Carbs Are Not The Enemy! Part 2

To see the big picture lets focus back in on what else is driving the obesity epidemic.

I had such a great response to last weeks post that I decided to do a part 2 on carbohydrates (CHO) and its relationship to obesity! So once again the focus will be on insulin, and like last week the information is not all inclusive and does not cover everyone with a special need, disease, or condition. Of course before I dive in I want to remind everyone that for healthy individuals, insulin is very tightly controlled by the body and there is no reason at all to fear it. And as a refresher on what insulin does I’ll remind you that one of insulin’s main roles is to maintain glucose homeostasis.
So this week I am going to start by saying why CHO’s are bad according to a couple of sources.
 – Increased sugar consumption has significantly contributed to the rise in obesity and metabolic diseases
 – There is an association between risk of overweight and obesity and fructose-containing sugars consumed as sugar-sweetened beverages
 – High intakes of highly palatable foods like refined grains, processed meats, red meats, French fries, and potato products play a role in weight gain
 – Insulin levels are typically increased in obese individuals
At this point you may be asking yourself “wait what? I thought this was about how carbs aren’t bad for me?” I will say first and foremost thatassociation is not causation. This means that the previously mentioned issues are only part of the problem. To see the big picture lets focus back in on what else is driving the obesity epidemic.
 – Physical inactivity!!!!!!!!!! (as I sit in front of a screen I realize that I’m a hypocrite… I’m doing 10 squats before I write more and so should you!)
 – Over consumption of all foods is associated with overweight and obesity
 – Western dietary pattern and lifestyle in general is just a culture of poor decisions
I say this because I really dislike absolutes. As in CHO’s are the reason why we have an obesity crisis. To me it doesn’t make sense. We have been eating the stuff forever without issue so why all of a sudden is it becoming a problem? Why are so many people blaming sugar and insulin to be the issue? Well the first, and most obvious, answer to this is that individuals want to make a quick buck off of a product, book, or alternative health care product. The second answer is that some individual just don’t understand whats really the issue. So here are some bullet point’s on why an increased insulin response to CHO consumption leading to lipogenesis (energy stored as fat) is not likely the mechanistic cause of the obesity problem.
 – The supportive data for insulin being the bad guy are largely supported by ecological observations, rodent models of overfeeding (humans are not rats), and select human trials (all are poor evidence)
 – There have been no high quality studies showing that fructose-containing sugars behave differently from any other forms of energy intake
 – Although the food mentioned earlier are associated with increased levels of obesity, total sugars or other important sources of added sugars such as cakes, pastries and sweets have not
 – If insulin was the true problem, we would observe increased insulin in all cases of obesity
 – While there is increased insulin in obese people (in most cases), it appears its action is reduced (i.e. its action of lipogenesis and reducinglipolysis on fat tissue is decreased)
 – Insulin can have short-term effects on how nutrients are stored in the body for things like muscle glycogen synthesis and muscle protein synthesis
 –
So what the hell does this all mean? Well to sum it all up I can say that CHO’s do not cause obesity. They do however, play an important roll. It is way to easy to consume CHO’s in large quantities so it’s important to know how much energy you are taking in. Insulin is a substrate conductor that tells your cells what to use for fuel and can be manipulated to optimize fuel portioning to promote fat oxidation and recovery from workouts. What this all means is that obesity is likely the cause of insulin resistance, and NOT the driving factor behind it.
For more information I recommend you read the three fantastic articles. Additionally check out this TED talk for more thoughts on insulin resistance.

Carbs Are Not The Enemy!

A highly controversial, and often a highly confused, subject.

Today’s post is about a highly controversial, and often a highly confused, subject. Carbohydrates (CHO) has been villainized by many in the health and fitness industry. However, as a lover of CHO’s, I thought I’d take the time to answer the question“do carbohydrates make us fat”?
Obviously, what I am about to write is not all inclusive and does not cover everyone with a special need, disease, or condition. But I think it is important for everyone to know that science isn’t always on the side of certain authors and their view points.
So let’s get to it. When it comes to CHO’s being bad, many point the all mighty finger of blame towards the “I” word. The word even makes some people feel a wee bit squeamish… INSULIN. Now before we go any further I want you to be comfortable with the word. So I will let you in on a little secret. For healthy individuals, insulin is very tightly controlled by the body and there is no reason at all to fear it. For those of you who are not sure what the hell I’m talking about, here is a brief history on how insulin works, and why some people think it’s bad.
Down Insulin! Bad Hormone! 
 – Insulin is a hormone that is released by the pancreas, and interacts with skeletal muscle, the liver, and our adipose tissue (fat)
 – When we eat CHO’s (sugars) insulin is released into the blood stream where it tells muscles to absorb sugar and and use it as fuel.
 – Because the liver releases sugar when our blood sugar gets too low, insulin replenishes what is lost there too
 – When the liver and muscle cells are filled up with sugars, insulin will turn the excess CHO into fat
 – Insulin decreases the rate of lipolysis (break down of fat for energy) in fat tissue and does stimulate fatty acid and triacylglycerol production
Why This Process DOES NOT Make You Fat
 – When we are resting our bodies use fat as the primary fuel source
 – When we work out, our body is using stored sugars as fuel so we typically need to top it off when we eat
 – Storing fat would require us to have a constantly high signal of insulin
 – Insulin is simply a switch in which fuel source we use, thus it tells us when we should burn sugar because we have enough of it to burn, but it does not tell our body that we should become fat!!!
Still wana be on that high protein diet because CHO’s are scary? Well the reality is that some high-protein foods elicit a greater insulin response than high-carbohydrate foods. In fact all proteins come with an insulin response. So by that logic, those who think that CHO’s affect on insulin is the cause of obesity must recognize that consuming protein would also encourage fat accumulation and not fat loss.
As I come to the conclusion I feel obligated to talk about diabetes, the disease that alters the body’s use of insulin. The fact of the mater is that those with type 1 diabetes can do nothing about their situation. However, those with type 2 diabetes often can. This is because the same reason why people accumulate fat due to insulin, is frequently the reason why type 2 diabetes occurs… a lack of response to circulating insulin. This is an entirely separate can of worm that I would be happy to discuss with anyone on an individual basis 🙂
All of this being said, CHO’s can also be a bad thing. When processed, they don’t provide much in the way of nutrition. This decreases how full we feel and makes it hard to judge just how much we ate.

All About The Heat, Hydration, & Sweat

Let’s take a look at what you should be doing to keep yourself healthy and cool while exercising and looking hot!

Today I wanted to stay on the theme of fluid consumption, so let’s take a look at how to have fun and stay safe during the summer heat. This topic is important to me for many reasons. I am an Athletic Trainer which means I am a health care professional who collaborates with physicians to provide preventive services, emergency care, clinical diagnosis, therapeutic intervention and rehabilitation of injuries and medical conditions. So naturally, I want to keep everyone safe. In addition, I am a super heavy sweater, so I know firsthand the perils of not properly preparing. So let’s take a look at what you should be doing to keep yourself healthy and cool while exercising and looking hot!

 

Warm Up to The Heat

When it comes to exercising in the heat, you don’t want to go into it cold. And by that I mean, you need to get your body prepared for the extra stress that heat places upon it. Acclimation is the process by which the body adapts to heat stress, and it is a crucial element to heat safety. Because it can take a few weeks to get acclimated, you want to slowly increase the volume, duration, and intensity of your training. The complete process will vary depending on activity, but in general, during days 1-5 there should be light to moderate exercise lasting no more than 1 hour. During days 6-14, increase the exercise load up to 3 hours (1). This process is extremely important and should be taken seriously. It would also be wise to learn about the dangers of heat illness such as heat syncope, exercise (heat) exhaustion, and exertional heat stroke (2). Especially when you’re starting to get used to the heat, it is wise to prepare yourself by adjusting your training sessions, training with a partner, pre-cooling with ice towels before exercise. Try to and have ice vests/towels and even cold-water baths ready in case you need to rapidly cool down.

 

Sweet Scent of Sweat

Sweating is a normal, expected outcome of exercise. And before we talk about how much you should be drinking, it’s important to know how much you’re sweating. One way to figure this out is to use the simple test of weighing yourself before and after a run to get a sense of how much fluid you’re losing. This way you know how much water you need to be drinking during that time span.

But why do some people sweat more than others? Well, the answer might not be what you expect because it doesn’t have to do with how much body fat you have, or if you’re in great cardiovascular shape (3)! Sweating is a cooling mechanism that aims to dampen your skin. Then the sweat gets evaporated, and that process of evaporation cools you down. So essentially, those who produce more heat will be the ones who sweat more. Acclimation plays a role in this as well because as you exercise more in the heat, your body knows that you will be getting hot, so it starts producing a lot sweat quickly (4). There are other factors that play into how much you sweat. Factors you can’t change include how many sweat glands you’re born with (2 – 5 hundred thousand) and the fact that men sweat more than women (5). Modifiable factors that will make you sweat more include taking stimulants (e.g. caffeine), alcohol consumption, nicotine, and non-breathable clothing such as synthetic fabrics. There are also medical issues that will make you sweat more including hyperhidrosis and anxiety that require a doctor to diagnose.

 

Hydration, Electrolytes, Cramps, And Other Myths

When it comes to hydration during exercise, and life in general, there are a lot of myths, old wives’ tales, and misinformation thrown around on the internet. This is a bit off topic, but I would like to start by saying you don’t need to drink 8 glasses of water a day regardless of what marketing departments tell you (6). Even though dehydration will decrease your metal abilities, you would need to fight the urge to drink something for quite a while before that takes effect. Up next, coffee does not dehydrate you (7)!!!!!! Drinking coffee in isolation won’t cause dehydration because, guess what, it’s a liquid. The water that comes with the coffee far offsets the increase in sweating that comes with it. Here comes the big shock of the post… hydration and electrolytes have NOTHING to do with cramps during exercise (8)! This widespread misconception is again largely driven by marketing. Cramps are more likely caused by a high intensity of exercise, family history of cramps, and muscle damage (9). The latter point is the most important. Muscle damage caused by excessive heat can be a sign that your body is entering a danger zone. So when you’re exercising outdoors in hot and humid weather, take cramps seriously as a possible sign of heat illness (10).

Now that the myth busting is out of the way, let’s dive into what you should be doing to be safe in the heat. The first tip is to begin with the end in mind. And by that I mean you should come into an exercise session already hydrated. Euhydration is when you’re at an ideal, or slightly greater than ideal, level of hydration. This is important because many people can only drink about a liter of fluid an hour even though they sweat much more than that (11). So how can you tell if you’re at a euhydrated state? Well the answer is in your pee! Check out the chart below to see where your hydration level should be.

AM I HYDRATED? A URINE COLOR CHART

 

There are many hydration strategies out there, but your best bet is to just sip on water regularly throughout your exercise routine. If you don’t like the taste of water, then you can drink something with a little more flavor if you prefer. No matter what you drink, the end result will be about the same. But it’s important to remember that unless you are exercising for more than two hours, sports drinks aren’t going to be beneficial and will only add to your total amount of calories consumed for the day. The most important thing to do is weigh yourself before and after your exercise and drink back what you lost during that time.

Body By Booz: The Effects Of Alcohol On Your Fitness Goals

How does doing 12oz curls can influence your fitness and physique? Whether you’re drinking whiskey, wine, or whatever else you use as social lube, we will dive into how it will influence your waistline.

Happy 4th of July! When I think about the celebration of this holiday, images of barbecues, fireworks, and beer dance through my head. I know that I’m certainly not alone when it comes to this way of thinking, which is why I wanted to write about how doing 12oz curls can influence your fitness and physique. So whether you’re drinking whiskey, wine, or whatever else you use as social lube, let’s dive into how it will influence your waistline.
The Basics Of Imbibing
Alcohol comes in many forms, but in general a unit is typically 12 oz (355 mL) of 5% beer, 5 oz (150 mL) 12.5% wine, or 1.5 oz (45 mL) of drinks with a higher (40%) alcohol content. Most of us drink alcohol because it’s a neuroactive chemical that gets us buzzed. But that inebriation comes at a caloric cost that most forget about. That fire water you’re enjoying contains 7 calories per gram energy-wise, but this does not always correlate well with body weight like the other macronutrients (carbs, fats, proteins) do. Finally, as you read the rest of this post it’s important to keep in mind that “moderate” drinking is dependent on gender and not ultimately defined, but an upper limit can be placed at 9 units per week for women and 12-14 units a week for men, with no single event exceeding 4 units.
Beer Nuts & Drunk Munchies
If you’re trying to lose weight, or at least not gain a beer belly, you know that you want to consume fewer calories than you expend. Drinking can certainly influence both aspects, but lets take a closer look at the former aspect of the equation. One important thing to consider when it comes to eating under the influence is that alcohol alters your brain activity along with your hunger hormones. In turn, it can influence what you perceive as tasty. We know that increased calorie consumption is not due to a drunken urge to chow down, but rather it’s due to an increased food-related reward when we taste energy-rich foods… like nachos (1). And remember how calories that come from booze don’t always correlate well with body weight? Well that’s because the calories that you get from alcohol have a large individual variability according to the absolute amount of alcohol consumed, drinking frequency as well as genetic factors. For instance, alcohol calories count more in moderate non-daily consumers than in daily (heavy) consumers as well as counting more in combination with a high-fat diet and in overweight and obese individuals (2). Just another reason why counting your calories can be frustrating. Although binge drinking can cause binge eating, it’s safe to say that exercising in moderation while tossing a few back together with a healthy lifestyle won’t cause weight gain (3).
Obviously, not gaining weight is not enough for most of us. If you want to lose weight then you may want to consider altering your drinking habits. This is because drinking is done in social situations, which leads to social eating, which can lead to poor nutritional choices. You should start by tracking your choices on getting tipsy with a drinking journal. From there, you can address where in your lifestyle you need to make adjustments. For more information on how exactly to go about this, you can listen to or read this wonderful information put you by the folks over at Precision Nutrition.
Ethanol & Exercise
Inline image 3

The key theme and take away from this whole post should be that moderation is key. Drinking a brew or two after exercise every once in a while won’t make you gain weight or lose any benefits you get from the bout of exercise. However, over indulging, especially on a consistent basis, will decrease your overall health and stop progress in its tracks. So have some fun if drinking is your thing, but don’t be an Animal House frat boy. This may be the best way to live life to the fullest.
 
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References
1. Yeomans, M. R. (2010). Short term effects of alcohol on appetite in humans. effects of context and restrained eating. Appetite, 55(3), 565-573. doi:10.1016/j.appet.2010.09.005
2. Suter, P. M., & Tremblay, A. (2005). is alcohol consumption a risk factor for weight gain and obesity? Critical Reviews in Clinical Laboratory Sciences, 42(3), 197-227. doi:10.1080/10408360590913542
3. Traversy G, Chaput J-P. Alcohol Consumption and Obesity: An Update. Current Obesity Reports. 2015;4(1):122-130. doi:10.1007/s13679-014-0129-4.
4. Jiménez-Pavón, D., Cervantes-Borunda, M. S., Díaz, L. E., Marcos, A., & Castillo, M. J. (2015). Effects of a moderate intake of beer on markers of hydration after exercise in the heat: A crossover study. Journal of the International Society of Sports Nutrition, 12, 26. doi:10.1186/s12970-015-0088-5
5. Burke, L. M., Collier, G. R., Broad, E. M., Davis, P. G., Martin, D. T., Sanigorski, A. J., & Hargreaves, M. (2003). Effect of alcohol intake on muscle glycogen storage after prolonged exercise. Journal of Applied Physiology, 95(3), 983-990. doi:10.1152/japplphysiol.00115.2003
6. Ebrahim, I., Fenwick, P., Williams, A. J., & Shapiro, C. (2015). Alcohol and sleep review: Sound statistics and valid conclusions. Alcoholism: Clinical and Experimental Research, 39(5), 944-946. doi:10.1111/acer.12708
7. Steiner, J. L., Gordon, B. S., & Lang, C. H. (2015). Moderate alcohol consumption does not impair overload-induced muscle hypertrophy and protein synthesis. Physiological Reports, 3(3), e12333. http://doi.org/10.14814/phy2.12333
8. Duplanty, A. A., Budnar, R. G., Luk, H. Y., Levitt, D. E., Hill, D. W., McFarlin, B. K., … & Vingren, J. L. (2016). Effect of Acute Alcohol Ingestion on Resistance Exercise Induced mTORC1 Signaling in Human Muscle. Journal of strength and conditioning research/National Strength & Conditioning Association.

The Cause Of, And Solution To, Back Pain

There are too many myths about what causes back pain, and far too many treatments for back pain to ignore (most of which are a waste of time and money).

Today I wanted to give a more in-depth look at causes and solutions to lower back pain. I have previously written about this in a more general sense, but I really feel like this topic deserves more attention. There are too many myths about what causes back pain, and far too many treatments for back pain to ignore (most of which are a waste of time and money). So let’s dive into some surprising factors causing pain, and some practical tips on how to deal with it!
Why Do I Hurt?!?!
I’ll start by saying that 80% of people will experience an episode of back pain during their lifetime. So it’s good to know you’re not alone in wondering what’s going on with your back. But the reason behind your back pain is surprisingly complicated. Aside from acute sprains and strains, the exact diagnosis of the root cause of the problem is often never made, or made incorrectly.
Imaging
We know that using techniques such as X-ray and MRI are often ineffective at catching the true problem (1). This is because most people, HEALTHY pain free people, already have some form of disc or spine degeneration (2). This simple fact can be very misleading when doctors are trying to interpret radiographic findings. The only exception to this rule seems to be for SI joint dysfunction, but even that has some major issues (3). Ultimately, this means that there is no evidence that back pain is caused by a bone or joint in the back being out of place, some change in spinal alignment, or your pelvis being out of alignment. . But on the bright side, we know that more pain does not always mean more damage! Here are two great podcasts going over in detail what types of examinations are often used, and which ones actually workONE TWO.
Inline image 1
Back Pain Exacerbates Itself
Often times pain can make someone afraid to move. This is called kinesiophobia and when it comes to back pain it can be terribly detrimental. This is because movement is key to preventing pain and getting your back better! We know that bending and lifting is not a problem, but rather that muscular fatigue during these tasks can be what causes back pain (4). And we know that stress and a lack of sleep can also cause low back pain (5,6). And if you read my previous post on back pain, you will know that sitting too long can cause back pain. So I hope by now you can see how back pain can make itself worse over time, and that it may not be caused by any physical issue that you may already have to begin with.
What To Do About That Back
DON’TS
Because there is generally no specific cause of back pain, there really is no specific way to treat it. However, we do have a good idea of what works and what doesn’t work. Let’s start with what’s on everyone’s minds… the core. Core training, is often the go to fix for back pain because one would think that a stable back/spine is what’s needed to fix a back problem. But as we know the spine is often not the problem so core training (e.g. targeted core training or Pilates) is not the solution (7). We also know that surgery,  orthotics, or focusing on “perfect posture”are not helpful as well. Finally, alternative methods such as massagetrigger point therapyglucosamine, and back crackin don’t work either (8)
DO’S
One great way to address the pain is by not freaking out and going to your doctor right away. The majority of people who experience back pain have their problems go away within 2-6 weeks of it’s onset. Even the dreaded disc herniation goes away on it’s own over time. Exercise your whole body to see the greatest benefits for both back pain and general health. Aside from making sure you have a strong tooshie (gluteus medius), there is no specific form of exercise that works the best but it seems that total body strength training does the trick (9). If you’re not up for that, then WALK!!! Walking has been shown to be just as effective, and walking backwards may even be a better way to go (10).
The key in all of this is to make sure you get a lot of exercise. Because when it comes down to it, it’s the quantity NOT the quality of exercise that you get that will solve your issues (10).
References
1. Chou, R., Qaseem, A., Snow, V., Casey, D., J. Thomas Cross, J., Shekelle, P.. . American Pain Society Low Back Pain Guidelines Panel. (2007). Diagnosis and treatment of low back pain: A joint clinical practice guideline from the american college of physicians and the american pain society. Annals of Internal Medicine, 147(7), 478.
2. Brinjikji, W., Luetmer, P. H., Comstock, B., Bresnahan, B. W., Chen, L. E., Deyo, R. A.. . Jarvik, J. G. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR. American Journal of Neuroradiology, 36(4), 811-816. doi:10.3174/ajnr.A4173
3. Laslett, M. (2008). Evidence-based diagnosis and treatment of the painful sacroiliac joint. The Journal of Manual & Manipulative Therapy, 16(3), 142-152. doi:10.1179/jmt.2008.16.3.142
4. Seyed Hoseinpoor, T., Kahrizi, S., Mobini, B., & Naji, M. (2015). A comparison of abdominal muscle thickness changes after a lifting task in subjects with and without chronic low-back pain. Human Factors: The Journal of Human Factors and Ergonomics Society, 57(2), 208-217. doi:10.1177/0018720814544213
5. Truchon, M., Côté, D., Schmouth, M., Leblond, J., Fillion, L., & Dionne, C. (2010). Validation of an adaptation of the stress process model for predicting low back pain related long-term disability outcomes: A cohort study. Spine, 35(13), 1307. doi:10.1097/BRS.0b013e3181c03d06
6. Alsaadi, S. M., McAuley, J. H., Hush, J. M., Lo, S., Lin, C. C., Williams, C. M., & Maher, C. G. (2014). Poor sleep quality is strongly associated with subsequent pain intensity in patients with acute low back pain: Sleep quality and pain intensity. Arthritis & Rheumatology, 66(5), 1388-1394. doi:10.1002/art.38329
7. Wang, X., Zheng, J., Yu, Z., Bi, X., Lou, S., Liu, J.. . Chen, P. (2012). A meta-analysis of core stability exercise versus general exercise for chronic low back pain. PloS One, 7(12), e52082.
8. Hegedus, E. J., Goode, A., Butler, R. J., & Slaven, E. (2011). The neurophysiological effects of a single session of spinal joint mobilization: Does the effect last? The Journal of Manual & Manipulative Therapy, 19(3), 143-151. doi:10.1179/2042618611Y.0000000003
9. Cooper, N. A., Scavo, K. M., Strickland, K. J., Tipayamongkol, N., Nicholson, J. D., Bewyer, D. C., & Sluka, K. A. (2016). Prevalence of gluteus medius weakness in people with chronic low back pain compared to healthy controls. European Spine Journal, 25(4), 1258-1265. doi:10.1007/s00586-015-4027-6
10. Ferreira, M. L., Smeets, R. J. E. M., Kamper, S. J., Ferreira, P. H., & Machado, L. A. C. (2010). Can we explain heterogeneity among randomized clinical trials of exercise for chronic back pain? A meta-regression analysis of randomized controlled trials. Physical Therapy, 90(10), 1383-1403. doi:10.2522/ptj.20090332

Snap, Crack, Pop: What Joint Sounds Really Mean

It’s harmless to be a crack addict (e.g. cracking your knuckles), the hazards of trusting others to crack you, and what those other sounds your joints make actually mean.

I cracked my knuckles while at work the other day and a patron looks at me like a mother scolding her toddler and says “You know cracking your knuckles causes arthritis. You wouldn’t want to deal with that down the road now would you?” Being the nice young man that I am, I just smiled and nodded. But I really wanted to explain to her that cracking your own joints is harmless! That’s why I am going to talk about how it’s harmless to be a crack addict (e.g. cracking your knuckles), the hazards of trusting others to crack you, and what those other sounds your joints make actually mean. So prepare yourself for some snappy puns, and let’s get started on this poppin post!
 
Tribonucleation
Tribonucleation is the formation of tiny bubbles between two submerged surfaces when those surfaces are suddenly pulled apart (A.K.A. knuckle cracking). What this means is that during a the cracking process the opposing knuckle joint surfaces resist separation until a critical point where they then separate rapidly creating sustained gas cavities. We know this, due to a very cool study where a person cracked their knuckles during an MRI showing that the cracking is due to cavity inception rather than collapse of a pre-existing bubble (1). In other words, if you want to get your crack on you must generate enough force to overcome tension within the joints (synovial) fluid that keeps the joint tight (not within the soft tissues). This means that you are disrupting the tension forces that keep the joint surfaces together that adds stability to the joint itself (2). This is why you feel nice and loose after a good popping. 
Inline image 1
When it comes to the safety/potential for harm, we know that there is no reason to fret. The old wives’ tale of knuckle cracking causing joint arthritis stems from the thought that the joint collapses during and/or after the force is applied (3). However, we now know for sure that the resting joint orientation is not changed by the cracking event. Furthermore, there is some pretty good research out there showing that cracking your knuckles won’t cause harm (4)… unless it annoys those around you enough for them to cut your fingers off.
Inline image 1
 
What About My Back?!?!
Cracking backs is a practice used by Doctors of Osteopathy, Physical Therapist, and of course Chiropractors. Although the latter of the professions may suggest otherwise, what happens during a back crack is cavitation of a spinal facet joint… same as with the knuckles (5). And what does this “treatment” do? Well it can relieve back pain by taking pressure off sensitive nerves or tissue, increase range of motion, restoring blood flow, reducing muscle tension, and, like more active exercise, promote the release of endorphins within the body to act as natural painkillers. Of course these effects last for about 5 minutes, so a spinal manipulation should be considered one part of a therapy, and not THE therapy (6). Anyone who says otherwise is either lying, or selling you something (The Princess Bride shout out).
 
The Neck
Here’s where things get serious. First of all, we know that cracking the neck is not super beneficial for resolving pain compared to medication (7). Second, we know that neck manipulations come with a rare, but serious, side effects such Cervical Artery Dissection, stroke, and even death (8). I’ll end this brief segment by saying that the risks simply do not justify the reward.
 
Clicking, Crunching, Snapping & The Others
You may notice that not all joints make the same noises. In fact, there are lot’s of sounds that your joints can make, and they can often mean different things. Some common places to experience snapping, clicking, popping, or crunching include the chestshoulderforearmhips, and knees. Of these, the knee is the most common area to experience some form joint sound. Crepitus is the formal term for popping or cracking under the patella (kneecap) and can mean different things depending on where you experience it or feel pain. For instance, a grinding sensation can indicate arthritis, a popping sensation can mean you have loose tissue (plica) getting caught, and a catching feeling could indicate you have a meniscus disorder. Check out this brief video to learn a bit more about what to lookout for if you have questions on how to determine what your knee issue is.
Finally, I would say that the most important factor in deciding what to do about your joint noises is to ask yourself “is this stopping me from doing the things I want to do?” If the answer is NO, then the issue may resolve on its own in time. If the answer is YES, you should seriously consider seeing your Doctor or a Physical Therapist about it.
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References
1. Kawchuk, G. N., Fryer, J., Jaremko, J. L., Zeng, H., Rowe, L., & Thompson, R. (2015). Real-time visualization of joint cavitation: E0119470. PLoS One, 10(4) doi:10.1371/journal.pone.0119470
2. ROSTON, J. B., & HAINES, R. W. (1947). Cracking in the metacarpo-phalangeal joint. Journal of Anatomy, 81(Pt 2), 165.
3. Unsworth, A., Dowson, D., & Wright, V. (1971). ‘cracking joints’. A bioengineering study of cavitation in the metacarpophalangeal joint. Annals of the Rheumatic Diseases, 30(4), 348-358. doi:10.1136/ard.30.4.348
4. Deweber, K., Olszewski, M., & Ortolano, R. (2011). Knuckle cracking and hand osteoarthritis. Journal of the American Board of Family Medicine : JABFM, 24(2), 169.
5. Patient positioning and spinal locking for lumbar spine rotation manipulation. (2001). Journal of Osteopathic Medicine, 4(2), 65-65. doi:10.1016/S1443-8461(01)80005-8
6. Hegedus, E. J., Goode, A., Butler, R. J., & Slaven, E. (2011). The neurophysiological effects of a single session of spinal joint mobilization: Does the effect last? The Journal of Manual & Manipulative Therapy, 19(3), 143-151. doi:10.1179/2042618611Y.0000000003
7. Gross, A., Langevin, P., Burnie, S. J., Bédard-Brochu, M., Empey, B., Dugas, E.. . LeBlanc, F. (2015). Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment. The Cochrane Database of Systematic Reviews, (9), CD004249.
8. Thomas, L. C., Rivett, D. A., Attia, J. R., & Levi, C. (2015). Risk factors and clinical presentation of cervical arterial dissection: Preliminary results of a prospective case-control study. The Journal of Orthopaedic and Sports Physical Therapy, 45(7), 503.

The Good, The Bad, The Ridiculous: Where To Get Health Info

The problem I have with poor information outlets is that at best they are robbing you of your time and money. At worst, they can cause or exacerbate serious injury or illness.

Today I wanted to talk about something that has been on my mind for a while. That, of course, is the issue of where to get proper information about health, wellness, and fitness. It’s not about promoting and individual person or idea. But rather, my objective is to help everyone figure out where to go when they have a specific question. The problem I have with poor information outlets is that at best they are robbing you of your time and money. At worst, they can cause or exacerbate serious injury or illness.
What To Avoid And Why
In the past I have written about challenging our assumptions, particularly when it comes to fitness and wellness products. I hope this message reigns particularly true as you read through this section, because I am sure some of you currently follow some of these resources. So please have an open mind, and if you think I am wrong, then at the very least Google the name of the resource followed by the word “scam” and see what shows up. That being said, let it be known that the following sources have been shown to:
 – Cherry-pick sources that agree with their beliefs while ignoring those that don’t.
 – Not interpreting data within the full context of what is known about a topic.
 – Over-extrapolating study results (like saying that findings from an animal trial apply directly to humans).
 – Citing invalid or uncredible sources (using anecdotes as hard evidence as opposed to peer-reviewed literature)
#1 David Wolfe – I don’t even know where to begin with this guy. The more I read from him, the more I think he must be joking. But when it comes down to it, his “solutions” are just quick “fixes” that don’t actually do anything. He’s #1 on my list because he is so popular. So please stop helping the spread of misinformation if you currently are a follower.
#2 The Food Babe – Her fame is slowly fading, but she is still a great marketer. She’s best known for her ability to be a sensationalist, and scare people into avoiding foods. Her claims don’t even have a shred of research backing them. Her “deadly food” can often be good for you, and “chemicals you cant pronounce” are everywhere.
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#3 Dr. Oz. – To start, there’s actual research showing that the majority of what he says isn’t correct or even wrong (1). He just can’t help but spread poor information. It’s time to say goodbye to the bad doctor.
#4 Dr. Mercola – This fraud is best know for his terrible customer service, fear mongering, and outright lies. That’s all I have to say about that.
#5 Natural News – I saved the best for last because it’s the easiest. Mike Adams and Natural News make claims that can be debunkedthrough a Bing search. You don’t even need Google! Althought their Wikipedia entry is quite entertaining.
 
These are my top 5 but here is the rest of the listAbel James a.k.a The Fat-Burning Man, Andreas Eenfeldt a.k.a The Diet Doctor, Andrew Weil, Barry Sears, Billy DeMoss, Bob Harper, Chris Kresser, Dallas and Melissa Hartwig / The Whole30 / Whole9Life / Healthy Mama, Happy Baby , Dana McDonald a.k.a The Rebel Dietitian, Daniel Amen, Dave Asprey, David Perlmutter, Deepak Chopra, Diane Sanfilippo, Erin Elizabeth a.k.a The Health Nut, Gary Taubes, Gwyneth Paltrow, Jason Fung, Jeffrey Smith, Jillian Michaels, Jimmy Moore, Joel Fuhrman, Jonathan Bailor, Josh Axe, Katie a.k.a Wellness Mama, Kevin Trudeau, Kris Carr, Mark Hyman, Mark Sisson, Nina Teicholz, Oprah Winfrey, Pete Evans, Peter D’Adamo, Robb Wolf, Robert Atkins, Robert Lustig, Sally Fallon Morell, Sarah Wilson, Stephanie Greunke, Suzanne Somers, The Kardashians (All of them), Tim Ferriss, Tim Noakes, Tom Naughton a.k.a Fat Head, Tom O’Bryan, William Davis, Zoë Harcombe
Here’s Where You Should Go
#1 Alan Aragon – A researcher, a writer, and hilarious. Alan Aragon puts out fantastic work and I can’t recommend him enough. Check him out for some nutrition advice!
#2 Brad Schoenfeld – He should be your go to source for muscle building information. The guy puts out more research than I can read! He’s also a very down to Earth writer.
#3 James Fell – If for no other reason, you should follow him for his humor. James fell puts out wonderful information about general health and fitness and is extremely readable.
#4 Examine.com – Examine.com is a third party independent group that evaluates nutritional claims. However, if you want some solid information about that supplement you’re thinking about buying, go to them first and Google second.
#5 Whole Health Source – This is a great place to go if you want to learn some advanced knowledge in a particular area. If you want to go beyond the basics, this is the place to get your information from!
Here is the rest of the list: The ISSN Scoop, StrengTheory, My Sports Science, Body Recomposition, Adel Moussa, Amber Rogers, Armi Legge, Arya Sharma, Asker Jeukendrup, Bill Shrapnel, Brad Dieter, Colby Vorland, Dan Pardi, Danny Lennon, David Despain, Denise Minger, Dr. Spencer Nadolsky, Evelyn Carbsane, James Krieger, Jeff Rothschild, Johan Leech, John Berardi, Jose Antonio, Kamal Patel, Kevin Hall, Kevin C. Klatt, Laurent Bannock, Layne Norton, Lyle McDonald, Maria Brilaki, Martin MacDonald, Menno Henselmans, Michelle a.k.a The Fat Nutritionist, Mike Israetel, Mike Sweeney, Patrick Umphrey, Peter Clark, Rosanne Rust, Seth Yoder, Stephan Guyenet, Steven Novella, Tim Crowe, Yann Le Meur, Yoni Freedhoff
Making your way safely through the internet can be tough. There are loads of people just trying to help, but there are just about as many people who are more concerned about only making money. This is especially true when it comes to nutrition. Only a registered dietitian (RD) can give specific nutrition advice so that should be the gold standard credential you look for when reading about the author. Proper education is important, but when all else fails make sure to check with your personal doctor before making and radical decisions about your health.
References
1. Korownyk, C., Kolber, M. R., McCormack, J., Lam, V., Overbo, K., Cotton, C.. . Allan, G. M. (2014). Televised medical talk shows–what they recommend and the evidence to support their recommendations: A prospective observational study. BMJ (Clinical Research Ed.), 349(dec17 11), g7346-g7346. doi:10.1136/bmj.g7346

Breaking Bad

Today we’re talking about breaking bad… habits.

Today we’re talking about breaking bad… habits. Because I am a huge KISS fan (keep it super simple), I really enjoyed reading the article published by My Fitness Pal. It talks about bad habits that can bugger up the works when it comes to your healthy lifestyle and nutrition. So lets take a look at the bad habits.
 
Bad Habit #1 Skipping the Grocery Store
We all know that eating out is almost always less healthy than making food for yourself. So make sure you have something to cook with by regularly going to the grocery store. If you like to save time, it is much easier to get in and out quickly if you go early in the day.
 
Bad Habit #2 Sleep Hygiene 
Want to get more done in your day, feel more energized, and able to take on the world? Well sleep should be one of your primary tools to do so. That cup of coffee wont do much if you’re regularly under sleeping. Practice some sleep hygiene and you will see a world of difference!
Bad Habit #3 Pantry Dropper
Dropping the ball on having your pantry stocked with good food is never a good thing. This poor habit plays into grocery shopping. Something is bound to happen to keep you from getting to the grocery store, so having a stocked pantry is a good way to not order junk food straight to your door. It can also pay off to freeze some fresh veggies and meats for the days you need to dig into your stash of quality food.
Bad Habit #4 Selecting Veggies
Eating old and out of season food can leave a bad taste in your mouth. So one solution is to make sure you’re buying fresh in season food that you will be getting at its ripest. Practicing this will make you happy to eat those vegetables and not dread it. Don’t know where to start? I recommend you check out our state farmers market that’s open year round. The vendors are always happy to educate and help you learn whats the best to eat this time of year.
Bad Habit #5 Kitchen Hygiene 
This is the bad habit I am most guilty of. This habit requires you to clean your kitchen frequently and thoroughly. However, I have to admit that doing the dishes quickly does result in less time/money wasted on ordering out food. Having a clean kitchen requires about 30m of work per day, but can save you hundreds (or more if bugs become a problem) of dollars per month overall.
Bad Habit #6 Over-exercising
Over exercising can cause anything from injuries to over eating at meal time. Keeping your exercise routine to a healthy work load can go a long way in keeping you sane and satisfied.
For more information on these topics, check out the link bellow. If you have any questions about what you can do to avoid these habits I’m always here to help!

Rise & Shine: Ways to Make Your Morning Great!

Let’s face it, mornings suck. But there are things that you can do to make it… suck less.

Last week I wrote about the importance of sleep, so what better way to follow it up than with a post about waking up?! Let’s face it, mornings suck. But there are things that you can do to make it… suck less. So take your hand off of the snooze button and listen up for some ways to make mornings less miserable!
 
Bright Idea
If you read last week’s post you know that bright lights at bed time are not a great idea. So being the smart individual that you are, you know that bright lights in the morning are a great idea! This is because light works as a signal for our natural circadian rhythm. So when the sun is up so are we and visa versa. That may be obvious, but light, even artificial sunlight, makes a huge positive impact to our mornings. Getting enough morning light can significantly enhance cognitive performance (1). Like to work out in the am? Well getting enough light can improve your ability exercise and improve reaction time (2). This means if you have a long commute it may be worth you while to invest in an artificial day light lamp. And I bet you didn’t know that along with diet, exercise, and sleep that light plays a huge role in obesity prevention (3)!
 
How Stimulating
Bright lights are great, but you can also make your mornings better by stimulating all of your sensesHearing – Most of us wake up to the sound of an alarm clock. But using your sense of hearing can, and should, involve other sources of sound. One great way to wake yourself up and start the day off right is through the use of positive affirmation. This means you literally say out loud “I’m going to have a good day.” Taking time to do this, as well as spending time focusing on yourself, is a great way to get the feel good hormones flowing early in the day. Smell – Wake up and smell the roses? Pshh. More like wake up and smell the bacon! Utilizing your sense of smell in the morning is an easy way to wake yourself up and make a positive ritual out of your day. Whether it’s having your coffee or tea pre-set to start around the time you wake up, using an invigorating soap first thing in the morning, or enjoying some bacon to start your day, waking up to smells can create a happy environment to start the day. Touch – A warm and cozy bed can be hard to break free from. So like tearing off the band aid, the best thing to do when you wake up is to break free of your bed! Rip the sheets off and stand up… it’s that simple. Taste – We will be looking at breakfast in depth later on, but for now what you need to know is that you can not go wrong with water in the morning. This is because we are constantly losing water and becoming dehydrated throughout the night. This can lead to a decrease in our immune response, poor cognitive ability, and bad breath (4,5)!!!
 
Not So Bright Idea
Okay so here’s where things get tricky. Breakfast is a very controversial area in general, but there are a few things that we do know. For instance, being hungry can decrease your decision making ability and make you a grumpy pants that no one wants to deal with (AKA hangry) due to the ghrelin hormone (6). So eat breakfast or else you will be known as the grump of the office! But what if you’re not hungry in the mornings? Isn’t breakfast the most important meal of the day? Well the answer to that question is not so simple, but here’s a quote that I think is good food for thought “if there is little or no appetite for breakfast this meal can be safely missed by those who are well nourished, including children, because this will not adversely affect performance (body energy reserves can be readily mobilized to fuel muscle and brain activity), but will likely help reduce excessive energy intake.” (7). So this means that for some, skipping breakfast may not be a bad idea if you’re trying to lose weight. However, other studies show that you MUST eat breakfast to lose weight (8)! In reality, meals, and their timing, are largely driven by culture. Have you ever stopped to think about why there is such a thing as “breakfast foods?” It’s mostly due to marketing. So if you’re looking to lose weight or gain muscle, the best thing to do is experiment on yourself. Pick a breakfast ritual and try it out for a month and see where it takes you. Personally, I eat 3 whole eggs (reduces ghrelin), 3 egg whites, and a hand full of home fries every morning. I chose this meal because it has plenty of protein, fat, and carbohydrates which helps to decrease my overall appetite throughout the day and decreases ghrelin (9). But most importantly I LIKE IT! So find out what works for you and make sure it’s what you enjoy. Because like so many other things in the health and fitness world, consistency reigns supreme.
Resources
1. Gabel, V., Maire, M., Reichert, C. F., Chellappa, S. L., Schmidt, C., Hommes, V.. . Viola, A. U. (2015). Dawn simulation light impacts on different cognitive domains under sleep restriction. Behavioural Brain Research, 281, 258-266. doi:10.1016/j.bbr.2014.12.043
2. Thompson, A., Jones, H., Gregson, W., & Atkinson, G. (2014). Effects of dawn simulation on markers of sleep inertia and post-waking performance in humans. European Journal of Applied Physiology, 114(5), 1049-1056. doi:10.1007/s00421-014-2831-z
3. Partonen, T. (2014). Obesity = physical activity + dietary intake + sleep stages + light exposure. Annals of Medicine, 46(5), 245.
4. Hanstock, H. G., Diment, B. C., Bendell, K. H. F., Carswell, A., Fortes, M. B., Moore, J. P., & Walsh, N. P. (2014). Effect of exercise-induced dehydration and subsequent overnight fluid restriction on immunity at the ocular surface. Medicine and Science in Sports and Exercise, 46(5)
5. Thornton, S. N., & Trabalon, M. (2012). Dehydration during sleep affects cognitive performance. Sleep Medicine, 13(1), 118; author reply 118. doi:10.1016/j.sleep.2011.06.018
6. Rozita H Anderberg, Caroline Hansson, Maya Fenander, Jennifer E Richard, Suzanne L Dickson, Hans Nissbrandt, Filip Bergquist, Karolina P Skibicka. The Stomach-Derived Hormone Ghrelin Increases Impulsive Behavior. Neuropsychopharmacology, 2015; 41 (5): 1199 DOI: 10.1038/npp.2015.297
7. Peter J Rogers (2016). Breakfast: how important is it really?. Public Health Nutrition, 19, pp 1718-1719. doi:10.1017/S1368980015003705. 
8. Astbury, N. M., Taylor, M. A., & Macdonald, I. A. (2011). Breakfast consumption affects appetite, energy intake, and the metabolic and endocrine responses to foods consumed later in the day in male habitual breakfast eaters. The Journal of Nutrition, 141(7), 1381-1389. doi:10.3945/jn.110.128645
9. Ratliff, J., Leite, J. O., de Ogburn, R., Puglisi, M. J., VanHeest, J., & Fernandez, M. L. (2010). Consuming eggs for breakfast influences plasma glucose and ghrelin, while reducing energy intake during the next 24 hours in adult men. Nutrition Research, 30(2), 96-103. doi:10.1016/j.nutres.2010.01.002

How to Boost Your Health, Fitness, and Metabolism By Doing Nothing

The importance of sleep, what it can do for you, and a few tips on how to get more without hitting that snooze button.

Today’s post is all about the awesomeness of sleep! That magical time where you get to relax, dream, and recover from those stressful work days. But for many of us, it seems like there is simply not enough time in the day to fit sleep in! That’s why I wanted to go over the importance of sleep, what it can do for you, and a few tips on how to get more without hitting that snooze button.
 
The BasiczZzZzZ
Sleep is an entire field of scientific research and is not completely understood. So naturally I am going to do an awesome job briefly summing things up. In any case, sleep is regulated by two body systems: sleep/wake homeostasis and the circadian biological clock. Sleep/wake homeostasis tells us that a need for sleep is building up and gets us feeling sleepy while also helping us maintain enough sleep throughout the night. It’s the mechanism used to balance sleep and wakefulness. Our circadian rhythm regulates the timing of sleepiness and wakefulness throughout the day. It’s a pattern of being awake and asleep that we can regulate. If you have ever woken up early on the weekend even though you wanted to sleep in, it’s because of your circadian rhythm. While we sleep, our body goes trough a cycle every 90 minutes as a way to recover and repair itself. Most people need 7-8 hours of sleep per night to sufficiently recover, but everyone is different. Some individuals may only need 5 hours, where others may require more than 10.
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Sleep To Get Shredded!
Let’s dig into the fun stuff! Sleep is crucial for so many reasons, but trying to stay healthy, lose weight, and get in shape without it can be a nightmare! We know that without proper sleep we will be more susceptible to decreased glucose tolerance, illness, elevated cortisol concentrations, increased cholesterol, decrease in the satiety hormone leptin, increased the appetite-stimulating hormone ghrelin, and increased hunger and appetite (1)! What’s also interesting is that you can have a decreased glucose tolerance, and be more susceptible to type 2 Diabetes, if you have too much sleep as well (2).
 
If you’re looking to lose weight, sleeping enough is a must. Not logging enough sleep can decrease your metabolism and give you the munchies (3,4). Getting quality sleep is also important for building muscle. This is because adequate sleep is needed to optimize your natural growth hormones (5). Not only that, but it can suck the life out of your gym performance by decreasing your motivation and efficiency of cognitive processes, increasing perceived effort, and limiting physiological recovery responses (6).
 
How to Get Better Sleep
 
By now you realize the you need to sleep a lot, but you also need to sleep well. Quality sleep is crucial for achieving the 90 minute cycle throughout the night. So here are a few tips on how to get more sleep and with greater quality. First up, avoid the booz. Alcohol can have a deleterious effect on sleep in many ways but a few highlights include making you go to the bathroom more, making you sweat, playing with your blood sugar, and decreasing the amount of REM you get. Next, get out of the bedroom. The bedroom is a place for maximizing mental and physical recovery, so using it as a work or play space throughout the day can actually decrease the amount of quality rest you get in there at night. Limit the amount of stimulants in your life including nutritional and environmental. This means cutting back on caffeine (especially after 4 pm), nicotine, computer, cell phone, T.V., and possibly using blackout curtains to block light that can keep your brain active. Finally, exercise is your friend! Resistance training is a great way to help you sleep. So for those of you who struggle to fall asleep, work out earlier in the morning, whereas those of you who struggle to stay asleep should try evening strength training sessions (7). When it comes to health and fitness, your immune system, and brain power sleep is paramount. So get some rest!
Resources
1. Tremblay, A., & Chaput, J.-P. (2010). Sleep and Metabolic Fitness. Sleep,33(7), 861.
2. Cappuccio, F. P., D’Elia, L., Strazzullo, P., & Miller, M. A. (2010). Quantity and quality of sleep and incidence of type 2 diabetes: A systematic review and meta-analysis. Diabetes Care, 33(2), 414-420. doi:10.2337/dc09-1124
3. S. Sharma., & M. Kavuru (2010). Sleep and Metabolism: An Overview. Int J Endocrinol. Volume 2010, Article ID 270832, 12 pages doi:10.1155/2010/270832
4. Taheri, S. (2006). The link between short sleep duration and obesity: We should recommend more sleep to prevent obesity. Archives of Disease in Childhood, 91(11), 881-884. doi:10.1136/adc.2005.093013
5. Brandenberger, G., & Weibel, L. (2004). The 24‐h growth hormone rhythm in men: Sleep and circadian influences questioned. Journal of Sleep Research, 13(3), 251-255. doi:10.1111/j.1365-2869.2004.00415.x
6. Marshall, G., Turner, A. (2016), The Importance of Sleep for Athletic Performance, Strength & Conditioning Journal 38(1),p 61–67
7. Alley, Jessica R (2015). “Effects of resistance exercise timing on sleep architecture and nocturnal blood pressure”. Journal of strength and conditioning research (1064-8011), 29 (5), p. 1378.