Feb052011's never too late!

Dr. Fischer Food for Thought

Dr. Rachel Fischer

Creativity–Your “Down-Time” Best Friend 

Whether you’re a daily exerciser, or someone committed to beginning a regular exercise routine, undoubtedly, there are circumstances that can dash even the best intentions.  For most people, these include normal life events, like travel, an increase in work or family demands, or something really frustrating like an injury.   However, as I mentioned in response to one reader’s recent question, there are ways to maintain fitness even during a “down” time.   Over the next few blog posts, I’m going to talk about a few strategies that may keep you from slipping into the “blah” feeling that comes with less activity.

Unless you’re bed ridden or it’s just not safe with your specific injury, the first strategy is to find some way to continue at least some level of moderate physical activity. Why is some level of activity a good idea?  Besides the obvious ones, like it maintains functional mobility and it feels good, there are a few more subtle reasons.  While it is well accepted that regular physical activity helps you maintain your current weight, it has only modest benefits for weight loss in the absence of calorie restriction.  But here’s the important point: in a sense, exercise helps you restrict calories.  This may be so because appetite-related hormones respond to exercise, causing you to feel less hungry and more satiated after eating a smaller amount of food.  This seems to be true for about an hour after physical activity.

By now you may be asking the question, “ How am I supposed to exercise if I don’t have time, or if I’m injured?”  Following are a few suggestions.

§  Incorporate stairs and walking into your day as much as possible. As the holidays approach, that means skipping the escalators/elevators at the mall and airport.  If you’re traveling during the holidays, use walking as a time to bond with family and friends.

§  Half the time of your normal workout, but double the intensity.  For example, if you usually go for a 5-mile run, go for a 20-minute run with 30-second sprint drills every minute.  You can do the same on a bike.  You can also make up your own routine using body-weight exercises, such as push-ups, tricep dips, squat jumps, etc. If you search “body weight exercises” on YouTube, you’re bound to find a wide variety of ideas to create a solid, fast, efficient workout.

§  If you’re healing from injury, definitely check with your physician before starting a modified exercise routine.  If you were instructed to rest—take advantage of the down time.  Stick to gentle stretching and range-of-motion exercises.  With proper time to heal, you’re more likely to bounce back to 100%.  If appropriate, modify your regular routine and use your recovery time to try something new. For example, if you’re biker, try more swimming, rowing and weight lifting.

The possibilities for maintaining fitness during busy times or injury are endless—just be flexible and a bit creative.  I wish you all a healthy and peaceful holiday season!

Rachel Fischer, MD, MPH



Beer and Fitness... Can It Be?  

In my opinion this is the ONLY way you should ever drink a light beer!

Recently, I ran a short 10K for something to do since none of the local tracks were open for riding. After the race, we headed to the beer tent for some liquid refreshment. As we were sitting there enjoying our brews and talking about how great we did in the race, I was asked by one of my clients if drinking beer was just washing away all of the hard work we had just put in. After all, the beer-belly is one of the most recognized stereotypes ever. Why would a bunch of athletes (the beer tent was full) drink something that was going to hinder their performance and give them a beer-gut? In this article, I answer one of the most important questions for beer lovers throughout the World: can beer and fitness exist in harmony and if so, how? 

First...the Facts
I have already confessed my love for the liquid spirit, so before you think I am a beer guzzling frat boy, let me define just how much I do drink on a weekly basis. Monday through Friday I am alcohol free except for the occasional glass of wine with a nice dinner. Weekends are a bit different and are usually reserved for my love of the aforementioned dark beer. My normal consumption is 2 to 3, 12 ounce glasses per weekend: sometimes more; sometimes less. Usually more when college football is on but who is counting. So, while I am no Saint I certainly do not consider my beer and wine consumption excessive. Some would even say its way less than the norm!

The good news is that I am in good company. More than milk, coffee, or even bottled water, beer is the drink of choice for thirsty Americans of age. Yes, we Americans grease the wheels of human emotion with this social lubricant like no other. Some 200 million barrels a year go down our collective hatches. And even better news says that drinking moderately has been proven by many doctors, as well as the New England Journal of Medicine, to be a healthy component of longevity. In fact, some studies have shown that moderate consumption of alcohol -- wine, beer, or spirits -- has been shown to lower the risk of heart attack, stroke, and other cardiovascular problems by 25% - 40%. "The key word here is moderate," cautions Kim Wathen, registered Dietician and regular contributor to Virtual Trainer. "Moderate alcohol consumption appears to raise HDL and act as an anticoagulant while antioxidants in red wine may block oxidation of LDL, keep platelets from clotting, and help keep blood vessels relaxed.  All of these factors may lower the risk of heart disease but not necessarily reduce the effects of high cholesterol and heart disease." And to clarify, moderate drinking is considered 2 drinks per day for men, and 1 for women. (Sorry ladies, I don't make the rules.) One drink is defined as; 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80 proof distilled spirits. And NO, you cannot save up through the week and catch up on the weekend drinking 10-12 beers in an evening. That is NOT moderation.

Only China has the U.S. beat when it comes to drinking beer!

Drink Beer, it's Good for You!
Well, sort-of. Beer, like red wine, does provide some health benefits. The malt and hops used to make dark beers contain flavonoids, the same heart-healthy compounds in vegetables and wine that counter cell damage, thus reducing your risk of heart disease and cancer. Beer also contains B vitamins and chromium, which aid in converting carbohydrates to energy. But because beer is less potent than liquor, it may be too easy for some people to overlook its five percent alcohol content. Besides causing embarrassing lapses of judgment (can you say Beer-Goggles?), too much beer can dehydrate you and slow recovery. The key, as with any indulgence, is moderation. "There's no reason for athletes to feel like beer can never cross their lips," says Leslie Bonci, R.D., director of sports nutrition at the University of Pittsburgh Medical Center. "You just need to drink it at the right time."

But be careful, along with the good comes the bad. Any more than the 1 to 2 glass limit and your risks go up again, since excessive alcohol intake can lead to liver damage, high blood pressure, and many kinds of cancer -- not to mention the risks of alcohol abuse. If you've been a teetotaler all your life, don't start drinking for health reasons. The benefits are modest, and drinking increases other risks. If you don't drink and want to improve your health, just do an extra 15 minutes on the treadmill.

Beer and Athletic Performance
If you are a runner or cyclist you have certainly heard of people who order a beer the night before a big race and joke about carb-loading. Alas, it's not so. "The idea that beer provides a significant amount of carbs is a misconception," says Nancy Clark, M.S., R.D. who specializes in nutrition for exercise and health. "A 12 ounce bottle contains 12 grams of carbohydrates, which is equivalent to about half a slice of bread." What's more, because of the way alcohol is metabolized, most of these excess carbs are stored as fat. "So you're actually fat-loading," says Bonci. And if you're drinking a lot, you may be exercising to burn off beer calories rather than combusting body fat. You can also look at a can of beer this way. The average 12 ounce can of beer has over 100 calories. Drinking one beer is equivalent to eating a chocolate chip cookie. Drinking four is equal to eating a Big Mac Hamburger. Putting it that way really sucks.

Sorry ladies, but I don't think those are 12 ounce glasses!

Alcohol is also a diuretic, which means drinking too much the night before a run or race could leave you dehydrated in the morning. To avoid the effects of poor hydration, drink  water before and after your beer. (That's right, one beer. Unless you're a large guy who drinks beer regularly, in which case, a second should do no harm.) Some runners can't imagine not having a pint the night before a race, because it helps calm their nerves. "If you usually have a beer, it's probably okay, but have it with dinner, which helps absorb the alcohol," says Bonci. If you don't usually drink, though, now is not the time to start; some studies suggest that as little as 12 - ounces can disrupt the most beneficial kind of sleep.

Beer as a Recovery Drink?
So you've had a great day at the race track or just finished a hard training session and now all you want is a nice refreshing beer. Will this interrupt or hinder the recovery process? While drinking alcohol after training is not recommended you can get away with it on occasion if you drink something else first since alcohol can interfere with refueling, which delays recovery. Have eight to sixteen ounces of water or other fluids (like a real recovery drink) and about 200 carb-and-protein calories before you start raising your beer mug.

If you've suffered an injury, however, it's best to wait. "Alcohol can delay the body's ability to heal," says Bonci. "It seems to limit the production of natural anti-inflammatories." After 36 hours, however, the inflammation should have subsided, at which point you're free to head to your favorite pub.

The Buzz on Beer, Wine and Spirits
Non-Alcoholic Beer
It's tops because, duh, there's no alcohol. Any buzz will have to come from savoring your own remarkable willpower.
70 calories; 13 grams carbs per 12-ounce serving.

Light Beer
Better than regular if you don't let the lower calories trick you into drinking more than usual.
95-110 calories; 6 grams carbs per 12-ounce serving.

Low-Carb Beer
It contains carbs but the same amount of alcohol as regular. "It's pure alcohol and carbonation," says Bonci.
95 calories; 2.5 grams carbs per 12-ounce serving.

Regular Beer
While a 12-ounce bottle has a lot of calories, one the night before or after a race won't hurt. But have a water chaser.
150 calories; 12 grams of carbs per 12-ounce serving.

High-Alcohol Beer
Be especially wary of some Belgian and other brews that have more than eight percent alcohol per 12 ounces (check the label).
200 calories; 13 grams of carbs per 12-ounce serving.

Wine (All types)
When grapes are made into wine, most of the fruit sugars (carbs) convert to alcohol, but a few carbs remain. Some people say erroneously that red wines are better for dieters because they are "less sweet". This usually has nothing to do with sugar content! It has to do with the fact that red wines are red because they are made with *contact of the skin* during the winemaking process - which gives them their rich, red color and their thicker, more tannic flavor. It's the grape skin that does most of these things. The "Sweetness" in white wines is the lack of those tannins, and the fruity flavors. It's not actual sugar! 105 calories for a merlot to 125 calories for a cabernet sauvignon (The average was 118 calories); 0.8 grams for chardonnay to 5.0 grams for cabernet sauvignon per 5-ounce serving

80 Proof Distilled Spirits (Hard Liquor)
Adding mixers to an alcoholic beverage can contribute significant calories in addition to the calories from the alcohol itself. 86 calories for spiced rum to 120 calories for gin. The average (not including mixers) was 98 calories; 0 Carbs per 1.5-ounce serving.

So there you have it! There is no reason why you cannot have a beer a day and still meet your goals as an athlete or weekend warrior. Once again, excessive beer drinking is not recommended by anyone in the health industry. If you simply enjoy drinking beer or wine and are serious about your health, moderation in drinking alcohol, eating foods low in fat and calories, combined with habitual daily exercise is your ticket to reaching your goals. So next time you see me at the beer tent at Loretta's, just assume I am on my first beer and feel free to plunk down a few bucks and buy me my second!

By Tim Crytser

Reprint from

Tim Crytser's work can be found at RacerX


Too Much Turkey!

Fischer Food for Thought

November 24, 2010

Embrace the Holiday Season–Including the Food!

The following is a new Forever Athletes Blog feature contributed by Dr. Rachel Fischer, a local Forever Athlete, specializing in occupational and environmental health.  In addition to  her doctorate (Univ. of Utah), she also has dual masters degrees–Masters of Science in Epidemiology (Univ. of Utah) and Masters of Public Health (Univ. of Washington).  Outside of the clinic, Dr. Fischer enjoys road cycling, cross-country skiing, cross-fit…she’s a self-proclaimed exercise-enthusiast.  She also shared with us that she did not start medical school until age 35.  Aligning with a Forever Athletes theme of “It’s never too late”, she too feels strongly that you CAN in fact start something new at almost any age and be successful ._____________________________________________________

This is not the typical message from health writers and nutrition experts when it comes to the holidays.  Most of the recommendations presented in the popular press are usually great strategies for avoiding weight gain and undoing all the healthy changes you’ve incorporated into your life.  But here’s the truth:  Thanksgiving is one day. Christmas is one day (maybe two if you count Christmas Eve). Okay, so Hanukah is eight days and Kwanzaa is seven, but you get the point.

We make a really big deal about how a few days are going to affect our health, well-being and our weight.  Here’s another truth.  Most medical studies show that the average weight gain for adults during the holidays is one pound.  Keep in mind this is weight gained over a period of six to eight days.  We know why studies include days before and after the actual holiday—that’s when all the pre-holiday parties occur and when the leftovers have to be eaten.

So here’s my simple recommendation for keeping yourself healthy during the holidays while still enjoying the festivities—on the day of the actual holiday, eat whatever you want.  This is your chance to savor your aunt’s amazing stuffing or your sister’s sinful pecan pie.  Your friends and relatives only whip out their favorite recipe once a year—so enjoy and thank them for it.

And what to do on those days leading up to the “big day”? Keep it simple.  Stay true as possible to your normal healthy routine—maintain your regular exercise schedule and get enough sleep to feel rested.  Both these things make it easier to resist quick-energy high-carbohydrate foods.  When special treats are offered, eat them in quantities that feel satisfying but not indulgent.  After a big holiday, don’t hold onto the leftovers that call you to the kitchen at midnight.  Alternative solutions: give them away or (radical thought here) throw them away.  Your body will thank you later.

Have a happy and healthy Thanksgiving!

Rachel Fischer, MD, MPH

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Does Your Back Hurt?

Exercise Is Key to Low Back Pain Prevention

Strengthen your core muscles to enhance physical function.

Up to 30 percent of all Americans experience the decreased quality of life, physical functioning and depression associated with daily back pain, according to the American Pain Foundation.  It’s particularly common in older adults, as increasing age, a lifetime of improper body mechanics, and wear and tear impact spine health.

    A typical response to back pain is often to do nothing - ceasing any kind of strenuous physical activity and staying in bed-but in the longer term this can undermine healing. The opposite approach-surgery to treat the age-related wear and tear that underpins most low back pain in older adults-can mean invasive procedures that result in a long recovery period. “Surgery should be the last option,” says Luke Madigan, MD, an attending physician at Knoxville Orthopedic Clinic and lead author of a recent review recommending physical therapy for back pain, “but too often patients think of it as a cure-all and are eager to embark on it.”

PROACTIVE REHABILITATION. But there is a middle ground call “active rehabilitation”-exercise that strengthens the muscles that support the spine.

    A study led by Dr. Madigan, published in the February 2009 issue of The Journal of the American Academy of Orthopedic Surgeons, found that 90 percent of patients with low back pain arising from degenerative disc disease (an age-related condition in which the spinal discs that form a cushion between each vertebrae break down) recover with the aid of conservative treatment or without any treatment at all within 6 to 12 weeks. However, the study concluded that the most effective treatment is a combination of physical therapy and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin).

    A second review, in the Feb. 13, 2009 issue of The Spine Journal, also suggests exercise is effective at preventing back problems from recurring. “Strong and consistent evidence finds many popular prevention methods to fail while exercise has a significant impact, both in terms of preventing symptoms and reducing back pain-related work loss,” says lead researcher Stanley J. Bigos, MD, University of Washington professor emeritus of orthopedic surgery and environmental health.

    CORE SUPPORT SYSTEM. The fact that new studies found exercise so effective underlines the importance of core muscle strength when it comes to protecting and supporting the back, and reducing pressure on the vertebrae. It’s the transversus abdominus and multifidi (the deepest layer of abdominal and back muscles, respectively) that carry out this function. However, in older adults these muscles often are weak due to lack of exercise and habitual slumping that leaves them in a state of constant relaxation.

    Previous studies have suggested that patients with low back pain are unable to properly utilize their core muscles. The “active rehabilitation” would rebuild strength, enabling the core muscles to do their job of stabilizing and supporting the spine in order to promote pain-free movement. A physical therapist can demonstrate the most effective exercises, to teaching patients how to effectively “switch on” their core and make sure it stays that way while going about daily activities.

    Weight training also may help. In a study published online Feb 7, 2009 by the Journal of Strength and conditioning Research, participants with chronic back pain who took part in a 16-week resistance training program showed a 60 percent improvement in pain and function levels compared to a 12 percent improvement experienced by those who took part in aerobic training such as jogging, walking on a treadmill or using an elliptical machine.DM*

*Duke Medicine Health News


Are Old MX Riders Athletes?

Of course we are. If anyone doubts that have them ride a few laps on any MX track. MX takes physical skills, fitness and mental toughness. bet!

I recently discovered a group that is all about remaining an athlete no matter what your age. I have included their list of secrets for remaining in the game. These secrets apply to any sport for any age group.

Let's go racing!

The Ten Secrets of Forever Athletes™

1. Realize you are never too old or too young.

2. Understand that your body adapts and regenerates.

3. Collect your winnings from the genetic lottery. (Over 99% of us won!)

4. Reject inverted social norms.

5. Practice the delicate art of self-discipline.

6. Be a cheerleader and surround yourself with cheerleaders.

7. Start now. (It’s always the right time).

8. Dream big; get there one baby-step at a time.

9. Create your own (happy) reality.

10. Bask in your rewards.

The 10 Secrets Briefly Explained

1. Realize you are never too old or too young.

The human body is designed to last a hundred years or so and remain fairly robust the whole time.  An old age that includes dementia, walkers, nursing care, assisted living, etc. is not inevitable.  In fact, the human organism is capable of functioning at a high level mentally, physically, and emotionally up until the very last moments of life, however long you live.  The decrepitude that we commonly associate with “old age” is brought on by the abuse of consistently following poor lifestyle habits, e.g. not exercising, being overweight, overindulging in vices (rich foods, alcohol, cigarettes, drugs), too much bad emotional stress, not enough sleep, etc.  Conversely, having a strong mind and body into your later years happens, less from accidents of hereditary genetics, more from consistently maintaining healthy lifestyle habits.

2. Understand that your body adapts and regenerates.

Even if you have spent many years not taking very good care of yourself, as long as you are living, it’s not too late to restore your health.  It should be obvious that “restoring health” must mean different things to different people at different levels of fitness versus impairment.  The important point is that the human organism has a remarkable ability to restore itself, provided that you take the right steps and give your body the chance to do what it will do naturally.

3. Collect your winnings from the genetic lottery. (Over 99% of us won!)

Many people (though no serious genetic scientists) mistakenly believe in a kind of “genetic determinism,” which might lead to something like the following idea, “I won’t live a long and healthy life because I don’t have the right genetics,” as if the die has been cast at birth and, virtually no matter what people do, the healthiness (or unhealthiness) of their lives will play out along certain predetermined lines.  For 99% of the human population this notion is completely false.  The truth is that your health and fitness will be determined predominantly by the way you live your life.  The good news is. . . you have near complete control over your own destiny in this regard.  Paradoxically, the bad news is. . . you have near complete control.  This may be the most vexing “secret,” especially for those who want their health (or lack thereof) to be because of factors outside of their control — basically people who have a problem with self-accountability.

NOTE: We’re not talking here about the kind of genetic heredity that helps one person grow to a height of 6’10”, while another grows to 5’10”.  No, there’s no amount of self-accountability that will help you run the 100m dash as fast as Usain Bolt or play basketball at the level of Kobe Bryant.  But you can probably enjoy close to the same level of health and overall fitness that they enjoy.  And that’s at least as valuable, isn’t it?

4. Reject inverted social norms.

We have, unfortunately, set-up our society in such a way that, generally, athletics have become the province of an anointed class of elites.  Essentially, sports have become something, that for most of us, we watch professionals and elite collegians do on TV, rather than something that we participate in ourselves.  There are many false beliefs that tend to go along with this “inverted” societal norm, e.g. “I’m not an athlete,” “I hate competition,” “I don’t like sports.”

5. Practice the delicate art of self-discipline.

The word “discipline” conjures many unpleasant associations.  Try to disregard those, and think differently about this word.  Try to see “self-discipline” only as what it is: the essential tool of the Forever Athlete™, used to consistently take the actions she wants to take, while avoiding those she wants to avoid.  For her, self-discipline is not some Herculean exertion of will, but rather the practice of a delicate, multi-faceted art.

6. Be a cheerleader and surround yourself with cheerleaders.

We are social beings.  We need each other.  We influence and are influenced by the people around us.  We can do and say things to help build others up, or tear them down.  Likewise, we can associate with those others who demonstrate love towards us; those who know us and have our best interests at heart, who inspire and aid us.  At the same time, we can avoid those individuals (or groups) that tend to work against us.

7. Start now. (It’s always the right time).

A chasm exists between action and inaction.  Although this chasm might be infinitely deep, it is extremely narrow.  Because of its infinite depth it may appear difficult to get over.  This is an illusion.  Actually, it is easy to cross.  We must simply overcome the relatively weak inertial forces holding us in the place of inaction.  And the time to cross it is always now. (read: not tomorrow, not next month, not next year, not when my kids are older, not when I’m less busy at work, etc.)

8. Dream big; get there one baby-step at a time.

Think for a moment about all the “impossible” things that humans have accomplished.  Every single one of these things was achieved the same way.  First, it was envisioned (dreamed of).  Second, the dreamer took the thousands or millions of tiny incremental steps he needed to take along the path towards the ultimate goal.

Having your own impossible dream as an athlete provides motivation that will sustain you over many months and years, many trials and tribulations.  It will tend to give you a “greater purpose” for your daily training.

9. Create your own (happy) reality.

You are the only person who can be you.  You are the only one who can actually mold the clay of your existence.  You are the only one who can know what you really want, what you really like.  You are the only one who can live your life.  And you can believe whatever you want to believe about your life; tell whatever story you want to tell; see the events of your life in whatever light you want to see them in.  Be a Pollyanna.  Tell your life’s story as a happy tale, even if this means practicing a “healthy oblivion.”

10. Bask in your rewards.

Congratulate yourself frequently, many times everyday, for every tiny little thing (or huge magnificent thing) you get right; for every goal – great or small – that you accomplish.  Take the time to note and appreciate every single good thing that comes your way, every blessing.  Give yourself lots of pats on the back.  Love yourself.


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