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For December 06, 2016

  • Sports Enhancers: The Good, The Questionable and The Dangerous
    Sports Enhancers: The Good, The Questionable and The Dangerous

    Creatine is the latest headline-grabbing substance said to help boost athletic performance. But how does it and other products really fare?

    By Edward G. McFarland, M.D. Director of Sports Medicine

    In a world where the difference between champion and loser is measured in hundredths of a second, athletes are willing to do just about anything to gain a competitive edge. When ability has been fully developed and training has maxed out, the next step for many athletes is to take sports-performance enhancers or ergogenic aids -- substances believed to make you bigger, faster and stronger by enhancing the body's energy use.

    The use of dietary aids to enhance athletic prowess is as old as competition itself: Centuries ago, men ate ground lion's teeth to give them strength and deer liver to increase their speed. Today, a wide range of substances from coffee to herbal supplements are used by professional athletes and weekend warriors alike for that "edge." The latest to gain attention is creatine, a compounds produced naturally in the body. Reports in the popular press suggest that taking creatine supplements may result in higher energy levels.

    Studies do show that high-dose creatine supplements (approx. 20 g/day) can increase the amount of creatine in muscles. But performance data is mixed, with nearly as many studies showing positive results as negative ones. If creatine does work as an ergogenic aid, its benefits will most likely be seen in high-intensity short-burst athletes and in vegetarians. Still, despite often favorable "reviews" in the popular press, its long-term effects are unknown. And since creatine is excreted by the kidneys, there are concerns about possible long-term effects on that organ.

    A run-down of other popular so-called sports enhancers":

    Protein

    Since muscles are composed of protein, some athletes believe that eating more protein will translate into more muscle. While athletes may require slightly more protein than non-athletes to build muscles (but not enhance performance), this extra amount is usually fulfilled by a balanced, varied diet. In fact, the typical American diet usually provides more than the recommended 15 percent of calories from protein -- more than enough to aid muscle intregrity.
    Advice: Unless you're a strict vegetarian, you don't need to increase protein consumption to boost athletic performance.

    Amino acids

    Over-the-counter amino acids have become a popular ergogenic supplement sold in health food stores because they are theorized to build muscle, accelerate the rate of recovery during training and generally improve both psychological and physiological responses during endurance training. Yet research studies have not demonstrated benefits to most athletes.
    Advice: Amino acids are ineffective and their long-term health effects are unknown.

    Coenzyme Q10

    Coenzyme Q10 (also known as CoQ10) is a type of lipid found in the energy producing mitochondria of cells. Some benefit of CoQ10 supplementation has been seen in patients with heart disease, including improvement in exercise capacity, but ergogenic improvements are generally not seen in healthy subjects.
    Advice: Don't waste your money.

    Caffeine

    Affordable and readily available in coffee or tea, caffeine seems to be among the few ergogenic aids that have been shown to work in a number of scientific studies. The caffeine equivalent of 2 cups of coffee ingested before exercise increases endurance in both well-trained and weekend athletes. The theory is that caffeine stimulates the breakdown of fats for energy which slows the depletion of glycogen, the main energy stores of the body. Caffeine doesn't seem to improve performance during conditions of high heat, and it can have harmful side effects if you have heart disease.
    Advice: If you're already a coffee-drinker, have 2 cups about 2 hours before activity.

    Chromium picolinate

    This trace mineral has generated a lot of interest -- and publicity -- for its alleged ability to build muscle, burn fat and increase energy. Research has not supported these claims.
    Advice: Chromium picolinate may improve glucose tolerance (making it useful to diabetics or those prone to diabetes), but it does nothing to improve athletic performance or burn fat.

    Ginseng

    Ginseng is an herbal plant that has been used as a medicinal for thousands of years in China and Korea, and more recently has been "discovered" in the U.S. and touted as a possible ergogenic. It's available in supermarkets and health food stores as supplemental pills, powders and in teas.
    Advice: Research has found that ginseng does not improve oxygen use, aerobic performance, exercise recovery rate or mood.

    Anabolic steroids

    Anabolic steroids are substances that are similar to the naturally-occurring hormone testosterone, which helps regulate growth and sexual development in men. Steroids are popular among weight lifters and track and field athletes because of their ability to increase muscle size and strength.
    Advice: The price far outweighs the benefits. Serious and sometimes irreversible side effects include liver damage, liver cancer and heart disease. In addition, the improvements made with steroids usually disappear when their use is discontinued.

    Growth hormone

    Growth hormone is taken by athletes who believe that it will build muscle and strength the way anabolic steroids do, but without the dangerous side effects. They are wrong. Although very little research has been done on its effects on athletes, it seems that growth hormone does not result in the kind of muscle growth seen with steroid use and it does not improve athletic performance, strength or endurance. Further, the side effects can be severe.
    Advice: Downright dangerous! Large quantities taken during the development stage can impair normal growth and hormonal balance. It is a banned substance for most athletic competitions.

    Edward G. McFarland, M.D., is a former Academic All-American college football player, is an Associate Professor of Medicine and Director of the Sections of Sports Medicine and Shoulder Surgery. He is Orthopaedic Consultant to the Baltimore Orioles and other athletic teams.
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  • Holiday Calories
    Holiday Calories

    Q: Sometimes caloric intake goes up during the holidays. What are the best ways to combat the inevitable?

    A: You figure it takes an extra 500 calories a day for a week to gain one pound. Try and have some days where you compensate for the days you overeat. During the holiday season you don't have to overeat every day. What people should keep in mind is that they're going to maintain their normal eating pattern during the holiday season but allow themselves a couple of treats a week. You don't have to have this mentality that it's the holiday season so you're going to overeat every day. You have to go into the holidays saying you're going to be in control, sticking with your normal eating pattern. You can even calorie bank.

    What I do a couple of times a week is eat a light dinner so I know if I'm going to a party on Friday and Saturday nights, I've saved up some extra calories so I can have a couple of drinks or eat extra treats. Be careful a few days a week and do some extra exercise to help compensate. The main thing is the whole mindset, that you don't give yourself permission to overeat all the time just because it's the holiday season.

    We all have bad days, and if you have a couple of bad days in a row, you just have to start fresh. You can't beat yourself up over these indulgences. So many times people have a couple of bad days and they feel totally out of control, and they just keep bingeing. You need to say, "Okay, I had a couple of bad days, I'll get back on track tomorrow." Overeating a couple of chocolates is not the end of the world, but if you do it everyday then it will be. What's important is forgiving yourself, not beating yourself up, and just starting fresh.

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  • New Drug Fights Osteoporosis
    New Drug Fights Osteoporosis

    Raloxifene regrows thinning bone

    (MSNBC News, Aug. 17 1999) � It is dramatically good news for the 22 million American women at risk for fractures from the bone-thinning disease osteoporosis � a drug that actually regrows bone.

    "WOMEN WHO ALREADY have osteoporosis can take a treatment that will markedly reduce their risk of fractures � reduce that fracture risk by 40 percent," said Dr. Bruce Ettinger of Kaiser Permanente's Division of Research in Oakland, Calif. "So even women in their late 60s who already have fractures can get a tremendous benefit for their health." The findings in the largest study to date of the drug raloxifene were published in Wednesday's Journal of the American Medical Association. The research was funded by Eli Lilly and Co. of Indianapolis, which sells the drug as Evista.

    The news comes only a month after data from the same women revealed that raloxifene appears to lower breast cancer risk by 70 percent. That is a major advantage for postmenopausal women who fear using estrogen for its bone-strengthening benefits because it slightly increases breast-cancer risk with long-term use.

    The drug is already on the market to prevent osteoporosis and it will now join the three other drugs that can treat the disease. Ettinger said the four approved osteoporosis drugs should not be considered competitors, because their benefits and limitations are so different. Doctors say each drug carries risks and benefits, but with the growing number of treatments, almost everyone should get help.

    "We can approach the patient with many choices," explained Dr. Joseph Lane of New York's Hospital for Special Surgery, "There is usually one drug or more than one drug that we can use."

    The four approved osteoporosis drugs are:

    • Alendronate, marketed as Fosamax, is the strongest bone builder and the only drug shown to protect against hip fractures. But it offers no other health benefits and causes many women stomach upsets severe enough to discourage them from taking it.
    • Estrogen, which is almost equal to alendronate as a bone-builder, and research suggests it also protects against heart disease and even mental decline for women past menopause. It relieves menopause's hot flashes and night sweats, but it commonly causes breast tenderness and a resumption of menstrual bleeding, unacceptable to many women.
    • Raloxifene, which has about two-thirds the bone-building power of alendronate but does not relieve menopausal symptoms and may worsen some, such as leg swelling. But it seems to lower "bad" cholesterol levels in the blood and is well tolerated.
    • Calcitonin, marketed as Calcimar, which is the least powerful of the bone-boosters but is offered in an easy-to-take nasal spray.

    Osteoporosis strikes women four times as often as men, usually after menopause. Women with thinning bones can suffer compression fractures in the spine that make them shorter and hunched over � and they are at great risk for debilitating hip fractures if they fall. "One in 20 women in the hospital are recovering from a hip fracture," said Lane. "It leads to profound loss of function."

    As important as treatment is, doctors say it is crucial for women in their 30s, 40s and 50s to start thinking about getting lots of calcium in their diets and taking other steps to prevent osteoporosis. "I think it is actually critical to start as soon as possible," said Lane. "Once you start losing bone we can replace it, but when we replace it we never rebuild the architecture the way God gave it to you and it is always weaker."

    A $150 test called a bone scan is an important way to make sure your bones are not getting weaker. If it shows a woman's bones are weakening, doctors can start her on one of the drug regimens. Four months ago when a bone scan revealed that Anna Borruso, a patient at the Hospital for Special Surgery, was starting to get osteoporosis, her doctor put her on Evista. When she suffered a bad fall, it was not nearly as bad as it could have been. "I was elated that I did not break my arm or my hip or my ribs," Borruso said.

    Doctors say the new drugs could give similar protection to millions of women � sharply reducing one of the worst dangers of aging.

    The Associated Press contributed to this report.

    Read More...
  • Toning Your Body -- and Your Thighs
    Toning Your Body -- and Your Thighs

    For many people -- particularly women -- hips and thighs are trouble spots. Efforts to achieve slim, trim thighs can seem futile, especially since exercise and diet won't necessarily reduce fat in the places you'd like. Though you target your stomach, the excess fat may come off your bottom, or vice versa. Still, dedication to exercise combined with good nutrition will trim fat throughout your body and help you tone all over, including your thighs.

    Cardiovascular and Aerobic Exercise

    Not only does aerobic exercise keep your heart and mind strong, but it can also help to make hips and legs more shapely and stronger. Exercise can't change your DNA: It can only do so much to counteract a genetic disposition to, say, cellulite or a particular leg and hip shape. But a good sweat will keep you healthier and firm up whatever you have inherited from your parents.

    Try weight-bearing forms of aerobic exercise such as running, jogging and brisk walking. If you can't do weight-bearing exercises, the stationary bicycle may suffice. Aim for at least three sessions of 20 minutes or more of aerobic exercise each week, according to the American Council on Exercise. If you're going after long-term weight control, work your way up to at least four sessions of 45 minutes of activity each week. And seek out opportunities for physical activity throughout the day: Take the stairs instead of the elevator, or walk or bicycle to work instead of driving.

    Strength Training

    Many women trying to trim down shy away from strength training because they fear they will "bulk up" -- exactly the opposite of what they want. But unless you are eating a very high-calorie diet, bulking up -- which requires heavy weight-lifting -- is unlikely. The benefits of strength training for hips and thighs are two-fold:

    Your legs will look and feel more toned and shapely. You will be stronger so that aerobic exercise, as well as daily physical activities, will be easier and more fun. Strength training is a type of weight training that emphasizes low weights and high reps, as opposed to the "bulk-up" type of weightlifting. Strength training helps to burn calories more effectively, enabling you to trim body fat. In addition, you'll burn more calories during your aerobic workout and even when you're sleeping because you have more muscle, which is metabolically active.

    Going For It

    There are a wide variety of exercises you can do at a fitness center or with strength-training equipment. Using machines such as the leg press, leg (knee) extension, leg (knee or hamstring) curl and the hip abductor/hip adductor are great ways to get started.

    If you don't have access to equipment, you can use your own body weight as resistance during lower body exercises, which can be very effective in toning and firming calves, hips and thighs.

    Below are a few strengthening exercises to get you started. If you have a health condition that limits your activity, check with your physician before doing any form of exercise. You might also want to consult with an expert trainer at your gym, who can show you how to use the machines safely and effectively.

    Step Up

    Muscles working: Front and back of thighs.

    The position: You will need a stable staircase for this exercise. Stand close to the bottom stair and use the handrail for support with your head up, looking straight ahead.

    The Move: Step completely onto the first stair with one foot. Keeping your weight supported on the front leg without letting your knee come over your toes, bring the other leg up and tap the toes of the back leg on the step and then slowly return to starting position. Repeat while alternating the starting leg until you have completed eight on each leg (one set), rest for a couple of minutes and then repeat one to two more sets.

    Side Leg Raise

    Muscles working: Hips and thighs.

    The position: You will need to lie on the floor on your side with your legs straight and together for this exercise. Bend your bottom leg up behind you slightly (keeping your hips stacked) and put your outside hand out in front of you for balance using your inside hand to support your head.

    The Move: With toes pointing straight ahead, slowly lift your top leg as high as possible, while maintaining straight hips. Then slowly return back to starting position and repeat eight times. Then switch to the other side and do eight repetitions. This is one set. Repeat for a total of two sets.

    Copyright � 1999 by WebMD, Inc. All rights reserved.

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  • The Role Of Pyruvate In Weight Loss
    The Role Of Pyruvate In Weight Loss

    By DENNIS R. SPARKMAN, PH.D.

    Pyruvate is the last metabolite in the breakdown of glucose (glycolysis). In the past several years it has become available as a dietary supplement and nine well-controlled human studies have not only demonstrated that it is a safe dietary supplement, but that it has a host of functions that are beneficial to the human body. Among these are enhanced weight loss and fat loss, reduced weight and fat regain following a calorie restricted diet, increased exercise endurance, decreased perceived exertion. The problem with these studies was that they used pyruvate in amounts that ranged from 31 to 100 grams per day, which are impractical outside of a research setting. Now a study has looked at what the minimum amount of pyruvate that is necessary to achieve these results.

    Fifty-three individuals took part in a study where one group took 6 grams of pyruvate per day for six weeks and two other groups took either a placebo or nothing, respectively. Each group exercised for 30 minutes five times per week. Although there was no change in their absolute bodyweight, those who supplemented with pyruvate had a 12% decrease in percent bodyfat, lost 4.8 pounds of fat, gained 3.4 pounds of muscle, and had a 2.2% increase in basal metabolic rates. Additionally, they reported a 17.7% increase in vigor and 71% decrease in fatigue.

    According to previous studies in animals, scientists have been able to estimate that the minimum effective daily dose of pyruvate in humans is between three and six grams. Although the six grams per day used in this study is far less that the amounts used in previous studies, it is effective in helping to reduce bodyfat, increase lean muscle mass, as well as increasing vigor and decreasing fatigue during exercise.

    Colker C, Stark R, Kaiman D, et al. The effects of a pyruvate based dietary supplement on weight loss, body composition, and perceived vigor and fatigue levels in mildly overfat individuals. Am J Clin Nutr. 1997 (in press).

    Read More...
  • Toning Your Body -- and Your Thighs
    Toning Your Body -- and Your Thighs

    For many people -- particularly women -- hips and thighs are trouble spots. Efforts to achieve slim, trim thighs can seem futile, especially since exercise and diet won't necessarily reduce fat in the places you'd like. Though you target your stomach, the excess fat may come off your bottom, or vice versa. Still, dedication to exercise combined with good nutrition will trim fat throughout your body and help you tone all over, including your thighs.

    Cardiovascular and Aerobic Exercise

    Not only does aerobic exercise keep your heart and mind strong, but it can also help to make hips and legs more shapely and stronger. Exercise can't change your DNA: It can only do so much to counteract a genetic disposition to, say, cellulite or a particular leg and hip shape. But a good sweat will keep you healthier and firm up whatever you have inherited from your parents.

    Try weight-bearing forms of aerobic exercise such as running, jogging and brisk walking. If you can't do weight-bearing exercises, the stationary bicycle may suffice. Aim for at least three sessions of 20 minutes or more of aerobic exercise each week, according to the American Council on Exercise. If you're going after long-term weight control, work your way up to at least four sessions of 45 minutes of activity each week. And seek out opportunities for physical activity throughout the day: Take the stairs instead of the elevator, or walk or bicycle to work instead of driving.

    Strength Training

    Many women trying to trim down shy away from strength training because they fear they will "bulk up" -- exactly the opposite of what they want. But unless you are eating a very high-calorie diet, bulking up -- which requires heavy weight-lifting -- is unlikely. The benefits of strength training for hips and thighs are two-fold:

    Your legs will look and feel more toned and shapely. You will be stronger so that aerobic exercise, as well as daily physical activities, will be easier and more fun. Strength training is a type of weight training that emphasizes low weights and high reps, as opposed to the "bulk-up" type of weightlifting. Strength training helps to burn calories more effectively, enabling you to trim body fat. In addition, you'll burn more calories during your aerobic workout and even when you're sleeping because you have more muscle, which is metabolically active.

    Going For It

    There are a wide variety of exercises you can do at a fitness center or with strength-training equipment. Using machines such as the leg press, leg (knee) extension, leg (knee or hamstring) curl and the hip abductor/hip adductor are great ways to get started.

    If you don't have access to equipment, you can use your own body weight as resistance during lower body exercises, which can be very effective in toning and firming calves, hips and thighs.

    Below are a few strengthening exercises to get you started. If you have a health condition that limits your activity, check with your physician before doing any form of exercise. You might also want to consult with an expert trainer at your gym, who can show you how to use the machines safely and effectively.

    Step Up

    Muscles working: Front and back of thighs.

    The position: You will need a stable staircase for this exercise. Stand close to the bottom stair and use the handrail for support with your head up, looking straight ahead.

    The Move: Step completely onto the first stair with one foot. Keeping your weight supported on the front leg without letting your knee come over your toes, bring the other leg up and tap the toes of the back leg on the step and then slowly return to starting position. Repeat while alternating the starting leg until you have completed eight on each leg (one set), rest for a couple of minutes and then repeat one to two more sets.

    Side Leg Raise

    Muscles working: Hips and thighs.

    The position: You will need to lie on the floor on your side with your legs straight and together for this exercise. Bend your bottom leg up behind you slightly (keeping your hips stacked) and put your outside hand out in front of you for balance using your inside hand to support your head.

    The Move: With toes pointing straight ahead, slowly lift your top leg as high as possible, while maintaining straight hips. Then slowly return back to starting position and repeat eight times. Then switch to the other side and do eight repetitions. This is one set. Repeat for a total of two sets.

    Copyright � 1999 by WebMD, Inc. All rights reserved.

    Read More...

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