The Couch Will Not Make You Faster

Sit or Get Fit?

Reprint From Tufts University

New research makes the choice clearer than ever:  Physical activity is key to living healthier longer, while inactivity shortens your life.

If you need a push to get off the couch, a flurry of new research should provide plenty of motivation.  The findings about the negative effects of inactivity and the benefits of physical activity couldn’t be more stark: Sitting too much is dangerous for your health, while getting fit helps protect everything from your waistline to your brain.

“Any activity is better than nothing. That’s the really important message,” says Miriam E. Nelson, PhD, director of Tufts’ John Hancock Research Center on Physical Activity, Nutrition and Obesity Prevention. “Don’t think, I’ll never get there.” It’s important to take a stepwise approach.”

Screen time

Two new studies, published almost simultaneously, point to the health risks of sitting too much. In one, published in the Journal of the American College of Cardiology, Emmanuel Stamatakis, PhD, of University College London, and colleagues analyzed data on 4,512 respondents to the 2003 Scottish Health Survey, ages 35 and up. Over an average follow-up of a little more than four years, participants suffered 215 cardiovascular events (such as a heart attack or stroke) and 325 died from all causes.

People who spent at least two hours a day sitting in front of the computer or TV for entertainment were more than twice as likely to suffer a cardiovascular event than those with less than two hours of average daily screen time. Those heavy “recreational sitters” were also 52% more likely to die. Strikingly, even participants who exercised when not “recreationally sitting” did not mitigate the extra risk associated with too much sedentary screen time.

An analysis of a subset of participants who provided blood samples found that elevated levels of C-reactive protein (a marker for inflammation), greater body mass index (BMI) and low HDL (“good”) cholesterol partly explained why the sedentary were at greater risk. Researchers also suggested that excessive sitting might decrease healthy nitric oxide in blood vessels, due to reduced blood flow.

While the study wasn’t designed to prove cause and effect, Stamatakis and colleagues did conclude, “Our results support the inclusion of a sedentary behavior guideline in public health recommendations for cardiovascular disease prevention.”

Are you sitting down?

The second study, rather than relying on self-reported data, actually used accelerometers on participants’ hips to record active versus sedentary time-both at work and at play. Participants wore the accelerometers for an average of 14.6 hours a day, of which 8.44 hours were completely sedentary and only about 20 minutes were spent exercising. Among 4,757 adults, average age 46.5, longer sedentary time was associated with less-healthy measures of HDL cholesterol, insulin, insulin resistance, fasting triglycerides and C-reactive protein, as well as greater waist circumference. Genevieve Healy, PhD, MPH, of the University of Queensland in Australia, and colleagues published their results in the European Heart Journal.

What can you do if your job, say, demands, extended sitting time? Researchers found that periodically getting up and moving around for as little as a minute was linked to improvements in C-reactive protein scores and waist circumference.

Healy and colleagues concluded, “While further evidence of a causal nature is required from longitudinal and intervention studies, less sitting time would be unlikely to do harm, and would, at the very least, contribute to increase overall levels of energy expenditure.”

Shrinking “middle-age spread”

On the flip side, the benefits of staying physically active include the expected, such as staying slimmer, as well as such less obvious positives as reducing diabetes risk, improving arthritis symptoms and maintaining brain volume.

Start with the dreaded “middle-age spread.” Arlene L. Hankinson, MD, MS, of Northwestern University, and colleagues looked at the relationship between maintaining higher activity levels and changes in body mass index (BMI) and waist circumference over 20 years in young adults. Participants, initially ages 18 to 30, were quizzed about physical-activity levels at the study’s start and at periodic follow-ups. They were asked about participation in 13 moderate-and vigorous-intensity activities during the previous year, including sports, exercise, home maintenance and occupational activities.

Over those 20 years, men who maintained the highest activity levels gained an average of almost six pounds less than the least-active group and added 1.2 inches less to their waistlines. The difference was more pronounced for women, with the most-active group putting on 13.4 fewer pounds and staying 1.5 inches slimmer around the waist. Little difference was seen for either gender between the middle and least-active groups. Participants who kept up the recommended 150 minutes of moderate activity per week gained significantly less weight over 20 years than those who did not.

“These results suggest that maintaining higher activity levels during young adulthood may lessen weight gain as young adults transition to middle age,” the researchers concluded in the Journal of the American Medical Association (JAMA). “Our results reinforce the role of physical activity in minimizing weight gain and highlight the value of incorporating and maintaining at least 30 minutes of activity into daily life throughout young adulthood.”

10,000 steps against diabetes

Stepping it up not only helps you keep trimmer but also improves insulin sensitivity, a key indicator of diabetes risk, according to a new Australian study. Terry Dwyer, AO,MD,MPH, of the Murdoch Children’s Research Center, and colleagues put pedometers on 592 non-diabetic adult volunteers for two days, then repeated the test five years later. Although nearly two-thirds became more sedentary over that span, those who increased their steps counts whittled down their BMI and waist-to-hip ratio while boosting insulin sensitivity.

Researchers calculated that relatively sedentary individuals who added activity to reach 10,000 steps (about five miles) per day could knock almost a point off their BMI and improve insulin sensitivity by about 12%. The insulin-sensitivity benefit, although independent of calorie consumption, appeared to be largely due to lower body fat. Previous studies, the scientists noted in BMJ, had found positive effects of exercise interventions for diabetes prevention, but these new results suggest that “real-world” lifestyle changes can also pay off.

Rx for OA

Even a little extra physical activity can improve function and mobility among older adults with osteoarthritis of the knee. That’s the encouraging takeaway from a new Northwestern University study of 2,589 participants in the Osteoarthritis Initiative, average age 62.4. Dorothy D. Dunlop, PhD, and colleagues assessed levels of physical activity, at baseline and after one and two years, using the 26-question Physical Activity Scale for the Elderly (PASE), which ranges from sports activity to gardening to housework.

Both initially and at two years, greater physical activity was correlated to faster walking speed. Among the least-active adults with arthritis, 51% couldn’t walk fast enough (4 feet per second, 2.7 mph) to cross a street with timed traffic lights. But as activity levels went up so did walking speed. The findings demonstrate a “strong relationship” between physical activity and function, researchers concluded in Arthritis & Rheumatism, adding that “there was evidence of potential benefit of greater physical activity regardless of the level achieved.”

This is your brain on exercise

Your brain also benefits when your body is active. The latest study to demonstrate such a connection links aerobic exercise to volume in the hippocampus, a part of the brain that’s key to memory. Arthur Kramer, PhD, of the University of Illinois, and colleagues randomly assigned half of a group of 120 men and women in their mid-60s to a program of aerobic walking three times a week. The other half enrolled in stretching classes and served as a control group. Participants were tested for fitness and memory ability and given MRI scans to measure hippocampal volume. The hippocampus normally shrinks 1% to 2% a year with advancing age, contributing to memory loss and dementia risk.

After a year, however, participants in the aerobic-walking group had actually gained an average 2% in hippocampal volume. Those in the control group lost an average 1.4%. Improvements in fitness, measured by treadmill testing, were significantly associated with greater hippocampal volume. Those changes didn’t directly translate into a correlation between fitness and memory across study participants. But for the individuals in the walking group, increases in hippocampal volume were related to improvements in memory. In Proceedings of the National Academy of Sciences, Kramer and colleagues wrote that the results “clearly indicate that aerobic exercise is neuro-protective and that starting an exercise regimen later in life is not futile for either enhancing cognition or augmenting brain volume.”

If you were still clinging to an excuse for staying on the couch–“It’s probably too late in life to matter for me,” for example-we’re pretty sure  that just popped it. Time to lace up those sneakers and join the folks who are living healthier longer.

IS YOUR BIG BELLY SLOWING YOU DOWN?

Whole Grains Battle Your Dangerous Belly Fat

American Journal of Clinical Nutrition, November 2010

Whole grains can help fight the belly fat that’s linked to heart disease and diabetes, according to Tufts researchers, while refined grains like white bread and pasta can cancel out those benefits.

“Observational studies have linked higher intakes of whole grains to lower abdominal adiposity; however, the association between whole- and refined- grain intake and body fat compartments has yet to be reported,” noted Nicola McKeown, PhD, a scientist in Tufts’ HNRCA Nutritional Epidemiology Program and program director of Nutrition Epidemiology at the Friedman School, and colleagues in the American Journal of Clinical Nutrition.

So McKeown and colleagues analyzed data on 2,834 men and women, ages 32 to 83, participating in the renowned Farmingham Heart Study.  Dietary information was assessed using a food-frequency questionnaire, and results were adjusted for other lifestyle factors such as smoking and alcohol consumption, as well as calorie intake.  Researchers compared grain intake with individuals’ abdominal subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) -essentially, belly fat.  Such fat around the abdominal organs is particularly unhealthy, and is a factor in metabolic syndrome, a precursor to heart disease and diabetes.

People who reported eating three or more daily servings of whole grains and who limited their intake of refined grains to less than one serving a day averaged 10% lower VAT volume.  Eating more whole grains was also associated with lower SAT, while people consuming more refined grains tended to have greater SAT volumes.

In this study, a serving of whole grains was considered one cup of whole-grain breakfast cereal, such as oat cereal; half a cup of cooked oatmeal, brown rice or other grains; one slice of dark bread; three cups of popcorn; or two tablespoons of added bran or added germ, such as wheat germ.  Refined grains included processed breakfast cereals, white bread, English muffins, bagels, muffins, biscuits, white rice, pasta, pancakes, waffles, crackers, and pizza.

McKeown and colleagues reported that the VAT-fighting benefits of whole grains were diminished among people also eating four or more daily servings of refined grains.  McKeown commented, “This result implies that it is important to make substitutions in the diet, rather than simply adding whole-grain foods.”

How much whole grains should you aim to include in your diet?  The American Heart Association recommends getting at least three one-ounce-equivalent servings of fiber-rich whole grains per day.

Exercise...it's never too late!

Dr. Fischer Food for Thought

Dr. Rachel Fischer

Creativity–Your “Down-Time” Best Friend 

Whether you’re a daily exerciser, or someone committed to beginning a regular exercise routine, undoubtedly, there are circumstances that can dash even the best intentions.  For most people, these include normal life events, like travel, an increase in work or family demands, or something really frustrating like an injury.   However, as I mentioned in response to one reader’s recent question, there are ways to maintain fitness even during a “down” time.   Over the next few blog posts, I’m going to talk about a few strategies that may keep you from slipping into the “blah” feeling that comes with less activity.

Unless you’re bed ridden or it’s just not safe with your specific injury, the first strategy is to find some way to continue at least some level of moderate physical activity. Why is some level of activity a good idea?  Besides the obvious ones, like it maintains functional mobility and it feels good, there are a few more subtle reasons.  While it is well accepted that regular physical activity helps you maintain your current weight, it has only modest benefits for weight loss in the absence of calorie restriction.  But here’s the important point: in a sense, exercise helps you restrict calories.  This may be so because appetite-related hormones respond to exercise, causing you to feel less hungry and more satiated after eating a smaller amount of food.  This seems to be true for about an hour after physical activity.

By now you may be asking the question, “ How am I supposed to exercise if I don’t have time, or if I’m injured?”  Following are a few suggestions.

§  Incorporate stairs and walking into your day as much as possible. As the holidays approach, that means skipping the escalators/elevators at the mall and airport.  If you’re traveling during the holidays, use walking as a time to bond with family and friends.

§  Half the time of your normal workout, but double the intensity.  For example, if you usually go for a 5-mile run, go for a 20-minute run with 30-second sprint drills every minute.  You can do the same on a bike.  You can also make up your own routine using body-weight exercises, such as push-ups, tricep dips, squat jumps, etc. If you search “body weight exercises” on YouTube, you’re bound to find a wide variety of ideas to create a solid, fast, efficient workout.

§  If you’re healing from injury, definitely check with your physician before starting a modified exercise routine.  If you were instructed to rest—take advantage of the down time.  Stick to gentle stretching and range-of-motion exercises.  With proper time to heal, you’re more likely to bounce back to 100%.  If appropriate, modify your regular routine and use your recovery time to try something new. For example, if you’re biker, try more swimming, rowing and weight lifting.

The possibilities for maintaining fitness during busy times or injury are endless—just be flexible and a bit creative.  I wish you all a healthy and peaceful holiday season!

Rachel Fischer, MD, MPH

From www.forever-athletes.com

Beer and Fitness... Can It Be?

In my opinion this is the ONLY way you should ever drink a light beer!

Recently, I ran a short 10K for something to do since none of the local tracks were open for riding. After the race, we headed to the beer tent for some liquid refreshment. As we were sitting there enjoying our brews and talking about how great we did in the race, I was asked by one of my clients if drinking beer was just washing away all of the hard work we had just put in. After all, the beer-belly is one of the most recognized stereotypes ever. Why would a bunch of athletes (the beer tent was full) drink something that was going to hinder their performance and give them a beer-gut? In this article, I answer one of the most important questions for beer lovers throughout the World: can beer and fitness exist in harmony and if so, how? 

First...the Facts
I have already confessed my love for the liquid spirit, so before you think I am a beer guzzling frat boy, let me define just how much I do drink on a weekly basis. Monday through Friday I am alcohol free except for the occasional glass of wine with a nice dinner. Weekends are a bit different and are usually reserved for my love of the aforementioned dark beer. My normal consumption is 2 to 3, 12 ounce glasses per weekend: sometimes more; sometimes less. Usually more when college football is on but who is counting. So, while I am no Saint I certainly do not consider my beer and wine consumption excessive. Some would even say its way less than the norm!

The good news is that I am in good company. More than milk, coffee, or even bottled water, beer is the drink of choice for thirsty Americans of age. Yes, we Americans grease the wheels of human emotion with this social lubricant like no other. Some 200 million barrels a year go down our collective hatches. And even better news says that drinking moderately has been proven by many doctors, as well as the New England Journal of Medicine, to be a healthy component of longevity. In fact, some studies have shown that moderate consumption of alcohol -- wine, beer, or spirits -- has been shown to lower the risk of heart attack, stroke, and other cardiovascular problems by 25% - 40%. "The key word here is moderate," cautions Kim Wathen, registered Dietician and regular contributor to Virtual Trainer. "Moderate alcohol consumption appears to raise HDL and act as an anticoagulant while antioxidants in red wine may block oxidation of LDL, keep platelets from clotting, and help keep blood vessels relaxed.  All of these factors may lower the risk of heart disease but not necessarily reduce the effects of high cholesterol and heart disease." And to clarify, moderate drinking is considered 2 drinks per day for men, and 1 for women. (Sorry ladies, I don't make the rules.) One drink is defined as; 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80 proof distilled spirits. And NO, you cannot save up through the week and catch up on the weekend drinking 10-12 beers in an evening. That is NOT moderation.

Only China has the U.S. beat when it comes to drinking beer!

Drink Beer, it's Good for You!
Well, sort-of. Beer, like red wine, does provide some health benefits. The malt and hops used to make dark beers contain flavonoids, the same heart-healthy compounds in vegetables and wine that counter cell damage, thus reducing your risk of heart disease and cancer. Beer also contains B vitamins and chromium, which aid in converting carbohydrates to energy. But because beer is less potent than liquor, it may be too easy for some people to overlook its five percent alcohol content. Besides causing embarrassing lapses of judgment (can you say Beer-Goggles?), too much beer can dehydrate you and slow recovery. The key, as with any indulgence, is moderation. "There's no reason for athletes to feel like beer can never cross their lips," says Leslie Bonci, R.D., director of sports nutrition at the University of Pittsburgh Medical Center. "You just need to drink it at the right time."

But be careful, along with the good comes the bad. Any more than the 1 to 2 glass limit and your risks go up again, since excessive alcohol intake can lead to liver damage, high blood pressure, and many kinds of cancer -- not to mention the risks of alcohol abuse. If you've been a teetotaler all your life, don't start drinking for health reasons. The benefits are modest, and drinking increases other risks. If you don't drink and want to improve your health, just do an extra 15 minutes on the treadmill.

Beer and Athletic Performance
If you are a runner or cyclist you have certainly heard of people who order a beer the night before a big race and joke about carb-loading. Alas, it's not so. "The idea that beer provides a significant amount of carbs is a misconception," says Nancy Clark, M.S., R.D. who specializes in nutrition for exercise and health. "A 12 ounce bottle contains 12 grams of carbohydrates, which is equivalent to about half a slice of bread." What's more, because of the way alcohol is metabolized, most of these excess carbs are stored as fat. "So you're actually fat-loading," says Bonci. And if you're drinking a lot, you may be exercising to burn off beer calories rather than combusting body fat. You can also look at a can of beer this way. The average 12 ounce can of beer has over 100 calories. Drinking one beer is equivalent to eating a chocolate chip cookie. Drinking four is equal to eating a Big Mac Hamburger. Putting it that way really sucks.

Sorry ladies, but I don't think those are 12 ounce glasses!

Alcohol is also a diuretic, which means drinking too much the night before a run or race could leave you dehydrated in the morning. To avoid the effects of poor hydration, drink  water before and after your beer. (That's right, one beer. Unless you're a large guy who drinks beer regularly, in which case, a second should do no harm.) Some runners can't imagine not having a pint the night before a race, because it helps calm their nerves. "If you usually have a beer, it's probably okay, but have it with dinner, which helps absorb the alcohol," says Bonci. If you don't usually drink, though, now is not the time to start; some studies suggest that as little as 12 - ounces can disrupt the most beneficial kind of sleep.

Beer as a Recovery Drink?

So you've had a great day at the race track or just finished a hard training session and now all you want is a nice refreshing beer. Will this interrupt or hinder the recovery process? While drinking alcohol after training is not recommended you can get away with it on occasion if you drink something else first since alcohol can interfere with refueling, which delays recovery. Have eight to sixteen ounces of water or other fluids (like a real recovery drink) and about 200 carb-and-protein calories before you start raising your beer mug.

If you've suffered an injury, however, it's best to wait. "Alcohol can delay the body's ability to heal," says Bonci. "It seems to limit the production of natural anti-inflammatories." After 36 hours, however, the inflammation should have subsided, at which point you're free to head to your favorite pub.

The Buzz on Beer, Wine and Spirits

Non-Alcoholic Beer It's tops because, duh, there's no alcohol. Any buzz will have to come from savoring your own remarkable willpower. 70 calories; 13 grams carbs per 12-ounce serving. Light Beer Better than regular if you don't let the lower calories trick you into drinking more than usual. 95-110 calories; 6 grams carbs per 12-ounce serving. Low-Carb Beer It contains carbs but the same amount of alcohol as regular. "It's pure alcohol and carbonation," says Bonci. 95 calories; 2.5 grams carbs per 12-ounce serving. Regular Beer While a 12-ounce bottle has a lot of calories, one the night before or after a race won't hurt. But have a water chaser. 150 calories; 12 grams of carbs per 12-ounce serving. High-Alcohol Beer Be especially wary of some Belgian and other brews that have more than eight percent alcohol per 12 ounces (check the label). 200 calories; 13 grams of carbs per 12-ounce serving. Wine (All types) When grapes are made into wine, most of the fruit sugars (carbs) convert to alcohol, but a few carbs remain. Some people say erroneously that red wines are better for dieters because they are "less sweet". This usually has nothing to do with sugar content! It has to do with the fact that red wines are red because they are made with *contact of the skin* during the winemaking process - which gives them their rich, red color and their thicker, more tannic flavor. It's the grape skin that does most of these things. The "Sweetness" in white wines is the lack of those tannins, and the fruity flavors. It's not actual sugar! 105 calories for a merlot to 125 calories for a cabernet sauvignon (The average was 118 calories); 0.8 grams for chardonnay to 5.0 grams for cabernet sauvignon per 5-ounce serving 80 Proof Distilled Spirits (Hard Liquor) Adding mixers to an alcoholic beverage can contribute significant calories in addition to the calories from the alcohol itself. 86 calories for spiced rum to 120 calories for gin. The average (not including mixers) was 98 calories; 0 Carbs per 1.5-ounce serving.

So there you have it! There is no reason why you cannot have a beer a day and still meet your goals as an athlete or weekend warrior. Once again, excessive beer drinking is not recommended by anyone in the health industry. If you simply enjoy drinking beer or wine and are serious about your health, moderation in drinking alcohol, eating foods low in fat and calories, combined with habitual daily exercise is your ticket to reaching your goals. So next time you see me at the beer tent at Loretta's, just assume I am on my first beer and feel free to plunk down a few bucks and buy me my second!

By Tim Crytser

Reprint from racerxvt.com

Tim Crytser's work can be found at RacerX

Too Much Turkey!

Fischer Food for Thought

November 24, 2010

Embrace the Holiday Season–Including the Food!

The following is a new Forever Athletes Blog feature contributed by Dr. Rachel Fischer, a local Forever Athlete, specializing in occupational and environmental health.  In addition to  her doctorate (Univ. of Utah), she also has dual masters degrees–Masters of Science in Epidemiology (Univ. of Utah) and Masters of Public Health (Univ. of Washington).  Outside of the clinic, Dr. Fischer enjoys road cycling, cross-country skiing, cross-fit…she’s a self-proclaimed exercise-enthusiast.  She also shared with us that she did not start medical school until age 35.  Aligning with a Forever Athletes theme of “It’s never too late”, she too feels strongly that you CAN in fact start something new at almost any age and be successful ._____________________________________________________

This is not the typical message from health writers and nutrition experts when it comes to the holidays.  Most of the recommendations presented in the popular press are usually great strategies for avoiding weight gain and undoing all the healthy changes you’ve incorporated into your life.  But here’s the truth:  Thanksgiving is one day. Christmas is one day (maybe two if you count Christmas Eve). Okay, so Hanukah is eight days and Kwanzaa is seven, but you get the point.

We make a really big deal about how a few days are going to affect our health, well-being and our weight.  Here’s another truth.  Most medical studies show that the average weight gain for adults during the holidays is one pound.  Keep in mind this is weight gained over a period of six to eight days.  We know why studies include days before and after the actual holiday—that’s when all the pre-holiday parties occur and when the leftovers have to be eaten.

So here’s my simple recommendation for keeping yourself healthy during the holidays while still enjoying the festivities—on the day of the actual holiday, eat whatever you want.  This is your chance to savor your aunt’s amazing stuffing or your sister’s sinful pecan pie.  Your friends and relatives only whip out their favorite recipe once a year—so enjoy and thank them for it.

And what to do on those days leading up to the “big day”? Keep it simple.  Stay true as possible to your normal healthy routine—maintain your regular exercise schedule and get enough sleep to feel rested.  Both these things make it easier to resist quick-energy high-carbohydrate foods.  When special treats are offered, eat them in quantities that feel satisfying but not indulgent.  After a big holiday, don’t hold onto the leftovers that call you to the kitchen at midnight.  Alternative solutions: give them away or (radical thought here) throw them away.  Your body will thank you later.

Have a happy and healthy Thanksgiving!

Rachel Fischer, MD, MPH

Learn more by visiting www.forever-athletes.com