DrMirkin's eZine: Stress and recover, artificial sweeteners, more . . .

Published: Thu, 04/28/22

Dr. Gabe Mirkin's Fitness and Health e-Zine
May 1, 2022
 
All Exercisers Can Benefit from Elite Training Methods

You will gain the most benefits from your exercise program if you follow the "stress and recover" training principles that competitive athletes use. A study using accelerometers to measure the physical activity of more than 90,000 healthy people over six years found that the more and harder they exercised, the less likely they were to suffer heart disease (PLoS Medicine, December 2, 2021). There was no maximum amount of exercise that increased risk for heart attacks or heart disease. The American Heart Association (AHA) recommends that adults should participate in either 150 minutes per week of moderate-intensity aerobic exercise, 75 minutes per week of vigorous aerobic exercise, or some combination of the two.

Researchers agree that exercise helps to strengthen your heart, prevent diseases and prolong life, but exercisers need to know the signs and symptoms of exercising too much, and know when to slow down or take a day off to avoid injuries.

Stress and Recover
If you want to improve your strength and endurance, you should train by stressing and recovering. Don't work out at the same intensity every day. You will get more benefit if you exercise harder on one day, feel a little sore on the next day and then go at a slow pace for as many days as it takes for your muscles to feel fresh again.

On your stress day, warm up by starting out at a very slow pace, and then alternate a series of going a little harder and faster until you feel a slight burning or tightness in your muscles. Immediately slow down and go at a slow pace until you feel fresh again. In the beginning, you may want to pick up the pace for only 5-10 seconds ("intervals"). As you improve, you can work up to 30-second "intervals" at your harder pace. For non-competitive exercisers, you don't ever need to stay in an "interval" for more than 30 seconds.
• You recover by going at a slow pace for as long as it takes for your muscles to feel fresh again. There is no advantage to time-limiting your recoveries. When your muscles feel fresh, you can pick up the pace and slow down immediately when you feel a burning or tightness again in your muscles. Novice cyclists can do 5-10 pedal strokes, and then go slow for as long as they need for recovery. Novice runners can start out by taking only 5-10 running steps. Swimmers can do short bursts of their favorite stroke, and so forth for any activity you choose.
• Continue to alternate these slight pickups of intensity with slow recoveries until your muscles stop recovering as soon as you slow down. Eventually you may want to work up to 30-second intervals followed by untimed recoveries. At your peak, your stress workout can include a 10 minute warmup, a maximum of 30 minutes of controlled intervals, and a 5-10 minute slow recovery. A typical hard-interval workout would include 20 to 30 intervals of 10 to 30 seconds each, with untimed full recovery between each interval.

Your recovery days ("easy days") should always be governed by how you feel. On the day after a stress day, your muscles will probably feel slightly sore and you are supposed to recover by going at a very slow pace. The muscle discomfort is called Delayed Onset Muscle Soreness (DOMS). You warm up by going very slowly, and if your muscles don't feel more comfortable after a 5-10 minute warmup, take the day off altogether.
• If your muscles feel better after your warmup, go at an easy pace for as long as you like and stop your workout when your muscles feel any protracted discomfort. You are never supposed to work through pain. Always stop if you feel fatigue or muscle tightness or discomfort.
• Continue to take slow recovery workout days for as many days as it takes for your muscles to feel fresh after you warm up for 5-10 minutes. Only then should you take your next hard stress-day workout. Most exercisers follow each stress day with one to three or more recovery days before they take their next intense workout.

How Can You Tell if You are Exercising Too Much?
There is no laboratory test that will tell you that you are overtraining. You should take days off or markedly reduce your workouts if you suffer:
• any injury
• muscle soreness that does not go away after you warm up
• any illness
• continued difficulty falling asleep or staying asleep
• continued loss of appetite
• continued fatigue or loss of energy
• recurrent or prolonged infections
• a persistent increase in resting heart rate of more than 10 beats per minute
• decreased muscle strength, endurance, or ability to perform and recover from your regular workouts

Heart Problems in Elite Athletes
If you follow the rules for recovery and back off if you have warning signs of overtraining, you should gain the health benefits of an exercise program. Countless studies have shown that exercise helps to prevent heart attacks, but some researchers have found scarring in heart muscle and increased plaques in the heart arteries of people who have run many marathons or triathlons, resulting in news headlines warning that "too much exercise can harm your heart." A 10-year review of 10.9 million regular distance runners found 59 instances of sudden death from heart stoppage, for an occurrence rate of about one in 200,000 participants (NEJM, 2012;366:130-40).

At this time, the prevailing opinion is that:
• heart attacks are the result of sudden complete obstruction of blood flow to the heart caused by clots formed by plaques breaking off from arteries leading to the heart,
• plaques form in arteries primarily from a faulty diet, and
• exercise helps to prevent heart attacks by stabilizing plaques so that they do not break off to start the process that leads to heart attacks.

My Recommendations
I believe that every healthy person can benefit from a regular exercise program, provided that they do not do so much exercising that they feel fatigued or sore much of the time. To increase strength and endurance, you should follow a stress-and-recover exercise program, and know the signs and symptoms of overtraining. In addition to trying to exercise every day to strengthen your heart and stabilize the plaques in your arteries, you should follow a lifestyle that helps to prevent plaques from forming in your arteries in the first place:
• eat lots of vegetables, fruits, nuts, beans, whole (un-ground) grains and other seeds
• restrict all sugared drinks including fruit juices, sugar-added foods, red meat, processed meats and fried foods
• avoid smoke, alcohol and recreational drugs
• avoid being overweight
• keep blood levels of hydroxy vitamin D above 30 ng/mL

Caution: Before you begin a new exercise program, if there are any questions about your health you should check with your doctor, particularly if you have chest pain or any heart attack risk factors or heart problems.




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Artificial Sweeteners Can Change Your Gut Bacteria

A review of 17 studies involving 1733 adults found that substituting artificially sweetened drinks for sugared drinks is associated with slightly reduced body weight, body fat percentage, and measures of fatty liver disease (JAMA Netw Open, 2022;5(3):e222092). However, artificially-sweetened drinks are less healthful than drinking water or unsweetened coffee or tea. Sugar-sweetened beverages are least healthful, increasing risk for diabetes, high blood pressure, weight gain, and heart attacks.

Research on Artificial Sweeteners and Inflammation
Artificial sweeteners can harm you by altering the bacteria in your colon (Nutrition Today, May 6, 2021;56(3):105-113). Some artificial sweeteners may cause inflammation, a condition in which your own immune system, which is supposed to kill invading germs, stays active all the time to attack you (Int J Mol Sci, May 15, 2021;22(10):5228). These authors showed in test tube studies that the amount of the most widely used artificial sweeteners (saccharin, sucralose, and aspartame) used in just two cans of diet drinks increased growth of Enterococcus faecalis (harmful colon bacteria that invade the colon cells). A review of the scientific literature shows that these bacteria turn on your immune system, and decrease the healthful E. Coli bacteria that do not invade your colon cells (Front Nutr, Sept 24, 2021;8:746247).

You have more than 100 trillion bacteria in your colon. Some are healthful, while others can harm you. The types of bacteria in your colon are determined far more by what you eat than by your genetics (Nature, 2018;555(7695):210-215), and some types of bacteria can turn on your immune system to cause inflammation that increases risk for heart attacks, dementia, auto-immune diseases and certain cancers (J Alzheimers Dis, 2017;58:1-15).

Colon bacteria eat the same foods that you do. The healthful bacteria are content to eat what you eat, so they stay in your colon and do not try to cross into your cells and bloodstream, but the harmful bacteria seek different foods by invading the cells lining your colon. Your immune system tries to defend you by producing huge amounts of white blood cells and chemicals that work to destroy the invading bacteria by punching holes in their outer membranes and trying to kill them. This constant invasion of your colon cells by harmful bacteria can cause your immune system to stay on all the time and attack you in the same way that it kills germs. It can punch holes in your arteries to start plaques forming and then cause the plaques to break off from an artery to cause a heart attack. Inflammation can also change the DNA in cells so they become cancerous, and if your immune system does not recognize and kill these cancer cells, they can spread to and damage other parts of your body.

How Artificial Sweeteners Work
Artificial sweeteners are components of food that cause a sweet taste in your mouth without causing the gain in calories or rise in blood sugar that you get when you eat sugars. They do this by being so sweet that you can get the taste of sugar by using only a very small amount. For example:
• Aspartame (NutraSweet, Equal) - 180 times as sweet as sugar
• Saccharin (Sweet'N Low, Sweet Twin, Sugar Twin) - 350 times as sweet as sugar
• Stevia (Truvia and other brands) - 250 times as sweet as sugar
• Sucralose (Splenda) - 660 times as sweet as sugar

As far as I know, only saccharin, sucralose and stevia have been shown specifically to change the composition of the gut microbiota, but many other artificial sweeteners, such as isomalt, maltitol, lactitol, and xylitol, may increase the numbers of bacteria that have been associated with weight gain (J Neuroendocrinol, Jun 2015;27(6):424-434).

Artificial Sweeteners Can Increase Risk for Weight Gain and Diabetes
You may have to take in large amounts of artificially-sweetened drinks to suffer significant health consequences, but many studies show that artificial sweeteners make you hungry so that you eat more food, increasing your risk for weight gain and diabetes. A review of 30 studies showed that artificial sweeteners are associated with weight gain, increased waist circumference, and higher incidence of obesity, hypertension, metabolic syndrome, type II diabetes and heart attacks (Can Med Assoc J, Jul 17, 2017;189(28):E929-E939).

Dietary sugar is supposed to be absorbed in the upper intestinal tract, but research from Yale suggests that taking in excessive amounts of sugar can cause some of the sugar to pass through the intestines unabsorbed. This sugar arrives in your colon where it can harm you by keeping healthful bacteria from growing in your colon and encouraging the overgrowth of harmful bacteria (PNAS, Dec 17, 2018). The safest drink for quenching thirst is water. Unsweetened coffee and tea appear to be safe also.

My Recommendations
• Restrict or avoid foods and drinks with added sugar. Most of the medical community now agree that sugar added to foods and drinks can increase your risk for weight gain, heart attacks and certain cancers.
• Artificial sweeteners appear to be safer than sugared foods and drinks, but increasing numbers of scientific papers show that artificial sweeteners can change the bacteria in your colon to increase risk for gaining weight and developing diabetes.
• If you are overweight and want to lose weight, I recommend adopting an anti-inflammatory diet that restricts sugar-added foods and drinks, mammal meat, processed meats, fried foods and refined grains (foods made from flour). Also try to exercise every day..
Drink Water Instead of Sweetened Drinks
Artificial Sweeteners Are Not Benign




Ancel Keys and John Yudkin Were Both Right about Meat and Sugar 

Ancel Keys was a prolific American scientist who is best known for his early work on heart attack risk factors in the 1950s. His theory was that dietary saturated fats and cholesterol in animal products raise blood cholesterol and blood pressure to increase risk for heart attacks, a leading killer of North Americans. Also in the 1950s, John Yudkin was the leading spokesman for the theory that sugar and other refined carbohydrates were the main culprits. Yudkin and Keys argued continuously, in journals and at medical meetings, about whether sugar or saturated fats were the prime cause of heart attacks. Today, both are heroes. Ancel Keys was given much credit and praise during his lifetime for his work on the causes of heart attacks, but only recently has Dr. Yudkin's theory that excessive amounts of sugar cause heart attacks become accepted, so he did not receive this richly-deserved credit while he was still alive.

Keys recognized correctly that red meat is associated with increased risk for heart attacks and diabetes, and he spent many years trying to prove that the culprit was saturated fat, but more recent research shows that other components that come from meat, such as Neu5gc or TMAO, may be responsible for the association with heart attacks. Even though some of his theories have been discredited, Keys showed that:
• smoking increases risk for heart attacks
• high blood pressure and high cholesterol increase risk for heart attacks
• eating less meat and taking in fewer calories help to prevent heart attacks
• traditional Mediterranean diets help to prevent heart attacks
• most heart attacks are preventable

Why Yudkin and Keys Were Both Correct
It is established beyond question that having high blood cholesterol levels is associated with increased risk for heart attacks. It is also established that both high-sugar and high-meat diets can markedly raise blood cholesterol levels, so now it appears that a diet to help prevent a heart attacks should restrict both sugar-added foods and drinks, AND meats. Read more



 
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