Category Archives: Exercise

May 25, 2023 · 2:22 AM

Management Options for Knee Osteoarthritis

Photo credit: Steven Paul Parker II

Dr. Howard J. Luks is an orthopedist who published a reasonable and fairly comprehensive article on knee osteoarthritis management. Thankfully, knee replacement surgery is a last resort for this surgeon. He discusses exercise, tai chi, diet, yoga, knee injections, NSAIDs, ice, heat, etc.

Osteoarthritis of the knee is a prevalent health issue.  Despite a diagnosis of arthritis of the knee, the majority of you can live an active, happy life.  But you’ve heard awful phrases used to describe your Xrays– phrases like Bone on Bone, bone spurs, degeneration, wearing away, etc. Those phrases scare you.  I get that! 

Life does not stop after a diagnosis of arthritis. Exercise is perhaps the best medicine for your arthritis.  Exercising a joint that you’ve been told is wearing out may seem counterintuitive.  Exercise is essential if your goal is to avoid surgery for as long as possible.  Being active will not cause your arthritis to worsen.  Not all pain implies harm

Click for Dr. Luks’ exercise recommendations for stronger legs.

Steve Parker, M.D.

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March 13, 2021 · 7:00 AM

Don’t Let Aging Reduce Your Muscle Mass

Exercise is a fountain of youth available to every one

Axel Sigurdsson, MD, PhD, published a great article on prevention of age-related sarcopenia (loss of muscle mass). Click through for details. To stay vigorous as you age, you want to preserve muscle mass and the strength it provides. If you’ve lost muscle mass, you can re-build it. Summary from the good doctor:

Age-related loss of muscle mass (sarcopenia)may start as early as in our thirties and appears to continue for the rest of our lives.

There is also a loss of muscle strength and muscle function. The consequences may often be severe, particularly in the elderly.

Increased physical activity and adequate nutrition are the most powerful tools at our disposal to delay age-related loss of muscle mass.

Well-rounded exercise programs consisting of aerobic and resistance exercises are believed to be most effective

Modification of dietary habits may be an important tool to prevent the decline in muscle mass and function that occurs with aging.

Adequate protein intake is of key importance. Animal-derived protein may provide a higher and broader biological value than vegetable protein.

Fish consumption is recommended and fruits and vegetables should be consumed regularly.

Nutritional supplements containing essential amino acids may be helpful. This is particularly true for whey protein.

Fish-derived protein hydrolysates also appear promising.

Adequate intake of vitamin D is essential.

“Fish-derived protein hydrolysates” doesn’t sound very appetizing. I’ll stick with whole fish for now, especially cold-water fatty fish.

Steve Parker, M.D.

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November 6, 2020 · 8:00 AM

Overweight Men Reduce Insulin Resistance Via Resistance Exercise Training

  • exercise for weight loss and management, dumbbells
    At least he’s trying…
  • Steve Parker MD, Advanced Mediterranean Diet, Ketogenic Mediterranean Diet
    Testosterone is one reason men are better than women at push-ups
  • Weight machines may be safer than free weights for some folks
    Weight machines may be safer than free weights for some folks
  • young woman, exercise, weight training, gym
    You go, girl!

Didn’t we already know this?

Insulin is a blood-borne hormone that the pancreas gland secretes in order to keep blood sugar levels from getting too high. (Insulin does many other things, but table that for now.) Insulin triggers certain body cells to absorb glucose from the bloodstream. “Insulin resistance” means that these cells don’t respond to insulin as well as they should, so either the pancreas secretes even more insulin (hyperinsulinemia) or blood sugar levels rise. Insulin resistance is a harbinger of type 2 diabetes mellitus. Most overweight or obese type 2 diabetics have insulin resistance. Many experts think hyperinsulinemia causes disease by itself, regardless of blood sugar levels. So it may be best to avoid insulin resistance and hyperinsulinemia.

The aim of the study was to investigate the effects of 6 weeks of resistance exercise training, composed of one set of each exercise to voluntary failure, on insulin sensitivity and the time course of adaptations in muscle strength/mass. Ten overweight men (age 36 ± 8 years; height 175 ± 9 cm; weight 89 ± 14 kg; body mass index 29 ± 3 kg m−2) were recruited to the study. Resistance exercise training involved three sessions per week for 6 weeks. Each session involved one set of nine exercises, performed at 80% of one‐repetition maximum to volitional failure. Sessions lasted 15–20 min. Oral glucose tolerance tests were performed at baseline and post‐intervention. Vastus lateralis muscle thickness, knee‐extensor maximal isometric torque and rate of torque development (measured between 0 and 50, 0 and 100, 0 and 200, and 0 and 300 ms) were measured at baseline, each week of the intervention, and after the intervention. Resistance training resulted in a 16.3 ± 18.7% (P < 0.05) increase in insulin sensitivity (Cederholm index). Muscle thickness, maximal isometric torque and one‐repetition maximum increased with training, and at the end of the intervention were 10.3 ± 2.5, 26.9 ± 8.3, 18.3 ± 4.5% higher (P < 0.05 for both) than baseline, respectively. The rate of torque development at 50 and 100 ms, but not at 200 and 300 ms, increased (P < 0.05) over the intervention period. Six weeks of single‐set resistance exercise to failure results in improvements in insulin sensitivity and increases in muscle size and strength in young overweight men.

Source: The effect of short‐duration resistance training on insulin sensitivity and muscle adaptations in overweight men – Ismail – 2019 – Experimental Physiology – Wiley Online Library

Steve Parker, M.D.

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November 5, 2020 · 7:00 AM

Compare Fitness Trackers

ConsumersAdvocate.org has an article comparing and contrasting some of the available fitness trackers:

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You go, girl!
HOW WE FOUND THE BEST FITNESS TRACKERFEATURES

We checked for fitness trackers with diverse features that users could choose to best match their lifestyle and goals. This includes multiple health and activity monitoring options.

CONNECTIVITY

Many fitness trackers sync with smartphones or Bluetooth to receive calls, get message notifications, and send data to their corresponding fitness apps. We looked at trackers that were easy to connect.

COST

Regular fitness trackers can range from $50 to $200, while hybrid smartwatches can cost over $400. We compared prices to special features to make sure consumers get the most out of their investment.

CUSTOMER EXPERIENCE

Fitness trackers should be durable, lightweight, and comfortable. We interviewed customers and read dozens of reviews and testimonies for thorough feedback on each product.

Source: The Best Fitness Trackers For 2020

Click through for details. I use none of these trackers, so have no dog in the fight.

Steve Parker, M.D.

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October 3, 2020 · 8:00 AM

The Best Exercises to Fight Obesity

From Obesity Reviews:

Current international guidelines recommend people living with obesity should be prescribed a minimum of 300 min of moderately intense activity per week for weight loss. However, the most efficacious exercise prescription to improve anthropometry, cardiorespiratory fitness (CRF) and metabolic health in this population remains unknown. Thus, this network meta‐analysis was conducted to assess and rank comparative efficacy of different exercise interventions on anthropometry, CRF and other metabolic risk factors.

* * *

Results reveal that while any type of exercise intervention is more effective than control, weight loss induced is modest. Interventions that combine high‐intensity aerobic and high‐load resistance training exert beneficial effects that are superior to any other exercise modality at decreasing abdominal adiposity, improving lean body mass and increasing cardiorespiratory fitness. Clinicians should consider this evidence when prescribing exercise for adults living with obesity, to ensure optimal effectiveness.

Source: What exercise prescription is optimal to improve body composition and cardiorespiratory fitness in adults living with obesity? A network meta‐analysis – O’Donoghue – – Obesity Reviews – Wiley Online Library

Steve Parker, M.D.

 

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April 25, 2020 · 8:00 AM

Don’t Be “That Guy”: Re-Rack Your Weights…

Arizona Governor Ducey, stop your unconstitutional business closures and let my gym re-open! Now. You’re doing more harm than good.

Steve Parker, M.D.

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January 25, 2020 · 9:00 AM

High-Intensity Interval Training May Prevent Dementia

Steve Parker MD

A slow leisurely pace won’t cut it

Dementia is a devastating and expensive development for an individual and his family. Most dementias are progressive and incurable. If it can be prevented, it should be. Exercise is one preventative. But how much and what kind of exercise?

Nine percent of U.S. adults over 65 have dementia. That’s 3.650,000 folks. The initial clue to incipient dementia is usually memory impairment.

From The Globe and Mail:

In 2017, a team led by the lab’s director, Jennifer Heisz, published a five-year study of more than 1,600 adults older than 65 that concluded that genetics and exercise habits contribute roughly equally to the risk of eventually developing dementia. Only one of those two factors is under your control, so researchers around the world have been striving to pin down exactly what sort of workout routine will best nourish your neurons.

Heisz’s latest study, published last month in the journal Applied Physiology, Nutrition, and Metabolism, offers a tentative answer to this much-debated question. Older adults who sweated through 12 weeks of high-intensity interval training improved their performance on a memory test by 30 per cent compared with those who did a more moderate exercise routine.

This was a small study, only about 20 sedentary participants (all over 60 years old) subjected to one of three protocols for twelve weeks, exercising thrice weekly:

  1. Four-minute bouts of vigorous treadmill walking at 90-95% of maximum heart rate, repeated four times, with three minutes easy walking between the high-intensity spells intervals (HIIT)
  2. Walking at 70-75% of max heart rate for 47 minutes (burning the same number of calories as group #1
  3. Thirty minutes of relaxed stretching

Alex Hutchinson’s full article is well worth a couple minutes of your time if you want to avoid dementia.

Source: New study shows the right workout routine can help fight dementia – The Globe and Mail

Most experts agree that diabetes is a risk factor for dementia, and the Mediterranean diet helps prevent it.

Steve Parker, M.D.

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December 11, 2019 · 11:52 AM

Taking an Exercise Break? Fitness Deteriorates After Just Two Weeks

A workout partner may motivate you

From UPI:

A new study proves that the old adage “use it or lose it” is definitely true when it comes to fitness.After just two weeks of sedentary behavior, formerly fit people had:

—A decline in heart and lung health

—Increased waist circumference

—Greater body fat and liver fat

—Higher levels of insulin resistance

Source: Study: Two weeks of no exercise enough to damage fit people’s bodies – UPI.com

On the other hand, taking a two-week break from exercise twice a year probably won’t have any lasting effect on health and longevity. And it may prevent burn-out and abandonment of fitness entirely.

It’s a small study, just 28 subjects, so may not be reproducible.

Steve Parker, M.D.

low-carb mediterranean diet

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November 10, 2019 · 1:42 AM

Fitness Training at Midlife and Beyond

You won’t see her at your home gym

From American Partisan:

If you have chronic pain or have been out of the gym a long time, build up volume (number of sets x number of reps x weight) slowly.  Pick weights you can lift without pain and increase weight and volume in pain-free steps.  The great thing about weight training is it allows you to easily control training variables in a safe, measurable, and repeatable manner while building work capacity and strength.  If one exercise hurts, substitute for another.  For example, if it hurts to back squat, substitute for a front squat….Right now, for example, I’ve built up a bit of pain in my biceps so I’ve substitute pull-ups for chin-ups which seem to take the stress off my biceps due to the weird angle between my upper and lower arms.

Cardio is built-up in a similar manner.  If one thing hurts, do something else or do it only within a pain-free time-interval and intensity to prevent pain flare-ups.  Develop a large variety of ways of doing cardio rather than do the same thing every day since training benefits heavily from novelty.  For example, you can use the assault bike one day, the agility ladder the next, barbell complexes a third day, and agility ladders a fourth day.  If you’re very overweight, start with walking.

Source: Fitness through midlife | American Partisan

I would add: Advance work load slowly. It took you years to get out of shape. What’s the rush? Progressing too quickly leads to injuries.

The article recommends a book by Bill Hartman called All Gain No Pain. The numerous five-star reviews (and very few with lesser stars) at Amazon.com seem a bit fishy to me due to over-the-top praise and few details. Do you have an opinion on the book?

Steve Parker, M.D.

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October 30, 2019 · 4:12 PM

Is 10,000 Steps a Day Really Necessary for the Longevity Benefit?

Dog owners live longer. Is it because of dog-walking?

It depends.

Among older women [average age 72], as few as approximately 4400 steps/d was significantly related to lower mortality rates compared with approximately 2700 steps/d. With more steps per day, mortality rates progressively decreased before leveling at approximately 7500 steps/d. Stepping intensity was not clearly related to lower mortality rates after accounting for total steps per day.

Source: Association of Step Volume and Intensity With All-Cause Mortality in Older Women | Geriatrics | JAMA Internal Medicine | JAMA Network

10,000 steps is about five miles, depending on stride length. 6,000 steps would be about three miles. Walking at two miles per hour, a leisurely stroll, it would take 90 minutes to walk three miles.

Steve Parker, M.D.

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