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What Is the Cause of Muscle Cramps?

by Len Kravitz, PhD and Rogelio Realzola on Oct 22, 2019

A discussion of the popular theories on what causes muscle cramps.

Muscle cramps can stop athletes in their tracks. Although they usually self-extinguish within seconds or minutes, the abrupt, harsh, involuntary muscle contractions can cause mild-to-severe agony and immobility, often accompanied by knotting of the affected muscle (Minetto et al. 2013). And cramps are common; 50%–60% of healthy people suffer muscle cramps during exercise, sleep or pregnancy or after vigorous physical exertion (Giuriato et al. 2018). There is no gender difference with skeletal muscle cramps, but they appear to occur more often in endurance athletes and in the elderly (Naylor & Young 1994).

During endurance exercise, muscle cramps correlate with the length and intensity of workouts. Fitness pros and clients frequently talk about muscle cramps, but until recently, little has been known about their actual physiology.

Types of Muscle Cramps

Giuriato et al. categorized muscle cramps into three groups:

    1. Nocturnal cramps occur during sleep without any clear trigger.
    1. Pathological cramps are a consequence of having diabetes, nerve dysfunctions or metabolic disorders.
  1. Exercise-associated muscle cramps occur during or after exertion. The first scientific confirmation of these types of cramps dates to 1908, when they were described in miners working in hot and humid conditions.

Muscle Cramp Risk Factors

With marathon runners, research has found certain risks associated with the occurrence of a muscle cramp (Schwellnus, Derman & Noakes 1997). These risks include a longer history of running, advanced age, higher body mass index, shorter daily stretching time, irregular stretching habits and a family history of cramping. Schwellnus, Derman & Noakes report that the two most important observations from the research are that exercise-associated cramps for marathoners are muscle fatigue (linked to longer runs) and poor stretching habits.

Early Theories About Muscle Cramp Causes

Theories on the Cause of muscle cramps
Early theories on the source of muscle cramps focused on electrolytes, dehydration and the environment.

Schwellnus, Derman & Noakes analyzed three early theories on the causes of exercise-associated muscle cramps.

SERUM ELECTROLYTE THEORY

Blood plasma contains electrolytes, such as sodium, potassium, chloride, bicarbonate, calcium and phosphate. Although electrolyte depletion is often blamed for causing cramps, there currently is no solid explanation of how low serum electrolyte concentrations can result in the condition. Schwellnus, Derman & Noakes pointed to two studies that measured serum electrolyte concentrations in endurance runners at prerace, immediate postrace and at 60-minute postexercise recovery. Neither study found a connection between postrace recovery, muscle cramps and changes in serum electrolyte concentrations.

DEHYDRATION THEORY

In the past, studies have suggested treating muscle cramps in workers and firefighters with fluids and electrolytes. But those studies did not measure hydration. More recent studies that have estimated blood volume and plasma volume do not support the theory that dehydration has a direct link to exercise-associated cramps.

ENVIRONMENTAL THEORY

This theory sprang from the condition referred to as “heat cramps.” While exercising in a hot, humid environment may be correlated with the development of muscle cramps, no evidence shows cramps are linked to an increase in core body temperature.

Current Theory on Muscle Cramps

The newest concept of muscle cramps is a neuromuscular theory (Giuriato et al. 2018). This theory has evolved to point to two origins: a central (spinal column) and a peripheral (neuromuscular junction).

The central or spinal origin theory suggests that the involuntary contraction of a muscle occurs when nerve messages to the spinal column are altered, perhaps due to muscle fatigue (see “The Neuromuscular Theory of Skeletal Muscle Cramps,” below). This results in an imbalance of excitatory (from muscle spindles) and inhibitory (from Golgi tendon organs) spinal messages to muscles (see “What are Muscle Spindles and Golgi Tendon Organs?,” below). This neural signaling imbalance leads to enhanced muscle cell excitability and cramping.

With the peripheral origin theory, scientists suggest there is abnormal excitation of the motor nerves terminal branches to the muscle, causing cramping.

The scientific evidence of a neuromuscular theory is mounting. The research appears to show that, in some cases, fatigued muscle can’t fully relax. This condition leads to an imbalance between excitatory signals and inhibitory messages to the muscle. So the most recent research appears to support the central origin theory of the muscle cramp (Giuriato et al. 2018; Scwellnus, Derman & Noakes 1997).

For information on the neuromuscular theory of skeletal muscle cramps; muscle spindles and Golgi tendon organs and muscle cramp prevention, see “Ouch! What Causes Muscle Cramps” from the October 2019 print edition of Fitness Journal. If you cannot access the full article and would like to, please contact the IDEA Inspired Service Team at 800-999-4332, ext. 7.

Carbohydrates: Why are They So Confusing?

by Nancy Clark
on

 

Carbohydrates can be a source of confusion for athletes and fitness enthusiasts alike, many of whom believe they should avoid pasta, bagels, juice, bananas, sugar… the list goes on. In reality, people who are physically inactive whose bodies do not readily metabolize carbohydrates may need to take a different approach to consuming carbohydrates compared to regular exercisers and athletes. Here’s some information to help resolve carbohydrate confusion.

What do you actually mean when you say “carbs”?

  • Carbohydrates include both sugars and starches; they are biochemically similar. For example, an unripe banana (or any fruit) is starchy. As it ripens, it becomes sweeter; the starch converts into sugar. In comparison, peas (and other vegetables) are sweet when young and their sugar converts into starch as they mature.
  • All forms of sugar and starch digest into the simple sugar glucose. Glucose travels in the blood and, with the help of insulin, is taken up for fuel by the muscles to fuel your workouts. Fit bodies handle carbohydrates better than unfit bodies.

Are carbs bad for you?

  • Regarding health, some carbs are better for you than others because some offer more nutrients than others. Even though refined sugar adds “empty calories” to a sports diet, you need not eat a sugar-free diet to have a healthy diet. A physically fit, healthy person’s menu can accommodate 10% of calories from refined sugar (World Health Organization’s guidelines). Yet, if you frequently consume sweets plus sports drinks, gels and sports candies, you can easily consume more than 250 to 350 calories (10% of calories) from refined sugar.
  • The fear-mongering terms of unhealthy, toxic and poisonous that surround conversations regarding carbohydrate are simply unscientific. People who lack knowledge about physiology accept this disease-mongering, anti-sugar rhetoric. But the fact is no one food is healthy or unhealthy.

Are carbs fattening?

  • Despite popular belief, carbohydrates are not inherently fattening. Excess calories are fattening.

What about high-fructose corn syrup?

  • High-fructose corn syrup (HFCS) is less evil than is often portrayed by the media. HFCS is a double molecule comprised of 45% glucose, 55% fructose—the same as honey and similar to white sugar (50% glucose, 50% fructose).
  • The negative hype about HFCS applies primarily to people who consume excessive calories of sweets, soda, candies and processed foods sweetened with HFCS. While no one needs excessive, lack-luster calories that could be better spent on nutrient-rich fruits, veggie and whole grains, does an athlete really need to fret about a few calories of HFCS in ketchup?

What about sugar “crashes”?

  • The most common reason for “sugar crashes” (hypoglycemia) among athletes relates to running out of fuel. The shakiness and sweats are because the athlete did not eat enough food to maintain normal blood glucose levels and the brain is now demanding sugar. One marathoner, who thought the 100-calorie gel he consumed at mile 16 caused him to “crash,” more likely needed 200 to 300 calories to meet his energy needs.
  • A sharp rise in blood sugar that may occur after eating sugary foods is not pathological, and has more to do with the efficiency of the muscles and liver in their ability to take up the sugar. Exercise enhances the transport of sugar from your blood into your muscles with far less insulin than needed by the body of a person who is physically inactive.

Summary

For physically active, fit people who are at lower risk for heart disease, diabetes and obesity, sugar and carbs are not toxic, and may be a helpful way to enhance athletic performance. The one-size-diet does not fit all.

No one is suggesting that you or your clients should eat more sugar, but rather understand that athletes and people who are regularly physically active can embrace a way of eating that includes an appropriate balance of carbohydrate (sugars and starches) in each meal. Strive for a healthy eating pattern that includes 85-90% quality foods and 10-15% whatever. Some days, whatever might be an apple; other days, it might be a slice of apple pie.

Want to help your clients make healthier, long-lasting food choices? Become an ACE Fitness Nutrition Specialist

 

Carbohydrates can be a source of confusion for athletes and fitness enthusiasts alike, many of whom believe they should avoid pasta, bagels, juice, bananas, sugar… the list goes on. In reality, people who are physically inactive whose bodies do not readily metabolize carbohydrates may need to take a different approach to consuming carbohydrates compared to regular exercisers and athletes. Here’s some information to help resolve carbohydrate confusion.

What do you actually mean when you say “carbs”?

  • Carbohydrates include both sugars and starches; they are biochemically similar. For example, an unripe banana (or any fruit) is starchy. As it ripens, it becomes sweeter; the starch converts into sugar. In comparison, peas (and other vegetables) are sweet when young and their sugar converts into starch as they mature.
  • All forms of sugar and starch digest into the simple sugar glucose. Glucose travels in the blood and, with the help of insulin, is taken up for fuel by the muscles to fuel your workouts. Fit bodies handle carbohydrates better than unfit bodies.

Are carbs bad for you?

  • Regarding health, some carbs are better for you than others because some offer more nutrients than others. Even though refined sugar adds “empty calories” to a sports diet, you need not eat a sugar-free diet to have a healthy diet. A physically fit, healthy person’s menu can accommodate 10% of calories from refined sugar (World Health Organization’s guidelines). Yet, if you frequently consume sweets plus sports drinks, gels and sports candies, you can easily consume more than 250 to 350 calories (10% of calories) from refined sugar.
  • The fear-mongering terms of unhealthy, toxic and poisonous that surround conversations regarding carbohydrate are simply unscientific. People who lack knowledge about physiology accept this disease-mongering, anti-sugar rhetoric. But the fact is no one food is healthy or unhealthy.

Are carbs fattening?

  • Despite popular belief, carbohydrates are not inherently fattening. Excess calories are fattening.

What about high-fructose corn syrup?

  • High-fructose corn syrup (HFCS) is less evil than is often portrayed by the media. HFCS is a double molecule comprised of 45% glucose, 55% fructose—the same as honey and similar to white sugar (50% glucose, 50% fructose).
  • The negative hype about HFCS applies primarily to people who consume excessive calories of sweets, soda, candies and processed foods sweetened with HFCS. While no one needs excessive, lack-luster calories that could be better spent on nutrient-rich fruits, veggie and whole grains, does an athlete really need to fret about a few calories of HFCS in ketchup?

What about sugar “crashes”?

  • The most common reason for “sugar crashes” (hypoglycemia) among athletes relates to running out of fuel. The shakiness and sweats are because the athlete did not eat enough food to maintain normal blood glucose levels and the brain is now demanding sugar. One marathoner, who thought the 100-calorie gel he consumed at mile 16 caused him to “crash,” more likely needed 200 to 300 calories to meet his energy needs.
  • A sharp rise in blood sugar that may occur after eating sugary foods is not pathological, and has more to do with the efficiency of the muscles and liver in their ability to take up the sugar. Exercise enhances the transport of sugar from your blood into your muscles with far less insulin than needed by the body of a person who is physically inactive.

Summary

For physically active, fit people who are at lower risk for heart disease, diabetes and obesity, sugar and carbs are not toxic, and may be a helpful way to enhance athletic performance. The one-size-diet does not fit all.

No one is suggesting that you or your clients should eat more sugar, but rather understand that athletes and people who are regularly physically active can embrace a way of eating that includes an appropriate balance of carbohydrate (sugars and starches) in each meal. Strive for a healthy eating pattern that includes 85-90% quality foods and 10-15% whatever. Some days, whatever might be an apple; other days, it might be a slice of apple pie.

 

The REAL Scoop on Protein Powders

by Matthew Kadey, MS, RD on Sep 06, 2019

Research suggests more protein foods and less powder will balance training needs.

Protein powders, especially the whey variety, have long been glorified in fitness circles for their muscle-building benefits. “Pump some iron and chug back a protein shake” is a preferred muscle-making formula. But research published in the journal Nature Metabolism, led by scientists from the University of Sydney, suggests that while the essential branched-chain amino acids (BCAAs) leucine, isoleucine and valine—found in high amounts in certain protein powders—can indeed help muscles recover and grow in response to training, excessive consumption of BCAAs may have unwanted side effects if taken at the expense of other amino acids from additional protein sources.

For instance, supplementing with high doses of BCAAs leads to high levels in the blood, potentially triggering competition with another amino acid, tryptophan, for transport to the brain. This can negatively affect mood, as tryptophan is a precursor for the feel-good hormone serotonin. Lower brain levels of serotonin can also stimulate appetite, leading to possible excess consumption of calories and, in the end, weight gain.

The take-home message is that it’s fine to include a scoop of whey protein in your daily diet to support training needs, but it’s best to eat a wide range of protein foods—including those from plant sources like legumes—to get a better balance of amino acids.

Correcting Misconceptions About Fat

May 22, 2019

Fitness Handout

A dietitian explores the latest research and clears up some common myths about fat.

 

 

For years, fat was demonized as dietary “Public Enemy Number One.” Despite the essential roles it plays in the body, including temperature regulation, hormone production and protection of organs, we were told it was also responsible for weight gain and other health woes. As a result, people stocked their kitchens with low-fat items.

Now the tide has turned. New research and popular diets like paleo and ketogenic have caused the fat stigma to wear off. But what is the real truth about fat?

Matthew Kadey, MS, RD, James Beard Award–winning journalist, Canada–based dietitian, freelance nutrition writer and recipe developer, explores the latest research and clears up a few common myths.

The Myth: Fat-Free or Low-Fat Is Healthier

THE REALITY

The low-fat craze led to the formulation of thousands of lower-fat products, from yogurts to cookies. “But when the fat is reduced or removed from a food, you lose much of its flavor,” explains Michelle Babb, MS, RD, author of Anti-Inflammatory Eating for a Happy, Healthy Brain (Sasquatch Books 2014). “So to make up for the flavor shortage, manufacturers often add sugar, artificial flavors and salt, which is hardly a nutritional upgrade.” For instance, the calorie savings in reduced-fat peanut butter is negligible owing to its higher sugar numbers. When you opt for fat-free salad dressings, you won’t fully absorb the fat-soluble antioxidants—like lycopene and beta-carotene—that are found in vegetables.

BOTTOM LINE

As long as you are mindful of portions, Babb says, there is no reason you can’t enjoy foods that are closer to their natural, full-fat state.

The Myth: High-Fat Is Healthier Than High-Carb

THE REALITY

In a study published in The Lancet, higher carb intake was associated with an increased risk of total mortality, whereas total fat intake was not found to raise death risk (Dehghan et al. 2017). But context is key: The typical American diet is roughly 49% carbs, 34% fat and 16% protein, so it cannot be considered especially high in carbs or low in fat. In turn, we shouldn’t use research like this as permission to greatly fatten up our diets.

But that’s beside the point. David Katz, MD, MPH, director of the Yale University Prevention Research Center and founder of True Health Initiative, feels strongly that we need to stop paying attention to such studies, as they do the public a major disservice. “Depending on the foods you choose, you can eat a low-fat, high-carb diet full of jelly beans and soda that’s terribly unhealthy and raises your disease risk, or you can eat a high-fat diet rich in fried foods that does the same.” So if the diets in the aforementioned study were skewed toward higher intakes of processed carbs like white bread and white rice and higher intakes of beneficial fats like olive oil and nuts, it’s not surprising fat came out on top.

BOTTOM LINE

Look past simplified recommendations and instead look at diets in the context of what you are eating overall. In other words, choose mostly healthful foods, and the healthful fats and carbs will take care of themselves in whatever percentages suit a person’s tastes.

The Myth: Coconut Oil is a “Superfood”

Busting Myths About Coconut Oil as a Superfood
Coconut oil is not nearly the health-boosting miracle its fans want it to be.

THE REALITY

Often demonized for its super-high saturated fat content (91% of calories), coconut oil has experienced a renaissance. But coconut oil is not nearly the health-boosting, fat-fighting miracle its fans want it to be.

“There’s no strong evidence directly tying coconut oil to either a greater or reduced risk of cardiovascular disease,” says Patrick Wilson, RD, PhD, assistant professor of exercise sciences at Old Dominion University in Norfolk, Virginia. Officials at the American Heart Association still say we should steer clear of coconut oil, citing concerns about its potential impact on cardiovascular health (Sacks et al. 2017).

BOTTOM LINE

If you like its flavor or the moist­ness it adds to baked goods, it’s probably fine to include modest amounts (no more than a tablespoon daily) as part of an overall healthy eating plan.

References

Dehghan, M., et al. 2017. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): A prospective cohort study. The Lancet, 390 (10107), 2050–62.

Sacks, F.M., et al. 2017. Dietary fats and cardiovascular disease: A presidential advisory from the American Heart Association. Circulation, 136 (3), e1–e23.

Fitness Journal, Volume 16, Issue 6

A Woman’s Place Is in the Weight Room

by Tessa Yannone on Jan 15, 2019

Ex Rx

Optimize workouts to account for differences in musculature and hormones.

Every day, more women are moving from the cardio room to the weight room. It’s a welcome transition; getting stronger can transform their self-esteem, confidence and self-efficacy.

Supporting your female clients’ strength-training ambitions is fundamental to their long-term success. Women and girls enjoy a wealth of benefits from resistance exercise: reduced injury risk, better cardiovascular health, stronger bones, protection against diabetes, and less inflammation, to name a few. As more women flock to strength training, however, fitness professionals face a host of challenges. For starters, the research on weight training for women is relatively new, and there are fewer studies on women than there are on men. Also, the physiological differences between genders is either misrepresented or not discussed.

We aren’t that much different. In equally trained men and women, research finds most strength differences result from differences in muscle size, not gender (Bishop, Cureton & Collins 1987). These findings suggest that a man and a woman with the same muscle size should display the same amount of strength. Thus, we can retire terms like “toned” and “girl pushups”—and the pictures of pink dumbbells—because women should and can do the same exercises your male clients do. You, of course, already know this.

You should consider two crucial points, however:

  • Women and men have different muscular fiber type compositions, making women less prone to fatigue (Hunter 2014).
  • Female sex hormones, especially those involved in the menstrual cycle, can affect program timing and recovery (Sung et al. 2014).

Understanding these differences is pivotal to building programs that will help your female clients achieve muscle growth, strength gains and training success.

Fiber Types in Women vs. Men

Type I and type II. Generally speaking, the skeletal muscles of men are larger than those of women, and, in men, some muscles possess “a greater proportional area of metabolically and functionally faster muscle fibers,” whereas in women there is “a greater proportional area of the ‘slow’ type I fibers” (Hunter 2014). The higher concentration of type I fibers makes women more resistant to muscle fatigue. Men have a higher glycolytic capacity based on their larger concentration of type II fibers, priming males for quick, explosive activities like sprinting and weightlifting.

While muscle fiber type plays a large role, it is important to remember that the tendency to fatigue depends a lot on task conditions, including contraction type, speed and intensity; the muscle group involved; environmental conditions; and state of arousal (Hunter 2014).

Metabolism. The makeup of muscular tissue affects the energy substrates that each gender uses. Women typically carry 6%–12% more fat than men. Women are also better at handling fat and using it for energy during exercise, which spares muscle glycogen and decreases exertion ratings, again playing into fatigue resistance. Additionally, women are more sensitive to insulin across the entire body and are better able to take up glucose (Lundsgaard & Kiens 2014).

Program design. If muscle growth is a female client’s main goal, keep in mind that she is probably more resistant to fatigue than a male client would be. Programming sets in the 6- to 10-rep range seems to yield maximal muscle growth (Schuenke et al. 2012) and maximal increases in strength.

Because women can theoretically handle more work, your general-population clients might benefit from harder-intensity training sessions with supersets and timed rest periods. Consider challenging them to fatigue a little faster than they normally would, since you need to push them beyond their comfort zone to achieve muscle growth.

Sex Hormone Differences

Menstrual cycle. Women’s menstrual hormones fluctuate throughout their cycle, which usually lasts 28 days (hormonal contraceptives and other issues can alter the cycle). Hormonal fluctuations play a huge role in strength training, a reality only recently discussed in academic literature. By opening up this conversation with your female clients, you can tap into their strengths a little more and use biology in their favor (Sung et al. 2014).

The menstrual cycle has four phases:

  • menstrual (days 1–5)
  • follicular (days 1–13)
  • ovulation (day 14)
  • luteal (days 15–28).

The luteal phase triggers sharp hormonal changes—progesterone peaks and then plunges, along with estradiol. Hunger increases, moods change suddenly, core temperature rises, and more calories are burned; in fact, basal metabolic rate has been shown to increase by as much as 9% (Webb 1986). In this phase, symptoms of premenstrual syndrome often discourage interest in going to the gym.

The follicular phase, by contrast, is the time for women to really push themselves in hard workouts because estrogen hits its peak at this time, improving mood, energy and strength.

Estrogen vs. testosterone. These sex hormones have the most impact on the relative strength of women and men. Men have much more testosterone, affecting their baseline strength. Thus, men start out stronger with higher absolute strength, but relative strength gains are about the same for both genders.

Estrogen, on the other hand, has proved to have some anabolic and protective effects against various injuries and diseases. Within muscle, estrogen has been shown to influence contractions and postexercise muscle damage by acting as an antioxidant and a stabilizing membrane and by binding to estrogen receptors (Enns & Tidius 2010). Estrogen also has regenerative properties, which is why combining exercise and hormonal therapies can increase lean tissue mass (Velders & Diel 2013).

Program design. Maintain an open dialogue with your female client: Ask how she is feeling and if she would like to disclose the current phase of her menstrual cycle. Explain that while she doesn’t have to push through the bothersome symptoms of the luteal phase, she will benefit from some type of movement.

In the luteal phase, steer clear of high-intensity interval training and avoid going for personal bests or heavy strength sessions. Save these for the follicular phase. The luteal phase is an optimal time for deloading if the client is on a strength program. It’s also a great time for moderate conditioning or low-intensity cardio training.

Optimize periodization around her cycle. For instance, if she usually does strength training three times a week, you might keep the frequency the same during the luteal phase and ramp it up a session or two during the follicular phase (Sung et al. 2014). See “Sample Program Design,” below, for more.

Putting It All Together

Though men and women are different, your approach to strength training should be similar: Optimize physiological differences to produce peak training performance. As a fitness professional, you need to do three things to avoid alienating female clients by suggesting that their strength training programs are somehow inferior to men’s:

  1. Lead by example. Show pictures, videos and articles of women doing what men (and other women) do. Show what these women’s bodies look like, what they are capable of and how they got there, while also (if you are a female trainer) disclosing the importance of strength training in your own life. You have the power to be a role model and a leader. Be the example, and your female clients will follow.
  2. Banish biased language. Remove gender-labeled equipment and exercises from your vocabulary: Words like long, lean, toned and girl pushups have no merit or place in this space. This kind of language reinforces the false notion that women require a different type of exercise that will not make them “bulky” or “manly.”
  3. Make room for self-discovery. Strength training can be scary and intimidating. Women almost never approach weight training wholeheartedly unless they’ve grown up around it. Let your clients draw their own conclusions about the experience—what they like or dislike. Female clients will appreciate having the space to find what they love about moving their bodies in this way. When the motivation comes from within, they will be more likely to stick with the activity and see the benefits of a strong body and mind throughout their entire lives—inside and outside of the gym.

References

Bishop, P., Cureton, K., & Collins, M. 1987. Sex difference in muscular strength in equally-trained men and women. Ergonomics, 30 (4), 675–87.

Enns, D.L., & Tidius, P.M. 2010. The influence of estrogen on skeletal muscle: Sex matters. Sports Medicine, 40 (1), 41–58.

Hunter, S.K. 2014. Sex differences in human fatigability: Mechanisms and insight to physiological responses. Acta Physiologica, 210 (4), 768–89.

Liu, D., et al. 2010. Skeletal muscle gene expression in response to resistance exercise: Sex specific regulation. BMC Genomics, 11.

Lundsgaard, A.M., & Kiens, B. 2014. Gender differences in skeletal muscle substrate metabolism—molecular mechanisms and insulin sensitivity. Frontiers in Endocrinology, 5, 195.

Schuenke, M.D., et al. 2012. Early-phase muscular adaptations in response to slow-speed versus traditional resistance-training regimens. European Journal of Applied Physiology, 112 (10), 3585–95.

Sung, E., et al. 2014. Effects of follicular versus luteal phase–based strength training in young women. SpringerPlus, 3 (668).

Velders, M., & Diel, P. 2013. How sex hormones promote skeletal muscle regeneration. Sports Medicine, 43 (11), 1089–1100.

Webb, P. 1986. 24-hour energy expenditure and the menstrual cycle. The American Journal of Clinical Nutrition, 44 (5), 614–19.

Fitness Journal, Volume 16, Issue 2

© 2019 by IDEA Health & Fitness Inc.

About the Author

Tessa Yannone

Tessa Yannone IDEA Author/Presenter

4 Ways to Incorporate Whole Foods Into Your Diet

 

 

 

 

 

 

 

 

 

 

 

 

 

Did you know that the closer a food is to its natural state, the more nutrient-dense it is? Whole foods give you the best bang for your caloric buck since you are eating the entire food with all its vitamins, minerals and fiber, and the food has not been subjected to potentially damaging processing.

Make a goal this year to include more whole plant–based foods in your diet. You probably already eat berries as whole foods. Try these other suggestions from Lourdes Castro, MS, RDN, adjunct professor at New York University’s department of nutrition, food studies and public health.

1. Beets, Garlic, Sweet Potatoes

Why eat these foods? Roots, tubers and bulbs grow underground and function as a plant’s nutrient-storage system, so it’s no surprise they are packed with vitamins and minerals. They provide antioxidant benefits, such as protection against many chronic diseases and conditions associated with aging.

Whenever possible, use the entire plant from root to leafy greens. Different parts of the plant may require different cooking methods, but the nutrient density is worth it.

Try this at home. Roasted beets with sautéed garlicky beet greens are delicious and easy. Remove the beet tops where stems meet the root, and roughly chop. Quarter the beets and lightly toss with olive oil, salt and pepper. Roast in the oven at 425 degrees Fahrenheit for 35 minutes, or until beets are fork tender. Meanwhile, finely chop 1–2 cloves of garlic and place in a pan with 1 tablespoon olive oil. Place over medium-high heat and add beet greens when the garlic begins to sizzle. Sauté until all greens are wilted. Serve with roasted beets.

Alternative. Roast sweet potatoes and substitute watercress for the beet greens.

2, Lentils, Chickpeas, Fresh Snap Peas

Why eat these foods? Legumes are seeds that grow in pods. The seeds can be fresh or dried, the pods edible or inedible. Legumes are rich in protein, fiber and iron, and they get an extra punch from folate. High folate intake can decrease cardiovascular risk (Willet 2001).

Try this at home. Dried lentils are quick-cooking and versatile. Simmer them in water until tender and then drain and cool. Toss with tomatoes, arugula, corn and carrots, and drizzle with olive oil and a squeeze of lemon. Eat this salad alone or augmented with sliced chicken breast. It also makes great leftovers.

3. Chia Seeds, Walnuts, Ground Flaxseeds

Why eat these foods? All nuts and seeds are rich in healthy monounsaturated fats and help stabilize blood sugar levels. But these foods are especially high in essential omega-3 fatty acids, which lower inflammation throughout the body (Calder 2006). This is especially good for people with arthritis and other inflammatory diseases.

Flaxseeds must be ground to enable your body to absorb all their beneficial nutrients, because the whole seeds pass through the intestines undigested. Chia seeds, on the other hand, do not have to be ground and have a longer shelf life because they can be left whole.

Try this at home. Soaking a table-spoon of chia seeds (or ground flaxseeds) in water will form a gel. Add this gel to your berry purée for a thick smoothie.

4. The Sea Has Vegetables, Too

Why eat these foods? Sea vegetables (types of seaweed) such as dulse, wakame and hijiki are high in both iron and vitamin C, which make them high-value iron sources because vitamin C is necessary for the absorption of plant-based iron. Sea vegetables are thought to have an anti-inflammatory effect, and regular ingestion has been linked to low blood pressure (Wada et al. 2011).

Try this at home. Crumble dulse or wakame leaves and sprinkle over salads, soups, noodles or rice dishes.

References

Calder, P.C. 2006. N-3 polyunsaturated fatty acids, inflammation, and inflammatory diseases. American Journal of Clinical Nutrition, 83 (6), 1505S–19S.

Wada, K., et al. 2011. Seaweed intake and blood pressure levels in healthy pre-school Japanese children. Nutrition Journal, 10, 83.

Willet, W. 2001. Eat, Drink, and Be Healthy. New York: Free Press.

Fitness Journal, Volume 13, Issue 1

Ask the RD: Farmed or Wild Fish for Nutrition Value?

by Sanna Delmonico, MS, RDN, CHES on Jun 19, 2019

Food for Thought

Exploring the nutritional benefits of wild and farmed fish.

Question

I have been trying to eat more salmon for the omega-3 fatty acids. What’s better nutritionally, wild or farmed fish?

Answer

All fish are good sources of protein. Fatty fish like salmon, mackerel, tuna, trout, anchovies and sardines are also good sources of vitamin D and omega-3 fatty acids. The American Heart Association recommends two 3.5-ounce servings of fish every week, especially fatty fish, because omega-3 fatty acids help reduce the risk of heart arrhythmias and lower blood triglycerides and blood pressure (AHA 2019).

The nutritional content of a fish depends on its diet. Wild salmon get omega-3 fatty acids from plankton, smaller fish and other seafood. These salmon get their color from pink and orange crustaceans like krill. Farmed salmon, raised in pens, are fed pellets made from fish meal, fish oil, plant proteins (such as corn and soy), animal proteins, vitamins and minerals, as well as carotenoid pigments to turn their flesh orange (NOAA 2018).

Because of differences in diet and how active and, therefore, relatively lean the wild fish are, Atlantic farmed salmon has twice as much total fat as Atlantic wild salmon (13.5 grams per 100 g, compared with 6.5 g per 100 g), significantly more omega-6 fatty acids, and three times as much saturated fat (USDA n.d.). Farmed fish can be higher than wild fish in omega-3 fatty acids, too. Since the early 2000s, however, the composition of farmed salmon has been changing. Fish meal and fish oil for feed have become scarcer and more expensive, so these ingredients are being replaced by plant proteins and plant oils in fish feed. Farmed salmon in 2015 had about half the omega-3 fatty acids it did in 2001 (Sissener 2018).

When it comes to choosing salmon, both farmed and wild are low in saturated fat compared with red meat. Salmon is delicious, but why not try some less popular sources of omega-3s, like anchovies or sardines? Quickly grilled, these small, flavorful fish pair extremely well with fresh herb sauces like gremolata, chimichurri or salsa verde.

References

AHA (American Heart Association). 2019. Fish and omega-3 fatty acids. Accessed Mar. 10, 2019: heart.org/en/healthy-living/healthy-eating/eat-smart/fats/fish-and-omega-3-fatty-acids.

NOAA (National Oceanic and Atmospheric Association). 2018. Feeds for aquaculture. Accessed Mar. 10, 2019: fisheries.noaa.gov/insight/feeds-aquaculture.

Sissener, N.H. 2018. Are we what we eat? Changes to the feed fatty acid composition of farmed salmon and its effects through the food chain. Journal of Experimental Biology, 221, jeb180976.

USDA (United States Department of Agriculture). n.d. USDA food composition databases. Accessed Mar. 15, 2019: ndb.nal.usda.gov/ndb/search/list.

Daily Steps and Health | Walking Your Way to Better Health

Kyle Sprow, MPH | Jun 14, 2019

Walking 10000 Steps a Day Physical Activity Guidelines ACSM

Walking 10,000 steps a day – what is the correct number? ANSWERED by the Physical Activity Guidelines Advisory Committee.

Being physically active is one of the most important actions people of all ages and fitness levels can take to improve their health. A 2017 survey suggests that more than 75% of U.S. adults acknowledge that “being in shape and looking good are ‘very important,’” yet only 31% of those surveyed exercise regularly and almost half are inactive. Beyond “being in shape and looking good,” exercise and physical activity provide a myriad of health benefits, many of which are easy to achieve.

In November 2018, the Department of Health and Human Services released the second edition of the Physical Activity Guidelines for Americans. Some of the key updates are: an expansion of the list of health benefits associated with physical activity; greater flexibility on how to achieve those benefits; and highlighting the many proven strategies to help people be more active. The key guidelines for adults and older adults have a few main takeaways:

  • Adults should move more and sit less throughout the day. Some physical activity is better than none. Adults who sit less and do any amount of moderate-to-vigorous physical activity gain some health benefits.
  • For substantial health benefits, adults should do at least 150 minutes to 300 minutes a week of moderate-intensity, or 75 minutes to 150 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity.
  • Additional health benefits are gained by engaging in physical activity beyond the equivalent of 300 minutes of moderate-intensity physical activity a week.
  • Adults should also do muscle-strengthening activities of moderate or greater intensity that involve all major muscle groups on 2 or more days a week, as these activities provide additional health benefits.

There are many ways for adults of all ages and fitness levels to achieve these federally recommended amounts of physical activity. However, simplifying the guidelines into something such as daily step counts may be an easy way for the majority of Americans to understand and achieve these guidelines. Step counts provide a straightforward metric of physical activity, and measuring daily step counts through a physical activity tracker is an easy and accessible way to monitor and set physical activity goals. In many health and fitness circles, a goal of 10,000 steps/day is often prescribed. In fact, some countries are adopting a 10,000 steps/day target as a national public health goal.1 However, the research supporting the 10,000 steps a day recommendation is limited and many believe this recommendation was derived from the name of a Japanese-made pedometer sold in the 1960s called Manpo-kei, which translates to “10,000 steps meter.2

Given the simplicity and utility of steps/day as a metric for physical activity, translating the “150 to 300 minutes per week of moderate-to-vigorous physical activity” into a steps/day recommendation is important. As a result, the Physical Activity Guidelines Advisory Committee (PAGAC), who produced the scientific report that informed the development of the physical activity guidelines, systematically reviewed the literature to better understand the relationship between steps/day and health.

The PAGAC results were first published in the 2018 PAGAC Scientific Report but have recently been updated in ACSM’s journal, Medicine & Science in Sports & Exercise. This recent publication, titled Daily Step Counts for Measuring Physical Activity Exposure and Its Relation to Health, identified eleven studies that evaluated the relationship between daily step counts and all-cause mortality, cardiovascular disease morality, incident cardiovascular disease, and type 2 diabetes mellitus. In short, the investigators found that, compared to people who accumulated the least number of steps/day, those who accumulated the most steps/day were less likely to suffer from cardiovascular disease, type 2 diabetes, and experience premature mortality. The authors acknowledge and specify that many research gaps still exist, and that more evidence is needed before these findings can be accurately translated into public health guidelines. However, the investigators suggest that step counts in the range of 7,000 to 9,000 steps/day may result in health benefits that are similar to achieving the federally recommended amounts of 150 to 300 minutes per week of moderate-to-vigorous physical activity.

The physical activity guidelines encourage all adults to move more and sit less throughout the day. Locomotion, specifically walking, is an easy and popular form of physical activity for most Americans4 and can be of moderate-intensity. Worldwide, the average number of steps accrued daily is approximately 5,000. In United States, it is 4,800.3 So, whether it is somewhere in the range of 7,000 to 9,000, 5,000, or 4,801steps/day, let’s keeping walking our way to better health.

View the Full PAG Library


Author
: Kyle Sprow, MPH is a Cancer Research Training Award Fellow with the National Cancer Institute. He was part of the federal staff that supported the Physical Activity Guidelines Advisory Committee and the development of the second edition of the Physical Activity Guidelines for Americans.

References

  1. Duncan MJ, Brown WJ, Mummery WK, Vandelanotte C. 10,000 Steps Australia: a community-wide eHealth physical activity promotion programme. Br J Sports Med. 2018;52(14):885–6
  2. Lee I, Shiroma EJ, Kamada M, Bassett DR, Matthews CE, Buring JE. Association of Step Volume and Intensity With All-Cause Mortality in Older Women. JAMA Intern Med. Published online May 29, 2019. doi:10.1001/jamainternmed.2019.0899
  3. Althoff  T, Sosič  R, Hicks  JL, King  AC, Delp  SL, Leskovec  J.  Large-scale physical activity data reveal worldwide activity inequality.  Nature. 2017;547(7663):336-339. doi:10.1038/nature23018
  4. Watson, K. B., Frederick, G. M., Harris, C. D., Carlson, S. A., & Fulton, J. E. (2015). U.S. Adults’ Participation in Specific Activities: Behavioral Risk Factor Surveillance System–2011. Journal of physical activity & health12 Suppl 1(0 1), S3–S10. doi:10.1123/jpah.2013-0521

Men’s Health Month: Improving cardiorespiratory fitness reduces heart failure mortality

Written by
Steve Farrell, PhD, FACSM

Posted in

Wednesday, Jun 05, 2019

June is Men’s Health Month, which is a great opportunity to raise awareness about the importance of preventive health care for men.

When you look at the statistics from the Centers for Disease Control (CDC), it looks grim. Women are 100% more likely than men to visit the doctor for annual exams and other preventive health care measures. Men die at higher rates than women from 9 of the top 10 causes of death and die an average of 5 years earlier than women.

The number one cause of death is still heart disease, which can largely be prevented, or at least delayed by making positive lifestyle choices such as eating healthy, not smoking, and getting more physical activity. We know after decades of research that increasing physical activity to improve aerobic fitness is key to living a longer, healthier life.

Nearly 6 million Americans are living with heart failure, a condition where the heart’s ability to pump and fill properly steadily declines. Heart failure is the leading cause of hospitalization in the U.S. for individuals ages 65 and older, and accounts for nearly 60,000 deaths annually. Well-established risk factors for heart failure include hypertension, diabetes, age, obesity, smoking, heart valve disease, previous heart attack, and family history.   

A sedentary lifestyle is another known risk factor for heart failure, but previous studies focused solely on self-reported physical activity levels. The problem is that self-reported studies of physical activity usually come from a questionnaire and are not an objective measurement of physical fitness. In fact, the self-report numbers can be quite different from the reality of a true fitness assessment. This is why studies from the Cooper Center Longitudinal Study (CCLS) are so important. The CCLS is the largest and longest-running study in the world that uses measured fitness rather than self-reports of activity.

A CCLS study by researchers at The Cooper Institute shows that baseline levels of cardiorespiratory fitness are strongly predictive of future risk of heart failure mortality. Results from the study showed:

  • Moderate and low fit men were 1.63 and 3.97 times more likely to die from heart failure, respectively, compared to those in the high fit category.
  • Unfit men with no heart failure risk factors were 2.5 times more likely to die from heart failure than fit men with no risk factors. The same trend was seen in men with any one, two or more risk factors.
  • Fit men were substantially less likely to die from heart failure than unfit men, regardless of the number of heart failure risk factors present.

The authors concluded that low levels of cardiorespiratory fitness are a powerful and independent risk factor for heart failure mortality. The recommendation is that all men should consider annual checkups and be counseled on physical activity by their health care provider, with the goal of achieving at least a moderate level of cardiorespiratory fitness in order to reduce risk of heart failure mortality.

But this doesn’t just apply to men. All adults can do more to reduce the risk of heart failure and heart disease death with these tips:

  • Monitor and control your blood pressure if you have hypertension.
  • Control your blood glucose level if you have diabetes.
  • Avoid obesity. Lose weight if you are overweight.
  • Avoid tobacco in all forms.
  • Avoid a sedentary lifestyle. Aim for at least a moderate level of cardiorespiratory fitness.
  • Eat more unrefined plant-based foods, such as fruits, vegetables, whole grains, raw nuts, seeds, and legumes and increase your intake of reduced-fat dairy.

Everyone is encouraged to meet the current public health guidelines for aerobic activity. The guidelines recommend a minimum of 150 minutes per week of moderate-intensity aerobic activity, but don’t be afraid to hold back. Exceeding these guidelines is very likely to result in higher fitness levels, further decreasing the risk of heart failure mortality.

References

Farrell, S., Finley, C., Radford, and Haskell, W. (2013). Cardiorespiratory fitness, body mass index, and heart failure mortality in men: Cooper Center Longitudinal Study. Circulation:Heart Failure, 6:898-905. Doi: 10. 1161/CIRHEARTFAILURE.112.000088.

Blumenthal, J. et al. (2010). Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure. Arch Intern Med, 170(2), 126-134.

 

Faster Meal Prep: 5 Kitchen Hacks to Master

Everybody has that friend who claims to be a meal prep master. They’ll batch cook all weekend and fill the fridge with colorful containers brimming with pre-cooked food. Then there’s the obligatory posting of pictures with all of the wholesome meals they’ve made ahead. But do you ever wonder, “Where do they get the time?!” or, “…that had to have taken all weekend!”

If you’d like to make it through the week without worrying what’s for dinner (but you don’t have all weekend to do so), here are five time-saving tips to give your meal prep process a makeover.

1. Write it Down

As Benjamin Franklin once said, “If you fail to plan, you are planning to fail.” If you want to succeed in making meals ahead of time, you need a plan—preferably in writing. If your kitchen prep steps start by opening a cabinet or sharpening a knife, switch it up and get in the habit of reaching for you notebook instead (or an app on your phone).

Map out ahead of time what your upcoming week looks like and exactly for which meals need prepping. Do you have plans to go out with a friend one night? Do you have a work lunch on the calendar? Chart on paper how many breakfast, lunch and dinner meals you will need for the upcoming week. And don’t forget to include snacks.

2. Set a Timer

A successful meal prep plan includes multiple steps, such as outlining the number of meals and snacks, researching the recipes, purchasing the ingredients and putting it all together in the kitchen. Even the best-designed meal prep plan can fall flat if you don’t allot adequate time to execute all of these actions.

Consider that most people use part of their weekend to meal prep for the upcoming week. You may not accomplish a whole week of meal prep if you don’t start until Sunday night. Set aside a chunk of time earlier in the weekend to select the recipes you want to prepare. Setting a time limit or timer for yourself to get this step finished can be incredibly helpful. Many a well-intentioned meal prepper has gone down the rabbit hole of online recipe research never to return to actually prepare those dishes.

3. Reuse Recipes

The easiest way to streamline meal prep is to reuse recipes or meal ideas that already work for you. If you’re trying to knock out dinner for the upcoming workweek, it may not be realistic to try five new recipes. Try limiting yourself to one or two new recipes and relying on old standbys that you know you like and will actually eat.

Keeping track of meal ideas can be tricky in an age where every recipe is readily available at our fingertips. Go old school and print the recipes you’ve tried, taking notes on what worked and ditching those that didn’t work. Save time by keeping your recipes in a folder organized by breakfast, side dishes, slow cooker mains, etc.

4. Call on Convenience Foods

Convenience foods can get a bad rap as being expensive or unnecessary. But there are some really innovative items at the grocery store that can save you time when you get back in the kitchen.

While you could peel and scoop and chop and roast a butternut squash, buying pre-cut bagged vegetables (such as butternut squash) can save you hours in the kitchen. Other shortcuts to check out in the produce section include tubes of fresh herbs and spices and pre-washed, chopped salad mixes and greens.

When it comes to the middle aisles, bottled marinades and sauces can be a meal prepper’s savior. Check out lower-sodium canned beans and spice packets that can make whipping up flavorful foods a snap.

5. Befriend Your Freezer

If you’re going to take the time to cook it once, you might as well make enough to eat it twice. Double your efforts by doubling your recipes and freeze the leftovers for future weeks. You can even pre-portion your larger batches into containers or baggies before popping your food in the freezer.

Put these time-saving tips to work and get your make-ahead meals made faster.

Interested in learning more about health and fitness or possibly making a career change? Become an ACE Certified Health Coach!

Post Author

AUTHOR

Katie Ferraro

Contributor

Katie Ferraro, MPH, RDN, CDE is a consultant dietitian and diabetes educator specializing in nutrition communications and family feeding. As a mom to 5 small children and creator of the popular blog The Fortified Family, Katie believes that good food fuels strong families. You can read more of her work at www.fortifiedfam.com