Dehydration & Exercising with Certain Medical Conditions

What don’t we need water for?

Water is essential in everyday life. The human body needs water for anything from digestion to hormone regulation to circulation. The body will function properly as long as there is an adequate fluid intake. The water we need can come from both foods and beverages. “In the United States it is estimated that about 22% of water comes from our food intake while it would be much higher in European countries, particularly a country like Greece with its higher intake of fruits and vegetables, or South Korea¹.” When the human body needs more water than what is taken in, dehydration occurs. Dehydration can have some severe signs and symptoms and can also exacerbate some medical conditions. Also, certain medical conditions require medication use that can change how much water the body needs.

Hypertension and Diuretics

Hypertension, or high blood pressure, is sometimes treated with a diuretic or “water pill.” Diuretics encourage the body to get rid of “unneeded” water and salts through the urine. By getting rid of this excess water the heart can pump more easily and as a result lowers blood pressure. Diuretics can also be used to treat heart failure, liver problems, and kidney problems. A common side effect of water pills is increased urination to expel the extra water from the body. Dehydration can occur in individuals on this type of medication during exercise due to the increase in perspiration coupled with the diuretic medication. It is important to remember that diuretics help to get rid of unneeded water and it is still very important to drink water throughout the day and when you exercise.

Hypotension

On the other hand, drinking water can actually help hypotension (low blood pressure). Orthostatic hypotension- low blood pressure caused when changing from a lying position to a sitting or standing position, often too quickly- can be mediated by drinking small sips of water over a 15- 20 minute period¹.

Headaches

Drinking water can help get rid of headaches. “Ingestion of water provided relief from headache in most individuals within 30 minutes to 3 hours³.” Headaches can be caused for a number of reasons. Dehydration headaches can be caused by a lack of water or an electrolyte imbalance, so hydrating and replacing the electrolytes that were lost is best.

Adequate Intake (AI) for Water

The World Health Organization (WHO) has done multiple research studies to find out how much water to drink each day. Every person is different and the amount of water an individual's needs just to survive varies depending on age, gender, height, weight, climate, and activity levels. The WHO came up with an adequate intake guideline. Please keep in mind that 1 liter is equal to almost 34 fluid ounces.

AI for boys and girls birth to eight years of age²

0- 6 months	0.7 L/day of water, assumed to be from milk
7- 12 months	0.8 L/day of water, assumed to be from milk and other beverages
1- 3 years	1.3 L/day
4- 8 years	1.7 L/day

AI for ages nine and older²

9- 13 years	Boys: 2.4 L/day Girls: 2.1 L/day
14- 18 years	Boys: 3.3 L/day Girls: 2.3 L/day
19- 70+ years	Men: 3.7 L/day Women: 2.7 L/day

If you have questions about water intake, dehydration, or its effects on certain medical conditions, please speak with your doctor directly. They will be able to help determine exactly how much water you need!

Reference

1.  —Popkin, B. M., D’Anci, K. E., & Rosenberg, I. H. (2011, August 1). Water, Hydration   and Health. Retrieved February 13, 2016, from   http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908954/

2.  Grandjean, A., & World Health Organization. (2004, August). Water   Requirements, impinging Factors, and Recommended Intakes. Retrieved   February 13, 2016

3.  —Simpson, M. R., Howard, T., & American College of Sports Medicine. (2011).   Selecting and Effectively Using Hydration for Fitness. Retrieved February   13, 2016, from https://www.acsm.org/docs/brochures/selecting-and-  effectively-using-hydration-for-fitness.pdf

Blog post by Nikki Courtney.

Vitamin and Mineral Supplements: Yes or No?

Diet fads: they’re everywhere.

It’s hard to keep healthy eating habits when there is a fast food joint on every corner and pizza is just a phone call away. We’ve all been there- too tired, no time, or just too lazy to want to cook. Two key factors to good nutrition are planning and balance. Planning what to eat throughout the week will help keep you on track while balancing food groups will ensure adequate nutrient intake. 

A new fad is supplementing the nutrients you miss in your food in order to meet the recommended daily intake. There are a lot of supplements out there, but how do you know if they’re “good for you” or actually work?

There are many different types of nutrients found in food. These can be broken down into two categories: macronutrients and micronutrients. Macronutrients are carbohydrates, protein, and fat. When we think about food, these are what we typically think about. Most of our diets consist of these three nutrients because we need them in large amounts to survive. Micronutrients, however, are often overlooked. Vitamins and minerals are micronutrients; we only need these nutrients in small amounts. Without micronutrients, our bodies would not function properly.

If you eat a balanced diet, you typically do not need to take supplements. Not getting enough vitamins and minerals, however, can be very detrimental to your health. For example, B vitamins are essential for healthy skin, hair, and brain function. Vitamin D works to maintain calcium levels which is needed for healthy teeth and bones; calcium- a mineral- also plays a very important role in muscle contractions and nerve impulse transmissions.

If you do not get enough of these nutrients in your food, supplementing them can be very helpful. However, many nutritionists recommend getting these vital nutrients from food first because the body will more easily break them down. The body can have a harder time catabolizing supplements, specifically fat soluble vitamins which is absorbed better when eaten with a food that provides fat.

If you are curious about nutrition, supplements, or eating healthier, you should speak to your doctor or nutritionist first. Everybody is different.  A doctor or nutritionist can help you break down your eating habits, add nutrient rich foods, and possibly recommend the supplements that will work best for you. 

Remember- planning and balance are key to healthy eating habits!

Blog post by Nikki Courtney.

Running with Music: the Good and the Bad

Running is a great cardio workout and a way for many to clear their minds. Whether you’re training for a race or just feel like going for a run, there are many benefits to this aerobic activity. I was speaking to some of the members at the Barnstable Fitness Center in Hyannis, MA who are avid runners about their training methods when the topic of music came up. It is very common for people to listen to music while running, but is it really that beneficial?

There are two categories for runners in regards to why they run. An associator is considered a person who prefers to focus inwardly during a run: thinking about their day, how they are breathing, listening to their foot strokes, etc. A dissociator is someone who will spend their runs looking forward to forget what they’re putting themselves through (Bean, 2010; Kurton & Blair, 2013). Dissociative runners are more likely to listen to music to help them “forget” they are running; this isn’t always a good thing. Here are the pros and cons for running with music:

Pros

There are 5 conditions that runners should consider with music: the tempo, the genre of music, the lyrics in the song, any memories and emotions the song could trigger, and the order of the music in your playlist (Kurton & Blair, 2013). A high tempo, fast pace song can help you keep pace. This type of music also can elevate positive aspects of your mood such as excitement and happiness, reducing negative aspects such as tension, fatigue, and even confusion (Bean, 2010).

Joe Carroll PT DPT SCS, owner of Cape Cod Rehab and an avid runner, says he trains with music but doesn’t race with it. “Sometimes when I have my headphones on I’m not actually even listening to my music. It’s just playing,” says Carroll. In this respect, Carroll is using music as a distraction, selecting playlists with different types of music for different types of running (i.e. hill workouts, long runs, treadmill runs, etc.). “External stimulus such as music can actually block some of the internal stimuli trying to reach the brain- such as fatigue related messages from muscles (Bean, 2010).”

Cons

While music is a necessity to get through the long, boring miles on the treadmill for RRCA Certified Run Coach Jen Skiba, she is a strong believer in leaving the headphones at home when running outside.  "I look at it from a safety standpoint.  It is so easy to get lost in your music and become totally oblivious at what's going on around you." While music can distract you, this can be very hazardous while running outside. Being aware of your surroundings is important. Look out for potential hazards such as cars, the weather, and even others around you.

While safety is extremely important, training with music can be detrimental from a training standpoint as well. Two key factors in determining effort exerted are breathing and foot strike- both you cannot hear while listening to music (Bean, 2010). Also, if you train only listening to music, what if your iPod dies? How do you keep pace without it? Many road races actually ban runners from having head phones in, even causing disqualifications and ineligibility for elite runners in championship races if they run with music.

As you can see, there are many pros and cons to listening to music while running. If you do, try listening with only one headphone in at a lower volume. Also, try not to run with music every time you run. You might find that you enjoy your run without it.

                                                                                                                       

Blog post by Nikki Courtney.

References

Bean, A. (2010, December 1). Running With Music. Retrieved December 29, 2015, from http://www.runnersworld.com/workout-music/running-debate-running-with-music

Kurton, M., & Blair, S. (2013, March 13). Running with music: The case for and against. Retrieved December 29, 2015, from http://www.theguardian.com/lifeandstyle/the-running-blog/2013/mar/13/running-with-music-for-against

Easy Exercises for Better Balance

It’s that time of year where we start walking in a winter wonderland. This winter wonderland is great for the holiday season, but with winter also comes snow and ice. Losing your balance in these conditions can lead to slipping and falling and possible injuries. Luckily, there are exercises you can do to help train your balance and avoid sliding around! Here are a few:

Stand on One Foot

Stand near the wall, a rail, or the back of a chair. Staying tall, stand on one leg. Start with 20 second intervals and work your way up. You can start with holding on, but try to use only fingertips and eventually using no hands once you are ready. For an added challenge, try standing with your eyes closed.

Tandem Walk

Walk heel to toe. Try not to look down at your feet!

Half Roll Exercises

Step Forward and Backward

This can also be done while doing the tandem walk. Stand on the half roll with one foot in the middle. Step forward, shifting your weight. Then step backward. Try not to look down. This can be done close to a wall, but try to work your way to not using your hands. Make sure you are focusing on shifting your weight! Switch which foot is in the middle as well.

Squat and Touch

Stand on the half roll with one foot in the middle. Step forward and slowly squat down. Try to touch your knee first, then stand back up. Once you feel comfortable, try squatting down and touching your shin or the insole of your foot. This can also be done stepping backward on the half roll.

Leg Swing

Stand with one foot in the middle of the half roll. Simultaneously swing the other leg forward with the opposite arm (I.e. swing left leg with right arm). Then swing the leg back, again coordinated with the opposite arm. Stand tall, leg the swing come from the hip not the knee. Make sure to switch the leg you stand on.

Blog post by Nikki Courtney.

DOMS: That Day After the Gym Feeling

Ever go to the gym and wake up the next day feeling like you can’t move? That sore- wow I worked out hard yesterday- feeling? Well, you can thank DOMS for that.

DOMS stands for delayed onset muscle soreness. The science of why DOMS occurs isn’t exact, but a lot of research points to the major cause being microtrauma to the muscle being worked. This is especially true in exercises that require a lot of eccentric muscle contractions, or the “lengthening” of the muscle being worked. Typically this soreness is felt 6-8 hours post-exercise but the effects can be felt for up to 48 hours (Levy, 2015).  DOMS is not caused by a buildup of lactic acid or metabolic waste in the body as many believe. “DOMS appears to be a product of inflammation caused by microscopic tears in the connective tissue elements that sensitize nociceptors and thereby heighten the sensations of pain (Schoenfield & Contreras, 2013).”

It’s a common misconception that being sore after a workout means that you will gain muscle. DOMS is not an indicator of hypertrophy (building muscle size). In fact, there are really 3 factors for hypertrophy to happen: mechanical tension, metabolic stress, and muscle damage (Levy, 2015). What does this all mean in the long run? DOMS indicates that there is damage done to the muscle which, although necessary in building muscle mass, does not mean that you are. Being too sore can cause you to take more rest time, becoming very counterproductive. “First, severe soreness can significantly decrease force-producing capacity, which will be detrimental to performance in subsequent workouts. Second, motivation levels can take a hit when you’re hindered by crippling muscle soreness (Levy, 2015).”

Being sore is normal. Being so sore you cannot move is not. Make sure you aren’t overtraining and your exercise regimen is suited for your goals. If you are not sure, seek the help of a trainer. Remember- train smart!

Blog post by Nikki Courtney.

References

Levy, W. DOMS: The Good, the Bad, and What It Really Means to Your Training (Breaking Muscle). http://breakingmuscle.com/strength-conditioning/doms-the-good-the-bad-and-what-it-really-means-to-your-training. (2015)

Schoenfeld, B.J. and Contreras, B.  “Is Postexercise Muscle Soreness a Valid Indicator of Muscular Adaptations?” Strength and Conditioning Journal, vol. 35 No. 5 pp. 16-21 (2013)