The View from Sports Center

Supplements for Women - Do Multivitamins Really Work?

It's a lot easier to pop a pill than it is to plan and prepare well balanced meals and for a long time, I think everyone believed that a multivitamin was a good backup plan for diets that were, well, less than balanced.

But in this report from Harvard Medical School, we might have to reconsider the pill-popping strategy at least for some vitamins.

Check out the article here.

Looks like the best choice is to eat nutrient dense foods (a list is in the article from Harvard) and supplements for Vitamin D and Calcium. Good things to talk over with your family doctor.

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Latest on my knee recovery is here.

ShouId I Take Glucosamine and Chondroitin Sulfate?

I

get asked this question a lot. If you have osteoarthritis, you might have heard about these two supplements: Glucosamine and Chondroitin Sulfate. If you've read or listened to any of the mainstream media, you've probably also have heard that neither of these supplements are effective for people with osteoarthritis.

The media latched onto an article published in Arthritis & Rheumatism in 2008 and declared that the supplements were ineffective even though the lead author, Allen Sawitzke, said that the study had significant limitations, like a small sample size, and that the study couldn't determine whether glucosamine and chondroitin are effective for patients with arthritis. Sawitzke also admitted that the study needed a better method for measuring the joint space. Some critics have argued that the method used was not sensitive enough to detect meaningful change.

Here's my suggestion. Chondroitin Sulfate is a disease modifying agent for osteoarthritis. It slows the progression of the disease and deterioration of the joint cartilage. If you have osteoarthritis and have clearance from your doctor (people who have diabetes, are allergic to shellfish or take blood thinners need to visit with their doctor first), you should be taking at least 800 mg of Chondroitin Sulfate for at least two years. This is how long it takes for the supplement to slow the deterioration of the cartilage and the disease modifying effects are independent of symptoms. So, take it even if you feel fine.

DK

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Stephan Reichenbach, Rebekka Sterchi, Martin Scherer, Sven Trelle, Elizabeth Bürgi, Ulrich Bürgi, Paul A. Dieppe, and Peter Jüni Meta-analysis: Chondroitin for Osteoarthritis of the Knee or Hip
Ann Intern Med 2007; 146: 580-590

Michel BA, Stucki G, Frey D, et al. Chondroitins 4 and 6 sulfate in osteoarthritis of the knee: a randomized, controlled trial. Arthritis Rheum 2005 Mar;52(3):779-86

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Do you have a copy of my new book, "The Little Book of Sparks?" It's a great thing to have around when you need a little emotional boost. You can read a sample and order it here.

Protein Content of Foods

Something every person needs who is trying to rebound from an injury or surgery is adequate protein intake. And,  the two most frequent questions we hear are, "How much protein do I need?" and "How much protein is in the food I eat?"

To help you figure this out, below is a list of foods and the protein content published by the Harvard School of Public Health. Aim for 50% of your body weight in grams of protein per day (e.g. a 150 lb person would need 75 grams of protein).

Click here to download the file.

Low Fad Diet

It always feels good to be validated.  An article recently published in the Journal of the American Medical Association, substantiates what we have said for many years when it comes to weight loss: fads fail and the basics work.

This study showed that the type of diet mattered less than adhering to a diet that controlled caloric intake. Managing the amount of energy you consume and use are the keys. How you do that can take a variety of pathways but once you understand the essentials, you can then choose the Ornish, Zone, Weight Watchers or create your own plan and succeed. You'll achieve the best results from a combination of controlled energy consumption (what you eat and drink) and energy expenditure (the nature and type of exercise).

Doug Kelsey

Is a Protein Bar Really Better than a Candy Bar?

I start my day early walking with Spencer, our Dalmation, by 6 AM. By the time 10:30 -11:00 AM rolls around, I am usually hungry and lunch around here isn't until 1:30 PM. So, I would often eat a "protein bar" or some equivalent, convincing myself that although the bar is 200+ calories, at least it's a healthy snack. Right? But which is really better for you? A Snickers Bar or a PowerBar? Most people would choose the PowerBar and they would be correct - but not by much.

There are several issues buried in this onset of late morning hunger but the most pressing is whether it matters if I choose a Snickers Bar or a PowerBar. They have about the same amount of energy packed into them at roughly 250 calories. And after all, it's the energy I'm worried about more than anything else. So if they have roughly the same amount of energy in them, who cares if I choose one over the other?

In an ideal world, we would spend slightly more calories than we consume. Your daily routine would churn through the calories like superstar swimmer Michael Phelps churns through laps in an olympic pool. You could eat a Snickers Bar or a burger or a small pizza and your body could care less. You could get away with this because of a highly inefficient body. Yes, I have that correct. Inefficient. You don't want your body to be like a Yugo: a low powered, fuel conserving machine. You want to be a Ferrari that guzzles energy just idling (and by the way, Michael Phelps reportedly sails through nearly 10,000 calories a day when he is in training).

But, we live in a largely sedentary world and spend less energy than we consume leading to an average weight gain of 1-2 lbs. per year after the age of thirty. We gradually turn into human Yugos (unlike a Yugo, you can change your fuel efficiency. For more information on how, click here).

A "protein bar" is marginally healthier than a "candy bar". Yes, candy bars have more fat but the energy content is about the same. And, unless you're exercising several days per week for at least one hour per day, a candy bar and a protein bar have the same effect: more calories. And, more calories mean more exercise or activity to burn it off. If you don't use the calories, the energy has to go somewhere and for many of us, where it goes is not what we prefer - like our abdomen or thighs (For every "protein bar" you eat, you must, for example, walk for 45 minutes at 3 mph, a leisurely pace, to burn off the extra calories).

So, if you're munching on protein bars thinking, "Well, at least it's not a candy bar," you might want to think again.

Doug Kelsey
Chief Physical Therapist

PS - If you're wondering, "Well, ok, so what DO I eat if I need a snack?" Take some advice from Oprah Winfrey. Her snack idea works, it tastes good and is good for you.

Blood and Madness: The Discovery of How Excess Energy Turns to Fat

Julius served as the ship's surgeon as it sailed the tropical seas of the East Indies. It was during this voyage he stumbled onto his first discovery. As he was draining some of the blood of an ill sailor, he noticed it was much too red. Venous blood should have a bluish tint to it as it carries less oxygen than arterial blood. But the blood of the ship's sailors was a different color in the tropical climate than their home climate. The blood was redder. He deduced that this change was due to an increase in the concentration of oxygen in the blood since the climate was warmer. A warmer climate would mean that the body did not need to use as much oxygen to keep the body warm. From this observation, he concluded that muscular work, heat, and other forms of chemical energy from the oxidation of food must be interchangeable. The energy is transferred from one source to another. It is neither created nor destroyed.

After he concluded the voyage, he returned to his home in Germany, married and began his practice as a local physician. But, the observation of the reddish blood tugged at his mind. He set out to record his observations and publish a theoretical paper later that year in 1840. It was ignored by everyone in the scientific community. Julius's paper was rubbish. Julius had no formal training in physics so he returned to study the discipline and two years later published a much better and more robust argument. It was still ignored.

At about the same time Julius was publishing his observations, James Joule was conducting scientific experiments about how mechanical work is converted into heat. His work, detailed and methodical, was 99% correct. The scientific community accepted Joule's work and ignored Julius. Julius was devastated and in 1850 tried to kill himself. He spent the next several years in and out of mental asylums. It was not until 1862, that Julius Robert Mayer was recognized for his original theory which became known as the First Law of Thermodynamics.

The First Law of Thermodynamics states that energy is neither created nor destroyed. Energy is conserved. Energy can be converted from one form into another. Ice into water. Water into gas. Your body follows this law. The food you eat is converted into energy through the digestion process. The amount of energy in food is measured and reported in the form of Calories. One Calorie (a calorie from food is expressed with a capital C and is equal to 1000 calories) is the amount of energy required to raise 1 kilogram of water 1 degree centigrade (this is about a 2 degree increase in Fahrenheit).  A Calorie in a cookie contains the same amount of energy as a Calorie in lettuce. The difference between a cookie and a cup of lettuce is the total number of Calories and the way your body processes or uses the energy.

Whatever energy your body does not use, it must change into something else. The unused energy is stored as fat. Your body has a limited ability to store protein or carbohydrate, no ability to store alcohol, but virtually an unlimited ability to store fat. We call this process of energy entering your body, being converted, used and stored your Energy Flux. When you have a positive Energy Flux, you will deposit the excess energy as fat. When you have a negative Energy Flux, you will burn fat. Expressed as a formula, Energy Flux is:

• Energy Flux = Calories In - Energy Demand
• Positive Energy Flux = Excess Energy
• Excess Energy = Fat Deposition

When your body runs at high speeds, you have a negative Energy Flux. You use most of what you consume and have little left over to be deposited as fat. It's like your body is the engine of a Hummer instead of a Geo. You just suck up the energy. Lance Armstrong consumes 8,000 - 10,000 calories a day during the Tour de France. Do you see any fat on his body? No. He churns through all that energy spending hours on his bike. So, the logical next question is, "What are the best and easiest ways to help your body run at a higher speed to create a negative Energy Flux"? Especially if you do not have the time to spend hours on a bike, at the gym or in a pool? And, are there certain things that might be counter productive? Hmmm....... 

I'll let you in on the secrets soon about what science tells us really revs your engine. In the meantime, you can find the answers in Fat Burning 101 available through our online store. Just released in audio CD format, this product is filled with great information about how to change your body from a Geo to a Hummer for way less than filling a Hummer's gas tank. As always you can still purchase this product in a DVD format.

Make today count.

Doug Kelsey

Move It to Lose It - Scientists Discover Key to Burning Fat

I was just talking with a client in our lab the other day and happened to mention that my pedometer reading was too low. She wondered what I meant and I explained I record the number of steps I take each day. Today the reading was too low: 2000 steps. She exclaimed, "2000! How many do you want in a day?"

Good question. I shoot for 5000 steps per day for now and must make a concentrated effort to reach 5000 steps per day. And, frankly, 5000 steps for me is not that far; about 3.0 miles. I chose 5000 because one of the worst things you can do for your body is to sit for extended periods of time and I CAN achieve 5000 (I hate to lose even to myself). Of course a lot of people sit most of the day. In fact, if you really want to know just how sedentary you are, buy a pedometer and wear it for a few days from the time you get up in the morning until the time you get back into bed. I bet you'll be shocked. The first time I recorded it, I had 1500 steps in a day.

Well, scientists have studied the effect of just getting up and moving around more each day and what they found so impressed one of the researchers he changed his office set up. People who move frequently, have a higher Non Exercise Activity Thermogenesis (NEAT), and tend to have fewer problems with fat accumulation than those who sit still. So, he put a treadmill under his computer so he can walk while he works. He found that the ideal walking speed (for working) is 0.7 mph (in case you get brave and give it a go). Great idea as long as you can walk, talk and type all at the same time. I likely would end up on the floor.

If you want to burn fat, scientists say get moving. But,as for the treadmill under my computer, I think I'll wait.

Doug Kelsey
Author. Speaker. Therapist.

Feeling Hungry?

It would have been helpful to receive a user manual with your body. I would have settled for one page, hand written or even just an outline. Learning to translate the body's messages takes time and some people never quite comprehend the incoming stream of garbled, fuzzy impulses.

Hunger is a feeling. As with all feelings, we cannot quantify them. We cannot turn hunger into some sort of Spock-like logic. We eat because we are hungry, but we cannot always explain why we are hungry.

The feeling of hunger has three elements:

1. Physiologic
2. Emotional
3. Cognitive (coincidentally, the same three elements are found in pain)

Physiologically, a fall in your blood sugar, a change in fatty acid levels, or a drop in your body temperature will cause hunger. If you exercise too hard, too fast, your blood sugar level will drop and you will feel hungry. Hungry enough to quit exercising.

The biological signals of hunger can also be confusing. Thirst, fatigue, irritability, pain, weakness can all be the foreign language of hunger. Add those to your hunger dictionary.

Sometimes, the environment we are in can make us feel hungry (which is why restaurants go to such great effort in creating a specific atmosphere) even though we do not technically need any more food. The message of hunger is false. We are not truly hungry. We associate the pleasure of the event (the sights, sounds, smells, etc.) with the food. The signal we respond to is pleasure; not hunger.

If we feel sad or overly stressed, we may seek the comfort of a friendly carton of Hagen-Daas ice cream. We may eat it all hungry or not. Our emotions will masquerade as hunger.

The color of the food you eat influences your hunger feelings. Imagine sitting down to a nice, sizzling, warm rib eye steak. But, it is blue. Entirely blue. You will suddenly not be hungry. God makes no blue food. Blue food is a natural hunger suppressant (so, maybe if you just color your food blue, you can control your hunger?).

Recognizing the signs of hunger is much like learning a foreign language. You have to study every day. You have to review the basics and apply them. Pay attention to the basic biologic feelings of fatigue, thirst, irritability, weakness or pain. You may be hungry. Pay attention to how you feel when you smell a favorite food or see a delicious dish. Were you hungry the moment before or just now?

As you learn the language of the body, you will make new choices and form new habits. You will eat because you choose to and you will know why.

Make today count.

Doug Kelsey
Author. Speaker. Therapist.

Are You Stuck In a Traffic Jam?

It is 8:30 AM on Monday morning. Traffic is at a standstill. You have the most important meeting of your business career in fifteen minutes and you will be late. Very late.  A meeting worth several million dollars to your company. A meeting you spent several months in preparation. And, it will all be gone.

The longer you sit in the mass of immobile metal, the worse you feel. You cannot get the negative thoughts out of your head. Your neck starts to hurt and the hint of headache appears. After thirty minutes, traffic begins moving. You finally arrive at your destination only to find the meeting is over.

You missed it.

You manage to avoid getting fired and feel some relief only to find, upon arriving home, your 15 year old daughter has pierced her nose, her tongue and her belly button and has a tattoo the size of Texas across her low back. And it's only Monday.

The physiologic response to the stress of a missed meeting and a tattooed daughter is the same type of response you would have if you opened your door to find a grizzly bear grinning at you. You would either fight or flee. In either case, your heart rate goes up, blood flow to your brain and internal organs goes down and key hormones designed to give you extra energy, like Cortisol, are released. This fight or flight response was designed as a short term solution to immediate stress or danger. We no longer encounter lions, tigers or bears. Yet, the body acts as if we do. Our stress is no longer a  short term scuffle or a 200 yard mad dash. It is hours long each and every day. Year after year.

The rise of Cortisol and other stress related hormones in your body releases fat from fat stores into the bloodstream to be used as fuel. But, you are sitting in your car. Doing nothing. You are not demanding any more energy. Meanwhile, the fat flows freely through your blood hoping you will call it into action. But, you do not. The fat then needs to find a home. Some of it is deposited inside the walls of your arteries and some goes to fat banks under your skin. Since the stressor continues throughout the day, so does the fat reaction: release from stores, flow through the blood, deposit on the arterial walls and back into the fat banks.

But, the deposition of fat is just the beginning. When Cortisol levels are too high your:

1. Blood pressure rises
2. Brain cells die
3. Immune system malfunctions
4. Sex drive drops

Initially, your appetite decreases but this is a short term response. Before long you're hungry. Insulin is released to promote access to sugar (remember, your body thinks you are fighting or running from a bear) for quick energy. Sugar is released and the body thinks it needs more. Your craving for sugar goes up which is why you reach for a Snickers bar instead of a carrot.

Having consumed the Snickers bar, your body begins to break it down. If your stress level remains elevated, the fat from the Snickers bar, will first float through the blood. But, since you are not moving or using your muscles, the fat will be dropped off for storage. The extra energy goes unused.

When you find yourself craving sweet foods, alcohol or carbohydrate (chips, crackers, pretzels) and you have not just been running from a bear, stop and think about what and how you feel. You are probably overly stressed. There is growing evidence that emotional stress is linked to fat gain and in particular, around the abdomen. A better choice than the Snickers bar is to use our Stress Busting Techniques throughout the day.

Not to stress you out, but I'm out of time. More on how to lower your stress another day.

Make today count.

Doug Kelsey
Author. Teacher. Therapist.

P.S. We still have seats available for this Tuesday's free public seminar, Runner's Knee: The 10 Mistakes Athletes Make. Can't attend? You can now purchase Runner's Knee: The 10 Mistakes Athletes Make on audio CD. Even if you don't live in Austin, you can hear Dr. Kelsey explain how to beat your Runner's Knee. Purchase your copy online today for only $9.99!

How to Use Supplements to Help Rebuild Your Joints

Many people with achy, stiff, sore joints who have been diagnosed with degenerative joint disease, patellofemoral disease, chondromalacia, or degenerative disc disease (all forms of osteoarthritis), are unaware of certain nutritional supplements that help the joint rebuilding regimen. Others may be using supplements, but are unclear about the dosage or frequency. Below are our suggestions for proper use of nutritional supplements.

The supplements are:

1. Glucosamine (GLUE-CO-SAH-MEAN)
2. Chondroitin Sulfate (CON-DROY-TIN-SULF-ATE)
3. SAMe (SAMMY)
4. Omega Three Fatty Acids
5. ACES (Vitamin A, C, E, and Selenium)

Glucosamine is an amino sugar that produces special proteins (glycosaminoglycans or GAG) your cartilage need to bind water. Healthy, sturdy cartilage traps water molecules which allows it to deform and bounce back protecting your bone and other structures.

• Dosage (based on body weight)
  
  • less than 120lbs., 1000 mg / day
    
  • 120 to 200lbs. 1500 mg/day
  • more than 200 lbs. 2000 mg/day
• Frequency
  • Two times per day (divide daily dosage in half)

Chondroitin Sulfate is a component of GAG, is a water magnet and retards the degradation of cartilage. Both Glucosamine and Chondroitin Sulfate have been extensively studied and have been shown to both reduce the symptoms of joint injury / disease as well as enhance the basic infrastructure of cartilage.

• Dosage (based on body weight)
  
  • less than 120lbs., 800 mg/day
    
  • 120 to 200lbs. 1200 mg/day
  • more than 200 lbs. 1600 mg/day
• Frequency
  • Two times per day (divide daily dosage in half)

SAMe is s-adenosylmethionine, a naturally occurring substance in your body resulting from the metabolism of the amino acid methionine, has been used extensively as a treatment for depression. In an Italian study, the researchers discovered that the subjects who also had knee pain due to osteoarthritis reported much less pain after taking SAMe. Double blind short term studies since then have shown SAMe to be as effective as Non-Steroidal Anti-Inflammatory Drugs (ibuprofen).

• Dosage
  
  • 200-400 mg
• Frequency
  • Three times per day on an empty stomach.
  • Precautions: flatulence, vomiting, diarrhea, headache, and, in depressed patients, anxiety. SAM-e should not be taken concomitant with anti-depressive agents to avoid serotonin syndrome-like symptoms such as tremors, tachycardia, tachypnea, and hyperreflexia.

Omega Three Fatty Acids are a form of fat - the kind that is good for you called an unsaturated fat. Most frequently found in cold water fish, Omega Three is also found in flax seed oil and in capsule form. Insufficient Omega Three will cause your cells to use saturated fats resulting in more fragile and easily damaged cell walls.

• Dosage
  
  • 1000 - 2000 mg/day (fish oil tablets).
  • Precautions: "Omega-3 fatty acids should be used cautiously by people who bruise easily, have a bleeding disorder, or take blood-thinning medications because excessive amounts of omega-3 fatty acids may lead to bleeding. In fact, people who eat more than three grams of omega-3 fatty acids per day (equivalent to 3 servings of fish per day) may be at an increased risk for hemorrhagic stroke, a potentially fatal condition in which an artery in the brain leaks or ruptures. Fish oil can cause flatulence and diarrhea. Time-release preparations may reduce these side effects, however." Source:http://www.umm.edu/altmed/ConsSupplements/Omega3FattyAcidscs.html

ACES (Vitamin A, C, E, and Selenium): While a complete and balanced diet that includes plenty of fresh fruits and vegetables can supply you with ACES, many people either do not have such a diet or are inconsistent with their diet. ACES are excellent anti-oxidants and improve cell function.

• Vitamin A  5000 IU per day
• Vitamin C  500 - 2000 mg per day
• Vitamin E  100-400 IU per day
• Selenium    55-200 mcg per day

The above supplements require 2-3 months of consistent use before you will notice any significant improvement. After 6 months of use, you can reduce the dosage by 50% for three months then, in most cases, discontinue them.

Rebuilding joints requires adequate water, the necessary building blocks (glucosamine, chondroitin sulfate), controlling inflammation (SAMe) and sturdy cell walls (Omega Three Fatty Acids, ACES) plus specific exercises to aid in the transport of nutrients and signaling cellular activity.

As new supplements become available and research supports their use, we will post the information. Check back often or if you subscribe to a news aggregator (Bloglines for example), add The View from Sports Center to your reader and new posts will appear automatically for your reading. Or, if you are an athlete with joint pain, give us a call at 512-206-0433 and schedule a Sports Center consult to learn how to beat your injury.

Make today count.

Doug Kelsey
Author. Teacher. Therapist.