liver fat, and in some cases muscular fat. The publication notes that it doesn’t technically matter where the fructose is coming from as it is used in several different types of sugar such as high fructose corn syrup and table sugar. Most of the “added sugars” or excess amounts of added sugars come from classic examples such as desserts. The primary focus of the article is on the added sugars from sweet drinks such as soda and fruit juice. One study is quoted where individuals who consumed 100% fruit juice increased their risk for diabetes whereas the individuals who consumed whole fruits did not. It is theorized that this may be due to the fiber and other possible nutrients which do not remain in the juice. As I do not have the magazine here with me, I will use other research to further examine this topic.

In a study by Stanhope et al. (2009), the effects of fructose (sugar naturally occurring in fruit) or glucose (sugar or a carbohydrate from plants that is also what our body creates and uses for energy)-sweetened beverages as 25% of one’s diet for a period of 10 weeks was examined. The average age across both groups was between 52-56 and the average baseline weight was 81.9-89.3 kg. In the glucose group, body weight went up by an average of 1.8% and 1.4% in the fructose group. Total body fat increased by 3.2 and 2.8% respectively. Clearly, based on these numbers, total weight and fat gain was similar for both groups. The next bit of data is where it gets interesting. In the glucose group, waist circumference, total abdominal fat, extra-abdominal fat, and intra-abdominal fat increased at 1.7%, 4.8%, 4.6%, and 3.2% respectively. In the fructose group these same variables increased by 1.9%, 8.6%, 7.3%, and 14%. These are large and very significant differences.

When I read this in the “Nutrition Action” health letter I was intrigued, interested, but not surprised. To actually review a bit of the research and see how significant the differences actually are is amazing. Not only did fructose negatively affect visceral fat more significantly than the glucose, it also affected fasting cholesterol with an average increase of 10.1% as compared to 3.9% in the glucose group.

Now, it is important to understand that just because fructose is sugar that comes from fruit, this article does not mean “do not eat fruit”. In fact, I am attempting to recommend just the opposite. As mentioned initially in this blog post, in the study where individuals ate fructose from whole fruit, they did NOT increase their risk for diabetes where as those who digested the fructose from 100% fruit juice DID increase their risk for diabetes.

TAKE HOME POINT: Added sugar intake should be limited no matter your age. Sugar is ok, in fact it is needed to create energy. We generally call sugar “carbs” when we discuss them for energy. The take home point is to get these carbs or sugars from naturally occurring substances such as fruit. The American Heart Association recommends less than 6 teaspoons (100 calories) for women and less than 9 teaspoons (150 calories) for men of added sugar (processed) a day. Below is a link to a document from myplate.gov with 10 tips for limiting sugar intake in our kids, but many of them also apply at all ages.

http://www.choosemyplate.gov/food-groups/downloads/TenTips/DGTipsheet13CutBackOnSweetTreats.pdf

Reference

Stanhope, K., L., Schwarz, J., M., Keim, N., L., Griffen, S., C., Bremer, A., A., Graham, J., L., Hatcher, B., Cox, C., L., Dyachenko, A., Zhang, W., McGahan, J., P., Seiber, A., Krauss, R., M., Chiu, S., Schaefer, E., J., Ai, M., Otokozawa, S., Nakajima, K., Nakano, T., Beysen, C., Hellerstein, M., K., Berglund, L., & Havel, P., J. (2009). Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. Journal of Clinical Investigation, 119(5), 1322-1334.

Sitting is toxic to our health!

In continuing the general theme of the last few posts, we will examine sitting and its effects on our health. In the most recent blog we discussed how sitting for extended periods of time over months or years can compound and lead to potential muscular imbalances possibly causing pain. The purpose of this blog is to examine recent literature on how sitting affects our guts. More scientifically stated, how sitting affects our risk for diabetes, heart disease, cancer, and mortality rate among other things. In a study utilizing data from the 2003-2004 National Health and Nutrition Examination Survey, it has been reported that children and adults in the US spend 55% of their waking day in sedentary pursuits (Katzmarzyk, Church, Craig, & Bouchard, 2009). The pursuits include the more obvious possibilities such as working at a desk, playing video games and using a computer. This data also included less considered sedentary pursuits such as eating a meal at a table and riding in a car. It is important to understand that sitting is not only considered “sitting” when you do it at a desk or on the couch.

In the actual study conducted by Katzmarzyk et al. (2009), data from the Canada Fitness Survey was used which included a sample size of 7278 men and 9735 women. In this study, the researchers examined sitting time as almost none of the time, one fourth of the time, half of the time, three fourths of the time, and almost all the time during waking hours. In this study, several elements were considered such as smoking, alcohol consumption, leisure time physical activity, and body mass index.  There are many studies out there which examine sitting time as an independent factor in contributing to diabetes, heart disease etc. This study is interesting because it examined sitting time not only independently but co-dependently in smokers, non-smokers, former smokers, active individuals, inactive individuals, individual’s alcohol consumption, cardiovascular disease, and cancer.

The study found that no matter the circumstances, those who sat more, were more likely to die from all causes than those who sat less. There was in fact a dose response relationship which means that the more the individuals sat, the higher their rate of mortality was. Even in the individuals who were meeting the minimum recommended amounts of physical activity, if they sat for the majority of the rest of the day, they still maintained a higher mortality rate than those who were just as active but sat less. The only cause in which there was no correlation found between sitting and mortality rate was cancer.

Perhaps going forward, we must consider decreasing our sitting time just as important as exercising and eating healthy. Below are 10 tips for decreasing your likelihood of being a statistic in this study:

1: Stand up more!

2: Exercise at least 30 minutes a day!

3: Exercise more than that!

4: Take frequent walking breaks if you have a desk job.

5: Walk at lunch.

5: Park further away at stores and work.

6: Run around with your kids when you get home from work.

7: Do yard work when you get home even when you had a long hard day of sitting on the job.

8: Walk the dog when you get home from work.

9: Turn off the TV!

10: Do not smoke!

 

Reference

Katzmarzyk, P., T., Church, T., S., Craig, C., L., & Bouchard, C. (2009). Sitting time and mortality from all causes, cardiovascular disease, and cancer. Medicine & Science in Sports & Exercise, 41(5), 998-1005.

How Sitting & Poor Posture Can Affect Our Body

 

So, let us take some time to examine sitting and how it affects our body. I touched on this briefly in my most recent blog post. Through that previous post we discovered that individuals who have a desk that requires them sit nearly every day for extended periods of time, tend to have high rates of neck, shoulder, and low back pain. We also learned that performing physical activity on a regular basis helps to alleviate some of this pain and that specific shoulder resistance exercises can lead to a lower incidence of reported neck pain.

Sitting for prolonged amounts of time can lead to anatomical issues as well. Maintaining a constant body position for a significant amount of time each day, for months or years on end can lead to postural distortions and muscular imbalances. By this I mean that sitting in a position similar to the picture to the right with the shoulders internally rotated, forward head posture or chin jutted forward and rounding of the upper back can lead to an imbalance between the muscles on the front of your body and the muscles on the back of your body. So if you sit as mentioned, you may have a very tight chest and an overstretched or weak upper back.

One must view the body as a chain. If there is a kink in the chain in one area, there may be issues with movement in other areas of the chain. Many of our muscles are linked together through connective tissues. They can be grouped into interdependent systems. If we maintain poor posture for extended periods of time such as that mentioned above, we are informing our central nervous system that this is how we are “supposed” to be. Our central nervous responds through allowing our muscles to adapt to the length or tightness or looseness with which they are in during these prolonged positions. Our body is not meant to be in this position. We are meant to remain upright. In an ideal world, when you are standing still, from a lateral view, I should be able to draw a straight line from your ear, to the middle of your shoulder, middle of the hip, middle of the knee, and the out the bottom of the heel.

When our body is out of alignment (a kink in the chain) and unable to move correctly, it can lead to pain. Low back pain, so called “sciatica”, neck pain, headaches, all of these can be positively affected by specific corrective exercise techniques as well as through proper posture during stationary and dynamic activity activities. Examples of these include frequent breaks from sitting, sitting or standing up straight with the shoulders back when sitting and standing, and participating in a regular exercise program. Stay tuned for my next blog post which will examine through research, the possible effects sitting can have on your health.

Thanks,

Joe

 

Pain from a desk job?

Are you a woman? Do you have a job which requires you to work at a desk most of the day? If so then this blog should resonate with you and possibly give you ideas on how to relieve some of the aches and pains that come along with a desk job.

Some of the most commonly mentioned pains associated with a desk job include neck and back pain. I know some who even complain of headaches. Interestingly, strength training has been associated with decreases in pain in those with a desk job. It is thought at when one becomes stronger, the relative workload on the muscles while sitting is less strenuous leading to less pain. I am not by any means saying that strength training is the only way to get rid of pain, nor is it the best. It is important to note, especially in those who are required to sit at a desk during the day that good posture and breaks for movement throughout the day are the most important and effective means for decreasing pain that results from a desk job.

Back to the subject at hand. I came across an interesting article which was just released in 2013 from the Journal of Strength & Conditioning Research. Pedersen, Andersen, Jorgensen, Sogaard, and Sjogaard (2013) examined the effect of specific resistance training on musculoskeletal pain symptoms in women with desk jobs. In the specific resistance training group, certain shoulder and neck exercises were completed for an average of 1.69 days per week with a goal of 3 days per week. The individuals who were able to progress to a greater volume of training which means heavier weight (something they could do for 10-15 repetitions but no more) showed greater decreases in pain as compared to the group which was unable to lift as much weight. When compared to the group that did not train at all, the weight training group as a whole reported significantly greater reductions in pain than did the group which did not exercise at all. Also, in a third group, which completed mostly aerobic exercise and did not do specific shoulder exercises, there was a significant decrease reported in pain. It was not however as great as the group that performed the shoulder and neck specific exercises.

So, what is our take away from this? What is the practical application? Including exercises specifically targeting the shoulders and neck at a resistance level in which only 10-15 repetitions can completed per set may lead to greater decreases in pain than not exercising at all. It may also be more effective in reducing desk job related pain than simply having a program consisting of walking or jogging.

My advice: No matter what, some exercise is better than none! Participating in any type of regular exercise if completed in a safe manner should help with pain. From the above mentioned study we learned that targeting exercises at specific areas of pain may work better.

Take Home Tips:
1: Take at least a break every hour just to get up and move around.
2: Maintain neutral alignment of the spine with the shoulder blades slightly pulled back while sitting or standing.
3: Add specific postural exercises to your exercise regimen to help ward off some of those annoying pains.
4: Perform postural exercises throughout the work day such as chin tucks, shoulder rolls backwards, and shoulder blade pinching (pretend to squeeze a can between them).
5: Drink plenty of water!

Pedersen, M., T., Andersen, L., L., Jorgensen, M., B., Sogaard, K., & Sjogaard, G. (2013). Effect of specific resistance training on musculoskeletal pain symptoms: Dose-response relationship. Journal of Strength & Conditioning Research, 27(1), 229-235.

Is a circuit routine be enough to get back what I have lost?

This is the third post in a series of posts meant to answer several questions that my little sister received on her facebook page from a fitness enthusiast whose primary interests include endurance competition such as 100m bike races and triathalons. To begin, we will answer the question as it has been asked with the intention of continuing the blogs into examining other methods of resistance training for everyone.

So, will a circuit routine be enough to get back what I have lost? This question stems from the individual suffering from an injury more than likely due to overuse in her endurance training which kept her from most physical activity. Because of this, she has lost muscle mass. We discussed how to begin addressing the injury in the last post. Now, we will assume that that injury is completely healed and we can move on to a more advanced resistance training routine.

Resistance training is recommended by several national health organizations as a part of a more comprehensive program. This is due to the many documented benefits of resistance training including reduced body fat, increased resting metabolic rate, decreased blood pressure, and an increase in insulin sensitivity to name a few (Kraemer, Ratamess, & French, 2002). There are 3 primary principles one must focus on in relation to resistance training.

The first is progressive overload, which refers to a gradual increase of stress placed on the body. The body adapts to everything we expose it to over time. Therefore an increase in the demand of the resistance training program must take place to allow for long term improvement. The second principle is the principle of specificity. This refers to the body's ability to adapt to specific stimuli based on program variables. So, to continue improvement we must progress a program through increases in intesity but to become better at a specific task, we must train for that task. For example, a body builder is generally lifting weights to increase muscle mass and definition, therefore they must dictate certain variables of their program to address that goal specifically in order to achieve it. The third principle is variation. Just as training must be progressive and specific, it must change over time to continue to force the body to adapt. Just as increasing intensity through progressive overload forces the body to change, altering other variables does so as well. You always hear P90X talking about "muscle confusion", the principle of variability is what they are actually discussing.

So our question came from someone who loves endurance training but feels that she has lost much muscle mass over the winter months. She wants to know if a simple circuit routine will help her with that. In all honesty, a circuit routine if executed correctly would most definetly help her to increase her muscle mass. This is also assuming that the proper amounts of nutrients are being coonsumed in her diet. As she is an endurance junkie, we will examine some research on resistance training in other endurance runners to figure out which type or method works best.

In one study by Mikkola, Rusko, Nummela, Pollari, and Hakkinen (2007), put a group of 13 runners aged 16-18 were put through an explosive resistance training program for 8 weeks. Normal endurance training was maintained however roughly 20% of it was replaced by the resistance training. There were significant improvements noted in 30m sprint times and strength. The aerobic capacity of the runners did not change. This is interesting because the runners put on some mass, got stronger, and faster in sprinting all while decreasing their endurance training and replacing it with resistance training. The actual resistance training itself took place 3x per week and consisted of some explosive sprint training and low load basic strength exercises such as half squats, knee extensions and curls, abdominal crunches, and calf raises (very basic).

From this small yet interesting study, we learn that in young women and men, it may be possible to decrease endurance training time as long as it is replaced by resistance training and maintain current levels of aerobic fitness.

This information could help our reader as she may be able to decrease her running time per week which may have lead to her overuse injury/IT band inflammation in the first place, and replace it with resistance training which will help her reach her goal of increasing her muscle mass and possibly improve her racing performance.

As I always state, this is not the only study on this subject however, this post is getting longer and longer. Because of this, I will have to continue examining the proper resistance training program for an endurance runner in our next post.

Until then, stay healthy!
Joe

IT Band Inflammation

To follow up on the last blog post:

 

First, lets address the IT Band inflammation. This must be addressed initially as this could affect the way one moves during exercise and lead to further pain and muscular imbalance. The IT Band is a term which is short for Iliotibial Band. The ITB consists of the gluteus maximus, the tensor fascia lata (TFL), and the myofascial and or connective tissue which originates at each of these muscles in some fashion and inserts into the lateral aspect of the proximal tibia (larger lower leg bone). When one complains of ITB inflammation, or runners knee, they generally exhibit lateral knee pain. This is generally due to a lack of flexibility of the tensor fascia lata which can result in increased tension on the ITB during the stance phase (when your foot is on the ground) of running (Clark & Lucett, 2011). Issues with the ITB can also result from overuse of the and a weakness in the same side gluteus medius which could contribute to decreased time to fatigue for the TFL.

In order to decrease the pain being felt from the ITB inflammation a simple yet systematic process must be put in to place to release the tension or inhibit the over active TFL, stretch or lengthen it back to its optimal length, activate or strengthen the underactive or weak muscles, more than likely the same side gluteus medius, followed by an integrated movement involving a full body exercise while focusing on proper posture and form to hopefully make the the newly synergystic movement pattern a "habit".

 

One of the jobs of the TFL is stabilize the pelvis. This is however not its primary job. The gluteus medius is a much larger role player when it comes to pelvic stabilization in the frontal plane (from left to right or right to left). If the gluteus medius is weak, the TFL may become more dominant in pelvic stabilization causing it to be used more often than it should be. This is what can cause the "tightness" or shortened position within the muscle itself. When there is a muscular imbalance such as this, it can affect the major joints above and below the problematic area as most muscles in the body are connected through connective or myofascial tissue. Hense, the pain one feels down near the knee although the "tight" muscle is located roughly at the top of the hip. Without going too in depth, utilizing pressure from an object (a hand, foam roller, PVC pipe etc.) inhibits neurological activity to the tissue where the pressure is applied allowing the muscles and or myofascial tissue to relax. The picture above is a basic picture showing how to use a foam roller to release or relax an overactive ITB. While maintaining neutral alignment of the spine, place the roller beneath the affected side. This is the space between the hip and the knee. You can use your top leg to alleviate some of the pressure if it is too intense. When you find a triggerpoint or tight spot, hold there for 30 seconds. If the sensation is too intense, simply roll away until you can handle the pressure. The lighter the pressure, the longer you must hold the position for up to 90 seconds. You may follow this with slowly rolling back and forth. If you have significant shoulder or wrist dysfunction, this may not be the best method for you. There are some associated risks with using a foam roller. Therefore, it is contraindicated in those with osteoporosis, organ failure, or going through treatment for cancer. As always, consult with your physician if you have questions. You are also welcome to email me, and I will do my best to provide answers.

Once the ITB has been released, one may properly lengthen the tissue back to its normal state. We do this in order to promote balance around the joints which are affected by the tissue. This can be done through a simple static stretch for 30-60 seconds. One must not bounce when performing a static stretch. Maintain a solid "pull" throughout the area for the entire length of the stretch. The picture here is quite generic and is only one of many ways to lengthen the ITB. In this picture, the model would be stretching the left ITB by poking her hips to the left and leaning the upper body to the right.








Once one has effectivly inhibited and lengthened the over active area, it is time to activate or strengthen the underactive or weak muscles which lead to the syngergistic dominance of the overactive muscle. In this particular case, without meeting the person or performing a static and dynamic movement assessment, we will assume the underactive tissue is the gluteus medius. One method for strengthening the gluteus medius would be to lye on your side with the affected leg up, and your back against a wall. While maintaining your heel in contact with the wall, toes aimed forward, you raise the leg as high as you can without form being affected for 2 seconds, hold for 2 seconds, and lower for 4 seconds. Perform this exercise initially for 10-15 repetitions for 1-2 sets.


Now that we have created balance around the joints affected by the overactive/underactive muscles, we can integrate them back into the human movement system through a full body exercise which promotes coordination between the muscles. To do so we could utilize the ball wall squat into overhead shoulder press. Overhead movements place further stress on the core and upper body during a squat thus increasing inter musculature coordination during the exercise (Clark & Lucett, 2011). I apologize for the picture as it does not include the overhead shoulder press portion of the movement. To perform the movement begin with the stability ball supporting the lower to mid back in the standing position with the dumbells to be pressed placed at chest level with palms facing inward. Feet are shoulder to hip width apart with the toes aimed forward and the knees remaining in line with the second and third toes. Squat to roughly 90 degrees or as tolerated maintaining the original alignment of the knees and feet. As you rise to the standing position, externally rotate the shoulders allowing the palms to turn outward as you raise the dumbells overhead. Once the arms are overhead they should remain in line with the ears without jutting the head forward at all. If this can not be completed, begin with the squat portion of the movement with the hands on the hips as further corrective exercise may be required to address shoulder dysfunction. Perform this exercise 10-15 repetitions for 1-2 sets.

This entire process must be performed consistently at roughly 3 days per week to yield its benefit in some individuals. I do not have research to back this frequency but I have found this to be effective in most of the individuals I work with. Once the improper movement patterns are corrected, one can slowly be reintroduced back into more intense training methods. Continuing a regular foam rolling and flexibility routine may help to decrease the likely hood of this problem repeating itself down the line.

I must include that this routine may seem "easy" to some but I have to stress that it is necessary to correct an improper movement pattern. The isolated and integrated movements may be progressed to more difficult or intense movements throughout the program. Also, this is not the only method available for correcting improper movement patterns. There are other other methods which can be explored such as physical and massage therapy.

Please comment in the comments section below! I believe that in order to comment, you must have a google account or email.

Thanks,
Joe

Clark, A., M., & Lucett, C., S. (2011). NASM essentials of corrective exercise training. Philadelphia:Wolters Kluwer and Lippincott Williams & Wilkins.



 

 



 

 

 

 

"I love endurance!" So how do I build muscle?

The title of this blog may be somewhat misleading. Don't get me wrong, I intend to answer this question as well as a few others but I hope to answer this question for those who do not "love endurance" training while leading into more specific information on building muscle while maintaining the endurance training that you may or may not love so much.

This blog is in response to several questions my sister received on her facebook account from a fellow fitness enthusiast. My sister is in great shape, she however is a novice to the health fitness field in terms of fitness advisement. So she fowards these questions to me. She is however, the most motivated, passionate, and encouraging person I have ever met and it won't be long before she is an expert in the health and fitness field!

 

The individual who sent these questions to my sister loves endurance training. She regularly competes in 100 mile bike races and triathlons when the weather permits. She would much rather ride a mountain bike for 4 hours than do yoga for 30 minutes. She recently moved to Colorado and has had some issues with IT band inflammation so she hasn't been running in months. This person states her goals of looking to increase her muscle mass for the upcoming year and would prefer workout routines she can complete outside of a gym as she is unlikely to join a gym until her home sells. She asks "Do you think a steady circuit routine will be enough to get back what she has lost and stay in shape for the winter?"

 

I look foward to using multiple blog posts to answer these questions as there are several areas here which will need to be addressed. If you have any questions so far, please feel free to ask!

 

Thanks,

Joe