The 3 Rules of True Fitness

The 3 Rules of True Fitness:

In today’s world there are thousands of health and fitness gurus touting wondrous and miraculous ways to quickly and efficiently modify your body into sculpted and chiseled works of art that surpass Michaelangelo’s David. There are pills that speed your metabolism, drinks that burn your fat, weights that if you simple gyrate them quickly back and forth are somehow a full body workout and turn you into a mass of manhood, or a queen of seductive femininity.  Add to that the options of augmentation, injection, lift, dropping, propping and de-drooping, and you’ve got yourself the perfect body.  All of these things may take care of one simple thing; you may, if all goes well, temporarily improve your appearance of health.    

Society has informed us in recent years that appearance is much more important than actually, genuine, fully engaged health and wellness.  I couldn’t disagree more thoroughly.  Health and wellness is a slow and consistently managed format of knowing where you are today, knowing where you want to be, and creating sustainability in planning that allows you to achieve your goals.

Rule One: Know where you’re starting.

Rule Two: Know where you want to be.

Rule Three: Learn how to get there Injury Free.

TidBits - Stomach Ulcers and Juicing

Vitamin U, and well…. You.  Peptic Ulcers are no small pain.

Peptic ulceration is a term that we use to describe a breakdown in the wall of the either the stomach (gastric ulcer) or the duodenum (duodenal ulcer), which is immediately past the lowest part of the stomach.  It’s basically what the stomach drains into. 

There are a few reasons why we might get one of these peptic ulcers. One is simply a breakdown in mucosal lining of the stomach, which leads to regions within the stomach where the wall can be contacted by gastric juices.  The problem here is that gastric juices, contain both strong acids, and pepsin. Pepsin, a proteolytic enzyme (proteo – meaning protein, lytic –meaning lysis or breakdown) is part of how we begin to breakdown food in the stomach.  This is why we don’t want it touching the unprotected areas of our stomach! These unprotected areas are actually muscles that contract and relax while we eat to keep our food moving as well as helping in digestive mixing. 

Stress ulcers are a little bit different.  They have more to do with an over-activity of proton-pumps in the stomach causing excessive production of stomach acids.  This is why proton-pump inhibitors are sometimes prescribed for these issues. However it still must be noted that the mucosal lining must be thin enough for the erosive material to get to and destroy stomach muscle tissue. 

When this happens repeatedly and over prolonged periods of time there is decreased motility (decreased movement, due to injured stomach muscle) as well as hemorrhaging (bleeding) and/or pain.

Consider this: We have found a link between Vitamin U deficiency and gastric ulcer healing.  (yet most of us don’t know about it) Vitamin U is a nutrient that when we are lacking it, the mucosal membrane protecting the stomach weakens and thus allows occurrence of ulcer formation.  A fantastic source of vitamin U supplementation can be found in cabbage juice (I drink this somewhat regularly and it is not nearly as bad as it sounds). 

One study showed that 92.3% of ulcers even if over 1cm in size will be healed within three weeks¹; A second showed that ulcer crater healing times were considerably shorter with cabbage juice treatment than with standard drug therapy and diet therapy²; and a third showed that average crater healing time was 7.3 days in cabbage juice treatment as compared to 42 days with standard therapy³. 

Here is the kicker… We have known about this since the 1940’s.  Each study that I have cited is from over 60 years ago, and yet this information is not used today regularly.  This disheartens me greatly.  Why are we on chronic medications that don’t solve the problem, when a simple and very healthy dietary supplement of cabbage juice can solve the underlying issue.  Vitamin U deficiency is curable.  So let’s cure it. 

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Sincerely, 

Dr. Rich

   Calif Med. Jan 1956; 84(1): 39–43 
   Calif Med. Oct 1952; 77(4): 248–252

   Calif Med. 1949 Jan;70(1):10-5.

TidBits – Knee Pain and Weight Loss

It has become a well established dogma that obesity relates to increased chances of osteoarthritis, but interestingly enough we don’t know until it’s too late.  Let me explain the theorized process. 

Let’s start by telling you that it has been shown that in healthy individuals the mJSW (or minimum joint space width) will remain constant without decrease throughout the lifespan of the individual.  For women and men, the average space is 4.8mm and 5.7mm respectively¹.  What this means is that when a person has healthy knees their entire life, they will not have cartilage breakdown.  This means that NOT EVERYONE WILL GET OSTEOARTHRITIS OF THE KNEE!

Cartilage is the cushion of the knee, is it is also used to cushion the knee against undue forces exerted on it from our weight.  The surprise is that cartilage doesn’t really have good blood flow.  Interesting right?  Our cartilage has poor blood flow.  So how does it heal?  Well, it gets fed by the fluid inside the knee joints.  When we take a step we compress the cartilage.  Think of a sponge being pressed flat for an analogy.  Our cartilage exchanges fluid and oxygen, and nutrients by being repeatedly compressed and released.  This happens when we walk! 

 Then we begin to gain weight.  This is where the problems set in. A higher BMI is directly correlated with the overall likelihood of damage of the knee cartilage.  We call these injuries cartilage defects.  This is really a very poor word choice.  The truth is that these “defects” are traumatic lesions in the cartilage.  One study rates them on a scale where a grade one is localized blistering without damage to the top or bottom of the lesion; a grade two is where the top or bottom of the cartilage is actually damaged and less than half of the thickness is gone; a grade three is where the injury leads to more than half of the thickness of the cartilage; and a grade four is where the injury is so great that the bone is now showing². 

So wait, doesn’t this sound really painful?  Well, here is the scary part.  Cartilage is aneural.  This means that there aren’t any pain sensing nerves that live inside the cartilage to tell us when it is injured.  That means we can’t feel when there is a blister, or a crater in our knee joint cartilage.  We don’t typically start to get much pain until the cartilage is so bad that it is actually already a grade 4 injury! 

This is why it is so important to understand exactly what is happening with your weight and how you begin your workout regiment at the gym, or the pool, or just your stretching program.  There are rules, and reasons as to why you start certain ways.  Walking into a gym, starting on the treadmill and jogging for 5 minutes may be the worst possible thing you can do if overweight or obese.    

The good news is that weight loss is a great predictor of reduced risk of knee pain.  The bad news is that knee pain doesn’t always disappear if we wait until it’s already started, because in many ways if it is severe, the damage is already done.  Keep that in mind when considering how you start your program.   You should seek the help of a professional to help you focus on your weight loss before you begin any type of training program that could damage your knees.  You may be injuring them more than you know. 

Please subscribe.  So much more to come.

Sincerely,

Dr. Rich

1.      BMC Musculoskelet Disord. 2008 Sep 8;9:119

2.      Rheumatology (2010) 49 (12):2362-2369

Exercise Habits You Need To Break : Number 1

Going in Cold (Build the Heat)

Yes, my job here stinks, because you’ve heard this a million times, and now I have to make you believe it.  What I want from you is to consider the value of what I will now call “the heat phase” only, warm-ups no longer exist in your world. It’s now called the heat phase.  I’m not going to talk about risk of injury just yet but I want you to focus on the benefits of building the heat.  When you build the heat you start an internal fire, metabolically speaking.  You won’t combust I swear.  You open up the stores in your body by telling it the work load is going to increase and we need to be prepared. You’re cells say “Ok, I’ll start opening up the channels.”  What it means here is that it’s going to increase the flow of energy.  You’re muscles cells and nerves are going to need elevated quantities of glucose (to put it simply) and oxygen.  By building the heat, you’re giving your cells warning and your body will start to break them down where they are stored. It takes a long time for this to happen from fat, but for now, you have to tell your body this is happening. This gives your muscles a really good shot at recovering well between sets during your workout.

Building the heat increases your heart rate and deepens your breathing, literally your alveoli (the little air pockets in your lungs that exchange air become more flexible and expand slightly to allow this).  This means more oxygen enters your system, gets to your blood therefore gets to the muscles.  If you start with shoulder presses before building the heat, your shoulders aren’t going to be able to get enough oxygen to complete your sets successfully.  This means that you likely won’t get the same repetitions at the same weight.  Essentially you will be building yourself weaker shoulders just by cutting your potential right off from the start.  That’s kind the opposite of the goal right?  

By building the heat, you’re able to elongate your muscle tissue. This is way more important than you might think.  Inflexibility of the muscle means shortened ROM or Range of motion.  So, you are literally only building strength through the ROM that you use.  If your arm motion is shortened even slightly, you are literally not strengthening outside of the range in which you complete the rep. This is also not benefiting you the way you imagined.  Why put in the hours of work, and dedication by gym or picking up those free weight, or even attempting a sitting V on your living room floor.  You want to be strong through the whole ROM, and better yet through your whole body.

Ok, let’s be honest, building the heat means you are less likely to get injured.  You can’t forget that you have knees, lumbar discs, ligaments, cartilage, etc, all throughout your body.  These tissues also have to build the heat to become more elastic.  Increasing your core body temperature does this very well when you start small and build up.  You literally increase the ability of your Synovial Fluid (joint fluid) to reduce friction.  This means reduced wear and tear(avoid a knee replacment anyone?).  The image I want you to think of here is the tin-man.  Building the heat is like oiling his joints.   You may not creak just yet, but most of us do when we get a little older.  Keep that in mind, and you won’t forget to build the heat.

You are more than a category! BMI, promise.

Last post you did the calculations, and figured out what BMI category you fit into.   Remember to subscribe!  This is a new blog, and I have not yet received any subscribers!

Today we explore those numbers.  Depending on what numbers you received in the Feb, 22 2014 post, you should read the section that discusses your current status.  I see no use in worrying about other categories of BMI when you don’t fit them.  Become aware of where you are today, and that is all.  If you treat today like it is your starting point, you can control your situation.  If you worry about all of the other categories yet to come, you will only become overwhelmed.  Know your category, know your risks.

I’m going to start by simply noting possible concerns for each category. 

When underweight (BMI <18.5) Primarily this is a condition in which impaired nutrient availability is your greatest concern.  In American society we are eating more highly processed foods than in most other cultures. The definition of processed foods differs depending on where you look.  Conceptually speaking, when you find processed foods they will have additives, including something as simple as high salt content, to chemicals that are difficult to pronounce.  Processing also has to do with the way products are treated, such as cooking, or freezing.  In each way that a food is processed consider that at the chemical level, nutrients that are of value to you are being destroyed. This is where the concern comes in for underweight individuals.  Most foods being eaten by Americans are high calorie, low nutrient foods.  So if you aren’t even getting enough calories to maintain a healthy weight, there is a very high likelihood that you are nutrient poor as well. This can be expressed as iron deficiency, anemic conditions, calcium deficiencies, or bone loss, as well as generally higher levels of fatigue and let’s be honest.  It’s going to allow your body to work less efficiently.  This could mean something as simple as not even being able to think as clearly in some instances. Fat is what you body uses to build neurons… (your brain!).   Or it could mean something a bit more worrying like inability to fight off an infection.  So if you are underweight consult with a dietitian and get on track with a focus on nutrient dense foods.

Normal weight (BMIM 18.6 – 24.9) should be looked at as the category in which you have the lowest degree of risk.  This means that you are maximizing your health simply by maintaining appropriate weight levels.  This allows great equilibrium in the inner workings of your body.  Consider your joints, they are now under less stress, your blood pressure may likely be reduced as compared to what it would be at overweight or obese. This could be a measurable difference that could lead you to a discussion with your physician as to whether or not modification of your medication regiment might be warranted. Intra-abdominal fat is lower, and less of it is surrounding the heart, allowing even greater blood flow through your coronary arteries.  This reduces your risk of cardiovascular events in the future.  It should be noted that an estimated average weight gain per American male every decade is about 5 lbs, and for females it’s about 3.5 lbs.  So just because you fit into this category does not mean you get to forget this. It just means it’s time to look at the quality of your diet, and other health related issues.

Overweight (BMI 25-29.9) and Obese (BMI 30-34.9)

Ok, let’s be real, this is more of a complex issue than the cdc or nih will legitimately put in writing.  First off they are simply going to post neutral comments about how obesity is possibly genetic, or behavioral, or a combination of both.  This is what gets me ticked off.  We all know that we make our own decisions regardless of disease and disorder.  Yes, there are reasons one person might be more likely than another to be obese.  But that is not your excuse to accept your current position.  Please, seriously consider the fact that you control your life.  You are the only person who puts food into your mouth.  No one else!  If you’re intake gives more calories and less nutrient value than you physically need, it IS primarily your choice.   To be able to make the change, you have to know you have a choice.  YOU DO!

This is a truncated list of what is ahead for you if you’re obese.  This is a list of conditions you are at risk for: When listing simply the condition, I feel people have little understanding of what comes afterwards, but I will make an attempt to elaborate.

Coronary Heart Disease (This means heart attacks, bypass surgery and a typical a lot of chronic chest pain and medications)

Type 2 Diabetes (This means blood sugar disorders that lead to numbness in the feet and amputations)

Cancers (This can mean undergoing chemotherapy, mastectomy, colon surgery, possibly having an  ostomy bag)

Hypertension (Being on chronic medications possibly leading to side effect, increased risk of heart attack and stroke)

Dyslipidemia (This means elevated bad cholesterol, which also increases your risk of heart attack and stroke)

Stroke (this means you might be wheelchair bound for the remainder of your life, or it could be minor and you would simply have poor strength on one side of your body.  Also you may lose your ability to speak fluidly)

Sleep Apnea (This means you may require a breathing machine at night, every night, or to wear oxygen during he day)

Liver and gallbladder disease (this means that you may undergo surgery to remove the gallbladder and be placed on chronic antidiarrheal medicine)

Osteoarthritis (This means you will likely have years of knee or hip pain that lead to eventual surgical replacement secondary to excess weight destroying your cartilage leading to OA.

I hope this leaves you slightly more informed about the dangers of being outside of the normal weight category and why it is not just a number and is not to be ignored.

NIH put out a pamphlet that you can read online.  The link for this document is http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf

Personally I think it’s a bit long, and all they do is talk about reduction in diet alone versus increased activity alone, or both combined and that it might help.  Truth is we all know this will help.

No information on this blog is intended to give advice or recommendations for action.  Rather this is a review of information only.  All action taken by a reader should be evaluated by their physician.

Yes, You are obese, and it's not just a number.

Only you can control this moment. 

I want you as a reader to recognize something very simple. There are truths out there about fitness and health and there are lies out there about fitness and health. I have grown very concerned over the previous ten years as my career in this industry has expanded.  My concern is related to what people think they know about health.  It's a terrible concern to me. The primary reason it is a concern is because I see the dysfunction and disease present in America every single day, and the truth is that a large percentage of the physical ailments present are not only stoppable, but reversible. Why then, is nothing being apparently done about these issues in most of our daily lives? I want to start discussion of these issues one by one, broken down, piece by tiny piece with open conversation about the clear and present reality of these issues without being pretentious or overbearing.

Let me be forthcoming -The truth is that many of the concerns I will speak about in this blog will be issues that I am currently dealing with myself, or that I see regularly. If we're going to be truthful, much of my concern is brought about by my own quality of life issues. I am overweight, and I have back pain that limits my daily activities. You will find out more about these issues in future posts, but let’s move to the topic of this week.

There is currently an epidemic running rampant throughout the United States at alarming rates. The epidemic is actually very well known and yet we seem to think that we can ignore it in our personal lives. The problem with this epidemic is less the current position it puts us in, but rather it is the quality of life it promotes as we age. I’m talking about obesity.  Don’t stop reading, as this is the beginning of great discussion that will explore health over the next few years.  

As a doctor of physical therapy is spend my days with patients that have a great variety of afflictions. These afflictions range from total knee replacements to such severe morbid obesity that a person cannot move from their bed to their toilet that is literally right next to their bed.

It pains me to see quality of life depleted to such sad levels. I directly tie a very large majority of disorders to the progression of the obesity epidemic.  According to the CDC, or Center for Disease Control (Let me be blunt, they don’t control our health, we do), the current percentage of Americans who are obese is 35.7%.  That means that one out of three of us are obese. The numbers to follow are going to be more important than my last statistic because you are not a statistic alone, you are you, and you get to decided where you go from here. I don’t really care about the stats.  What I care about is that each person reading this knows where they stand currently.  Let’s find out your truth.

Let me explain what obesity is.  First off it is a measurement of weight in comparison to height. We scale it into categories that we call underweight, normal weight, overweight, obese, or morbidly obese. 

Ok I’m going to get a little educational here, and I’m not apologizing because what we need to start with is a real understanding where each of us stands today, so that tomorrow can be better.

If you really aren’t going to read this go to http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm
so that you can simply plug in your numbers.

BMI = Weight (Kg) / Height (m²)

Let’s use me as an example: 

Now Let’s find meters squared or m².

Final Calculation:


                                       BMI = 83.6kg / 2.98m²

My BMI = 28.06 Therefore I am overweight.

Below you see the categories.
                                  

Now you know and understand what category you fit into.  The arrows simply indicate where you or I should be going from this point forward.

Though they are currently just a number for you, I will explore the issues present for each category more thoroughly in following blogs.  This is just the beginning, so please subscribe and the information you recieve will be quality.  Not just some random opinion.  I have been working in this field for years and am well versed in navigating the difficulties you have had at deciphering all the bits and pieces of broken information.