Tag Archive for: exercise

Boosting Immune Function: Exercise vs. Meditation

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Every once in a while, I come across some research that’s just so interesting and unique, I have to share it with you. In this case, it’s directly related to boosting the immune system, which is what a lot of people are trying to do right now. In this case, researchers tested whether an eight-week program of either moderate exercise or meditation would reduce the variables associated with an acute respiratory infection such as time lost from work.

Researchers recruited subjects who did not get a flu vaccination and also did not exercise or meditate; they used just about every survey related to health that was available. They also took samples from nasal rinses after subjects had acquired an acute respiratory infection of any type and tested for markers of immune function in the rinses.

The mean age of the subjects was 59 years old. The subjects were randomly assigned to one of three groups: the control group who agreed to do nothing during the eight weeks; a group who would exercise at a moderate level; and a group who would participate in a specific type of meditation.

On Thursday, I’ll talk about the training programs. Looking ahead, short of looking up the paper itself, what do you think will be more effective: exercise or meditation to boost the immune system?

Insider Conference Call

Tomorrow night is the August Insider conference call. I’m going to do a COVID-19 update focusing on the recent spate of doctors plugging hydroxychloroquine as well as answering Insider questions. If you become an Insider by 8 p.m. ET, you can participate live!

What are you prepared to do today?

        Dr. Chet

Reference: Ann Fam Med 2012;10:337-346. doi:10.1370/afm.1376.

The Bottom Line on Masks

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To satisfy my own curiosity, I wanted to do a run/walk to see how wearing a mask might impact my performance. This is tricky for someone with a scientific background; trying to duplicate everything with the exception of the one variable, the mask, is difficult when you’re outdoors. But the weather has been pretty stable: overnight lows in the mid 60s, rising to 90 degrees almost every day with little humidity.

I decided to run the half-mile loop in my neighborhood six times just like I normally do. Five days before I ran it with the mask, I had run it faster than I had in a couple of years; I’m not setting any speed records here, but my knee appears to be getting stronger and I’m able to open the jets a little bit. I ran the same six laps at the same time of day and at the approximate same temperature. The only variable was the mask.

Before I tell you the results, I have to say that I spent way too much time thinking about the mask instead of just running or walking. At this point, I’m running for one minute, and walking for 90 seconds. I maintained that with no real problems once I stopped thinking about the mask. I also must say then I decided to bulk up the day before by over-eating some great tasting pasta I made. I was four pounds heavier than last week. Five days before, I ran the six laps in 40:52. This time I ran it in 41:20—28 seconds slower.

Did I have any trouble breathing? Not really other than thinking about it too much. Did it affect my ability to run? I don’t think so. I intentionally tried not to make it a race, but just to go out and run/walk the best that I could. I didn’t feel like I was breathing any harder while walking or running. My recovery from the run seemed about the same. So I would have to overall say that wearing a two-layer, cloth mask (just like in the picture) didn’t have any impact on my ability to exercise.

Should Everyone Wear a Cloth Mask?

No. The Centers for Disease Control does not recommend cloth masks for:

  • Children younger than two years old.
  • Anyone who has trouble breathing.
  • Anyone who is unconscious, incapacitated, or otherwise unable to remove the cloth face covering without assistance.

They also list some pragmatic concerns for those who must travel in populated areas but cannot wear a mask. They do not qualify what “trouble breathing” means, but certainly respiratory issues as well as cardiac issues would probably be included. Of course, if you have heart trouble or respiratory problems, taking chances with your health doesn’t seem like a smart choice; I’d recommend staying home as much as you can.

The Size of a Pea or the Size of a House?

For those of you who think size matters, let’s talk about the relative sizes of the various items under discussion when we talk about masks.

Viruses are so small they’re measured in nanometers; a nanometer is one millionth of a millimeter. There are about 25 millimeters in an inch, so take one twenty-fifth of an inch and divide it into a million: that’s a nanometer. A human hair is around 75,000 nanometers. So here’s what you need to know:

Oxygen molecules are one-third of a nanometer; carbon dioxide is a carbon molecule with oxygen molecules on its right and left, so it measures about one-third of a nanometer by one nanometer.

Coronaviruses are 125 nanometers.

Droplets vary from 2,000 nanometers to 100,000 nanometers.

By definition, an N95 mask blocks 95% of particles of 300 nanometers.

Cloth varies so much it’s hard to determine the size of the comparative spaces between fibers, so it was hard to find any info at all. The best I could find is that it’s in roughly the same size range as the droplets; used, folded, tightly woven cotton has about 20,000 nanometers between fibers.

It’s hard to visualize the comparative sizes when we’re talking about a unit of measure that’s so incredibly small. Let’s transform everything into familiar sizes by changing nanometers to inches:

Oxygen would be about the size of a pea, and carbon dioxide would be three peas pushed together.

A coronavirus would be 10.5 feet tall, so it probably wouldn’t fit in your house.

An N95 mask blocks particles equivalent to 25 feet or more.

Droplets start at the size of a 12-story building (167 feet) up to almost 600 stories (over 8,000 feet).

So you can see how a cloth mask that stops droplets from getting through would allow plenty of oxygen and carbon dioxide to pass freely.

But how does a mask stop a 125-nanometer coronavirus if it filters out particles of 300 nanometers? It’s important to know the virus isn’t floating around by itself—it’s hitching a ride on the droplets of moisture we breathe out, and a mask definitely stops those.

Final Research Paper

Here’s a quote from the 2013 paper I used as a basis for the effectiveness of cloth masks:

“In the questionnaire on mask use during a pandemic, six participants said they would wear a mask some of the time, six said they would never wear a mask, and nine either did not know or were undecided. None of the participants said that they would wear a mask all of the time. With one exception, all participants reported that their face mask was comfortable.”

That seems to be where we are today during this pandemic, seven years after that study was published. Only today it’s reality, not answers to a questionnaire.

The Difference in Lives

If none of that convinces you to wear a mask, maybe this will: a new model by the University of Washington predicts more than 208,000 Americans will die from COVID-19 by November.

But if 95% of the population wears a mask in public from now until then, that number would drop to 162,808—a difference of more than 45,000 lives. Let’s bring that home. The U.S. has 3,141 counties; would you wear a mask to protect 14 people in your county?

The Bottom Line

This week I’ve reviewed some of the major objections that people have to avoid wearing a cloth mask, and the research doesn’t support the objections.

The final objection is that people are willing to take their chances that they will get only a mild version of the virus; it seems their freedom to enjoy life supersedes the safety of those around them. Maybe like Gus in Lonesome Dove, they’ll take their chances with an infection and die with their boots on. I challenge those people to do some research on long-term consequences of COVID-19.

It’s no longer a safe assumption that your local hospital will make everything okay if you get ill. Every area with a COVID-19 spike has seen hospitals at capacity, healthcare workers at or beyond the breaking point, and the necessary supplies running short, including PPE. All respect to healthcare workers, but they’re human and at some point mental, emotional, and physical exhaustion sets in and they’re not going to be able to give their best. Maybe you could wear a mask for the sake of the people you know in healthcare, like our daughter-in-law.

What are you prepared to do today? Wear the damn mask!

        Dr. Chet

References:
1. https://bit.ly/3gvDH0J
2. Disaster Med Public Health Preparedness. 2013;7:413-418.

Old School: One Step

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I’ve been lifting weights at home since the “Stay Home, Stay Safe” mandate closed all the fitness centers. I wanted to make the workouts a little more difficult and keep my heart rate elevated between sets, so I went old school: I used a step stool. I could have used a step on the stairs outdoors, but it’s still too cold and I would have to move the weights outdoors. Lucky for me, Paula has a sturdy wooden step made for her by her brother, Steve, many years ago.

Up-up-down-down. Over and over. Every five rotations, change the lead foot. In other words, if you stepped up with your right foot first, you switch to stepping up with your left foot first. I began with 60 seconds between sets of weight training and will cap it at two minutes. I still want to stress the muscles that are lifting as well.

Couple of important points. I always steady myself by lightly keeping my hands on a counter. You could always use handrails if you’re using a flight of stairs, but never use the top step; for safety’s sake always use the bottom step. You don’t want to fall down a flight of stairs.

You don’t need fancy equipment to get a good workout. All you need is just one step.

What are you prepared to do today?

        Dr. Chet

Observations and Questions About the Step Study

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Most research papers such as the step study I began to review on Thursday have a main point, sometimes a couple points, and that’s all we take from it. But there some interesting things that may not get headlines but are still worth mentioning. Let’s take a look at some other results from the steps and mortality study.

Observations

Whatever you might believe about exercise was proven true by this study—not the positive outcomes such as the decrease in overall mortality, as well as CVD and cancer mortality, but questions that paint a picture of who exercises. For every category, from education to smoking to alcohol consumption, what we would expect was confirmed. But we also learned that people are high steppers who we would not expect to be.

For example, would we expect obese subjects to be in the fewer than 4,000 steps per day category or in the greater than 12,000 steps per day category? You would be right if you thought most were in the more sedentary category; 36.7% of those with a normal BMI were in the highest step category. But it doesn’t mean that there were no obese subjects in the greater than 12,000 steps per day category; in fact, 24.8% of those with BMI greater than 30 were in the highest step category.

Why? That’s what we really need to find out. What makes them different? Why are they doing what we don’t expect, or did they just do that well when they wore the accelerometer? If we want to change behavior, that’s what we need to find out.

This was an observational study, so it cannot prove cause and effect, but it gives us insight into the type of studies that will be able to determine cause and effect, such as randomized controlled trials. They can be better designed by building on this study.

Questions

Because we’re in a “Stay Home and Stay Safe” environment, there were some logical questions about stepping and coronavirus infections but I couldn’t find a single answer. When I searched for “fitness and coronavirus,” I found the term fitness meant fitness of the virus, not humans.

I used different search combinations and finally decided to try exercise and coronavirus. There were a number of papers that were written in the last couple of months about the safety of exercise during the pandemic as well as exercise to relieve stress for first responders, but those are still not exactly what I wanted. I wanted to see if steps or exercise would reduce the rate of catching coronavirus, any coronavirus.

I didn’t find that, but I discovered an interview with exercise immunologist Dr. Jeffrey Woods. Rather than summarize it for you, I’m giving you a link to this article for you to read. While it’s difficult to prove improved resistance to coronaviruses, Dr. Woods’s creative research has come close. As long as most of us have the time, I suggest that you read it.

The Bottom Line

Research studies such as the one I’ve reviewed this week tell us a lot about what we know and what we still need to find out. There are too many questions left on the table that never get answered related to diet, nutrition, and exercise. Do you really get all the nutrients you need if you eat a perfect diet? No one knows because no one has ever tested it. Let’s hope we get some answers related to diet, fitness, and supplementation as it relates to the prevention and possible treatment of the coronavirus when this challenge is all over, but I’ll go out on a limb and say you’ll never be worse off by being in better shape. Now that many of us have more time, let’s work on that.

What are you prepared to do today?

        Dr. Chet

References:
1. JAMA. 2020;323(12):1151-1160. doi:10.1001/jama.2020.1382.
2. Journal of Sport and Health Science 9 (2020) 105-107.

Step It Out!

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By the looks of it, “Stay Home and Stay Safe” will extend through the beginning of May and perhaps longer. As we adapt to our new normal, here is a little incentive to make exercise a regular part of your life from now on.

Researchers analyzed data from the 2003–2005 National Health and Nutrition Education Survey (NHANES). During that version of this recurring study, they collected seven-day accelerometer data from over 4,850 adults 40 years and older representative of the population of the U.S. They tracked the group of subjects through 2015 to look at all-cause mortality and steps per day.

If you look at the graph, you can see that deaths per 1,000 decreased as the number of steps per day increased. The mortality rate was half the amount at 8,000 steps per day than at 4,000 steps per day. While it continued to decrease slightly, the optimal amount of steps seemed to be between 8,000 and 10,000 steps per day. One surprising outcome was that intensity didn’t seem to matter; just volume.

All-cause means just that: all causes. That’s a real motivating factor to work on stepping it out every day. But it raised a question: could steps per day reduce the risk of getting upper respiratory infections? I won’t make you wait until Saturday. The answer is that no research has answered that question yet. But there was a lot more to this study, and I’ll cover that on Saturday.

Reminder: this week you can save 19% on two items at drchet.com. Use the coupon code virus.

What are you prepared to do today?

        Dr. Chet

Reference: JAMA. 2020;323(12):1151-1160. doi:10.1001/jama.2020.1382.

No Time for Exercise!

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One complaint that I get all the time is this: people tell me they don’t have time to exercise. I can understand that. There are some days exercise just isn’t an option, especially when you’re sick. But that’s supposed to be the exception, not the usual situation, and it just isn’t true for most people.

A recent study was published by the CDC using survey data from the American Time Use Survey. They collected data on over 30,000 people on how they spend their time. That includes working, total leisure-time activities, and time in exercise. They collected data on gender, education, and of course, age. What they found is that in spite of what people say, they have between three to five hours per day of leisure time.

Where did they seem to be spending that time? They’re spending it on a screen: their phone, their computer, or their television. And that seems to suck up the time they could be exercising. There’s a lot more to this study and I’m going to cover that in a future Straight Talk On Health (free to Members and Insiders), but for now, I think it’s time to take an honest look at how much leisure time you really have, because it seems most of us have the 20, 30, or 45 minutes we need most days to be able to work out. No excuses. Do your job.

Reminder: there are still seats for the Nutrition in the 21st Century seminar in Chelmsford this Saturday. If you have the time, you could learn a lot about nutrition and supplementation.

What are you prepared to do today?

        Dr. Chet

Reference: Prev Chronic Dis 2019;16:190017. DOI: https://doi.org/10.5888/ pcd16.190017.

Holiday Eating: The Best Solution So Far

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In our quest to find the best holiday eating strategy, we may have been looking at the wrong metric. Prior researchers have been looking at the subjects reporting of how well they stuck to their eating habits and exercise program. The final study looked at a hard metric: body weight. Here’s what they did.

Researchers recruited subjects who were overweight and obese but had been losing weight, plus a group of normal-weight subjects. They further divided the two groups into control groups and experimental groups. The control groups simply weighed in before the holiday season began at Thanksgiving, after the season ended on January 1st, and again a month later. The experimental groups also weighed in during those times but in addition, they were told to weigh in every day using a scale with Wi-Fi access. Their results were displayed graphically to chart progress.

What happened? The control groups, whether overweight, obese, or normal weight, gained an average of close to six pounds during the holiday season. The normal weight subjects who weighed themselves daily maintained their weight. Those who were overweight and obese continued to lose weight, losing on average 2.5 pounds. At the one month follow-up, the control group lost only half the weight they gained over the holidays. Researchers speculate that annual holiday weight gain contributes to weight gain over years.

The Bottom Line

What’s the best strategy for holiday eating? There are two things that are critical: maintain your exercise program and weigh yourself regularly, preferably every day. True, your daily weight will fluctuate but you won’t let it get away from you—that’s when you get into trouble. As for your eating habits, not every day is a holiday party with mass quantities of food to consume. Chill out a little during the parties and pitch-ins, but for the most part, stick to your regular eating habits; that applies whether you’re overweight or not. I think that’s the best strategy for the holiday season.

What are you prepared to do today?

        Dr. Chet

Reference: Obesity. 2019;27(6):908-916. doi: 10.1002/oby.22454

Should You Have a Strict Holiday Eating Strategy?

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Tis the season for gaining weight. It began on Thanksgiving, but we’re in it big time now. If you’ve lost weight and want to make sure you don’t see it again, what do you do? Let’s review some of the research on strategies that people who’ve lost weight and maintained it have used.

The first is a report from the National Weight Control Registry. In order to be a subject in that study, you have to lose 30 pounds and maintain it for at least a year. Researchers took a group of recent additions to the study and asked them specific question on their strategies during the upcoming holiday season at that time, and then tracked how they did. They also recruited a group of normal weight people and did the same thing.

Most of the experimental group said they were going to follow their typical routine as related to diet and exercise plan. In other words, they were going to try to strictly follow their weight loss routine. The normal weight individuals didn’t really have any special plans. Most successful losers did follow their plan although it was more difficult during the holiday season. About the same percentage of successful losers and normal weight subjects gained weight, maintained their weight, or lost weight during the holiday season. The difference was that the successful losers found it more challenging to do so based on their response to survey questions.

Is that the best strategy? Stay the course? Another study on Thursday.

What are you prepared to do today?

        Dr. Chet

Reference: J Consult Clin Psychol. 2008. 76(3): 442–448.

How Your Microbiome Affects Exercise Benefits

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It seems every day, there are several studies on the microbiome and its impact on our health. At this point, they’re preliminary but the picture is emerging that as goes your gut, so goes your health. I’ve picked three new studies to review this week.

As an exercise physiologist who’s done research on this topic, I’ve always recommended exercise as a way to improve control of blood sugar for prediabetics; that’s why this study surprised me. Researchers assigned 39 prediabetic men who had never used medication to either a control group or a high-intensity exercise group for three months. All men in the exercise group had similar improvement in fitness and weight loss. But only 70% of the men demonstrated an improvement in insulin resistance.

The way the responders processed protein and carbohydrates was different from non-responders. The researchers collected stool samples and then transplanted the microbiome of responders and non-responders into a group of mice; the mice responded to exercise in the same way as the man whose microbiome they received. The microbiome somehow responded differently to exercise and modified the expected results.

We don’t know about dietary differences between subjects that might have impacted the outcome because the subjects were told to maintain their current diet, but the results were surprising nevertheless. But I would still give the same recommendation for exercise to all prediabetics. The only difference would be to make sure they tracked blood sugars to see how their blood sugar responded.

What are you prepared to do today?

        Dr. Chet

Reference: Cell Metabolism, DOI: 10.1016/j.cmet.2019.11.001.

It Gets Worse Before It Gets Better

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In last month’s Memos, I talked about many different aspects of exercise including flexibility, strengthening, and the various types of fitness and stamina. There’s one more thing you need to know. But first, a story.

Paula has been having an issue with her ankle and foot. She got it checked out with her podiatrist, and it’s a problem with the tendons in her foot including the Achilles tendon. Yesterday we went to see our favorite physical therapist; he did a thorough examination of her foot, ankle, knee, and hips. He recommended some stretching and strengthening exercises as well as some non-impact aerobic exercise. He then said something important: everything may seem worse before it gets better.

I’m going to tell you the same thing as you attempt to work on your body to help you really live instead of merely being alive: you may feel worse before the work you invest begins to pay off and you start to feel better. That’s one reason I ask you to see your doctor before you begin, who’s familiar with your orthopedic issues as well as any conditions that can be impacted by exercise. That’s why you always check first.

If you can get professional help to help you get started, that’s even better—someone to help you choose the right exercises to fit your particular body and limitations. Get a referral to a good physical therapist or find a certified personal trainer with experience helping people who are less fit; you definitely don’t need one of the no-pain-no-gain goons. It doesn’t need to be a long-term relationship, just advice to help you get a good, safe start. And you can probably work out a routine to do at home if joining a gym isn’t your style, but a short-term membership may be helpful in determining which exercises and types of equipment are best for you. For example, don’t buy an exercise bike without trying different types.

For a while, you’ll probably feel worse, especially if it’s been years since you’ve worked on some of these muscles and joints. You may want to refer to the pain scale on drchet.com. Take it slow and let discomfort be your guide. If you overdo it and you’re in pain, back off, ice or heat and rest, and then get going again with a little more caution. After all, you want to live all your days. The work you put in will generate some satisfaction before you may feel the benefits. Better to take longer to get there than stop altogether. The good news is that once you get over that hump, and it may take many months, you’ll feel better than ever.

What are you prepared to do today?

        Dr. Chet