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Continuous Glucose Monitoring- Is It Right For You?

Our metabolism is comprised of a complex set of cellular processes that result in energy production in our body. Regulation of insulin and glucose are critical to metabolic regulation. Insulin is not easy to measure, but glucose is a blood sugar that’s easily measured. For type 1 and type 2 diabetics, measuring blood sugar is a key component of health maintenance.

Continuous glucose measurement (CGM) is a technology that allows a person to monitor glucose levels in real-time, without having to prick your finger for a blood sample. This technology has been a game changer for diabetics, allowing very precise control of insulin dosing in type 1 diabetics, and monitoring response to foods and exercise for type 2 diabetics.

Why would someone who’s not a diabetic want to use a continuous glucose monitor? The theory is that getting this extremely precise data will allow someone to take steps before a problem like type 2 diabetes sets in, and by doing so you’ll lose body fat, get to your optimal body weight, and reduce your chances for chronic illnesses like heart disease, diabetes, stroke, and even Alzheimer’s disease.

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Low Vitamin D Increases Covid-19 Risk

This week I’ll highlight two interesting studies linking low Vitamin D levels to increased Covid-19 risk. Both of these studies suggest that low Vitamin D levels are independent risk factors for Covid-19 risk, meaning that there is something about the low Vitamin D level in the body that leads to the increased risk, without other contributing factors.

In my experience, a surprising number of adults have low Vitamin D levels. Given that it’s so easy to increase your Vitamin D level either through a modest increase in sunlight exposure, proper food sources, or through supplementation, this represents an easily controllable way to reduce risk of Covid-19.

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Sore Knees On Your Spin Bike? Stay In The Saddle.

Lots of folks are using stationary bikes in their exercise-from-home routines. Overall, I’m a huge believer in their effectiveness and safety but offer some words of caution. If you’re someone with pre-existing knee arthritis or kneecap pain, you might make your knee pain worse when you focus on power by standing on your pedals.

Many types of knee pain are “load dependent”, meaning that if you increase load across your knee joint you’ll likely increase your knee pain. If you find yourself with more knee pain when you stand on your pedals, consider modifying your exercise to stay in the saddle and focus on a faster cadence.

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Pre-Workout And Pre-Game Nutrition

In today’s post I want to visit some thoughts on pregame and pretraining food. This means a small meal, snack, or other food product. I’ve covered pregame hydration in another post. We’ve also given some ideas on after workout food separately.

As it is with so many aspects of nutrition, there’s quite a bit of controversy around pregame nutrition. I’m indebted to my colleagues at Apeiron Life, Jae Berman and Heather Rivera who are the two smartest sport and performance dietitians I’ve ever come across.

Jae and Heather take a very practical approach and recommend that all athletes ask themselves a few questions before coming up with an approach to pregame nutrition. And whenever possible use real whole food options over packaged products or bars to achieve your nutrition goals.

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Does Stretching Help?  Answer: Yes, And No.

Last week I wrote about increased risk for knee injuries with poor form on squats and lunges, and unaccustomed plyometrics. The fact is that increasing strength is a critical component of injury risk reduction, it’s just that you have to do it correctly.

This week let’s look at another controversial topic. Does stretching help? Between increasing strength, improving balance, and increasing flexibility is one better than another? It turns out that the most effective way to reduce injury risk is through increased strength, followed by improved balance.

Surprisingly, stretching to improve flexibility has not been shown to reduce injury risk. It doesn’t seem to be harmful so do it if you enjoy it or if you feel it improves your sport and fitness performance.

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How To Hurt Your Knees

There’s quite a bit of controversy between fitness professionals and medical professionals about the safety of various lower extremity conditioning activities. As an orthopedic surgeon, I typically see folks in the clinic after something has gone wrong so it’s a skewed population. But over and over again I see common themes emerge. I think of these as three easy ways to hurt your knees.

Deep squats (thighs below parallel), lunge with a short stride, and unaccustomed plyometric activities are more likely than not, in my opinion, to land you in the orthopedic or sports medicine specialist’s office. I suggest below some modifications to help you avoid trouble.

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Too Much Of A Good Thing?

During the new stay-at-home normal you’ve been doing your absolute best. You’re following all of the recommended safety precautions to avoid contracting the virus. You’re staying socially connected to your friends and relatives while maintaining a safe physical distance. You’re trying to exercise. And you’re trying to eat healthy.

But could you be doing too much of a good thing? I’ve written previously about overuse injuries or unaccustomed use injuries from exercises you may have recently started. And so it is also with the foods we eat. While many foods are nutritionally healthy, they may also be packed with calories and at some point you’ll need to figure out how to say “no”.

Author Tim Ferriss calls these “domino foods” because you can’t eat just one. Learning how to limit your consumption of domino foods is a useful skill.

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Relative Energy Deficiency in Sport (RED-S): An Under-Recognized Sports Health Disorder

We previously wrote about the Female Athlete Triad, and provide below an update. While most commonly found in female athletes, it’s been discovered that male athletes can also have a form of this problem. So a broader term has been in use recently, Relative Energy Deficiency in Sport (RED-S).

RED-S is a serious health condition typically affecting teenage athletes. It’s made up of three key components (“the triad” for female athletes):

Low energy availability, sometimes associated with an eating disorder (females and males)
Abnormalities in the menstrual cycle (females)
Low bone mineral density, sometimes leading to stress fractures or osteoporosis (females and males)

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Low Load Resistance Training For Strength And Bulk

It’s commonly believed that the best way to build strength and increase muscle size is to use heavier weights and a small number of repetitions, with multiple sets. While we believe that’s an effective strategy for active and healthy young adults, it can pose some problems for adolescents and adults age 50+.

Research shows that contrary to the popular belief, resistance training with lower loads and higher repetitions is also an effective way to gain strength and muscle bulk, but with the advantage that it can be very joint-friendly.

For adolescents with open growth plates and active older adults perhaps with arthritis, the lower load training is an attractive option.

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Post Workout Protein: What Your Muscles Need

Continuing our theme of return to sports and fitness after the coronavirus layoff, we’d like to briefly touch on the usefulness of dietary protein after your workout as a key factor in assisting your strength gains.

There’s some difference of opinion on this point, but we believe that taking in about 20gm of protein within the first 30 minutes after finishing your workout is the best time to take your protein.

Further, we believe protein intake after a workout becomes even more important as we age, and there are several natural food options available to help you.

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