Cross-training for fitness

Every time you exercise vigorously your muscles are injured, and the harder you exercise, the longer it takes for your muscles to heal. You are not supposed to exercise vigorously again until your muscles stop hurting. You can exercise hard on one day and easy on the next few days, or you can train in two sports. This is called cross-training, and it can make you very fit and help to prevent injuries.

Each sport stresses specific muscle groups. Cycling stresses the upper legs, while rowing stresses your back and upper body. If you cycle and row on the same day, you stress your upper legs and upper body on the same day. To reduce your chances of injuring yourself, you should take the next day off, or at least exercise at a very low intensity. If you cycle on Monday and row on Tuesday, you allow your muscles 48 hours to recover from each sport. Pick two sports that use different muscle groups and do them on alternate days. You can then exercise more intensely in each sport and achieve a higher level of fitness.

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Pedal faster to ride better

All cyclists should learn to pedal at a fast cadence, whether you are an experienced racer or a novice recreational rider. Muscle fatigue and damage are caused by excess pressure on the pedals, not by how fast you pedal. Pedaling at a faster cadence with less pressure allows you to pedal longer and harder. However, several researchers have expressed concern that pedaling very fast could decrease blood flow to muscles and thus decrease athletic performance. A study from Kansas State University shows that pedaling fast does not decrease a muscle's flow of blood or ability to extract oxygen from the blood (European Journal of Applied Physiology, March 2006). Once again athletes and coaches find new training and competing methods and years later, scientists tell them that they are correct.

After you have been riding regularly for a time, try to spin your pedals 80 times a minute. In the beginning, you will put so little pressure on your pedals that you will ride very slowly. However, after several weeks of pedaling at a cadence of 80, you will become more comfortable and be able to move fairly well at this pace. As you become stronger, you can maintain this high cadence while using higher gears and pressing on the pedals with more force, so you will be able to ride faster and longer.

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Diabetes risk screening tests

The best predictor of diabetes is a test called Hemoglobin A1C (HBA1C), which measures the amount of sugar stuck on cell membranes. At the American Diabetes Association meeting in June 2006, Dr. Peter Baginsky of Santa Rosa, California showed that HBA1C can be used not only to identify people who already have diabetes, but also as a screening test to predict which people are likely to develop diabetes in the future. This allows doctors to treat pre-diabetes before people suffer their heart attacks, strokes and other side effects that can be the first sign that the person has diabetes.

He also showed that people who have HBA1Cs above 5.8 have a 92 percent chance of being diabetic as determined by a fasting glucose tolerance test. The HBA1C test does not require fasting and can be done with only one draw of blood, while the glucose tolerance test takes seven. It is less expensive and has the potential to save a lot of lives by getting diabetics into treatment earlier. More

Should you restrict all fats?

Almost 50,000 women in the Women's Health Initiative Dietary Modification Trial from Harvard Medical School were given dietary counseling to reduce their fat intake to less than 20 percent of their daily calories (Clinical Diabetes, July 2006). This intense dietary counseling did not reduce the incidence of heart attacks, strokes, or cancers even though the women reduced their intake of fat by 8.2 percent.

Their data from the eight-year follow up show that it is difficult to reduce total fat intake, and that dietary counseling to reduce total fat intake does not reduce the risk of heart attacks or cancers. It lowered weight only an average of three pounds and diastolic blood pressure only slightly. However, other studies have shown that reducing total fat intake does lower risk for certain cancers.

The probable reason for these dismal results is that food contains both good fats and bad fats. Most doctor agree that we should restrict saturated fats found in meat, chicken and whole milk diary products, and partially hydrogenated fats found in many prepared foods. However, the monounsaturated fats found in seeds and nuts and the omega-3 fatty acids found in seafood and seeds are healthful fats that should not be restricted.

How to do sit-ups

Sit-ups can strengthen your belly muscles, but doing them incorrectly can hurt your back. Sit-ups should be done while you lie on your back with your knees bent enough for the soles of your feet to touch the floor. Place both hands on your chest and slowly raise your head off the ground. Raise your shoulders about one foot and then lower them to the ground. Do this slowly ten times, rest a few seconds and then do two more sets of ten. After a week or two this exercise will feel easy, so add a light weight held behind your neck or on your chest. As you become stronger, you can use heavier weights.

There's no need to do more than 30 sit-ups in one workout. To strengthen your belly muscles, you increase the resistance, not the number of repetitions. Keep your knees bent to protect your back. If you do a sit-up with your legs straight, you place a great force on the iliopsoas muscles that increase the arch in your back, which can damage the ligaments and joints. If your belly muscles are weak, you are likely to arch your back excessively when you sit up and increase the chances of injury. If you are doing sit-ups to flatten your stomach, you need to raise your head only about one foot because going higher than that uses the quadriceps muscles in the front of your upper legs, not your belly muscles.

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Children's exercise

Children need at least 90 minutes of exercise a day to avoid heart disease when they are older, according to a new study reported in Lancet (July 23, 2006). The old guidelines recommending 30 minutes of exercise three times a week, or even an hour a day do not appear to be adequate for preventing obesity and heart disease. Researchers used heart rate monitors to measure the activity of 1700 nine- to-fifteen-year-olds in Denmark, Estonia, and Portugal. They then calculated a heart-attack risk score consisting of blood pressure, cholesterol, insulin resistance, and skinfold thickness.

They compared physical activity from the heart rate monitors with the heart attack risk-factor score and found that the more active the child, the lower the heart attack risk score. Many children who exercised for 60 minutes a day were still overweight and had high heart attack risk scores. The authors suggest that the lack of regular physical activity is likely to mean that the children are spending too much time watching TV, playing video and computer games, and eating junk food. There is no reason to expect that the results would be different with American children. The current recommendation of at least an hour per day of moderate activity in children may not be sufficient for future heart health.

Sports Drinks or Water?

Drinks that contain salt and sugar are better than just plain water during exercise, unless you are also eating foods. A study from the Medical College of Georgia shows that tennis players have lower body temperatures when they drink fluid with electrolytes and sugar, rather than just plain water (British Journal of Sports Medicine, May 2006). Higher body temperatures during exercise slow you down and tire you earlier.

More than 80 percent of the energy that supplies your muscles is lost as heat. Less than 20 percent drives your muscles. So during exercise, your heart has to cool your body by pumping hot blood from your muscles to your skin, as well as pumping oxygen-rich blood to your muscles. If you heart has difficulty serving both functions, it cannot pump enough hot blood from muscles and your temperature rises.

You do not have to take sports drinks to protect yourself from high body temperature. During exercise, you need energy, salt and water and your body doesn't care how it gets these nutrients. Eating any salted food with water or any beverage you like will supply your body as efficiently as sports drinks.

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Second wind

Second wind means that when you run very fast, you reach a point where you gasp for breath, slow down but keep on pushing and after a few seconds, you feel recovered and pick up the pace. Some people think that you just slow down and allow yourself enough time to recover from your oxygen debt, but research from the University of California in Berkeley may give another explanation.

When you run fast, your muscles use large amounts of oxygen to burn carbohydrate, fat and protein for energy. If you run so fast that your lungs cannot supply all the oxygen that you need, you develop an oxygen debt that causes lactic acid to accumulate in your muscles to make them burn, and you gasp for air. The muscle burning and shortness of breath caused by the accumulation of lactic acid forces you to slow down. This research shows that the lactic acid that accumulates in muscles when you run very fast actually is the first choice of fuel for your muscles when you are running so fast that you can't get all the oxygen that you need (American Journal of Physiology- Endocrinology and Metabolism, June 2006). So your muscles switch to burning more lactic acid for energy, you need less oxygen and then you pick up the pace. Of course when you keep on pushing the pace, you can again accumulate large amounts of lactic acid in muscles, which makes them burn and hurt again.

Marathon training

Many runners have the mistaken impression that they have to run a lot of miles every week to be able to run fast in a marathon. Most will find that running too many miles slows them down. To run fast in races, you have to run very fast in practice. However, on the day after you run very fast, your muscles will feel sore. If you run fast while you are sore, you are likely to injure yourself and not be able to run at all. Take easy workouts until your muscles feel fresh again. Most competitive runners set up their programs so that they run fast on Tuesdays and Thursdays and longer on Sundays. The rest of the time they run slowly or not at all.

Before you increase the intensity of your running program or any other exercise, check with your doctor. Once you are in good shape, your goal on your fast days should be to run repeat intervals with short rests between each. For example, on Tuesdays try to run four half-mile repeats at a very fast pace with a quarter mile jog between each. If you can run a mile flat out in six minutes, you probably will try to run each half-mile repeat in about three minutes and 15 seconds. On Thursdays, try to run eight to 12 repeat quarter miles at close to the same pace of about 90 seconds each. On Sunday, try to run briskly for 90 minutes. The rest of the time, jog slowly, being careful not to run so much that it interferes with your two fast days and one long day each week.

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Exercise prolongs life

Dr. Todd Manini of the National Institute on Aging reports that older active people who walk, climb stairs, do household chores, or even wash windows are 69 percent less likely to die in a year, compared to people who are far less active (JAMA, June 2006). This study was far more dependable than previous studies because, instead of using a questionnaire, researchers measured how active a person was by measuring the metabolic end products of activity. They used a doubly-labeled water method that directly measures carbon dioxide production over an extended period, the most accurate estimate of energy expenditure.

If you are inactive, you should check with a cardiologist who will do a stress test. If you pass, you should start an exercise program. If you fail, you should work with your doctor to correct the problem and then start an exercise program.

Weight lifting helps to prevent diabetes

One third of Americans will become diabetic because they eat too much and exercise too little. A study in Medicine and Science in Sports and Exercise (July 2006) shows that lifting weights can help to prevent and to treat diabetes.

Extra fat prevents your body from responding normally to insulin. Before insulin can do its job of driving sugar from the bloodstream into cells, it must first attach to little hooks on cell membranes called insulin receptors. Having extra fat in cells turns these receptors inward, making it far more difficult for insulin to attach to the receptors. This prevents insulin from doing its job of lowering blood sugar levels, even though your body is making plenty of insulin. That’s why anything that makes you fat increases your risk for diabetes. Doctors can measure how cells respond to insulin with a sugar tolerance test.

In this study, adolescent boys were given a program of lifting heavy weights twice a week. After only 16 weeks, their muscles were larger and they lost fat. Sugar tolerance tests showed that the ability of their bodies to clear a load of sugar from their blood streams improved dramatically. This means that a regular weight lifting program decreases insulin resistance and thus reduces risk for becoming diabetic.

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Dizziness on changing position

Athletes and other very fit people may feel dizzy when they rise from lying to standing because of their slow pulse rates. Exercise makes your heart stronger so it can pump more blood with each beat and it doesn't have to beat as often. A slow pulse rate can be good. Since your heart doesn't beat as often, it has more time to rest between beats. Like a low-mileage used car, perhaps this will mean it takes longer to wear out. But a slow heart rate can make you dizzy when you change position.

When you raise yourself from lying to sitting, or from sitting to standing, the force of gravity pulls blood down from your brain towards your feet and your blood can't get back to your brain until your next heart beat. If you have a pulse rate of only 50 beats a minute, it will take more than a second between beats. That can be enough time for your brain to suffer briefly from a lack of oxygen, so you feel dizzy. You can even pass out while you wait for your next heartbeat to come along and pump blood back up to your brain.

Dizziness can also be a sign of an irregular heartbeat or blocked arteries leading to your brain, so people who feel dizzy when they get up should check with their doctors. If they are athletes, chances are that they only have a strong athletic heart with a slow rate, and all they need to do is remember to get up slowly.

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Rosacea: red in the face

Many people develop a red scaly rash on their faces as they age, particularly in the center on the nose and cheeks. They flush or blush and often also have small acne-like bumps on their faces, swollen noses and prominent red blood vessels. Sometimes, this same rash may extend to the shoulders, chest and back. It's called rosacea.

Nobody knows what causes rosacea, but most doctors feel that it is a genetic disorder associated with other skin conditions, seborrheic dermatitis and psoriasis. They may also have terrible dandruff, scaly ears, thick big toe nails, and sometimes thick skin on their elbows and knees. The recommended treatment is to take an antibiotic such as doxycycline 100 mg twice a day plus an antibiotic cream such as metronidazole cream until the rash clears. Then stop the doxycycline and resume it when the rash returns. You should also shampoo your scalp and face every day.


Two recent studies show that too much caffeine may cause problems for some people. Researchers at Queens University in Kingston, Ontario report that caffeine, in coffee, tea, chocolate, and most colas, raises blood sugar levels in healthy people and diabetics, which cannot be reversed by exercise or weight loss (1).

When you eat, your blood sugar level rises. If it rises too high, sugar sticks to cells, and once stuck on cells, it is converted to sorbitol which destroys the cell to increase risk for heart attacks, strokes, blindness, deafness, kidney failure and other effects of diabetes. Anything that increases blood sugar levels increases risk for diabetes. So, most doctors recommend restricting refined carbohydrates, in sugar and flour. Exercise and weight loss do not prevent this rise in blood sugar. These studies were done with caffeine pills. Coffee may contain nutrients, such as antioxidants, potassium and magnesium, that may prevent the high rise in blood sugar.

A second study, from the Netherlands shows that drinking coffee can raise blood pressure (2). High blood pressure markedly increases a person’s chances of suffering a heart attack, stroke and sudden death. The new guidelines state that normal blood pressure should be below 120 when the heart contracts and 80 when it relaxes. That means the almost 91 percent of all North Americans will eventually become hypertensive and suffer increased risk for premature death. The authors reviewed 16 studies on coffee drinking and high blood pressure and found that for most people, drinking coffee does not raise blood pressure, but for some, even one cup of coffee can raise blood pressure. If you drink coffee or any other caffeinated beverage regularly, it may pay to check your blood pressure twenty minutes after a drink. Your blood pressure is too high if it is above 120 over 80.

1) Diabetes Care, March 2005
2)Journal of Hypertension, May 2005

How to Warm Up

Warming up before you exercise helps to prevent injuries and lets you jump higher, run faster, lift heavier or throw further. Your warm-up should involve the same muscles and motions you plan to use in your sport. For example, before you start to run very fast, do a series of runs of gradually-increasing intensity to increase the circulation of blood to the muscles you will be using.

Muscles are made up of millions of individual fibers, just like a rope made from many threads. When you start to exercise at a very slow pace, you increase the blood flow to muscle fibers, increase their temperature, and bring in more oxygen, so the muscles are more pliable and resistant to injury. When you contract a muscle for the first time, you use less than one percent of your muscle fibers. The second time you bring in more fibers, and you keep on increasing the number of muscle fibers used in each contraction for several minutes of using that muscle. It’s called recruitment. When you are able to contract more muscle fibers, there is less force on each individual fiber to help protect them from injury. Usually you are warmed up when you start to sweat.

The same principle applies to your heart. Angina is a condition in which the blood vessels leading to the heart are partially blocked so the person has no pain at rest, but during exercise, the blocked arteries don't permit enough blood to get through to the heart muscles, causing pain. If people with angina exercise very slowly before they pick up the pace, they are able to exercise longer and more intensely before they felt heart pain. Always check with your doctor if you feel any heart pain during exercise.

Competitive athletes in sports requiring speed and endurance perform better after they warm up with increasing intensity. Warming up slowly does not increase the maximum amount of oxygen that you can bring to muscles that you need during competition. If you are a runner, skier, cyclist, or an athlete in any sport that requires endurance, warm up at a gradually increasing pace. Use a series of increasingly intense repetitions of 10 to 30 seconds duration, with short recoveries, until you are near your maximum pace. This type of warm-up increases endurance because intensity increases the maximum amount of oxygen that you can bring to your muscles, as you continue to compete, and lets your muscles contract with greater force as you begin to fatigue. You will then be able to bring in more oxygen to your muscles than you could have done without the intense warm-up.

Bonking: low blood sugar

Yes, I know the word has another meaning. But in sports, bonking is running out of blood sugar. If you watch a major bicycle race on TV, you have to be impressed by how the riders can eat enough to sustain them through races that require more than five hours of near maximum effort. If a rider does not get enough food during his or her ride, he can fall off the bikes, lie on the ground unconscious and start to shake all over in a in a massive convulsion. This is called bonking, or passing out from low blood sugar.

Your brain gets almost all of its fuel from sugar in your bloodstream. When your blood sugar level drops, your brain cannot get enough fuel to function properly, you feel tired and confused and can pass out. There is only enough sugar in your bloodstream to last three minutes. To keep your blood sugar level from dropping, your liver must constantly release sugar from its cells into your bloodstream, but there is only enough sugar in your liver to last 12 hours at rest. During intense exercise, your muscles draw sugar from your bloodstream at a rapid rate. Your liver can run out of its stored sugar and your blood sugar level can drop, and you bonk.

Bonking is common in bicycle races if a rider does not eat frequently, but is rare in long distance running races. When you run, your leg muscles are damaged from the constant pounding on the roads and you must slow down. However, you pedal in a smooth rotary motion which does not damage your muscles, so you can continue to pedal at a rapid cadence for many hours.

To prevent your blood sugar from dropping too low during intense exercise lasting more than two hours, eat at least every 15 minutes. It doesn't matter what you eat: salted peanuts, a peanut butter and jelly sandwich, chicken, an apple, a banana or anything else. Almost all fit people can take small amounts of food frequently during exercise without developing stomach cramps.

Belly fat: why it's dangerous

Storing fat primarily in your belly increases your chances of suffering heart attacks and diabetes.

When you take in more calories than your body needs, your liver turns them into fat. Fat cells in your belly are different from those in your hips. The blood that flows from belly fat goes directly to your liver, whereas the blood that flows from your hips goes into your general circulation. The livers of those who store fat in their bellies are blocked from removing insulin by the extra fat and therefore do not remove insulin from the bloodstream as effectively as the livers of those who store fat in their hips and have less fat in their livers.

People who store fat primarily in their bellies are called apples, while those who store fat primarily in their hips are called pears. The apples have higher blood insulin and sugar levels that raise levels of the bad LDL cholesterol that causes heart attacks, and lower levels of the good HDL cholesterol that prevents heart attacks. More

Interval training

To become stronger and faster, athletes use a technique called interval training, in which they exercise very intensely, rest and then alternate intense bursts of exercise and rest until their muscles start to feel heavy. Intervals are a fixed number of repeats of a fixed distance at a fixed pace with a fixed recovery time. There are two types of intervals: long and short. A short interval takes less than 30 seconds and does not build up significant amounts of lactic acid in the bloodstream, so an athlete can do lots of repeat short intervals in a single workout.

Long intervals take two minutes or more and are very tiring. In interval training, a runner may run a quarter mile 12 times, averaging 1 minute, with a 110-yard slow jog between each. A weightlifter may lift a heavy weight ten times in a row and then repeat another set of ten. Runners run intervals as fast as they can and recover enough to run the same fast pace several times. Runners need very short recoveries between intervals, usually only about 30 seconds; but weight lifters need much longer recoveries, at least two and a half minutes. Runners become short of breath and feel a burning in their muscles when lactic acid starts to accumulate in muscles, but it takes only a few seconds for a trained athlete to recover between each hard run. On the other hand, weight lifters feel burning caused by tearing of the muscle fibers and it takes a much longer time for the pain to disappear so they can lift very heavy weights again.

You can apply the concept of interval training to your program at any level of fitness. When you start a new exercise program, exercise for 30 seconds, stop for 30-60 seconds, longer if you need it. Alternate exercising and resting until you feel tired or your muscles feel heavy. Then stop for the day. The stronger you get in your sport, the more intense your intervals can become. You work at your maximum capacity for 30-60 seconds, then take 60-90 seconds to recover, then go very hard for another 30-60 seconds. Do this vigorous interval workout once a week until you get tired. At first you may only be able to do two or three intervals, but your muscles get stronger and you build up the number of intervals you can complete. Go easy the next day or take a day off if you feel any discomfort.

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Warm up your heart

Most people know that you have to warm up skeletal muscles to help protect them from injury, but many do not know that warming up the heart muscle also helps to prevent heart attacks in people with blocked arteries leading to the heart.

Before you try to run very fast, you can protect your muscles from injury by performing a series of runs of gradually-increasing intensity to increase the circulation of blood to your muscles. The same principle applies to the heart. Angina is a condition in which the blood vessels leading to the heart are partially blocked so the person has no pain at rest, but during exercise, the blocked arteries don't permit enough blood to get through to the heart muscles, causing pain. A study from the Quebec Heart Institute shows that exercising very slowly before a person with angina picks up the pace allows him to exercise more intensely before he feels heart pain.

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