Runners who don’t train well can have marathon of miseries
Today, as an estimated 20,000 runners begin their mad dash from Hopkinton to Boston, Dr. Malissa Wood, a cardiologist, four-time marathoner, and codirector of the Massachusetts General Hospital Women's Cardiovascular Health Center, will be setting up shop in the corner of the medical tent at the finish line.
As soon as they're finished, about 25 amateur runners will stroll or hobble over to Wood's corner to let her take a sample of their blood. They will also get a noninvasive test to see how well their hearts are working after the stress of running for about four hours. And, as they have done every year since 2003, Wood and her Mass. General colleagues will compare these postrace test results to the prerace exams done two weeks earlier.
The Mass. General findings on Boston marathoners — three published papers to date and two pending — are sobering and lend support to the idea that while moderate exercise is perhaps the most important thing a person can do for health, taking it to extremes, like a marathon, may be dangerous.
Among marathon runners, the biggest cardiac risk seems to arise in people who train the least. People who worked up to a marathon by running at least 45 miles a week for at least three to four months ''were golden. They didn't get into any trouble at all," said Wood. ''If they trained less than 35 miles a week, they were in big trouble."
Translated for the rest of us, this means that for people who are not in peak shape ''sudden, strenuous activity can trigger a heart attack," said Dr. Arthur Siegel, a 20-time marathoner and director of internal medicine at Harvard's McLean Hospital in Belmont.
Roughly 450,000 Americans run in marathons every year. And 325,000 do triathlons, which involves swimming, biking, and running, according to USA Triathlon, the sport's organizing body. Many of these are not well-trained athletes but newcomers who race to raise money for charities. That means, said Siegel, that in many such events, participants ''are getting older and slower. That's where the cardiac risk comes in, especially for middle-aged men with previously silent heart disease."
Moderation is the key, said Dr. Harvey Simon, an avid runner, former marathoner, Mass. General internist, and author of ''The No Sweat Exercise Plan," which advocates very moderate exercise — even as moderate as gardening and housework — instead of extreme exertion like marathoning.
''The greatest hazard of exercise is not doing it," said Simon.
''I used to preach 'No pain, no gain,' but now I say, ''No pain, big gain,' " he said. The whole ''aerobics doctrine" that a person needs a lot of strenuous exercise ''inspired the few but discouraged the many," he said. Even walking at the extremely leisurely pace of half an hour per mile has benefits.
Study after study has shown that moderate, regular exercise can indeed reduce the risk of heart disease, diabetes, stroke, hip fracture, and some kinds of cancer.
But exercising moderately takes patience and persistence. If you have not been exercising regularly, you should work up over several weeks to walking 45 minutes a day at least five days a week, said exercise physiologist Kerry Stewart at Johns Hopkins School of Medicine.
At first you may have to stop every few minutes and rest, he said. That's fine — just start up again. If you get chest pains or severe shortness of breath, of course, stop and call your doctor. If you have heart disease or have had a heart attack, check with your doctor before starting or substantially increasing your workouts.
You shouldn't underdo exercise, but you shouldn't overdo it, either. Chronic fatigue, trouble sleeping, muscle tiredness, nagging congestion or sore throat, persistent aches and pains, and depression are common signs that you may be working out too hard, said Siegel. To avoid this, try not to increase your exercise duration or intensity by more than 10 percent over any two-week period.
The easiest way to gauge whether you're working hard enough is to use the ''sing/talk test": Work hard enough that you can't sing but can talk.
Experienced athletes ''know how delicate the balance is between training to obtain optimal performance and overtraining to the point where muscle function begins to deteriorate," said Dr. Christopher Cooper, an exercise physiologist at UCLA. But for amateurs, finding that balance point can be hard.
As for marathoners, Wood and her Mass. General colleagues have found that running 26.2 miles can lead to clear signs of cardiac stress. They have found that cardiac troponin, a chemical that shows up in blood tests only when heart muscle is damaged, rises in 60 percent of runners, and in some, it rises so high that ''if you had just looked at these scores, these people would have been admitted to the hospital for heart attacks," Wood said.
They've found that another chemical, BNP, or brain natriuretic peptide, another red flag for cardiac dysfunction, goes up after a marathon in 60 percent of runners. Platelets also become activated and more likely to form the clots that can trigger heart attacks, according to a just-published paper by Siegel and Alexander Kratz, director of the hematology lab at Mass. General. And, as shown on echocardiograms, the heart's ability to relax after each beat remains impaired for at least several weeks in most marathoners.
Bottom line? You don't have to run a marathon to get into good shape. Just put on comfortable shoes, get out, and walk. Moderately. And consistently.
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Top 10 Disease-Fighting Foods
August 8, 2009
Filed under Diet And Nutrition
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 “Let food be your medicine, and medicine be your food.” When Hippocrates, the father of modern medicine, wrote those words more than 2,400 years ago, he was hundreds of years ahead of his time. Today, thousands of studies around the world confirm Hippocrates’ advice: What you eat has a powerful effect on your health. Functional Foods
The buzz today is about “functional foods” that provide health benefits beyond basic nutrition. Researchers say a diet high in fruits, vegetables, nuts and cold-water fish can make your immune system stronger and reduce your risk of heart disease, certain cancers, and age-related vision and mental problems. Supplements vs. Food
Studies say that taking supplements instead of eating whole foods doesn’t provide the same benefits and may actually increase your risk of disease. Researchers think that the combination of natural chemicals found in whole foods work together to promote health. 10 Important Disease-Fighting Foods
Enjoy the benefits of these top food choices, found on your grocery store’s shelves: Spinach
May prevent age-related vision problems; provides folate, a vitamin critical for reducing birth defects; reduces blood levels of homocysteine, an amino acid that increases heart disease risk; may protect the brain from aging Broccoli
High in sulforaphane, a naturally occurring compound that may help destroy tumor-causing chemicals; provides indole-3-carbinol, a phytochemical (nutrient that comes from plants) that may protect against estrogen-related cancers Salmon
One of the best sources for omega-3 fatty acid, a type of fat that may reduce the risk of blood clots and cardiovascular disease; has anti-inflammatory effect; may reduce risk of diseases such as diabetes, stroke, rheumatoid arthritis, asthma, inflammatory bowel disease, ulcerative colitis, some cancers and mental decline Nuts
Loaded with heart-healthy monounsaturated fats, omega-3 fatty acid and vitamin E; helps reduce total blood cholesterol Tomatoes
Rich in lycopene, a phytochemical that seems to play a role in preventing certain cancers Berries
High in cancer-fighting phytochemicals; appear to have brain-protective properties that may help prevent, and possibly reverse, age-related declines in memory and learning ability Beans / Legumes
Excellent source of protein, heart-healthy fiber, folate and antioxidants; may help reduce cholesterol levels Oats
Rich in a type of fiber that’s effective in reducing total and LDL (“bad”) cholesterol; effective in regulating blood sugar levels Purple Grape Juice, Red or Purple Grapes, Red Wine
High in a cancer-fighting compound that may also help reduce the risk of cardiovascular disease Coffee and Tea
Coffee: Appears to reduce risk of heart disease, type 2 diabetes and age-related cognitive decline |
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Staying Young is Just Another Meal Away
June 21, 2009
Filed under Diet & Fitness, Diet And Nutrition
Healthy foods to stay young? Of course, you’ve heard it before, probably when mom insisted to eat more apples and less burger even when you thought you were too young to age.
Indeed, mom was right. You’ll never know when you’ll start to age until you notice some crumpling and folding on your skin. Premature aging might just be a sleep away. And you never want to see that happen.
But it’s never too late. You can delay aging now by changing some items on your plates, and it’s just another meal away.
You Are What You Eat
The food and all other things that you take or don’t are laying the groundwork for your health and your appearance as well. For example, a person who has a pretty huge room for french fries and beef patties in his stomach may suffer more diseases and may not look age-appropriate. A person deficient in unsaturated fats, on the other hand, may have dry, flaky skin, and eventually look older than he actually is.
According to Samantha Heller, MS, RD, a clinical nutritionist at NYU Medical Center in New York City, what you eat becomes the outer fabric of your body. And the healthier that you put in your mouth, the better you will look.
Sure, you don’t wanna look like french fries, or do you? Then, what should your next meal include?
High- fiber foods
Whole grains, cereals, black beans, apples, and pears are just some of the foods that are rich in fiber. Fiber found in these foods moves quickly and relatively easily through your digestive tract keeping bowel movements regular. Thereby preventing constipation,-one of the problems that aging people commonly encounter.
Fish, walnut, and flax seed oil
These foods are among the best sources of Essential Fatty Acids (EFA). EFA especially the omega-3 fatty acids regulate the fluidity or softness of the cell membranes, thus making your cell membranes healthy and hold more moisture. So that means younger looking skin.
Deficiency is visible in a hardening of the skin, as with dry skin and acne. And to those who are living in colder climates, you need more EFA for membrane fluidity.
Fruits and vegetables
Antioxidants from fruits and vegetables fight off free radicals, the byproducts of the body’s everyday processes that damage DNA, cells, and tissues. The antioxidants and other phytochemicals lessens the chances of damage to he body’s cells. And because you are guarding your cells from premature damage, you are also protecting yourself from premature aging.
Whole-grain cereals, organ meats, chicken, egg yolk, and garlic.
Selenium, found in these foods, plays a key role in making the skin healthy. It is a sulfur-like mineral that lessens the oxidative damage of skin cells. It also helps in regulating the thyroid hormone and helps prevent hypertension, cancer, and stroke. Selenium is often added to antioxidant vitamins.
Easy Move
If you think looking younger is difficult, there’s not much to worry. The easiest move you can make is to include more fruits, vegetables, fish, and whole grains to your daily menu. Control yourself from eating foods stuffed with much cholesterol, sodium, and calories. What you get is a healthier body and a younger-looking you.
Well, if you think it’s too early to look old, better think twice. It just doesn’t feel good to be called older than you really are.
And if you think you’re too old to look young, you’re never right. You can stop aging right at your plate, and even prove that "looks can be deceiving."
Ten Surprising Nutrition Facts
May 23, 2009
Filed under Diet And Nutrition
The American diet circa 2007 is a disaster – but positive change has begun. Those were the twin themes of the "Fourth Annual Nutrition and Health Conference" held in San Diego, Calif., May 14-16, 2007. The conference was sponsored by the University of Arizona’s College of Medicine in conjunction with the Program in Integrative Medicine (PIM); PIM was founded and is co-directed by Dr. Weil.
The three-day event brought together leading nutrition researchers from around the world, bearing plenty of both bad and good news. Some highlights:
Bad News:
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Hunter-gatherers in the Australian outback today live on 800 varieties of plant foods. Modern Americans live principally on three: corn, soy and wheat.
From the presentation, "Phytonutrients: Nature’s Bonus from Plant Foods" by David Heber, M.D., Ph.D. Professor of Medicine and Public Health and Director, UCLA Center for Human Nutrition, David Geffen School of Medicine at UCLA
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One third of Americans get 47 percent of their calories from junk foods.
USDA" Trends in the United States – Consumer Attitudes and the Supermarket, 2000. From the presentation, "Phytonutrients: Nature’s Bonus from Plant Foods" by David Heber, M.D., Ph.D. Professor of Medicine and Public Health and Director, UCLA Center for Human Nutrition, David Geffen School of Medicine at UCLA
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The average American is eating 300 more calories each day than he or she did in 1985. Added sweeteners account for 23 percent of those additional calories; added fats, 24 percent.
Putnam et al. USDA. From the presentation, "Cultivating the Common Ground of Food, Nutrition and Ecological Health," by David Wallinga, M.D., Director, Food & Health Program, Institute for Agriculture & Trade Policy, Minneapolis, Minn.
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Vitamin D deficiency is widespread. The following health problems have been linked to vitamin D deficiency: type 1 and 2 diabetes; multiple sclerosis; rheumatoid arthritis, osteoarthritis, periodontal disease, increased susceptibility to infection; osteoporosis, low birth weight infants; low seizure threshold; cancers of the breast, prostate, colon, pancreas and ovary; non-Hodgkin’s lymphoma; hypertension, myocardial infarction, stroke, congestive heart failure; wheezing in childhood, and compromised muscle strength and falls in the elderly.
From the presentation, "Vitamin D Deficiency: The Cause of Everything?" by Louise Gagne, M.D., Clinical Assistant Professor, Dept. of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada.
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In real dollars, the price of fresh fruits and vegetables has risen nearly 40 percent since 1985. In real dollars, the price of soft drinks has dropped 23 percent. The reason unhealthy foods tend to be less expensive on average than foods such as fresh fruits and vegetables has much to do with American farm policy.
Condensed from "Food without Thought: How U.S. Farm Policy Contributes to Obesity" Institute for Agriculture and Trade Policy, Environment and Agriculture Program, from the presentation, "The Omnivore’s Dilemma: Searching for the Perfect Meal in a Fast-Food World," by Michael Pollan, Knight Professor of Journalism, University of California, Berkeley, Calif.
Hopeful News
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Ten cups per day of green tea delayed cancer onset 8.7 years in Japanese women and three years in Japanese men.
From the presentation, "Beef or Broccoli? Nutrition and Breast Cancer" by Victoria Maizes, M.D., Executive Director, Program in Integrative Medicine, Assoc. Professor, Clinical Medicine/Family & Community Medicine, the University of Arizona College of Medicine, Tucson, Ariz.
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Three meta-analyses of randomized, placebo-controlled trials found a 5-12 percent decrease in cholesterol levels in hyperlipidemic patients after at least 30 days’ treatment with 600-900 mg of garlic extract.
Warshafsky S., et al Ann Int Med 1993; 19;599-605; Silagy C, et al. JR Coll Phys Longdon 1994; 28:2-8; Ackermann RT, et al. Arch Intern Med 2001: 161: 813-24. From the presentation, "The Medicinal Spices" by Tieraona Low Dog, M.D., Education Director, Program in Internal Medicine, Assistant Professor, Dept. of Medicine, The University of Arizona, Tucson, Ariz.
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Maternal limitation of seafood consumption to less than 340 grams per week during pregnancy did not protect children from adverse outcomes. In contrast, this observational study [Avon Longitudinal Study of Parents and Children] showed beneficial effects on child development when maternal seafood consumption exceeded 340 grams per week, with no upper limit of benefit…
Hibbeln et al., The Lancet, 17 Feb., 2007. From the presentation of Joseph Hibbeln, M.D., Senior Clinical Investigator, Sectional of Nutritional Neurosciences, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Md.
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"I see a lot of hopeful trends, including the rise of alternative agriculture: organic, local, biodynamic…There are now over 4,000 farmers’ markets in the U.S. The number has doubled in 10 years."
From the presentation, "The Omnivore’s Dilemma: Searching for the Perfect Meal in a Fast-Food World," by Michael Pollan, Knight Professor of Journalism, University of California, Berkeley, Calif.
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Chocolate…may have a mild hypotensive [blood-pressure lowering] effect.
From the presentation, "The Medicinal Spices" by Tieraona Low Dog, M.D., Education Director, Program in Integrative Medicine, Assistant Professor, Dept. of Medicine, The University of Arizona, Tucson. Ariz.
Heatlh Diet
May 19, 2009
Filed under Diet And Nutrition
Why should I try to have a healthy diet?
Having a healthy diet is one of the most important things you can do to help your overall health. Along with physical activity, your diet is the key factor that affects your weight. Having a healthy weight for your height is important. Being overweight or obese increases your risk of heart disease, type 2 diabetes, high blood pressure, stroke, breathing problems, arthritis, gallbladder disease, sleep apnea (breathing problems while sleeping), osteoarthritis, and some cancers.
You can find out if you’re overweight or obese by figuring out your body mass index (BMI). Women with a BMI of 25 to 29.9 are considered overweight, whereas women with a BMI of 30 or more are considered obese. All adults (aged 18 years or older) who have a BMI of 25 or more are considered at risk for premature death and disability from being overweight or obese. These health risks increase as the BMI rises. Your health care provider can help you figure out your body mass.
Having a healthy diet is sometimes easier said than done. It is tempting to eat less healthy foods because they might be easier to get or prepare, or they satisfy a craving. Between family and work or school, you are probably balancing a hundred things at once. Taking time to buy the ingredients for and cooking a healthy meal sometimes falls last on your list. But you should know that it isn’t hard to make simple changes to improve your diet. And you can make sense of the mounds of nutrition information out there. A little learning and planning can help you find a diet to fit your lifestyle, and maybe you can have some fun in the process!
What are the most important steps to a healthy diet?
The basic steps to good nutrition come from a diet that:
1. Helps you either lose weight or keep your BMI in the "healthy" range.
2. Is balanced overall, with foods from all food groups, with lots of delicious fruits, vegetables, whole-grains, and fat-free or low-fat milk and milk products.
3. Is low in saturated fat,trans fat, and cholesterol. Keep total fat intake between 20 to 35 percent of calories, with most fats coming from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils.
4. Includes a variety of grains daily, especially whole-grains, a good source of fiber.
5. Includes a variety of fruits and vegetables (two cups of fruit and 2 1/2 cups of vegetables per day are recommended for a 2,000 calorie diet).
6. Have a small number of calories from added sugars (like in candy, cookies, and cakes).
7. Has foods prepared with less sodium or salt (aim for no more than 2,300 milligrams of sodium per day, or about one teaspoon of salt per day).
8. Does not include more than one drink per day (two drinks per day for men) if you drink alcoholic beverages.
How can I follow a healthy diet if I eat out a lot?
1. Ask the server to make substitutions, like having steamed vegetables instead of fries.
2. Pick lean meat, fish, or skinless chicken.
3. Make sure your entrée is broiled, baked, grilled, steamed, or poached instead of fried.
4. Ask for baked, boiled, or roasted potatoes instead of fried.
5. Order lots of vegetable side dishes and ask that any sauces or butter be left off.
6. Ask for low-calorie salad dressing or a lemon to squeeze on your salad instead of dressing.
7. Order fresh fruit or fruit sorbet in place of cake, pie, or ice cream desserts.
Triathlon Swimming: 3 Minute Swim Class
October 16, 2008
Filed under Triathlon
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