Category Archives: exercise

Right arm hurts when coughing

I was recovering from the flu and the only remaining symptom was a stuffy and runny nose.  I thought that I was already on my way to recovery when I became aware of a combination of a dull pain and numbness in my right arm.  When I coughed, I could feel a shooting pain in my arm.  Over the next two days, the pain got worse and I could not find a comfortable position to sleep without feeling the pain in my arm.

I am not one to run to the doctor for every little pain.  With experience, I have learned that doctors will drug you so that you don’t feel the pain, but the real diagnosis could take a long time after many visits and tests.  For something that is not life-threatening, my first instinct is to search the Internet to find out what the problem could be.

My search found that the problem might be a herniated disk, a blood clot, lung cancer or other equally serious conditions.  Since my pain had just started recently, and I did not have any pain in my neck or neck movement, it was unlikely to be a problem related to the spine.  My arm was still strong but the muscle of my forearm felt a dull pain.  I decided to be though and wait at least one more day before going to the doctor.

I spent another night trying to find a comfortable position for sleeping.  At this time, I noticed that I had a muscular pain just below my right scapula.  I pressed my fingers on the spot and felt some tenderness.  Aha!  I suddenly remembered what I had done the day before the pain started.  I had helped my wife weigh her luggage on a bathroom scale.  Since the scale was not big enough to hold the luggage, I weighed myself holding the luggage and then subtracted my weight.  I remembered straining while trying to balance my weight as I held the luggage.  I did not have a blood clot or cancer after all.  It was a simple strain.

I decided not to go to the doctor.  Many years before, while walking my dog, I had suddenly felt a back pain that had sent me to the emergency room.  The doctor gave me a pain killer that made me giddy and then asked me if I knew what was wrong with me.  I said, “No,” and he replied, “I don’t know either.  Back pains are very common and they generally go away after a week or two.”  On that occasion, I spent a week in bed and the back pain was most severe when I had to use the bathroom.

The back has many muscle fibers that extend from the spine to the hips, ribs and scapula.  During your lifetime, some of these muscle fibers will tear and give you great pain, although not necessarily right away.  Seek medical attention, but be aware that even modern doctors cannot heal your back; they can only numb the pain.  My advice is: Don’t lift heavy luggage!

Exercise regularly and in moderation


How To Get Ripped Abs

Most people would like to have a well toned body with ripped abs to show off at the beach. Unfortunately, our modern way of life is very sedentary and we eat too much, so we are generally overweight. We know that diet and exercise require perseverance and sacrifice. This is why when a TV advertisement offers a device that in 3 minutes can give the results of 100 sit-ups we are tempted to buy it even for $200 dollars or more, especially when the device is promoted by a good-looking fitness model like Jennifer Nicole Lee who lost over 70 pounds after bearing two children. The Ab Circle Pro is a fiberglass disk with handlebars and knee rests that can be used for doing pushups, swinging from side to side, and doing leg squeezes. The TV infomercials promoting the Ab Circle Pro ran more than 10,000 times between March 2009 and May 2010. One of the things that the TV commercials did no mention was that Jennifer Lee was already slim when she started promoting the exercise device.

Jennifer Nicole Lee and the Ab Circle Pro

The Federal Trade Commission (FTC), which is a consumer protection agency, charged the companies and individuals which promoted the Ab Circle Pro with making unsubstantiated claims that the device could cause rapid and substantial weight loss and that three minutes of exercise on the Ab Circle Pro was equal to 100 sit-ups. The FTC filed a civil lawsuit against four companies promoting the device: Fitness Brands Inc., Fitness Brands International Inc., Direct Holdings Americas Inc. and Direct Entertainment Media Group Inc.

The FTC proved that it was deceptive to promise that people could lose 10 pounds in two weeks by using the abdominal exercise device for only three minutes a day. In the settlements, the companies agreed to pay as much as $25 million in refunds to customers for deceptive advertising. Michael Casey and David Brodess, two executives who control the companies, agreed to pay a total $1.2 million. Under terms of the settlements, none of the defendants admitted wrongdoing.

The FTC warned marketers to refrain from promising magic solutions to health problems, and advised consumers to carefully evaluate advertising claims for weight-loss products because weight loss requires hard work.

If you bought the Ab Circle Pro and got ripped off instead of getting ripped abs, you can try to get your money refunded by applying through the Federal Trade Commission web site:
FTC Ab Circle Pro Refunds

Learn More About Exercise

Exercise before breakfast to burn fat

pancreasA recent survey found that over 63 percent of adults in the U.S. are either overweight or obese.  Most people know that diet and exercise can get the body back to normal shape, but diet and fitness plans generally do not discuss the mechanisms by which diets work.

The weight of the body is regulated by the digestive system, the respiratory system, and hormones from the pancreas.  Food provides proteins, fats and carbohydrates which are macronutrients absorbed by the digestive system and are used to build body tissues and provide energy.  The presence of carbohydrates in the blood causes the beta cells of the islets of Langerhans in the pancreas to release insulin.  Insulin is a hormone that regulates carbohydrate metabolism and causes cells to take up glucose from the blood and store it as glycogen in the liver and as fat in the skin, abdomen, hips and muscles.

The islets of Langerhans in the pancreas also have alpha cells that produce glucagon, a hormone that helps convert stored fat into carbohydrates, but the secretion of glucagon is inhibited by the presence of insulin.  Thus, the hormones secreted by the pancreas control the level of glucose in the body.  When we eat food, insulin reduces the level of sugar in the blood by converting it mostly to fat.  When we are hungry, glucagon raises the level of glucose in the blood by converting fat into carbohydrates through lipolysis.

When we lose weight, where does the lost body weight go?  Energy is extracted from the nutrients by the mitochondria in the cells.  The waste products are carbon dioxide, uric acid and ammonia.  These last two are nitrogen-containing compounds.  Uric acid is the result of oxidation of nucleic acids found in the DNA of the food that we eat, and ammonia is produced from the metabolism of proteins.  The liver combines ammonia and carbon dioxide into urea, and both, uric acid and urea are excreted in the urine, which is how the body removes waste nitrogen from the body.  The excess carbon dioxide from carbohydrate and fat metabolism is expelled through the lungs which also take into the body oxygen from the atmosphere.  So, the weight is lost through the urine produced by the kidneys and through the carbon dioxide exhaled by the lungs.

Exercise increases the rate of metabolism and promotes the breakdown of body tissues to produce waste products.  Every exhalation of breath carries some carbon dioxide that reduces the body weight by a corresponding amount, which is not very much.  One hour of exercise, such as walking at a brisk pace, burns 300 calories; this corresponds approximately to the calories in one bagel with a tablespoon of jelly.

The combination of exercise and a nutritious, limited calorie diet is crucial for weight reduction.  Exercising in the fasted state before breakfast improves insulin sensitivity and takes advantage of the fact that carbohydrate stores are burned during the night and the body switches to burning fat.  Exercise before eating maintains the fat-burning mode, and this can be extended by delaying breakfast for one hour after exercising.  It is important not to snack.  Even a small morsel of food can trigger the release of insulin and stop the fat-burning mode.

Learn more about Exercise

[1] Van Proeyen, K; Szlufcik, K; Nielens, H; Ramaekers, M; Hespel, P; Beneficial metabolic adaptations due to endurance exercise training in the fasted state, J Appl Physiol. 2011 January; 110(1): 236–245. PMCID: PMC3253005

[2] Van Proeyen K, Szlufcik K, Nielens H, Pelgrim K, Deldicque L, Hesselink M, Van Veldhoven PP, Hespel P., Training in the fasted state improves glucose tolerance during fat-rich diet, J Physiol. 2010 Nov 1;588(Pt 21):4289-302. PMID: 20837645

[3] Kiens, B; Skeletal muscle lipid metabolism in exercise and insulin resistance, Physiol Rev. 2006 Jan;86(1):205-43. PMID: 16371598

[4] Romijn JA, Coyle EF, Sidossis LS, Gastaldelli A, Horowitz JF, Endert E, Wolfe RR. Regulation of endogenous fat and carbohydrate metabolism in relation to exercise intensity and duration. Am J Physiol. 1993;265(3 Pt 1):E380–91. PMID: 8214047

What to eat to lose weight

Eating a daily portion of French fries will eventually make you fat, and eating yogurt every day can keep you from gaining weight. This is one of the conclusions of a report published by researchers at Harvard University[1] which found that specific dietary and lifestyle factors are independently associated with long-term weight gain. The study found that a combination of these factors have aggregate effects. In essence, if French fries can make you fat and, independently, sugar-sweetened beverages can make you fat, the combination of French fries and sweet sodas will make you fatter than either one of them alone. The image above shows the pounds gained or avoided over four years for every additional serving per day of specific foods.

The research followed for twenty years 120,877 non-obese U.S. men and women, free of chronic disease from three different groups. Relationships between lifestyle factors and weight change were evaluated at 4-year intervals, with various adjustments made for age, baseline BMI, and lifestyle factors.

Overall, the participants gained 3.35 pounds, or 2.4% of their body weight, in each four-year interval. Over the 20 years of follow up, that amounted to almost 17 additional pounds. The data also revealed a strong weight-gain connection with certain foods, such as potatoes in various forms, sugar-sweetened beverages, unprocessed red meats, and processed meats. Some foods such as vegetables, whole grains, fruits, nuts and yogurt were inversely connected to weight gain, i.e., people who ate these foods gained less weight over time.

The study found that daily consumption of yogurt prevented 0.82 pounds of weight gain over each of the 4-year periods. Physical activity translated into 1.76 fewer pounds gained during each time period. Participants who slept less than six hours or more than eight hours per night gained more weight within each study period. Those who watched more television gained an average of 0.31 pounds for every hour of TV watched per day. Foods most strongly associated with weight gain every four years were potatoes, including fries (a 1.28-pound gain), sugar-sweetened beverages (1-pound gain), unprocessed red meats (0.95-pound gain), and processed meats (0.93-pound gain). Alcohol use was also associated with about a 0.41-pound gain per drink per day.

Each increased daily serving of potato chips alone was associated with a 1.69 pound-weight gain every four years. Potato chips are basically carbohydrates and fat with very little protein and almost no nutritional value. The Nutrition Label of Kirkland Kettle brand krinkle cut potato chips shows that one serving of 28 grams consists of approximately 9 chips. Eating those nine potato chips every day for four years results in a weight gain of 1.69 pounds.

One serving of potato chips

The results of the study demonstrate that the quality of the diet, i.e., the types of food and beverages that one consumes, is strongly linked to weight gain. One of your best strategies for losing weight is to increase your physical activity and reduce your consumption of potatoes and other simple carbohydrates such as white bread and sugar-sweetened drinks.

Learn more about weight loss.

[1] Dariush Mozaffarian, et al., Changes in Diet and Lifestyle and Long-Term Weight Gain in Women and Men, N Engl J Med 2011; 364:2392-2404 June 23, 2011

What is moderate exercise?

To estimate the number of calories that you should eat, you also need to know your level of activity.  If you are very active, you will need more calories than if you are sedentary.  While it is relatively easy to estimate the number of calories in your food by weighing and measuring, it is a lot harder to estimate the number of calories burned by exercise.  People often overestimate their amount of activity and consequently they eat more calories than they burn, and gain weight over time.

The Calorie Restriction Calculator estimates the Basal Metabolic Rate, and then uses an activity factor to obtain the total number of calories needed per day.  Using the wrong activity factor alters the estimate of daily calories substantially.

A paper on metabolism used a definition of “vigorous exercise” as expenditure of 14.1 to 16.3 kcal/kg of ideal body weight per day.[1]  Using the rounded figure of 15 Calories per kilogram of body weight, then “vigorous exercise” for a person weighing 150 pounds (68 kilograms) corresponds to 1020 Calories per day.  If walking at 4 miles per hour burns about 300 Calories per hour, then you would need to walk 3 hours and 24 minutes to burn off 1020 Calories.

The activity factors for the Calorie Restriction Calculator are:

  • 1.200 = sedentary (little or no exercise)
  • 1.375 = lightly active (light exercise/sports 1-3 days/week, approx. 590 Cal/day)
  • 1.550 = moderately active (moderate exercise/sports 3-5 days/week, approx. 870 Cal/day)
  • 1.725 = very active (hard exercise/sports 6-7 days a week, approx. 1150 Cal/day)
  • 1.900 = extra active (very hard exercise/sports and physical job, approx. 1580 Cal/day)

The activity factor lightly active corresponds to walking 2 hours per day, moderately active corresponds to walking 3 hours per day, very active corresponds to walking 4 hours per day, and extra active corresponds to walking 5 hours per day (20 miles).  More strenuous exercises, such as climbing stairs or running, burn more calories per hour.  Most people who exercise from 30 minutes to 45 minutes per day are in the “lightly active” category.  You can use the CR calculator to determine the number of calories for each level of exercise for your particular weight by subtracting the calories for a specific activity level from the calories for the sedentary option.

See the chart listing the calories for various activities

[1] Thissen JP, Ketelslegers JM, Underwood LE., Nutritional regulation of the insulin-like growth factors, Endocr Rev. 1994 Feb;15(1):80-101. Review. PMID: 8156941

Yoga inversions may cause inner ear problems

The Upward Bow pose (Urdhva Dhanurasana) and other yoga poses that require the head to be inverted may disturb the inner ear and cause vertigo and dizziness.  The inner ear has a vestibular system formed by three canals that are approximately at right angles to each other and which are responsible for the sense of balance and spatial orientation.  The inner ear has chambers filled with a viscous fluid and small particles (otoliths) containing calcium carbonate.  The movement of these particles over small hair cells in the inner ear sends signals to the brain that are interpreted as motion and acceleration.  Inversion of the head can cause some of the otoliths to shift position or slip into one of the semicircular canals and induce vertigo and instability, often accompanied by nausea.

The disorientation resulting from changes in position of the head is often diagnosed as Benign Paroxysmal Positional Vertigo (BPPV), and is treated by trying to reposition displaced otoliths back to their original position by turning the head in specific ways.  The Epley Maneuver, developed by Dr. John Epley in 1980, is often performed by a doctor or a physical therapist and requires holding the head at specific angles, and then turning the head 90 degrees to the other side for specific periods of time to allow the otoliths to settle.

Vertigo is very debilitating because it makes it impossible to perform ordinary activities.  The irony of developing vertigo through yoga is that yoga is supposed to help the body and the mind.  Many people practice the yoga positions that require inversions without any problems, but unfortunately, it is not possible to predict who will be affected adversely by inverted yoga poses.

The purpose of yoga, and all other exercises, is to improve the body.  You have to use discretion in establishing the limits of stress to which you will subject your body in any physical activity.  Going beyond your comfort zone may improve your confidence, but it also has the potential of causing temporary or permanent damage.

Learn how to have a safe workout

Modern lifestyle promotes obesity

I just returned from a trip to Manhattan, New York.  The streets are packed with taxis, buses, and people walking.  Under the streets, you can hear the constant rumble of subway trains.  New Yorkers use public transportation and have to walk a lot more than other people in America.  Few New Yorkers seem to be excessively overweight.  Maybe this is a mistaken impression.  It is possible that New Yorkers who are overweight avoid going to Manhattan because then they would have to walk.

Over the last 20 years, Americans have become fatter.  Mississippi and Alabama lead the nation in the rates of obesity, but increased obesity is not only happening in the United States.  The obesity epidemic is engulfing the entire world.  Although obesity is a problem mainly in rich countries, the World Health Organization estimates that by 2010 the developing world will have caught up.  Overweight people now outnumber the undernourished.

Why is this happening?  The primary culprits are junk food and artificial foods, particularly sweetened soft drinks that provide only carbohydrate calories without any other nutrients, and hydrogenated fats that cannot be metabolized by the body.  Lack of exercise is a secondary reason.  Here is a list of some of the factors responsible for the increase in obesity.

  • We drive to the grocery store because otherwise we cannot carry the big load of groceries home.
  • We cannot walk to work or school because the distances are too great.
  • We are too busy commuting to have time to exercise, so we don’t exercise.
  • We drink too many sugary soft drinks with addictive ingredients like caffeine.
  • We eat too many foods that have hydrogenated fats.
  • Many staples are over-processed and refined so that they have less fiber and fewer nutrients.
  • Food is glorified as a social celebration.  TV programs like the Food Channel describe food preparation without regard for its nutritional content.  Add more butter…, Deep fry it…, Add a cup of sugar…, etc.
  • We snack too much and expect that every meal should have dessert.
  • We eat too much fast food that is usually too greasy.
  • We use food as celebration.  If you have a birthday, how do you celebrate?  You have to eat cake!

Food consumption is promoted very agressively.  Manufacturers cannot make much money from people who fast or eat small meals.  Calorie Restriction and moderate eating are not good for business.

Learn how to lose weight

Foraging for mushrooms and bamboo shoots

Bamboo Shoots Bamboo Shoot cross section
Bamboo Shoots

After almost one week of continuous spring rains, the trees are green and the the ground is moist.  These conditions promote the growth of mushrooms and bamboo.  A nice walk in the woods will bring you closer to nature, burn up some calories and, if you are lucky, you can find some edible mushrooms, berries, or bamboo shoots.

Bamboo shoots are frequently used in Chinese cooking.  They are also a favorite food of Panda Bears.  Bamboo shoots are low in calories and contain a significant amount of B vitamins and minerals.  100 grams of raw bamboo shoots have only 27 calories and the following nutrients:

Nutrients in Bamboo Shoots

Next time that you go for a walk, keep your eyes open.  You can enjoy nature, and perhaps find a nice edible treat.

Oprah Winfrey’s diet failure

Oprah Winfrey 1988 Oprah Winfrey 2008
Oprah Winfrey in 1988 and 2008

Oprah Winfrey has a history of yo-yo dieting that has been parodied on Saturday Night Live.  In 1988 she lost 67 pounds on a liquid protein diet and appeared on her talk show dressed in size 10 Calvin Klein blue jeans wheeling a wagon loaded with fat representing the weight that she had lost.  Recalling the occasion in 2005, she said:

“I had literally starved myself for four months – not a morsel of food. Two hours after that show, I started eating to celebrate. Of course, within two days those jeans no longer fit!”

The talk show hostess now weighs 200 pounds, up from 160 in 2006, according to an article in the January 2009 issue of O magazine.  Oprah writes:

“I’m mad at myself.  I’m embarrassed. I can’t believe that after all these years, all the things I know how to do, I’m still talking about my weight. I look at my thinner self and think, ‘How did I let this happen again?’ “

Oprah has blamed her weight problems on an out-of-balance thyroid and her fear of working out because of her condition.  In 1990, she regained the 67 pounds that she had lost saying:

“I’ve been dieting since 1977.  The reason I failed is that diets don’t work. I tell people, if you’re underweight, go on a diet and you’ll gain everything you lost plus more. Now I’m trying to find a way to live in a world with food without being controlled by it, without being a compulsive eater. That’s why I say I will never diet again.”

In 1994, she had slimmed down by exercising with the help of a personal trainer and a full-time, in-house chef. She even finished the Marine Corps Marathon. Oprah kept up the fitness regime through 1996, when she posed on the cover of People magazine, in which she described the diet and workout routine that finally worked for her.  In 2007, Oprah told viewers that a thyroid disorder had caused her to gain 20 pounds.  Oprah feels embarrassed by her current weight of 200 pounds.

The lesson that we can take from Winfrey’s experience is that proper nutrition and exercise have to be a way of life.  You cannot just say “I am going to lose weight” and stop eating or go on a fad diet.  You have to figure out how to meet your nutritional needs for your target weight by eating real foods.  You also have to be realistic about your goals.  You should not wish to be too thin or too muscular.  You have to aim for a normal weight and be happy with that.  You also have to limit your consumption, even if you can afford abundance.  And you have to be consistent.  You have to set your goals and remain steadfast. This requires psychological strength.

Basketball is the Most Dangerous Sport

Sport Injuries

We naturally assume that boxing is a dangerous sport because its purpose is to try to knock out the opponent.  However, statistics from the U.S. Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS) indicate that the greatest number of visits to hospitals occur from basketball.  Injuries from basketball include cut hands, sprained ankles, broken legs, as well as eye and forehead injuries.  The large number of injuries may be due to the popularity of basketball.  There are basketball hoops in many driveways and playgrounds.  It seems so easy to bounce the ball around and shoot a few balls.  It is the jumping and competitive aspects of the game that cause the injuries.  Players collide, fall, hit each other accidentally, or land improperly after jumping and they get hurt.

Exercise is important for fitness, but we have to stay alert and keep safety in mind.