Celebrate Your Independence

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Tomorrow we celebrate Independence Day in the U. S. with parades, picnics, and fireworks. We will eat our favorite grilled foods—burgers and dogs or smoked slow-cooked ribs and corn on the cob and on and on.

The problem is that while we celebrate our nation’s Independence, we are giving up our own independence. Based on a just-released report from the Centers for Disease Control, just 22.9% of all adults meet the exercise guidelines set 10 years ago (1).

It’s this simple: if you’re not working at moving, you’ll eventually lose your independence to move. You’ll need canes and walkers just to be able to prevent falls. You may graduate to a wheelchair and then the ultimate: the motorized cart. The more sedentary you are, the more independence you lose. Ever sink your behind into a chair you couldn’t get out of without help? Imagine if that’s your life all day, every day.

The guidelines aren’t that complicated. Two days a week, do some muscle-strengthening activities: lifting weights, calisthenics, yoga, whatever strengthens and stretches your muscles. Then either moderate-intensity aerobic exercise for at least 150 minutes per week or 75 minutes of vigorous-intensity aerobic exercise or some combination of the two. That’s it. Just about 30 minutes per day.

Yet less then 23% of all adults meet those guidelines. Some states are better than others. The best? Colorado at 32.5%. The worst? Mississippi at 13.5%. Just for comparison, I checked a similar map of the diagnosed type 2 diabetes rate of the U.S. If you super-imposed the type 2 diabetes diagnosis rate over the exercise levels, they would be close to identical. The lower the rate of exercise, the higher the rate of diabetes. Diabetic neuropathy, diabetic retinopathy, and a whole host of other health issues wait for those who stay sedentary.

The Bottom Line

Over this holiday and the succeeding weekend, try doing some type of aerobic activity every day for 30 minutes. Continuous or broken up into two 15s or even three 10s. If you can, try to do some stretching for 10 minutes one of those days. Find out for yourself that it’s not that big a deal. Then make it a habit to meet those guidelines. Years from now, you can celebrate your independence from canes and walkers, and so on.

Today, I record the 700th edition of my Grand Rapids radio show Straight Talk on Health. See the Health Info page for info on how to listen online; if you’re a Member or Insider, this new edition will be posted after it plays this weekend.

Happy Fourth of July, a belated Happy Canada Day, and a simple thank you to all my readers all around the world—I continue to be amazed at how many countries this Memo reaches. I’ll be back with new Memos next Tuesday. Until then:

What are you prepared to do today?

Dr. Chet

 

References:
1. https://www.cdc.gov/nchs/data/nhsr/nhsr112.pdf
2. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf.

 

Toddler Health Tip: No More

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“No more!” Those are the words Riley says when he doesn’t want any more milk, food, or anything else we feed him. When he says “no more,” that’s really it—he’s done. At dinner last week, Paula said, “That pasta was great and I could eat more, but I think I’ll be like Riley: no more.”

Wouldn’t it be great if we would just use those words when our brains tell us we’ve had enough and our eyes tell us it still looks really good? No more. Say it out loud and really make a commitment. It doesn’t mean that seconds aren’t available. It doesn’t mean that a sweet dessert isn’t there. It just means you’re not having any more. You can say that any time during the meal or after you’ve cleaned your plate, but that lets you and everyone else know that you’re done eating. Period.

“Just one more bite.” I’ll bet you’ve done that a time or two or a thousand. I have. But you’ll take no more even when you’re putting away leftovers or getting the take-home box from the restaurant. And you don’t clean up the bite or two the kids left on their plates. No more means no more.

You can follow the ketogenic diet, the Mediterranean diet, a vegan diet, or any of the many ways to eat, but unless you learn to say “no more” on a regular basis, you won’t get to the body weight you desire.

Be like Riley. Say “no more” and see how it affects your weight.

The Bottom Line

The Memos this week have focused on a common-sense approach to health. We absolutely need to get ourselves checked out by healthcare professionals to make sure there’s no underlying disease going on. Once that’s done, remember that many times, the simplest solution is the correct one. That’s a common-sense approach to health.

What are you prepared to do today?

Dr. Chet

 

Common-Sense Health: Pillow Talk

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Sometimes the smallest mechanical changes can make a big difference. Here’s an example. When I lived in Indiana, a member of my running club had developed chronic hip pain. He spent over a year trying one thing after another with no real relief: new shoes, different types of shoes, orthotics, stretching the iliotibial band that runs the outside of the hip down to the knee, chiropractic. He tried everything. Finally, one day, he went into his closet to find a specific type of shoe and he happened upon his old pillow. About a year before, his wife had purchased new pillows; he always liked the old one, so he put it back on the bed. Within three days, his hip pain was gone.

I could try to explain the changes in forces on the body due to the pillow, but it’s complicated. Suffice it to say that small changes in mechanical forces can create changes in the way the body is aligned. Most of the time we probably just adapt with no issues. Once in a while, people don’t adapt and they have problems that in no way seem related to those changes. It can and does happen.

Common-sense lesson? When you have pain, you should always get it checked out. Once the possible has been eliminated, check for the changes you’ve made—even something as innocuous as getting a new pair of jeans. If they’re just a few millimeters tighter than the last pair, you could change the forces that result in lower back pain. New desk chair, new sofa, any change in your environment can have detrimental effects.

The final common-sense health tip comes from our grandson Riley on Saturday.

What are you prepared to do today?

Dr. Chet

 

Common-Sense Health: Where Is Your Wallet?

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Keeping things balanced is important, and I try to do that in the Memos I write. Usually I tackle issues that are serious with significant health implications, but life is to be enjoyed so this week, we’ll lighten up before a holiday by talking about a guy’s wallet. And this is also about balance.

When Paula and I had dinner with friends this weekend, the husband talked about the physical therapy for back pain he’s been doing. The exercises have worked, but he chided me: “You didn’t tell me my wallet could affect my back.” Oops. He’s correct.

If you have a wallet in your back pocket and you sit most of the day, the force of the chair on the wallet can compress the sciatic nerve, and voila, you may have pain shooting down your lower back and the back of your leg. A recent paper talked about three men with lower back pain that was due to their wallet.

The simplest solution is to reduce the size of your wallet or just carry what you actually need on a clip in your front pocket or in your jacket: a picture ID, a credit card, your Costco card, and some cash. What more do you need? Membership cards? I have an app on my phone that shows my gym membership so I don’t need to carry that card.

If you have lower back pain, I would recommend you get a referral to a physical therapist to find out how you should deal with it; there may be different muscle groups involved depending on your specific anatomy. But if you’re sitting on a fat wallet that throws off your balance, changing that could make a difference.

How could your pillow affect your hip? I’ll let you know on Thursday.

What are you prepared to do today?

Dr. Chet

 

Reference: Curr Rheumatol Rev. 2017 Mar 9. doi: 10.2174/1573397113666170310100851.

 

The Bottom Line on Essential Amino Acids

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Essential amino acids are becoming more prevalent in the sport nutrition supplement offerings. Yet there are still questions that remain, and we don’t have a total picture of who will benefit from EAA use. Let’s take a look.

Questions

Even with this new research, there’s so much we still don’t know about EAAs.

  • Is there a special proportion of EAAs that works best? In other words, should the amount of leucine or isoleucine or tryptophan be higher than other EAAs? What’s the best proportion?
  • What’s the best source? Milk, which contains whey and casein? Soy? Rice? Pea? Or a form of meat such as chicken, fish, or beef?
  • Do the EAAs compete for absorption? Does eating a complete protein such as the protein in beef or chicken inhibit the absorption of the EAAs in the protein? After all, just eating more meat could potentially be the best solution, but maybe it’s not as efficient as getting the EAAs in a stand-alone product.
  • How much muscle will athletes build in how long a time? Will it be 1% or 5% better than just eating more protein or will it be the same?
  • Should the EAAs be taken alone or as part of a protein shake?
  • When is the best time to take the EAAs in relation to a workout? Or does it really not matter? What about other nutrients taken at the same time such as carbohydrates or fats? Will they positively or negatively impact the EAAs?

There are some partial answers in the research but nowhere near enough to say “This is how you do it for the best benefit.” That’s not to say that there are no opinions, but it’s based more on limited research or personal experience than anything else.

The Bottom Line

Based on all of the available information, here is the bottom line on EAAs.

  • Everyone needs more EAAs in their diet, especially those of us over 50. (We all need to do more resistance exercise, but that’s a different Memo.) It’s more than just losing muscles mass as we age; it’s also about being able to make all the hormones we need for optimal health.
  • Eat about one gram protein per pound of body weight up to about 150 grams per day. If someone is overweight or oversized, trial and error is the only way to set an upper limit. But it’s critical for athletes and older people to hit that mark. Chicken seems to be the best profile for EAAs next to milk protein, but there’s more research needed.
  • If you get your EAAs from powders, whey protein isolate seems to have the best profile based on the content of branch-chained amino acids, but soy protein has a good profile as well. There doesn’t seem to be a perfect source yet.
  • If you want to take a separate EAA product that has no other amino acids, that’s fine. It will probably be best to take it before you work out or lift weights, but there’s good reason to take it after working out as well. About 15 to 30 minutes later, take your complete protein, whether from powders or food.

As research continues, I’ll update the recommendations as we get more answers. For now, make sure you get enough protein for health and growth based on what we know today.

What are you prepared to do today?

Dr. Chet

 

Essential Amino Acids for Older Adults

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One of the issues we all face as we get older is the loss of muscle mass; the technical term is sarcopenia. While some of the loss can be attributed to declining hormone levels as well as the decline in physical activity, we tend to eat less protein as we get older. Less protein intake means less muscle and other protein synthesis.

Researchers in Japan wanted to see if increases in muscle mass were related to protein intake, specifically EAAs. Instead of jumping right into supplementing with EAAs, they recruited 10 older men with a mean age of 69 and gathered nutritional information using a three-day dietary record. They put the men on a progressive weight training program, lifting three days per week for 12 weeks.

All men gained muscle mass, about one pound of muscle per leg. In analyzing the diet, the average protein intake was 99 grams of protein per day with 37 grams from EAAs. What they found was that those men with higher EAA intake, especially leucine, had a greater increase in muscle mass. It was even better if they had the EAAs with their breakfast.

This was a small preliminary study that examined current food intake with no intervention other than exercise. It may indicate that in order to be efficient at adding muscle mass, EAAs are important in older adults. What does this mean for you if you’re in that age group or an athlete wanting to add muscle mass? I’ll let you know on Saturday.

What are you prepared to do today?

Dr. Chet

 

Reference: J Nutr Sci vitaminol (Tokyo). 2017;63(6):379-388. doi: 10.3177/jnsv.63.379.

 

Essential Amino Acids: The Basics

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I’ve been getting many questions about essential amino acids lately. What are they? Why do I need them? Are they only for athletes? What can they do for me? In addition, I came across an interesting study that supports the use of EAAs in a specific population.

The EAAs include the amino acids phenylalanine, threonine, tryptophan, methionine, lysine, histidine, leucine, isoleucine, and valine. They’re essential because we can’t make them, but we can make other amino acids from these EAAs. In addition, three of the EAAs are designated as branch chain amino acids (BCAAs): leucine, isoleucine, and valine; they’re known as protein-building amino acids and important for building muscle.

Think of the EAAs as the rate-limiting amino acids. If we don’t have enough of them, we can’t make the other amino acids and thus, every protein made in the body can be affected. We often think only in terms of muscle, but the lack of EAAs could affect the manufacture of insulin, human growth hormone, leptin, and adiponectin to name just a few.

BCAAs have been marketed to athletes who are training to make muscle for years. Recently, EAAs have entered the arena because of their ability to make proteins that support muscle building. But that’s not the only group that may benefit as a recent study demonstrated. I’ll cover that on Thursday.

What are you prepared to do today?

Dr. Chet

 

Triathlon Observations: Prepare to Compete

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Let me be clear: I think that the single most important thing that you can do to be healthy is to exercise regularly. Whether walking, swimming, or one of the hundreds of other types of exercise, talking with your physician about it may be all that’s required for you to get started.

Moving from exercise that helps your health to competing in fitness events requires more—that’s independent of your body weight lest you think I’m talking only about the very heavy people that competed in the triathlon. Here’s what I recommend.

First, you should have a stress test that assesses how your heart and blood vessels perform under maximal conditions. That applies to men over 40 and women over 50, for sure. But I also think if you have been overweight for over five years, you should have the test regardless of age. The maximal exercise test is not foolproof, but it’s the best available predictor of heart problems. This isn’t just me being a worrier; I’m sad to report that one participant died of a heart attack last Sunday. Getting checked out before you start is the best way to protect yourself.

Second, you should have a complete lipid profile, HbA1c, and a blood insulin test as a minimum. As I suggested in Thursday’s memo, you need to know whether you’re a prediabetic or even an undiagnosed type 2 diabetic. The best option for you would be to exercise, but when you push yourself hard for long periods of time, it’s going to affect your blood sugar levels as it would affect a diabetic’s, not someone who has a normal carbohydrate metabolism; for instance, you could pass out if your blood sugar gets too low, and if you’re out alone on a run, that’s a problem. You can deal with it, but you have to know if it’s an issue.

Third, you should get an orthopedic analysis. By that I mean that your joints should be evaluated for range of motion, tendon and ligament stability, and gait. Swimming affects the shoulders, bicycling the lower back, and running the hips, knees, and feet. Any abnormality will be exacerbated; for example, the forces you create when you run is five times your body weight. Do the math—that’s a lot of stress on your knees and feet.

Once you get the all clear, get after it. Start conservatively but if you have the urge to compete to see what you’re capable of, do it. I think if you want a challenge, whether to walk or run a 5K, swim a mile, or bike 50 miles, or combine them into a single event such as the triathlon, you should do it. Just make sure you get your body checked out before you do.

Final Observation

While I believe exercise is important no matter the level at which you do it, exercise won’t help you lose a lot of weight. Surprised? Remember the size of the people I mentioned that competed in the triathlon—not just overweight but obese? If they had put in the training, and I know some of the competitors and know that they did, you’d have thought they would have lost a significant amount of weight. They didn’t.

Burning calories helps with weight loss, but as a well-known expert once said “Americans can’t out run their appetites.” If you could exercise six or eight hours a day, you could probably lose weight without changing your diet, but I doubt you have that kind of time. You can use exercise as a tool to help you lose weight, and exercise pays major benefits in fitness, strength, and stamina. But you will not lose weight unless you also eat less and eat better.

What are you prepared to do today?

Dr. Chet

 

Triathlon Observations: Heavy and Healthy?

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The major observation I had as I volunteered at the Grand Rapids Triathlon was that the body weight distribution of the people participating in the triathlon mimicked the population of the U.S. We’re a fat nation; 70% of the population is overweight and half of those are obese. Those percentages also seemed to apply to the participants in the race.

In addition to being a regular Grand Rapids event, the Grand Rapids Triathlon was also the National Championship for the Clydesdale and Athena athletes. In order to qualify for the Clydesdale division, men must weigh over 220 pounds; for women to qualify for the Athena division, they must weigh over 165 pounds. Based on my observations, a majority of the participants would have qualified for that category, whether that was their intention or not.

There were men well over 300 pounds and women over 250 pounds that participated in the triathlon. Talking with several other volunteers, I said that unless they had a signed release from their physician, I would hesitate to let them participate. They countered that as long as people put in their time training, they were fit enough to compete. Good point, but that logic doesn’t really hold up. The primary concern everyone thinks of is cardiovascular disease and that makes sense. But if someone is overweight, the real concern is undiagnosed type 2 diabetes and orthopedic stress.

While I applaud their effort and would never want to prevent anyone from exercising, I would hope that they would have had a thorough medical exam before they took their first step. We can’t assume because they had trained for the race they were actually healthy enough to compete in the race. I’ll cover what those tests should be and a surprise conclusion that you don’t want to miss on Saturday.

What are you prepared to do today?

Dr. Chet

 

Triathlon Observations: The People

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The Grand Rapids Triathlon was held this past weekend, and I volunteered to work at an aid station. The station happened to be at the transition area where everything is happening; I couldn’t have picked a better spot. People lined up to head to the river for the swim, coming back from the swim to get on their bike, then parking their bike and finishing up with the run portion of the triathlon. It was fascinating to watch as they finished one portion of the event and had to change modes to do the other.

There were three different triathlons going on at the same time, made possible by advancements in chip timing. The computer knows where everyone is all the time. Here are the events and distance for each:

Sprint: 600 meter swim, 20K Bike, 5K Run
Olympic: 1500 meter swim, 40K Bike, 10K Run
Half-Ironman: 1.2 mile swim, 56 Mile Bike, 13.1 Mile Run

People of all ages and sizes competed. I think that’s the operative word: compete. Even though it was most likely a personal goal to see whether they could finish or not, trying to finish in a specific time, or maybe even trying to win their age-group, the willingness to complete and put forth such a tremendous effort is something to be admired.

But should everyone have been out there swimming, biking, and running? I’ll talk about that on Thursday.

What are you prepared to do today?

Dr. Chet