Tag Archive for: exercise

Observations and Questions About the Step Study

/in /by

Most research papers such as the step study I began to review on Thursday have a main point, sometimes a couple points, and that’s all we take from it. But there some interesting things that may not get headlines but are still worth mentioning. Let’s take a look at some other results from the steps and mortality study.

Observations

Whatever you might believe about exercise was proven true by this study—not the positive outcomes such as the decrease in overall mortality, as well as CVD and cancer mortality, but questions that paint a picture of who exercises. For every category, from education to smoking to alcohol consumption, what we would expect was confirmed. But we also learned that people are high steppers who we would not expect to be.

For example, would we expect obese subjects to be in the fewer than 4,000 steps per day category or in the greater than 12,000 steps per day category? You would be right if you thought most were in the more sedentary category; 36.7% of those with a normal BMI were in the highest step category. But it doesn’t mean that there were no obese subjects in the greater than 12,000 steps per day category; in fact, 24.8% of those with BMI greater than 30 were in the highest step category.

Why? That’s what we really need to find out. What makes them different? Why are they doing what we don’t expect, or did they just do that well when they wore the accelerometer? If we want to change behavior, that’s what we need to find out.

This was an observational study, so it cannot prove cause and effect, but it gives us insight into the type of studies that will be able to determine cause and effect, such as randomized controlled trials. They can be better designed by building on this study.

Questions

Because we’re in a “Stay Home and Stay Safe” environment, there were some logical questions about stepping and coronavirus infections but I couldn’t find a single answer. When I searched for “fitness and coronavirus,” I found the term fitness meant fitness of the virus, not humans.

I used different search combinations and finally decided to try exercise and coronavirus. There were a number of papers that were written in the last couple of months about the safety of exercise during the pandemic as well as exercise to relieve stress for first responders, but those are still not exactly what I wanted. I wanted to see if steps or exercise would reduce the rate of catching coronavirus, any coronavirus.

I didn’t find that, but I discovered an interview with exercise immunologist Dr. Jeffrey Woods. Rather than summarize it for you, I’m giving you a link to this article for you to read. While it’s difficult to prove improved resistance to coronaviruses, Dr. Woods’s creative research has come close. As long as most of us have the time, I suggest that you read it.

The Bottom Line

Research studies such as the one I’ve reviewed this week tell us a lot about what we know and what we still need to find out. There are too many questions left on the table that never get answered related to diet, nutrition, and exercise. Do you really get all the nutrients you need if you eat a perfect diet? No one knows because no one has ever tested it. Let’s hope we get some answers related to diet, fitness, and supplementation as it relates to the prevention and possible treatment of the coronavirus when this challenge is all over, but I’ll go out on a limb and say you’ll never be worse off by being in better shape. Now that many of us have more time, let’s work on that.

What are you prepared to do today?

        Dr. Chet

References:
1. JAMA. 2020;323(12):1151-1160. doi:10.1001/jama.2020.1382.
2. Journal of Sport and Health Science 9 (2020) 105-107.

Step It Out!

/in /by

By the looks of it, “Stay Home and Stay Safe” will extend through the beginning of May and perhaps longer. As we adapt to our new normal, here is a little incentive to make exercise a regular part of your life from now on.

Researchers analyzed data from the 2003–2005 National Health and Nutrition Education Survey (NHANES). During that version of this recurring study, they collected seven-day accelerometer data from over 4,850 adults 40 years and older representative of the population of the U.S. They tracked the group of subjects through 2015 to look at all-cause mortality and steps per day.

If you look at the graph, you can see that deaths per 1,000 decreased as the number of steps per day increased. The mortality rate was half the amount at 8,000 steps per day than at 4,000 steps per day. While it continued to decrease slightly, the optimal amount of steps seemed to be between 8,000 and 10,000 steps per day. One surprising outcome was that intensity didn’t seem to matter; just volume.

All-cause means just that: all causes. That’s a real motivating factor to work on stepping it out every day. But it raised a question: could steps per day reduce the risk of getting upper respiratory infections? I won’t make you wait until Saturday. The answer is that no research has answered that question yet. But there was a lot more to this study, and I’ll cover that on Saturday.

Reminder: this week you can save 19% on two items at drchet.com. Use the coupon code virus.

What are you prepared to do today?

        Dr. Chet

Reference: JAMA. 2020;323(12):1151-1160. doi:10.1001/jama.2020.1382.

No Time for Exercise!

/in /by

One complaint that I get all the time is this: people tell me they don’t have time to exercise. I can understand that. There are some days exercise just isn’t an option, especially when you’re sick. But that’s supposed to be the exception, not the usual situation, and it just isn’t true for most people.

A recent study was published by the CDC using survey data from the American Time Use Survey. They collected data on over 30,000 people on how they spend their time. That includes working, total leisure-time activities, and time in exercise. They collected data on gender, education, and of course, age. What they found is that in spite of what people say, they have between three to five hours per day of leisure time.

Where did they seem to be spending that time? They’re spending it on a screen: their phone, their computer, or their television. And that seems to suck up the time they could be exercising. There’s a lot more to this study and I’m going to cover that in a future Straight Talk On Health (free to Members and Insiders), but for now, I think it’s time to take an honest look at how much leisure time you really have, because it seems most of us have the 20, 30, or 45 minutes we need most days to be able to work out. No excuses. Do your job.

Reminder: there are still seats for the Nutrition in the 21st Century seminar in Chelmsford this Saturday. If you have the time, you could learn a lot about nutrition and supplementation.

What are you prepared to do today?

        Dr. Chet

Reference: Prev Chronic Dis 2019;16:190017. DOI: https://doi.org/10.5888/ pcd16.190017.

Holiday Eating: The Best Solution So Far

/in /by

In our quest to find the best holiday eating strategy, we may have been looking at the wrong metric. Prior researchers have been looking at the subjects reporting of how well they stuck to their eating habits and exercise program. The final study looked at a hard metric: body weight. Here’s what they did.

Researchers recruited subjects who were overweight and obese but had been losing weight, plus a group of normal-weight subjects. They further divided the two groups into control groups and experimental groups. The control groups simply weighed in before the holiday season began at Thanksgiving, after the season ended on January 1st, and again a month later. The experimental groups also weighed in during those times but in addition, they were told to weigh in every day using a scale with Wi-Fi access. Their results were displayed graphically to chart progress.

What happened? The control groups, whether overweight, obese, or normal weight, gained an average of close to six pounds during the holiday season. The normal weight subjects who weighed themselves daily maintained their weight. Those who were overweight and obese continued to lose weight, losing on average 2.5 pounds. At the one month follow-up, the control group lost only half the weight they gained over the holidays. Researchers speculate that annual holiday weight gain contributes to weight gain over years.

The Bottom Line

What’s the best strategy for holiday eating? There are two things that are critical: maintain your exercise program and weigh yourself regularly, preferably every day. True, your daily weight will fluctuate but you won’t let it get away from you—that’s when you get into trouble. As for your eating habits, not every day is a holiday party with mass quantities of food to consume. Chill out a little during the parties and pitch-ins, but for the most part, stick to your regular eating habits; that applies whether you’re overweight or not. I think that’s the best strategy for the holiday season.

What are you prepared to do today?

        Dr. Chet

Reference: Obesity. 2019;27(6):908-916. doi: 10.1002/oby.22454

Should You Have a Strict Holiday Eating Strategy?

/in /by

Tis the season for gaining weight. It began on Thanksgiving, but we’re in it big time now. If you’ve lost weight and want to make sure you don’t see it again, what do you do? Let’s review some of the research on strategies that people who’ve lost weight and maintained it have used.

The first is a report from the National Weight Control Registry. In order to be a subject in that study, you have to lose 30 pounds and maintain it for at least a year. Researchers took a group of recent additions to the study and asked them specific question on their strategies during the upcoming holiday season at that time, and then tracked how they did. They also recruited a group of normal weight people and did the same thing.

Most of the experimental group said they were going to follow their typical routine as related to diet and exercise plan. In other words, they were going to try to strictly follow their weight loss routine. The normal weight individuals didn’t really have any special plans. Most successful losers did follow their plan although it was more difficult during the holiday season. About the same percentage of successful losers and normal weight subjects gained weight, maintained their weight, or lost weight during the holiday season. The difference was that the successful losers found it more challenging to do so based on their response to survey questions.

Is that the best strategy? Stay the course? Another study on Thursday.

What are you prepared to do today?

        Dr. Chet

Reference: J Consult Clin Psychol. 2008. 76(3): 442–448.

How Your Microbiome Affects Exercise Benefits

/in /by

It seems every day, there are several studies on the microbiome and its impact on our health. At this point, they’re preliminary but the picture is emerging that as goes your gut, so goes your health. I’ve picked three new studies to review this week.

As an exercise physiologist who’s done research on this topic, I’ve always recommended exercise as a way to improve control of blood sugar for prediabetics; that’s why this study surprised me. Researchers assigned 39 prediabetic men who had never used medication to either a control group or a high-intensity exercise group for three months. All men in the exercise group had similar improvement in fitness and weight loss. But only 70% of the men demonstrated an improvement in insulin resistance.

The way the responders processed protein and carbohydrates was different from non-responders. The researchers collected stool samples and then transplanted the microbiome of responders and non-responders into a group of mice; the mice responded to exercise in the same way as the man whose microbiome they received. The microbiome somehow responded differently to exercise and modified the expected results.

We don’t know about dietary differences between subjects that might have impacted the outcome because the subjects were told to maintain their current diet, but the results were surprising nevertheless. But I would still give the same recommendation for exercise to all prediabetics. The only difference would be to make sure they tracked blood sugars to see how their blood sugar responded.

What are you prepared to do today?

        Dr. Chet

Reference: Cell Metabolism, DOI: 10.1016/j.cmet.2019.11.001.

It Gets Worse Before It Gets Better

/in /by

In last month’s Memos, I talked about many different aspects of exercise including flexibility, strengthening, and the various types of fitness and stamina. There’s one more thing you need to know. But first, a story.

Paula has been having an issue with her ankle and foot. She got it checked out with her podiatrist, and it’s a problem with the tendons in her foot including the Achilles tendon. Yesterday we went to see our favorite physical therapist; he did a thorough examination of her foot, ankle, knee, and hips. He recommended some stretching and strengthening exercises as well as some non-impact aerobic exercise. He then said something important: everything may seem worse before it gets better.

I’m going to tell you the same thing as you attempt to work on your body to help you really live instead of merely being alive: you may feel worse before the work you invest begins to pay off and you start to feel better. That’s one reason I ask you to see your doctor before you begin, who’s familiar with your orthopedic issues as well as any conditions that can be impacted by exercise. That’s why you always check first.

If you can get professional help to help you get started, that’s even better—someone to help you choose the right exercises to fit your particular body and limitations. Get a referral to a good physical therapist or find a certified personal trainer with experience helping people who are less fit; you definitely don’t need one of the no-pain-no-gain goons. It doesn’t need to be a long-term relationship, just advice to help you get a good, safe start. And you can probably work out a routine to do at home if joining a gym isn’t your style, but a short-term membership may be helpful in determining which exercises and types of equipment are best for you. For example, don’t buy an exercise bike without trying different types.

For a while, you’ll probably feel worse, especially if it’s been years since you’ve worked on some of these muscles and joints. You may want to refer to the pain scale on drchet.com. Take it slow and let discomfort be your guide. If you overdo it and you’re in pain, back off, ice or heat and rest, and then get going again with a little more caution. After all, you want to live all your days. The work you put in will generate some satisfaction before you may feel the benefits. Better to take longer to get there than stop altogether. The good news is that once you get over that hump, and it may take many months, you’ll feel better than ever.

What are you prepared to do today?

        Dr. Chet

Maintaining Bone Health

/in /by

In trying to live every day we’re alive, I’ve spent a lot of time talking about the ability to move, but it’s not just about muscle. Those muscles connect to bones for the most part, and the bones must be healthy as well. One of the basic tenets of healthy bones is Wolfe’s law, which can be summarized as “function determines structure.” In everyday terms, to have healthy bones you must stress them regularly. Exercise is critical to that effort. But it’s not as simple as that.

Hormones and nutrients are also critical to bone health. Our ability to make hormones and absorb and utilize nutrients diminishes as we get older. Hormone replacement therapy has been controversial, and that’s a discussion a woman should have with her physician. In terms of nutrients, the ones critical to healthy bones are calcium, magnesium, vitamin D, and vitamin K2.

Before increasing any nutrients via supplements, have a bone-density test as well as a vitamin D test. If either test has low results, then taking a combination of the nutrients mentioned earlier would help the bones when combined with exercise. Any exercise that’s weight bearing is beneficial such as walking, but not swimming, with added benefits for weight training.

Maybe the best we can do is to stop the loss of bone mass, but that will help you live better for longer. We’ll move from bones to joints on Thursday.

What are you prepared to do today?

        Dr. Chet

How Flexible Are You?

/in /by

Living every day you’re alive requires flexibility. Range of motion in your joints is important to your ability to move, but it can be difficult. As the years add up, touching your toes with your knees locked, whether sitting on the floor or standing, lifting your arms over your head, or even lifting your arms to shoulder level can be a challenge.

Connective tissue tends to tighten as we age; it’s another case of use it or lose it. And when I say age, I mean from teen years on. Later, after we’ve torn ligaments, sprained ankles, been in accidents, and on and on, if we haven’t worked on our range of motion, we can end up restricted in our ability to move. The less we move, the more restricted we can get.

The obvious way to increase flexibility is to stretch. There are dozens if not hundreds of programs online, but I would recommend that you get an examination by a physical therapist who can identify your strengths and weaknesses and prepare a program just for you, taking into account your current level of flexibility and previous injuries. The older you are, the more strongly I recommend physical therapy, because if you stretch too far and damage connective tissue, you’ve just made your situation worse. Another option, especially if you’re younger or more fit, is to try yoga, which is an overall muscle-strengthening and stretching program. Take a class with an experienced instructor so you can get feedback on whether you’re doing the movements correctly.

Stretching is something you should do every day. There’s one area that needs special attention and that’s your core. I’ll cover that on Thursday.

What are you prepared to do today?

        Dr. Chet

Preventing Muscle Loss

/in /by

This final installment on muscle focuses on keeping the muscle mass you’ve got. That’s one of the keys to living every day you’re alive: the ability to move at every age. There are three things that are important to hanging onto muscle.

  • Use it or lose it. Actually, you’re going to lose it not matter what, but the degree to which you will is partially dependent on using it. Whenever you can take the stairs, take them. Whenever you can lift something, lift it. While I would hate it personally, it was better when we had to get up and actually walk to the television to change the channel. More today than ever, we don’t take the opportunity to build muscle or increase stamina.
  • Exercise regularly. No matter your age, there’s always something you can do. Orthopedic issues happen as we get older—arthritis in hands, shoulders, hips, and knees, or torn ligaments and cartilages. They can all put limitations on what we can do. We have to work within those restrictions and do as much as we can to maintain and even increase what we have. A session with an excellent physical therapist (ask your doctor if you qualify for some free sessions) or certified personal trainer could be worth the money. It’s never too late to begin. Research has shown that even people over 100 years old can increase strength and stamina.
  • Consider taking essential amino acids every day. While the focus has been on what EAAs can do for people who train hard, the bulk of the research has been done on people 50 and older. It’s clear you can slow down muscle loss and increase muscle strength by exercising regularly and taking EAAs every day. I’ve been taking them the days I lift, but I’m considering taking them every day. In continuing to research the benefits, there doesn’t seem to be a downside to taking EAAs. There’s some preliminary research that indicates that taking EAAs may even be beneficial for pre-diabetics to reduce insulin levels and triglycerides if they exercise regularly as well.

The purpose for the month’s Memos is showing you how to learn to live every day you’re alive. Muscle is critical to that goal. We’ll move on to another important physical component of living next week.

What are you prepared to do today?

        Dr. Chet