How to Avoid Inflammation of Your Arteries

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Inflammation of the blood vessels and other bodily tissue has become increasingly recognized as being complicit in heart disease, arthritis, and decline of mental capacity. Fortunately, the choices we make concerning what and how much we eat and drink, and how much exercise we do, can dramatically influence the degree of inflammation we experience. The information presented herein concerning lifestyle factors that affect inflammation, comes from a review article by O’Keefe, Gheewala, and O’Keefe in the Journal of the American College of Cardiology (vol. 51, no. 3, 2008).

Meals that are high in calories, and/or contain easily digestible, quickly absorbable, calorie-dense processed food and drink result in spikes in blood glucose and triglycerides (blood-borne fats), overwhelming the body’s ability to process them. Oxidative free radicals are then produced which attack the lining of the arteries (endothelium), inflaming them, causing them to constrict, and building up fatty deposits (atherosclerosis). In contrast, smaller meals containing ingredients that digest more slowly (e.g. fiber) produce smaller surges in blood sugar and triglycerides, and are thus not inflammatory.

Even a single meal high in saturated fat results in an increase of triglycerides, oxidative free radicals and inflammation, which negatively affects the function of the endothelium, causing constriction of the arteries, and raising systolic blood pressure.

A high glycemic meal is one that causes a spike in blood glucose. The Glycemic Index rates foods in comparison to glucose. Foods scoring closer to 100 cause relatively large spikes in blood sugar, while foods scoring closer to zero produce relatively small spikes. See a table listing the glycemic index of various foods from Harvard medical school. The body often responds to high glycemic index foods with insulin surges that remove sugar from the blood and can actually result in low blood sugar (hypoglycemia), an ebb in energy, and hunger. Regularly eating this way predisposes one to excess fat on and around the organs below the abdominal muscles (visceral fat) which, in turn, leads to inflammation and insulin resistance and raises the risks of diabetes, high blood pressure, and cardiovascular disease.

Dietary changes that reduce the magnitude of the triglyceride spike following meals by 20% and 40% respectively have been shown to reduce the risk of coronary artery disease by 30% and 40%. In addition to avoiding foods with a high glycemic index, adding certain foods to the diet can slow down digestion and reduce the spikes in glucose, insulin, and triglycerides. For example, nuts eaten along with a high-carbohydrate meal slow digestion and reduces blood sugar spikes by 30-50%. This both reduces oxidative stress, and provides antioxidants that combat such stress. In fact, a Mediterranean diet supplemented with either 30 grams of nuts or olive oil was found to reduce systolic blood pressure, blood sugar, and biomarkers of inflammation significantly better than a low-fat diet. Eating nuts 5 times per week was found to reduce risk of diabetes and cardiovascular disease by 20-50%. Quality protein sources low in saturated fat have a similar beneficial effect. These include egg-whites, lean meats, fish, casein, and whey protein, among others. Fish oil lowers triglyceride levels by 16-40%.

As expected, physical exercise has a positive effect, reducing post-meal spikes in blood sugar and triglycerides. Exercise is most beneficial in this regard if it is done within 2 hours before or after a large meal. Loss of body fat by diet control and/or exercise can also reduce post-meal spiking of blood sugar and triglycerides.

Alcohol consumption shows a J-shaped relationship with inflammation and blood sugar spiking, in addition to various other health problems such as coronary artery disease, diabetes, stroke, dementia, and all-cause death, with the lowest levels of these problems at 1-2 drinks per day for men and 0.5-1 drink a day for women. The J-shape means that drinking no alcohol increases the risk of these problems somewhat, while drinking in excess greatly increases the risks of these problems.

Characteristics of Inflammatory Meals

• High in calories
• High in calorically-dense foods
• High in saturated fat
• High in refined carbohydrates
• Contain foods with high glycemic index

Characteristics of Diets That are Not Inflammatory

• Smaller meals spread over the day
• Low in saturated fat
• Low in, or free of trans fats
• Low in processed carbohydrates
• Low in foods with high glycemic index
• High in unprocessed fruits and vegetables rich in antioxidants
• High in nuts, seeds, and whole grains
• Contain vinegar (1-2 tbsp eaten with a meal high in refined carbohydrates reduces the blood sugar spike by 25-35% and reduces hunger)
• Moderate amounts of lean animal protein
• Moderate amounts of beneficial fats such as fish oil and monounsaturated oils (e.g. olive,canola)

The following Foods High in Antioxidants Help Prevent Oxidative Damage to the Endothelium

• Berries
• Red wine
• Chocolate
• Tea
• Pomegranates
• Cinnamon (also reduces glucose spike caused by high-glycemic-index meal)

If you are concerned about the possibility of inflammation in your arteries, you can ask your doctor about testing the C-reactive protein level in your blood when you get a checkup. However, if your total cholesterol level is below 200 and your HDL level is above 55, it is very unlikely that you have a problem with arterial inflammation. If your C-reactive protein level is above 1.0 or the ratio of your total cholesterol level to your HDL level is above 4.0, you would likely benefit from following an anti-inflammatory diet and exercising regularly.

Can Video Games Improve Physical Fitness?

With the development of video game devices that detect body motions of players and use those motions to control games, the opportunity for turning the formerly sedentary activity of video gaming into physically active fun has greatly expanded. However, it is only recently that the exercise stimulus of such games has been scientifically evaluated. One such study, by Worley, Rogers, and Kraemer was recently reported in the Journal of Strength and Conditioning Research (vol. 25, no. 3, pp. 689-693, 2011).

Experimental Procedure
8 young women averaging 22 years of age were first tested for the maximal rate at which their bodies could process oxygen (VO2max). Then they played 2 different Nintendo Wii Fit video games (Hula and Step) at the beginner and intermediate levels for 10 minutes each. During each game session, each subject was connected to a metabolic cart that measured the rate of oxygen consumption.

Results
The percentage of VO2max elicited during the video games ranged from 30.6% for the beginner level Step game to 39.4% for the intermediate level Hula game. These levels respectively corresponded to walking speeds of 2.5 mph and 3.6 mph, categorized as mild to moderate exercise.

Bottom Line
Video games that require physical activity have excellent potential for getting people who would not ordinarily exercise to do so. Nintendo’s Wii system involves a controller that is held in the hand and picks up movements using accelerometers. The XBOX game with the Kinect accessory is revolutionary in that it senses whole body movements without anything held in the hand or attached to the body. While the games in this study only elicited mild to moderate levels of exercise, the advanced game levels were not tested, probably because they require a lot of practice. Thus, the potential for higher exercise levels is certainly there. These games are a great way of getting people who are not attracted to sports or typical exercise routines but who like video games to become more physically active.

Effectiveness of Different Kinds of Strength Training Periodization

Periodization of strength training entails changing over time the weight handled in each exercise along with the number of repetitions per set. When the weight used is higher, the number of repetitions is lower and when the weight used is lower, the number of repetitions is higher. It is widely agreed among strength and conditioning professionals that periodized strength training is more effective than non-periodized training.

There are various versions of strength training periodization, including:

• Traditional periodization - The trainee starts with relative light weights and high repetitions, and over a period of several weeks, increases the amount of weight lifted while decreasing the number of repetitions. For example, the trainee might begin by doing 10 repetitions per set with 60% of the maximum weight that can be lifted for a single repetition and progress to 4 repetitions with 80% of the max weight.
• Daily Undulating Periodization - On different days, the trainee uses a different combination of weights and repetitions. A sample schedule might be medium weight and medium reps on Monday, light weight and high reps on Wednesday, and heavy weight and low reps on Friday.
• Weekly Undulating Periodization - Weight and reps fluctuate from week to week. A sample schedule might be low weight and high reps on week 1, medium weight and medium reps on week 2, and high weight and low reps on week 3, with this 3-week pattern repeating several times.

A recent study by Apel, Lacey, and Kell in the Journal of Strength and Conditioning Research (vol. 25, no. 3, pp. 694-703, 2011) sought to determine the relative effectiveness of traditional vs. weekly undulating periodization.

Experimental Procedure
Forty-two young, physically active men were divided into three groups of 14 that trained for 12 weeks as follows:

• Control group - Performed no strength training
• Traditional periodization (TP) - Increased the resistance in a fairly linear manner from 57% of max the first week to 80% of max the final week.
• Weekly Undulating Periodization (WUP) - Started at 57% of max, but increased resistance over 3 weeks before reducing weight close to where it started and increasing it back again over 3 weeks. This was done over 3 cycles in which both the starting and ending weight for each 3-week cycle became greater than for the previous 3-week cycle, ending at 78% of max.

There were 15 different exercises selected to work the entire body. The exercises used, rest time, total exercise volume and average percent of maximum weight used were the same in both groups. There were 3 training sessions per week for the first 2 weeks and 4 per week for the remaining weeks, in which half the exercises were performed 2 days per week (e.g. Mon. and Thu.) and the other half on 2 other days per week (e.g. Tue. and Fri).

Results

• Both periodized training groups increased significantly in strength, while the control group did not.
• Increases in back squat strength were significantly greater for the TP group (54%) than for the WUP group (34%).
• Increases in bench press strength were significantly greater for the TP group (24%) than for the WUP group (19%).
• Increases in pull-down strength were significantly greater for the TP group (29%) than for the WUP group (19%).
• Increases in dumbbell shoulder press strength were significantly greater for the TP group (48%) than for the WUP group (36%).
• Increases in leg extension strength were greater for the TP group (39%) than for the WUP group (27%), although the between-group difference did not reach statistical significance.
• There was more muscle soreness and fatigue reported among the WUD group, which may have hindered training progress.

Bottom Line
For this group of recreationally active males, traditional periodization produced superior results to weekly undulating periodization. The between-group differences were great enough to be meaningful.

New Army Physical Fitness Test to Simulate Battlefield Activities

On February 28, 2011 the Official U.S. Army website reported that, after 30 years of using the same physical fitness test, the Army is developing a new physical fitness test battery to better simulate battlefield activities. The previous test was comprised of the following 3 tests done with a short rest in between:

• As many pushups as possible in 2 minutes
• As many situps as possible in 2 minutes
• Running 2 miles a quickly as possible

Scoring was based on age and gender. See our web site for testing details and scoring charts.
The revised test has not been finalized, but trials are being held this month on 7 Army bases and at the U.S. Military Academy at West Point. A review and approval process will take place before full implementation. The article states that there will be a general physical readiness test for all soldiers and a physical readiness test for those going into combat:

Army Physical Readiness Test

• 60-yard shuttle run
• one-minute rower (see diagram)
• standing long-jump
• one-minute push-up
• 1.5 mile run

Army Physical Readiness Test
The examinee will be timed while performing the following obstacle-course sequence while wearing a combat uniform and helmet and carrying a rifle:

• 400-meter run
• Low hurdles
• high crawl
• Over and under
• casualty drag
• Balance beam while holding ammo cans
• Point and move
• 100 yard shuttle sprint while holding ammo cans
• Agility sprint around cones

See the Army article for a diagram of the course. As with the current Army Physical Fitness Test, scoring charts will be developed that take age and gender into consideration.

The change in the fitness tests appears to be a good one because the new test more closely simulates battlefield physical demands. It might even be better if the Physical Readiness Test were performed while the examinees carried a combat load similar to those normally worn by soldiers.

Mens-fitness-and-health.com is very supportive of functional training that seeks to improve performance in sports, combat, or daily living. Function-based training programs emphasize improved physical performance rather than appearance. Workouts designed to “get big” generally train isolated muscle groups and do not prepare the body for strenuous whole-body physical demands.

Does Heavily Advertised Exercise Equipment Really Provide Advantages?

Advertisements on TV and elsewhere make it appear that, if you buy the latest innovative exercise device you will make faster and greater gains than you could using more conventional exercise equipment. Unfortunately, such claims, however seductive, do not usually stand up to scrutiny. The following articles in the December 2010 issue (vol. 24, no. 12) of the Journal of Strength and Conditioning Research highlight instances in which such equipment fails to provide any training advantage over standard exercises.

An article by Youdas et al. (pp. 3552-3562) compared the electrical activity of 4 chest, arm, and shoulder muscles of 20 subjects doing pushups using the Perfect-Pushup device and the same subjects doing standard pushups. The Perfect-Pushup device allows free horizontal rotation of the hands during the pushup movement while, during the standard pushup, the hands maintain their position throughout the movement. Pushups both with and without the device were done 3 different ways - using wide, shoulder-width, and narrow hand placements. While the results showed some small advantages of either the Perfect-Pushup or standard pushup as to the intensity of involvement of specific muscles when using particular hand positions, neither the Perfect-Pushup nor standard pushup showed any overall superiority to the other form of exercise. Hand position had a much more striking effect on muscle involvement, indicating that pushups should be done at various hand placements in order to stimulate a wide range of chest, shoulder, and arm musculature.

Another article by Youdas et al. (pp. 3404-3414) compared exercise using the Perfect-Pullup device to standard pull-ups (overhand grip) and chin-ups (underhand grip) using an overhead straight bar. The Perfect-Pullup device allows free horizontal rotation of the hands during the pull-up movement while, during the standard pull-up and chin-up, the hands maintain their position throughout the movement. Muscle electrical activity sensors were used to monitor the effort of 7 different muscle groups for 21 men and 4 women during the exercises. The results showed that, while there were some significant differences in muscle activation between the chin-up and pull-up, there were no significant differences between the Perfect-Pullup device and either the chin-up or pull-up. The authors concluded that the Perfect-Pullup device did not provide any advantage over standard pull-ups or chin-ups.

An article by Willardson et al. (pp. 3415-3421) compared the electrical activity of 3 abdominal muscles and 1 set of back muscles during 3 traditional trunk exercises and abdominal exercise using a device called the Ab Circle. Results showed no statistically significant differences in muscle activity between the Ab Circle and standard exercises. Yet the mean activity of the rectus abdominis muscles (6-pack) and lower abdominal stabilizer muscles was highest during the standard crunch, and the erector spinae (low back) muscles and external obliques (lateral waist) were most active during the side bridge. Thus the Ab Circle provided no advantage over standard calisthenic exercises for working the abdominal and low back musculature.

An article by Schoffstall, Titcomb, and Kilbourne (pp. 3422-3426) compared the electrical activity of 5 muscles involved in abdominal and hip flexion (upper rectus abdominis, lower rectus abdominis, internal obliques, external obliques, and rectus femoris) during the following isometric exercises:
- Crunch
- Supine V-up (while facing upward, back and legs rise off the ground to make a V-shape)
- Prone V-up (while facing down, butt rises up while hands and feet approach each other, making inverted V-shape) done as follows:

• Feet on ground (no equipment)
• Feet on FB large exercise ball
• Feet on Power Slide
• Feet supported by TRX suspension straps
• Feet on Power Wheel

The results showed that:

• All exercises stimulated the external obliques, upper rectus abdominis, and lower rectus abdominis similarly
• The supine V-up without equipment showed greater internal oblique activity than the V-up done on the slide board.
• The rectus femoris was less active during the crunch than during any of the other exercises. This is not surprising since the knees are specifically bent during a crunch to take the hip-flexors out of play and focus only on the abdominal muscles.
• Overall, the prone and supine V-up exercises done without equipment provided as much training stimulus to the muscles tested as did the prone V-up using any of the commercial equipment.

Bottom Line
These studies indicate that much of the exercise equipment heavily marketed to the public provides no advantage in training stimulus over standard exercises. The only advantage of such equipment is that it provides variety, which may be important to maintain the motivation to exercise. Some exercise enthusiasts, even when informed that such equipment usually provides no shortcuts to the results they desire, may still wish to purchase them in order to keep their workout fresh, and that is fine. However, for those who would rather use their money for different purposes, there are other ways to add variety to a workout. Using standard gym equipment, a wide variety of exercises can be performed, especially using free-weight barbells and dumbbells and an overhead bar for hanging exercises.

Is Resisted Sprint Training Effective?

Coaches in sports requiring  high acceleration and all-out sprint speed have increasingly endorsed sprint training resisted by a variety of means including weighted vests, towed weighted sleds, long elastic cords, or straps for towing another individual. Yet there have been few studies examining the effectiveness of such training. A recent study by Clark et al. in the Journal of Strength and Conditioning Research evaluated the effectiveness of two types of resisted sprint training.

Experimental Procedure
There were 3 groups of  collegiate lacrosse players that trained twice a week for 7 weeks as follows:

• Weighted Sled: 7 of the subjects trained while towing 10% of their bodyweight in a sled
• Weighted Vest: 6 of the subjects wore vests containing 18.5% of their bodyweight
• Unresisted: 7 of the subjects did not use any resistance device during their training

For all groups, each training session consisted of 7-10 sprint intervals of 20-60 yards (18.3-54.9 m) separated by rest intervals of 3-4 minutes. Both before and after training, all subjects were tested as to their sprint-speed over 40 yards (36.6 m) after a 20-yard (18.3 m) running start.

Results
For the subjects as a whole, there was significant reduction (-1.1%) in the time taken to sprint 40-yards. However, there was no significant difference in improvement between any of the training groups. However, the percentage of improvement of the unresisted training group (-2.0%) was greater than for the weighted sled group (-0.1%) or the weighted vest group (-1.2%).

Bottom Line
The fact that the number of subjects in each group was relatively low made it difficult to obtain statistically significant differences in improvement between groups. However, it does appear that the resisted training was no more effective than unresisted training for improving 40-yard sprint speed following a running start. Because the timed portion of the sprints followed a running start in this study, the results do not address the effectiveness of resisted sprint training for improving the initial acceleration phase of a sprint.

For Pure Flexibility, Static Stretching Beats Dynamic Stretching

This blog contains several articles that have shown that static stretching impairs physical performance in jumping, running, and team sports, when the stretching is done immediately prior to the effort. Dynamic stretching has not been shown to cause a similar impairment and may even enhance performance. Yet, this finding does not mean that dynamic stretching is superior to static stretching for all purposes. Indeed, a study published by Covert et al. in the Journal of strength and Conditioning Research (vol. 24, no. 11, pp. 3008-3014, 2010) indicates that static stretching is better for improving pure flexibility.

Study Procedures
Over a 4-week period, 16 men and 16 women, aged 20-27 were randomly divided into the following 3 groups:
Static Stretching: Held a stretched position of the hamstring muscles for 30 seconds 3 times a week
Dynamic Stretching: Got into a stretched position of the hamstring muscles then performed small bounces into and out of that position at a rate of 1 per second for 30 seconds, 3 times a week
Control: Did not stretch
Hamstring flexibility was measured as the number of degrees short of 180 degrees that the knee could be extended to while the subject lay on a table with the thigh in a vertical position. Thus, a smaller number of degrees indicated better flexibility.

Results
The differences between changes in hamstring flexibility among all three groups were statistically significant
The control group declined by a mean of 3.3 degrees in hamstring flexibility
The static stretching group improved a mean of 11.9 degrees in hamstring flexibility
The dynamic stretching group improved a mean of 3.8 degrees in hamstring flexibility

Bottom Line
Either form of stretching improves flexibility. However, static stretching improves flexibility significantly more than does dynamic stretching. For sports in which flexibility in not very important, dynamic stretching is best. However, for sports which require a lot of flexibility (e.g. gymnastics, wrestling, high-hurdles) some static stretching is advisable. But because static stretching impairs performance when done immediately prior to the sport activity, it is best to do such stretching immediately following a training session, when the muscles are well warmed up. The impairment in performance caused by static stretching has not been found to carry over to the following day, so post-exercise static stretching should not impair a subsequent day's performance.

More Evidence in Favor of Post-Activation Potentiation (PAP)

We have previous discussed post-activation potentiation (PAP) by which an explosive athletic performance is improved by doing heavy resistance exercise beforehand (see http://mens-fitness-and-healthdotcom.blogspot.com/2010/10/method-for-improving-explosive-physical.html).  A recent study provides further evidence of the effectiveness of this technique.

Matthews, Comfort and Crebin performed a study on ice hockey players from the English National League.

Experimental Procedure
On two different days, 11 players were timed for their maximal 25-meter sprint-speed on ice both before and 4 minutes after doing the following:

1. resting
2. sprinting while towing another skater

Results

• When the players rested between sprints, they showed no significant improvement in time between their first and second sprints.
• When the players skated against resistance following the first sprint, their second sprint took a significant 2.6% less time than their first one.

Bottom Line
This study supports others that have found improvement in explosive athletic performance when heavy resistance exercise is performed first. The resistance exercise should call upon the same muscles used in the athletic performance. Using resisted skating in this study was a good way to achieve this goal.

Estimating the Caloric Cost of Running or Walking

A recently published article by Loftin et al. in the Journal of Strength and Conditioning Research (vol. 24, no. 10, pp. 2794-2798, 2010) measured the caloric consumption per mile of 19 normal-weight walkers, 11 overweight walkers, and 20 marathon runners. The subjects were about evenly divided among males and females.

Results

• Caloric consumption was more related to lean body mass than to total body mass
• Men burned more calories per mile than women
• Men and women did not differ in calories consumed per mile per unit body mass
• In terms of calories per mile per unit body mass, marathon runners burned significantly more than normal-weight walkers who burned significantly more than overweight walkers

The following equation was developed from the experimental data to predict an individual’s caloric consumption per mile:

Men weighed in kilograms:

Calories per mile = (0.789 x kg body mass) + 43.5

Men weighed in pounds:
Calories per mile = (0.3586 x lb body mass) + 43.5

Women weighed in kilograms:

Calories per mile = (0.789 x kg body mass) + 35.8

Women weighed in pounds:
Calories per mile = (0.3586 x lb body mass) + 35.8

Bottom Line

The equation can be useful for those interested in estimating the caloric cost of their walking or running workout.

The Drawback of Exercising on Unstable Surfaces



Stability training, mainly in the form of lifting weights while standing on unstable surfaces, became somewhat popular with the advent of the Bosu Ball, which is a hemispheric ball about 2+ feet across mounted on a flat plastic base. The idea is that the instability of the surface brings muscles into play that are required for maintaining stability; muscles that would be minimally involved when exercising on a stable surface.

A study by Chulvi-Dedrano et al. in the Journal of Strength and Conditioning Research (vol. 24, no. 10, pp. 2723-2730, 2010) tested force production and muscle electrical activity during deadlifts on a stable surface and on two different unstable surfaces.

Method
31 young adult subjects did the following:

1. Isometric deadlift in which the lifter pulled upward maximally for 5 seconds against an immovable bar
2. Dynamic deadlift in which a barbell weighing 70% of the individual’s maximal isometric deadlift was lifted for 5 repetitions 

Lifting force was measured during the isometric efforts. Muscle electrical activity of the lower back muscles (paraspinals) was measured during both the isometric and dynamic lifts to indicate how hard the muscles were working. Both of the lifts were done on the following 3 surfaces:

1. Stable floor
2. Bosu Ball
3. T-Bow (a curved board that can rock laterally as one stands on it)

Results

• In the isometric deadlift, both the force produced and the muscle electrical activity were significantly higher on the stable surface than on either unstable surface.
• In the dynamic deadlift, muscle electrical activity was significantly higher on the stable surface than on either unstable surface

Bottom Line
This study backs up other ones that have shown that exercising on unstable surfaces does not provide as much stimulus as stable-surface training to the main muscles (prime movers) used to effect the exercise movement. It has previously been shown that more weight can be handled when lifting on stable than unstable surfaces, providing greater stimulus to the muscles. In view of these factors, training on unstable surfaces is not best for increasing the size or strength of the major muscles. However, since such training does bring stability muscles into play, it can be effectively used as a supplement to training on stable surfaces, especially for athletes who engage in sports in which maintaining stability is of major importance (e.g. hockey, figure skating, snow-boarding, gymnastics). The major part of the resistance workout should still be on stable surfaces.

Plyometric Training for Improved Sports Performance

Plyometric training has been popular among strength and physical conditioning coaches for a number of years. Yet many people who exercise on their own are not familiar with this method. Simply put, plyometric exercise involved rapid stretch and shortening of a muscle. This occurs in such movements as hopping, jumping, and bouncing. For example, when you jump vertically, you naturally first do a countermovement in which you bend your knees quickly while stretching your quadriceps (front thigh) muscles, then rapidly contract those muscles to straighten the knees and propel the body upwards. Thus, repeated vertical jumps are one kind of plyometric exercise.

There are various gradations of plyometric exercise, and it is considered prudent to start with low-stress ones before progressing to more difficult ones. One of the most stressful plyometric exercises is depth-jumping, in which one jumps down from a box and, after contacting the ground, immediately jumps vertically. This is considered dangerous for anyone who does not already have a strong lower body and has not progressed from low-stress, through moderate-stress, to high-stress plyometric exercise. Various sources have recommended being able to squat with 1.5 times one’s bodyweight before taking on a serious plyometric exercise program. However, it is generally considered safe for people in good health without orthopedic problems to perform low-stress plyometric exercises like low bounces, hops, and jumps.

A recent study by Chelly et al. in the Journal of Strength and Conditioning Research (Vol 24, no. 10, pp. 2670-2676, 2010), showed how effective plyometric training can be.

Method
A group of experienced young male soccer players, average age 19 years, trained as follows:

• August - preseason training consisting of light resistance exercise and calisthenics
• September through March (the competitive season) - The players trained 5 days per week for 90 minutes by doing skill and tactical drills along with 30 minutes of continuous play. On one day per week they engaged in a competitive soccer game against another team.

The subjects were divided into 2 groups:

Group 1 only did the training program above.
Group 2 did the training program above plus from January-March they also did the following plyometric training twice per week:

• Week 1: 5 sets of jumping over ten 40-cm (24“) hurdles spaced 1 meter (39.4”) apart
• Week 2: 7 sets of jumping over ten 40-cm (24“) hurdles spaced 1 meter (39.4”) apart
• Week 3: 10 sets of jumping over ten 40-cm (24“) hurdles spaced 1 meter (39.4”) apart
• Week 4: 5 sets of jumping over ten 60-cm (36“) hurdles spaced 1 meter (39.4”) apart
• Week 5: 4 sets of depth-jumps from a 40-cm (24“) box
• Week 6: 4 sets of depth-jumps from a 40-cm (24“) box
• Week 7: 4 sets of depth-jumps from a 40-cm (24“) box
• Week 8: 4 sets of depth-jumps from a 40-cm (24“) box

Extensive testing on speed, power, and jump height was performed before and after the training.

Results

The group that did regular soccer training did not show significant improvement in any of the pre-post tests.

The group that did plyometric training in addition to their regular soccer training showed the following statistically significant improvements:

• Thigh muscle volume: +2.5%
• Cycle ergometer absolute power: +4.5%
• Cycle ergometer power relative to body mass: +5.9%
• Jump height without a countermovement: +8.3%
• Jump height with a countermovement: +2.5%
• 40-meter sprint first step velocity: +18.2%
• 40-meter sprint velocity over first 5 meters: +10.0%
• 40-meter sprint velocity between 35 and 40 meters: +9.8%

Bottom Line
Although not all studies of plyometric training have produced improvements of this magnitude, it appears that the evidence supports inclusion of plyometric exercise in physical training programs for sports involving sprinting and/or jumping.

NOTE: This description of experimental results is for informational purposes only and does not constitute a recommendation. Anyone engaging in an exercise program should obtain proper medical authorization before doing so.

Static Stretching Can Impair Distance Running Performance

At times it can be difficult to find sports science articles that have true relevance to athletes. But here's one that can have real impact. A study by Wilson et al. (Journal of Strength and Conditioning Research, vol 24, no. 9, pp. 2274-2279, 2010) provides strong evidence that static stretching before a distance-running event can impair performance among young, male athletes.

Static stretching involves stretching a muscle to the point of mild discomfort and holding the stretch for 10-30 seconds. We have previously highlighted previous evidence that static stretching can impair jumping performance. It has also been shown to reduce maximal leg-press strength, 20-meter sprint speed, and knee-extension torque. Yet this is the first study to examine the effect of static stretching on endurance performance.

Experimental Procedure
10 male collegiate competitive distance-runners and triathletes who ran at least 20 miles per week and were in excellent aerobic condition were tested on 2 different days, at least a week apart, after the following:

1. 16 minutes of stretching consisting of the following 5 stretches each performed 4 times for 30 seconds of holding:: 1) sit on floor with knees straight and reach with both hands to and beyond the toes, 2) stand with balls of feet on a block, letting bodyweight stretch calves, 3) for both left and right, stand on 1 leg and pull the opposite heel toward the butt 4) for both left and right, lunge deeply, and 5) cross the left leg over the right one, and pull the right thigh towards the torso, repeating for other side
2. Quiet Sitting

After stretching or not stretching, the subjects underwent the following treadmill tests:

1. Run at 65% of maximal aerobic capacity (VO2max) for 30 minutes while energy-cost is measured.
2. After 2 minutes of rest and rehydration, run as far as possible in 30 minutes (subjects could control treadmill speed and see a time display, but not see a speed or distance display).

Experimental Results
On the no-strech day, the athletes performed significantly better as follows:

• They covered an average of 6.0 km in 30 minutes on the no-stretch day compared to 5.8 km on the stretch day
• They required an average of 425 calories on the stretch day vs. 405 calories on the no-stretch day to do the 30-minute submaximal run.

Bottom Line
Static stretching before running hurt the athletes' distance-running performance. After stretching they required more energy to run the same speed in the submaximal test, while in the maximal-distance 30-minute test they were not able to run as far. These differences can easily affect the chance of winning a race. The negative effect of static stretching appears to be due to a reduction in the spring-like stiffness of the leg muscles resulting in lower efficiency. Thus, it does not appear advisable to do static stretching before distance-running events. While dynamic stretching has not been subject to similar testing, it is a possible alternative. The evidence suggests that the best warmup before a distance-running event may be walking followed by jogging followed by short-distance runs at speeds increasing to race-pace.

Heart Attack Deaths in the U.S. Have Dropped Sharply

In the Harvard Health Letter, vol 35, no. 10, August 2010, and article appeared entitled, "Is the heart attack going out of style?". It stated that, based on Medicare data, the U.S. heart-attack hospitalization rate declined by 23% from 2002 to 2007. Also, a study based on 3 million members of a northern California health plan showed a 24% drop in heart attack hospitalizations between 1999 and 2008. While an increasing number of people are diagnosed with heart disease, fewer are dying from it - heart attack deaths have been declining in the U.S. for the past 40 years.

The article conjectures that, "Maybe decades of efforts to eat right and exercise more, stop smoking, lower LDL cholesterol levels, and control blood pressure are working." This appears only partially true. Yes, fewer Americans smoke, and Lipitor, a medication for reducing LDL and total cholesterol, is the most prescribed drug in the U.S. Many people are also taking blood pressure medication. Yet, there is little evidence that people are "eating right" as fast-food consumption and obesity continue to increase. Also, various national campaigns, such as the American College of Sports Medicine's Healthy People 2000, have failed dismally to get people to exercise more. Thus, it appears that the reduction in heart attacks is less due to anything that requires will power than to modern medicine. Another possible factor is reduced stress, as the economy was doing well over the study period. It remains to be seen what the recession and high unemployment rate will do to the heart attack rate. Hopefully, and emphasis on family and personal fulfillment and relationships will help keep stress to a minimum, even in the face of economic difficulties.

The reduction in heart attacks is encouraging, yet it would be even better if people became healthier through lifestyle changes such as exercise and good nutrition.

Mixed-Intensity Interval Training vs. Steady-Speed Running

Evidence continues to pile up concerning the advantages of interval training. A study by James Clark in the Journal of Strength and Conditioning Research (vol. 24, no. 7, pp. 1773-1781, 2010) compared interval training comprised of runs of varying lengths and intensities to steady-speed running as to which produced greater improvements in maximal oxygen uptake (VO2max), the gold standard of aerobic fitness.

Study Procedure
The subjects were 32 female league and college competitive soccer players who were divided into 2 groups that trained as follows for 8 weeks:

1) Mixed-Intensity Interval Training (MIIT): The workout consisted of repetitions of the following 6-minute exercise cycle:

• 30 sec of jogging
• 30 sec running at 90-100% of max effort
• 60 sec of jogging
• 60 sec running at 80-90% of max effort
• 90 sec of jogging
• 90 sec running at 70-80% of max effort

      The subjects did 2 cycles (12 min) the first week and increased to 6 cycles (36 min) by the eighth week.

2) Steady-Speed Training (SST): They ran steadily at a "moderate to hard" pace (heart rate corresponding to 60-80% of that at maximal oxygen uptake). Run time was 40 minutes the first week and increased to 60 minutes by the eighth week.

Results
The mixed-intensity interval training group improved in maximal oxygen uptake by over 25% while the steady-speed training group improved less than 17%, a statistically significant difference.

Bottom Line
The mixed-intensity interval training improved aerobic fitness more than did steady-speed running, and required less time per workout. In addition, while it was not tested, it is likely that the sprinting segments of the interval training produced more improvement in sprinting ability, which is essential for soccer and other sports requiring bursts of speed. Thus, it appears that mixed-intensity interval training is advantageous for athletes in various team sports. Steady-speed running is still important for distance runners, who generally work out at various intensities during a training week.

NOTE: This description of experimental results is for informational purposes only and does not constitute a recommendation. Anyone engaging in an exercise program should obtain proper medical authorization before doing so.

Spending More Time Outdoors Benefits Health

The increased availability of in-home entertainment systems such as TV's, computers, sound systems, and video games along with perceived discomforts and even dangers of spending time outdoors has prompted Americans to spend more time indoors. The U.S. government has estimated that the average American spends 90% of his/her time indoors. But that may be deleterious to our health. A recent article in the Harvard Health Letter (July 2010) details the following benefits of spending more time outdoors:

1. Your Vitamin D levels will go up - Sunlight hitting your skin begins the process of the body's manufacture of biologically active Vitamin D. Fifteen minutes of sun exposure on bare skin can result in the manufacture of far more Vitamin D than you can get in any supplement pill. An increasing number of studies have shown the association of high Vitamin D levels with various health benefits including protection against osteoporosis, cancer, depression, heart attack and stroke. The northern latitudes get less direct sun exposure than southern latitudes and some forms of cancer are more common in the northern vs. the southern states. As we age, our ability to manufacture Vitamin D from sun exposure drops considerably. People with darker skin also generate less Vitamin D from a given amount of sun exposure. While there is an ongoing controversy about whether sun exposure without sunscreen causes more benefit from Vitamin D production than danger from skin cancer, the Harvard Health Letter recommends some limited daily unprotected sun exposure along with protection against the sun when outdoors for long periods or during the middle of the day in summer.
2. You will get more exercise - Physical exercise has been shown to have a very wide range of health benefits. People tend to be more sedentary when spending time indoors. When outdoors, people tend to spend more time in physically active pastimes such as walking, biking, gardening, and playing sports. Children are more active outdoors as well. A study using GPS units found that children were more than twice as active when outdoors than indoors.
3. Your mood will improve - The kind of light you get outdoors tends to elevate mood, and light-therapy has been used to treat people who tend to become depressed during the long winter months. The increased physical activity associated with spending more time outdoors also has a mood-enhancing effect. Exercising in a natural setting has even more positive effect on mood and self-esteem, as a British study has shown.
4. Your focus may improve - A study has shown that children with Attention Deficit Hyperactivity Disorder do better on a test of concentration after walking through a park than when walking through residential or downtown neighborhoods.
5. You may heal faster - A University of Pittsburg study showed that surgical patients experienced less pain and stress and needed less medication when exposed to natural light. Even a window view of a natural setting seemed to promote recovery better than a view of buildings.

It's clear that the evidence in favor of spending more time outdoors is quite solid. So find an outdoor activity you enjoy and get out there.

Can Mental Imagery Improve Physical Strength?

Mental imagery involves envisioning oneself performing a physical activity without actually doing it. It is currently used by many high-level athletes to enhance their physical performance. While the method is well-accepted for maintaining focus and consistency of technique, its use has recently been examined for improving strength as well.

Study Method
In a study by Lebon, Collet and Guillot in the Journal of Strength and Conditioning Research (vol. 26, no. 6, pp. 1680-1687, 2010) male college athletes who had not been weight training were put on a program of bench-press and leg-press training 3 times per week for 4 weeks. The only difference between the training groups was that the imagery group visualized doing each exercise during the between-set rest periods while the control group performed another thought task.

Results
Both groups improved in strength and the number of repetitions they could perform with 80% of the maximal weight they could lift during pre-training tests. However, the imagery group improved 26% in leg press strength vs. 21% in the control group. Repetitions with 80% of pre-training max increased 92% in the imagery group vs. 79% in the control group. Both between-group differences were statistically significant. There were no differences between training groups as to changes in bench-press performance and neither group showed any significant increases in muscle-size.

Bottom Line
It is known that the strength gains resulting from the first few weeks of training are largely due to neuromuscular adaptations rather than muscle-size increases. Mental imagery may enhance the neuromuscular component of strength change and thus the most applicable to novice lifters. It is not clear why the method was effective for the leg press but not the bench press.

Is Elliptical Training as Good as Running for Improving Fitness?

Elliptical trainers have become very popular in gyms as well as in the home. Their popularity is due to a lack of impact on the body while providing resistance to both the lower and upper body musculature. The movement pattern looks similar to running but does not involve pounding of the feet on the ground. An added advantage is the relative silence of an elliptical device compared to a treadmill, which produces considerable noise from foot strikes and its motor.

An important question is whether the elliptical trainer provides as good an aerobic workout as a treadmill or running outside. A study by Brown et al. in the Journal of Strength and Conditioning Research (volume 24, number 6, pp. 1643-1649, 2010) was designed to answer that question.

Experimental Procedure
9 male and 9 female college-aged subjects worked out for 15 minutes on different days on both a treadmill and an elliptical trainer at a difficulty level they self-selected as “somewhat hard.” The subjects were instrumented to collect information on their rate of oxygen utilization, pulse rate and other relevant variables.

Results
The only statistically significant differences between exercise on the elliptical machine and the treadmill were that the elliptical machine produced higher:

• heart rate
• percentage of maximal rate of oxygen utilization
• Ratio of carbon-dioxide produced to oxygen used

However, there were no significant differences in total energy expenditure or total oxygen consumption.

Bottom Line
The similarities between the responses to exercise on the elliptical trainer and treadmill were far more important than their differences. They both produced very similar aerobic stimulus to the body when the subjects worked out at a moderate level of difficulty, which is typical. Therefore, for general health, one can use an elliptical trainer with confidence. However, since running is a very basic human activity that is essential for sports and reacting to emergencies, run training is still generally more useful. Someone who trains exclusively on an elliptical machine and reaches a high level of fitness will not perform as well when faced with a running challenge, and muscle soreness will surely result. Yet, elliptical training is a good way to maintain cardio-respiratory function for injured athletes and others who cannot tolerate lower body impact. It can also provide variety in training for those who run regularly.

How to Avoid Weightlifting-Related Shoulder Injuries

Terms used in this article:

• Rotator cuff: Muscles (supraspinatus, infraspinatus, teres minor, subscapularis) that stabilize the shoulder joint and rotate the arm at the shoulder
• Internal shoulder rotation: Standing with your upper arm against your torso with your elbow at a right angle, rotate your upper arm inward until your hand touches your abdomen.
• External shoulder rotation: From the position you just attained by internally rotating your shoulder, rotate your upper arm outward so that your hand moves away from your abdomen, as you would when throwing a Frisbee.
• Trapezius muscle: Extends from the back of your head and neck down your central upper back and serves to raise the shoulders and draw them backwards.
• Range of motion: The number of degrees through which a joint can be rotated.

A recent article by Kolber et al. in the Journal of Strength and Conditioning Research (Vol 24, no 6, pp. 1696-1704, 2010) reviewed existing scientific research articles on shoulder injuries brought on by weightlifting. It noted that 25-35% of people who engage in resistance training sustain an injury severe enough to require medical attention and that 36% of such injuries are to the shoulder. The vulnerability of the shoulder is related to the high number of exercises that involve the shoulder, the great stresses the exercises place on the shoulder, and the unfavorable positions in which some exercises place the shoulder. In addition, many lifters do not warm up properly, select a balanced set of exercises, use proper lifting technique, or modify/eliminate exercises that cause pain. Major muscles are frequently worked to the exclusion of minor ones, leading to muscle imbalances. Shoulder muscles commonly injured include the pectoralis major, biceps, deltoid and rotator cuff group.

The Most Common Signs of Shoulder-Dysfunction Among Weightlifters:

• Reduced internal shoulder rotation range of motion
• Excessive external shoulder rotation range of motion
• Underdeveloped external rotation strength relative to internal rotation strength
• Underdeveloped external rotation strength relative to arm abduction (raising) strength
• Underdeveloped lower trapezius strength relative to upper trapezius strength
• Instability of the anterior (front) shoulder
• Tightness of the posterior (rear) shoulder

Common Pain-Producing Exercises
The following exercises in which the upper arm is raised to the side and parallel to the floor while the forearm is vertical put the shoulder in a fully externally rotated position and are considered hazardous:

• Behind the neck pull-down
• Behind the neck overhead press
• Overhead stack machine press in which the hands move rearward as the weight is lifted

Other exercises, although generally safe, also associated with shoulder pain:

• Bench press
• Incline chest fly
• Supine chest fly
• Dip
• Biceps curl

The following may help to prevent weightlifting-related shoulder injury:

• Discontinue any exercise that causes pain.
• If an exercise hurts, try variations that do not hurt (e.g. bench press with rolled up towel on chest to limit movement).
• Balance every push exercise with a pull exercise in the opposite direction.
• Balance exercises involving major body movements (e.g. bench press, pull-down) with those that stabilize and rotate the shoulder.
• Exercises that strengthen external shoulder rotation are particularly important (e.g. do the external rotation movement described above, resisted by weight stack cable or elastic band).
• Do strength exercises for the lower trapezius (e.g. rowing motions with elbows high and shoulders drawn fully back).
• Do flexibility exercises to increase internal shoulder rotation.
• Do flexibility exercises to stretch the rear shoulder (e.g. Stand with upper arm parallel to the ground. Grip elbow with other hand and pull arm horizontally across the chest).

Should You Skip Breakfast to Burn More Fat During a Workout?

An Associated Press article suggesting that, because skipping breakfast before a workout burns more fat, such a practice may be effective for body fat loss. Yet, the study on which the article is based provides absolutely no evidence that such a practice would result in a stable loss of body fat. Sure, if your body is depleted of stored carbohydrates in the form of muscle and liver glycogen, you will burn more fat during exercise. However, a close look at the article reveals that the fat burned is in the muscle, and not around the waist or other parts of the body where people generally want to lose fat. Thus, exercising in a fasted state merely depletes intramuscular fat that is replenished upon eating. So there is no net body fat loss unless one consumes fewer calories than are used, which requires dietary control. So we can’t escape from the truism that the only way to lose weight is to burn more calories than you take in.

The following are additional reasons not to exercise in a fasted state:

• You will feel less energetic and more lethargic
• The quality of your workout will diminish
• Your motivation to exercise will be reduced
• You will cannibalize muscle to convert protein into needed carbohydrates

The only advantage to running in a fasted state might be for long-distance runners who wish to train their bodies to preferentially burn fat, thereby sparing muscle and liver glycogen to avoid “hitting the wall” late in a race. However, training with long-distance runs accomplish the same goal.

Caffeine May Interfere With Muscle Building

An online article in the Journal of Sports Science and Medicine by Wu and Lin (vol 9, pp 262-269, 2010) indicates that going heavy on the caffeine before resistance training may be counterproductive.


Experimental method
Ten men performed a workout consisting of 3 sets of 8 exercises. Each set consisted of 10 repetitions of 75% of the weight that could be lifted only once. On one day, the workout was performed an hour after caffeine ingestion and on another day an hour after ingesting a non-caffeinated placebo. The amount of caffeine was 6 mg/kg or about 475 mg for a 175 lb man. That’s about the amount of caffeine in one-and-a-half 16 oz Starbucks Grande coffees or four-and-a-half 8 oz cups of home-brewed coffee. Blood was analyzed at various times for levels of insulin, testosterone, cortisol, growth hormone, glucose, free fatty acid and lactic acid.

Results
As has been observed in previous studies, blood levels of free fatty acids were higher in those who ingested caffeine than in those who did not. That is why caffeine is considered an ergogenic aid (performance enhancer) for endurance sports. Long distance runners often take in caffeine to promote the burning of fats in preference to carbohydrates, allowing the limited store of carbohydrates in the muscle and liver to last longer, sparing the athlete from “hitting the wall’ later in the race.

A result not noted in previous studies was that blood concentration of human growth hormone (HGH) was significantly lower when the subjects had previously ingested caffeine than when they hadn‘t. Since HGH is a muscle-building hormone, caffeine ingestion prior to resistance training can be considered counterproductive.

There were no significant differences in blood levels of insulin, testosterone and cortisol between caffeine and no-caffeine conditions.

Bottom Line
It appears prudent to avoid caffeine consumption for at least 3 hours prior to a resistance training session in order to maximize results. Since the time it take for the body to rid itself of half of ingested caffeine is approximately 5 hours in healthy adults, then excessive caffeine consumption is not recommended, even several hours before a workout.