Recently, a reader shared with me their concern about the aging process. They were not happy with the changes in their body, despite exercising regularly. New research suggests that there may be some forms of exercise that are better than others to counteract the aging process. With the accumulation of more and more birthdays, I too, am concerned about the changes in my body!
The deterioration and degeneration of the body associated with the aging process is well-documented and the musculoskeletal system is no exception. As we age, weight bearing joints of the lower body (hips and knees) frequently suffer from wear and tear degeneration. Loss of muscle mass and strength is also common with age. Specifically, damage to older muscles has been found to regenerate slowly and incompletely and the problem runs as deep as the cellular level as the mitochondria diminish in quality and quantity. However, there is good news: a recent study published this spring in Cell Metabolism suggests that certain types of exercise can actually regenerate and reverse the aging mitochondria.
As popular and common as exercise is, little is known about the influence and impact it has on the cellular level. A research team at the Mayo Clinic decided to answer this question and conducted an experiment to determine the cellular effects of different types of exercise on aging muscles.
The Mayo team chose 72 men and women and separated them into two groups: 30 and under and older than 64. All subjects were healthy but sedentary. Pretest analysis was performed for blood sugar levels, gene activity, muscle cell mitochondrial health, and aerobic fitness level. Subjects from the 30 and under group and the over 64 group were randomly assigned to one of four research groups.
Group One: Vigorous weight training 3-5 times per week, Group Two: Interval aerobic exercise on a stationary bike (pedaling hard and fast for four minutes followed by a recovery at a slow pace for three minutes then repeating the sequence 3 or more times) 3 times per week, Group Three: Moderate aerobic exercise on a stationary bike for 30 minutes 2-3 days per week and light weight lifting on the other 2-3 days, Group Four: Control group who did not exercise. After 12 weeks, lab tests were repeated and data compiled and analyzed.
In the 30 and under group as well as the over 64 group, all three experimental groups improved in fitness level and blood sugar regulation. As expected, Group One, the vigorous weight training group, showed the greatest gains in muscle mass and strength. Also, not surprisingly, Group Two, the interval training group, had the greatest gains in endurance. However, the most unexpected results came when retesting the muscle cells by biopsy. Only group two, the interval aerobic exercise group demonstrated the most significant improvement in the activity levels of their genes in both the young and older groups, when compared to the vigorous weight training and moderate exercise groups.
Moreover, the positive improvements in the genes of the older group far surpassed that found in the younger group. For example, in the younger group, 274 genes improved compared to 170 genes in the moderate exercise group and 74 in the vigorous weight training. In the older group, 400 genes were improved in the interval aerobic group while 33 for weight training and 19 for moderate exercise groups.
It is well known that loss of muscle mass and strength is common with age. Specifically, older muscles have been found to regenerate slowly and incompletely, and the problem runs as deep as the cellular level as the mitochondria diminishes in quality and quantity. However, this study suggests that interval aerobic exercise can regenerate and reverse the aging mitochondria. Healthier mitochondria can produce energy for muscle cells to function at a higher level.
Interval aerobic exercise can have anti-aging effects. In fact, the older your muscles, the more you will benefit from, not just moderate exercise, but more vigorous interval aerobic exercise. Furthermore, interval training may be applied, not only to aerobic exercise, but to weight training for the upper and lower body. According to the American College of Sports Medicine, high intensity interval training, also called HIIT workouts, involves a repetition of a series of high-intensity exercise (aerobic or weight training) for a specific period of time (3-5 minutes) followed by a specific period of rest or low-intensity exercise (1-3 minutes).
The intensity can be increased by speed or resistance. HIIT workouts have been associated with increased caloric expenditure with less exercise time, as well as improved strength and endurance. Most recently, it has been found to improve cell energy in the aging population. However, do not attempt to increase the intensity of your exercise program without consulting with your physician first. Once medially approved, consult with a Doctor of Physical Therapy to create a program specifically designed for you.
Therefore, if your gene pool is questionable like most of us, don’t use that as an excuse. There are things you can do to have a positive impact on your DNA to live longer and healthier…one of them is EXERCISE!
Visit your doctor regularly and listen to your body. Keep moving, eat healthy foods, exercise regularly, and live long and well!
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
82 million adults spend an estimated 28 billion dollars on gym memberships each year! WHY? There are many reasons we exercise. Some people exercise to prevent illnesses such as cardiovascular disease or osteoporosis. Others exercise for mental health and as a stress release; others do it to improve strength, flexibility, and endurance to prepare for a sport. However, the number one reason people exercise is TO LOSE WEIGHT!
When it comes to losing weight, patients have asked me a wide variety of questions over the years. However, certain questions are consistent. “What exercise is the best to burn calories?” “Even though I exercise 2-3 times per week, why can’t I lose weight?” “What is BMR?” “If I eat a Snickers bar, how much exercise do I need to do to burn it off?” “Are there any tools that I can use to help me track my calories and exercise output?”
Have you ever heard people say that they never felt better or burned more calories than they did when they ran? Well, they may be right! The following numbers are based on the average male weighing 150 pounds: running 6 miles per hour will burn 700+ calories (11-12 calories per minute); vigorously skipping with jump rope or fast cycling will do the same; vigorous walking at 4 miles per hour and moderate biking will burn 600+ calories (10 calories per minute). The 400-500 calorie club includes the following activities: slow jogging, swimming, football, basketball, baseball, tennis, skiing, and moderate walking (3.5 miles per hour). Light gardening burns more calories than golfing using a cart (250 vs. 180).
How many times have you heard people say, “It is hard for me to lose weight because I have a slow metabolism?” What does that mean? To explain this in detail you first must understand BMR. BMR is basic metabolic rate. It is the number of calories that your body requires to operate basic body functions that you don’t actively control, such as continuing to breathe, and keeping your cells and organs working each day. The BMR is influenced by age, height, gender, body fat, and fitness level. BMR is inherently different (high or low) in everyone.
While you can’t change your gender or height, you can influence some things to influence your BMR and burn more calories at rest. One, exercise for longer durations, with greater intensity and more frequently. Two, lower body fat by eating less calories, especially fat and carbohydrates in your diet. Simply, eat less calories than you burn! Three, improve your muscle/fat ratio by weight training.
Basic Metabolic Index (BMI):
BMI: < 18.5 = Underweight
BMI: 18.5 – 24.5 = Normal Weight
BMI: 25. - 29.9 = Overweight
BMI: >30. = Obestiy
For example, I am a 66-year-old male, weighing 155 pounds at 5 feet 8 inches tall with a BMI of 23.6
*Calculate your BMI by entering your gender, height and weight and find how many calories per food item at:
There are several tools available for free online to help with tracking calories and exercise visit Prevention Magazine at: www.myfooddiary.com or try the App “Lose It”
BMI Calculator – to calculate your BMI
Calorie Burner – to calculate how many calories are burned with various activities
Daily Calorie Calculator – Find how many calories are in specific foods and what you need to do to lose or gain weight.
So, remember, the number one reason we exercise is TO LOSE WEIGHT! But depending on exercise alone to lose weight is an exercise in futility. Losing weight is an intelligent and consistent combination of a balanced diet with portion control, proper nutrition, adequate exercise and activity grounded in lifestyle changes.
Mayo Clinic –December 2009
FOOD/CALORIES
MINUTES NEEDED TO BURN CALORIES AT MODERATE PACE: (Walk/Dance/Bike)
MINUTES NEEDED TO BURN CALORIES AT MODERATE PACE: (Run/Swim/Bike)
(Body Weight) (Body Weight)
125# 175# 225# 125# 175# 225#
SNICKERS BAR 65 48 37 28 20 16
(2 oz. - 271 cal)
APPLE 17 13 10 8 5 4
(Med - 72 cal)
ROOT BEER 37 27 21 16 11 9
(12 oz. – 152 cal)
SPARKLING WATER 0 0 0 0 0 0
(0 cal)
GROUND BEEF 51 38 29 22 16 12
85% lean
(3 oz. – 213 cal)
WHITE TUNA 26 19 15 11 8 6
Water Packed
(3 oz. – 109 cal)
ICE CREAM 66 48 37 29 21 16
Vanilla
(1 cup – 274 cal)
STRAWBERRIES 13 9 7 6 4 3
(1 cup – 53 cal)
GLAZED DOUGHNUT 57 42 33 25 18 14
(med – 239 cal)
TOAST 30 22 17 13 9 7
Whole-grain – 1 slice
(1 tbsp jam – 125 cal)
STARBUCKS CAFFE’ 65 48 37 28 20 16
MOCHA
2% milk – whp crm
(12 oz. – 270 cal)
COFFEE 10 7 5 4 3 2
1 tbsp half/half – 1 tbsp sugar
(12 oz. – 40 cal)
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
Last week, this column discussed the many benefits of snowshoeing as an option for those in NEPA to get outdoors and enjoy the winter. Today’s column will present another option for outdoor exercise when the weather is inclement…winter walking or running.
We live in such a beautiful environment. Each season brings its own unique beauty and winter is no different. Most will not have to abandon outdoor activities, but you must make some adjustments in equipment, clothing and food for each season and temperature changes that go with it. These tips are also appropriate for those who qualified for the Boston Marathon in the spring and will be training all winter, as well as those who enjoy walking and running throughout the winter for exercise. Consider the importance of making changes and adjustments in training as well as clothing and equipment, according to the weather and temperature.
There are running shoes specifically designed for use in wet, cold and sloppy winter conditions. These running shoes, which can also be used for walking, are considered “winterized” because they offer waterproofing, sealed seams, gaiter collars to keep out snow and slop, slip resistant fabric, anti-roll stability features, anti-microbial material and aggressive tread patterns for traction on slippery surfaces. Some shoe recommendations for both walkers and runners include:
Additionally, I am a strong proponent of walking with trekking poles for improved balance and safety when brisk walking in winter conditions. They are light weight, adjustable, and collapsible. Some examples are: Trekology Trek Z 2.0 – 45. and REI Co-op Trailmade $79.00. Also, an old pair of ski poles will work just fine.
Over the past several years great strides have been made on understanding the effects of extreme temperatures on performance. Current wisdom from the University of Otago in New Zealand has found:
Visit your doctor regularly and listen to your body.
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
It is one week away from the 27th Steamtown Marathon. This column is dedicated to all the runners preparing for the big day. One small piece of advice; start slowly, avoid the first mile adrenaline sprint downhill, and enjoy the journey! Remember, only one Olympic marathon winner (Juan Zabala, Argentina, 1932) was in the lead at the 5 mile mark. Lesson: The last miles matter more than the first!
Today, I hope to address some common questions for the novice marathon runner or for those coming from other locations to run in the race. What should you pack? How should I dress? What supplies will I need?
Elite runners are so experienced that they know exactly what to pack in preparation for the big marathon day. However, those, running in marathon for the first or second time usually have lots of questions. First, what you need and what you can bring will depend on your support team. If you are running alone and will not have family or friends meeting you along the way, then you are limited to a fanny pack and a few supplies. If you have a support team, then they can carry a bag with supplies, meet you along the course and you can have a sense of security.
Remember; do not do anything different on race day. Try out special clothing, water with supplements and snacks on a practice run. Also, experiment with your best pre-race meal. You will be getting up at 5-6:00am to catch the bus from Scranton to Forest City. You may want to pack breakfast to eat in the high school gym such as; bagel, peanut butter, jelly, banana and coffee or Gatorade. Moving your bowels before the race is a must.
Dress: Columbus Day Weekend in NEPA could bring 30 to 40 degree temperatures when you catch the bus in Scranton and at the 8:00 am race starting time in Forest City.
Clothing:
Accessories:
If you don’t mind the little pack on your butt, a fanny pack can be valuable. In it, you will want supplies such as: small bandages, small roll of medical tape, ibuprofen, antacid tablets, small tube of lubricant, favorite running snack, and extra shoe laces. One might also consider packing a little money, credit card, ID, emergency contact numbers and medical insurance cards. A cell phone is optional.
your supply bag. In the bag, you might consider all of the above fanny pack items and: A change of clothes such as: extra running shoes, socks, shorts, shirt, water proof wind breaker, according to the weather, especially if rain is predicted. Towels, ace bandages, gauze pads and wrap, antibiotic cream, mole skin, sunscreen, petroleum jelly, safety pins, extra water and favorite sport drink, favorite sport snacks, extra ibuprofen, antacid, anti diarrhea medicine, chemical ice pack, mobile phone, money, credit cards, ID, medical insurance cards.
For those with allergic reactions, remember to pack: epinephrine, antihistamine, and other important medications.
Map and directions to the bus or starting line, course map, race number, and get your timing chip.
Enjoy! Enjoy! Smell the roses, take in the fall foliage and chat with a fellow racer. Savor the moment enjoy the day…you are doing something very special!
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
We’ve all heard it before – encouragement to exercise to trim our waistline or to speed up our metabolism. However, there may be more benefit to lacing up those sneakers than you’d think. Recent studies have established a link between exercise and cognition, making physical activity even more important.
Exercise has been shown to improve sleep and mood, decrease stress, and even increase libido. It also can bolster our self-esteem and ability to problem-solve and to remember details. In fact, strength training has even been shown to reverse cognitive decline to a degree in aging adults with mild impairment. Though the medical community is still trying to elucidate exactly how exercise boosts our brains physiologically, increased circulation to the brain and modulation of the hypothalamus-pituitary-adrenal axis that regulates the body’s response to stress have been implicated as the bearers of benefit. While exercise can be advantageous for everyone, it perhaps is even more valuable to those struggling with mood disorders. Exercise can help combat anxiety and depression and quell the symptoms of Attention Deficit Hyperactivity Disorder and Post Traumatic Stress Disorder as it helps the brain to pump out neurotransmitters and pain-fighting endorphins. Exercise makes addiction management easier, as well, and has recently been shown to help alcoholics lessen consumption.
So, how much exercise exactly is enough to illicit tangible cognitive benefit, you ask? Any amount of weight lifting, running, walking, or yoga helps, but habitual activity helps the most. Studies cite that a few consecutive weeks of participation in a fitness regimen yielded notable, positive results in subjects. Try to make exercise part of your daily routine to encourage good fitness habits. If you find the idea of adopting a strenuous new fitness program intimidating or off-putting, have no fear. Moderate exercise is enough to do the trick. The Mayo Clinic cites both brisk walking and mowing the lawn as examples of moderate activity, so an average fitness level is adequate for yielding positive mental results.
If you’re thinking about beginning an exercise program for the first time, start gradually. Begin with walking for 10 to 15 minutes twice daily, and add 1 or 2 minutes to your session every time you walk until you can walk continuously for 45 to 60 minutes. The same principle can be used when beginning other fitness routines involving biking, swimming, running, etc. Begin a weight training program to strengthen bones and tendons using 3 to 5 pound dumbbells, and increase the weight you use by a pound once you can easily perform 30 consecutive repetitions. Be careful to pay close attention to posture and form. Contact your physical therapist or a personal trainer for assistance with designing an appropriate exercise program. Don’t hesitate to contact your physician, either, if you have questions about whether a particular exercise program is safe and suitable for your age group or current fitness level. Consider these tips to make the most of your workout:
Guest Contributor: Leanne Woiewodski, MD, graduate, GCSOM
Sources:
US National Library of Medicine, National Institutes of Health, Helpguide.org, IDEA Health & Fitness Association, Mayo Clinic, Public Library of Science
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
PEOPLE OFTEN ASK ME, “IS THERE SUCH A THING AS AN EXERCISE RUT?”. THEY WANT TO KNOW WHY THEY DO NOT SEEM TO BE IMPROVING WITH THEIR EXERCISE PROGRAM. They exercise 3-4 times a week for 30 to 45 minutes and they feel frustrated and STUCK in a rut.
The purpose of this column is to offer suggestions to improve or get more out of a “stale” exercise program. Last week’s column offered tips to improve a stale cardiovascular and strength program. We will discuss flexibility and functional training tips, including the components necessary for a healthy mind, body and spirit connection.
Flexibility training involves the careful stretching of the muscles, tendons and joints to improve range of motion in order to safely perform daily activities and sports without injuring or tearing soft tissues. It is probably the most neglected part of the fitness program. However, while the amount of inherent flexibility varies for each person, a minimal range is necessary as it relates to daily activities and sports. For example, as you age it is important to have enough flexibility in your back, hips and knees to wash your feet, put shoes and socks on. After a warm –up activity, perform flexibility exercises slowly and gently. There are two types of flexibility exercises; dynamic and static. Perform dynamic stretching with movement such as pushing the ankle up and down like a gas pedal. Complete passive stretching using an outside force, such as a towel to pull the ankle up to stretch the calf. Dynamic should be performed before an activity (before running or playing tennis) and static performed after the activity is over in order to increase range of motion for future activities.
In order to prevent an exercise program from getting stale, one must incorporate all aspects of wellness…a healthy mind, body and spirit!
It is easy for fitness enthusiasts to get so focused on maintaining a routine that they allow their program to become stale and ineffective. It is essential to reassess and update your program to prevent stagnation.
Make sure the routine has all three fundamental components of a well-balanced exercise program; cardiovascular, strength and flexibility training. Moreover, to be truly healthy, one must work toward a “Healthy Mind, Body, and Spirit. Therefore, in addition to traditional exercise one must incorporate the following: nutrition; meditation, relaxation techniques, yoga, core fitness; functional/sports specific training; leisure sports and activities
In order to prevent an exercise program from getting stale, one must incorporate all aspects of wellness…a healthy mind, body and spirit!
While each component offers its own specific benefit, the combination of all three cooperatively provides unique value. Too often, fitness enthusiasts concentrate on the exercises they LIKE or are good at more than the ones they NEED.
Sources: National Institutes of Health; American Council on Exercise
Model: Lily Smith, Physical Therapy Student, University of Scranton, PT aide, Mackarey Physical Therapy
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
PEOPLE WILL OFTEN ASK ME, “IS THERE SUCH A THING AS AN EXERCISE RUT?” THEY WANT TO KNOW WHY THEY DO NOT SEEM TO BE IMPROVING WITH THEIR EXERCISE PROGRAM…they exercise 3-4 times a week for 30 to 45 minutes and they feel frustrated and STUCK in a rut. While initially responding favorably to exercise, after 6 -9 months or more, they do not notice progress in weight loss, strength, tone, endurance or daily function.
The purpose of this column will be to offer suggestions on how to improve or get more out of a “stale” exercise program or an exercise rut. Step one is to build an exercise program that is grounded in the basics. Next step two, which begins after the basics have been mastered, includes the components necessary for a healthy mind, body and spirit connection and translates into functional activities of daily living including work and leisure sports.
Make sure your routine has all three fundamental components of a well-balanced exercise program; cardiovascular, strength and flexibility training. While each component offers its own specific benefit, the combination of all three cooperatively provides unique value. Too often, fitness enthusiasts concentrate on the exercises they LIKE or are good at more than the ones they NEED. A well-balanced program includes what you like and need! In fact, recent studies show that those performing all three components surpassed those performing one or any combination of two of the training types when tested for efficient oxygen uptake (VO2 Max), production of HDL (good cholesterol), lower body fat percentage, and lower blood glucose levels.
Cardiovascular exercise is any activity that raises your heart rate and respiratory rate. This type of exercise strengthens the heart muscle and the muscles that assist in breathing. When these muscles are stronger, they in turn work more efficiently to deliver oxygen to your muscles and other parts of the body. Ultimately, these oxygenated muscles can work harder and longer to burn fat during exercise and at rest.
Examples of Cardiovascular Exercises: Running, Brisk Walking, Swimming, Biking, Rowing, Elliptical Training and Stepper Training. Most experts recommend at least 30 minutes of sustained cardio, 3-4 days per week. However, recent studies support the notion of performing 10-15 minutes, twice daily, 4 days per week. For those “stuck” in a fitness or exercise rut, to advance your program, cardio should be performed 5-6 days per week for 45-60 minutes.
Strength training is an activity that provides any type of resistance to muscle contraction to build strength in the muscle. The resistance can be without movement against an immovable object such as pushing against a wall (isometric) or with movement such as lifting up or lowering a weight down against gravity (isotonic/dynamic). There are two types of isotonic muscle contraction; concentric, which involves raising the weight against gravity as the muscle shortens and eccentric which involves lowering a weight against gravity as the muscle lengthens. A standing biceps curl is an example that incorporates both concentric and eccentric contractions. A progressive strength training program includes all three types of muscle contraction. By using the classic bicep muscle curl these photos will demonstrate all three types of muscle contraction:
-Isometric Bicep Muscle Curl – pull up on door knob without allowing any movement of the arm.
-Concentric Bicep Muscle Curl – raise a dumbbell up against gravity as the muscle shortens.
-Eccentric Bicep Muscle Curl – lower a dumbbell slowly (4-6 seconds) against gravity as the muscle lengthens.
Sources: National Institutes of Health; American Council on Exercise
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
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NEXT WEEK! Read Stuck in an Exercise Rut…Part II of II:
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
During a recent “lunch-and-learn” meeting at our office, several younger staff members were discussing the use of supplements to compliment their fitness routines. One such staff member, Lily Smith, a physical therapy student aid at our clinic from the University of Scranton, is also a serious weight training and fitness enthusiast and shared her experience with creatine supplements with the hope of educating others, especially those preparing to “get fit” in 2024!
A National Health Interview survey found the creatine use among adolescents and young adults to be 34%. It is also very popular in the military with 27% average usage. While athletes and exercise enthusiasts use protein shakes and creatine supplements with hopes to improve size, strength and performance, it appears that most users do not have a full understanding of the risks and benefits. In view of this, today address the use of creatine in strength training and make recommendations based on the literature.
As long as I can remember, young athletes would take or do anything that they believed would improve their speed, strength, agility and athletic edge in order to succeed in sports. Running with weights wrapped around the ankles, drinking raw eggs and whole milk, and consuming copious amounts of beef, pork, and chicken were not unusual. Today, it may not be much different. However, the products do not come from our kitchen cabinet and tremendous misinformation is associated with it. Creatine is one example that was purported to enhance performance as early as the 1970’s but only gained popularity in the 1990’s. 40% of all college athletes and 50% of professional athletes admit to using creatine at some point, despite a lack of scientific evidence to support its effectiveness or safety.
This supplement is a natural substance that turns into creatine phosphate in the body. Creatine phosphate helps produce adenosine triphosphate (ATP), which provides energy for muscles to contract. While the body produces some creatine, it can also be found in foods rich in protein such as meat and fish. Manufacturers claim that creatine use will improve strength, increase lean muscle mass and aide in the recovery from exercise induced fatigue.
While creatine is popular among young people due in part to its availability, very little research has been done in people under 18 years of age. Even in the few studies conducted on adults, the results regarding efficacy are mixed. Some studies show that creatine may improve strength performance due to the recovery cycle of ATP. In theory, the use of creatine is purported to allow one to recover more quickly from exercise. For example, shortly after lifting heavy weights to failure, a quick recovery might allow the weight lifter to lift an additional set of repetitions to increase the duration of intensive training. Therefore, based on this theory, one must work out to complete failure during training to benefit from creatine. However, it is important to remember, there is no evidence that this purported benefit is realized in performance improvement in weight training or endurance sports.
Furthermore, no studies support the notion that it improves performance in endurance sports. Also, research does show that not all users are affected by creatine the same way. Most users fail to find any benefit at all. More concerning to this author is the fact that there are no guidelines for safety or disclosure of side-effects from long term use. Make no mistake, based on the research and current wisdom, CREATINE IS AN UNPROVEN TREATMENT SUPPLEMENT!
If one decides that creatine is a product they would like to use, despite the lack of evidence for its effectiveness, there are recommendations that one should follow for proper use. But there is no consistently established dose. Some studies have found 25 grams daily for 14 days as a “kickstart” dose or “loading” phase followed by 4-5 grams (or 0.1 g/kg of bodyweight) daily for 18 months with few side effects such as: muscle cramps, dehydration, upset stomach, water retention/bloating with weight gain. It is important to remember when establishing a dosage that many weight training supplements already contain creatine and in high doses excess creatine is excreted by the kidneys. It is also recommended that creatine users “wean off” the product when they decide to discontinue use.
Remember, an average adult in the United States receives 1 to 2 grams of creatine each day from a normal, well-balanced diet. Creatine is naturally found in meat, poultry and fish and theoretically, one could increase their creatine intake through dietary changes. Some manufacturers recommend 10 to 30 grams per day with a maintenance dose of 2 to 5 grams per day for athletic performance. Creatine is available in many forms; tablets, capsules and powder. It should be kept in a cool, dry place out of direct sunlight.
Creatine use is not recommended if you are pregnant, breast feeding, have kidney disease or bipolar disorder. There are many reported side effects associated with creatine use such as; water retention, nausea, diarrhea, cramping, muscle pain and high blood pressure. It is recommended that users consume large quantities of water when taking creatine to prevent dehydration. It may be very dangerous to use creatine when dehydration or weight loss is associated with an activity such as wrestling or summer sessions during football.
Furthermore, some studies show that large amounts of carbohydrates may increase the effects of creatine and caffeine may decrease the effects. Users are warned that using creatine with stimulants such as caffeine and guarana (a Brazilian plant extract similar to caffeine found in energy drinks) can lead to serious cardiac problems. The effects of creatine supplements on the many organ systems of the body are unknown. High doses may cause kidney damage. Although no cases have been reported in the literature, it is not known how it may interact with other supplements, over-the-counter medications and prescription drugs.
In conclusion, despite the lack of scientific evidence that creatine is more effective than proper nutrition and effective weight training, it remains a popular, easily available supplement purported to improve strength, endurance and performance in athletes. While relatively safe if taken as directed, it is always wise to consult your physician, especially if you have a history or risk of kidney problems. And, by the way, Lily did not feel that creatine supplements made any significant difference, positively or negatively. She no longer uses it due to the expense, inconvenience and lack of scientific evidence to support its efficacy.
Sources: University of New England; Medicine & Science in Sports & Exercise; NIH and Lily Smith, PT student, University of Scranton, Student PT aide, Mackarey Physicla Therapy
.Visit your doctor regularly and listen to your body.
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
January is the time of year that many people set goals and resolve to be their very best. Not surprisingly, weight loss and fitness are the most common resolutions. It is also a time when many residents of NEPA will plan vacations and travel to warmer climates. Well, it may be that you can do both… This year consider visiting a “Fitness Resort.” According to “FitStays,” fitness resorts are rapidly gaining popularity for people of all sizes and shapes. Last week in Part I of “Fitness Resorts” we discussed value of fitness resorts. This week we will present “a typical day, how long you should stay, expected costs, and some recommended resorts.
A fitness resort is a vacation destination where travelers go to exercise and lose weight. Sometimes called a “weight loss resort”, “fitness retreat”, “wellness resort”, “weight loss boot camp”, or “adult fat camp”, fitness resorts around the United States cater to people of all shapes and sizes.
Most fitness resorts consist of pre-determined, calorie-limited menus to help travelers in their weight loss journey. Some resorts promote menus of 1,000 to 1,500 calories-per-day, which is fewer than most people burn naturally via their resting metabolic rate (RMR).
In addition to net-negative calories through nutrition, fitness resorts and retreats typically have an extensive workout plan as part of their standard program. Many resorts and retreats offer daily hiking, in addition to strength classes, cardio, sports, and other physical activities.
The combination of healthy nutrition and active exercise means that most visitors can expect to lose weight at a fitness resort. Specific weight loss goals are determined by which fitness resort you pick, how long you stay, and how strenuously you want to stick to the program.
Fitness resorts (fitness retreats) are not your average “Reality TV Fat Camp.” In fact, your do not have to be excessively overweight to attend as people of all shapes and sizes benefit and enjoy the experience. Thousands of people chose to visit fitness resorts and fitness retreats every year because they are looking for a healthy alternative to a typical vacation. Instead, many want to “kick-start” a healthy lifestyle in a controlled environment. The basic concept of combining a limited-calorie diet with daily exercise, most people will have net-negative calories every day, lose weight, and gain strength and endurance at a fitness resort—provided they stick to the program.
Typically, fitness resorts offer one week programs but multiple weeks with a variety of options are available. However, for the best outcomes and carryover, experts recommend 2-3 weeks for your first visit to a fitness resort.
Fitness resorts, like everything else, vary in cost. According to FitStay, programs cost as little as $1,500 per week (all-inclusive), while some are more than $7,000 per week.
To choose the best fit for you, your budget, and goals, visit fitstay.com. Remember, most fitness resorts are all-inclusive, meaning that you won’t need to budget any extra for food. The program includes meals. Also, when choosing a fitness resort consider: location (where would you like to travel?); cost (how much can you afford to spend?); how long can you stay (one, two or three weeks?)
NOTE: One of these includes a fitness retreat in our very own Pocono Mountains!
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
January is the time of year that many people set goals and resolve to be their very best. Not surprisingly, weight loss and fitness are the most common resolutions. It is also a time when many residents of NEPA will plan vacations and travel to warmer climates. Well, it may be that you can do both…this year consider visiting a “Fitness Resort!” According to “FitStays,” fitness resorts are rapidly gaining popularity for people of all sizes and shapes.
A fitness resort is a vacation destination where travelers go to exercise and lose weight. Sometimes called a “weight loss resort”, “fitness retreat”, “wellness resort”, “weight loss boot camp”, or “adult fat camp”, fitness resorts around the United States cater to people of all shapes and sizes.
Most fitness resorts consist of pre-determined, calorie-limited menus to help travelers in their weight loss journey. Some resorts promote menus of 1,000 to 1,500 calories-per-day, which is fewer than most people burn naturally via their resting metabolic rate (RMR).
In addition to net-negative calories through nutrition, fitness resorts and fitness retreats typically have an extensive workout plan as part of their standard program. Many resorts and retreats offer daily hiking, in addition to cardio and strength classes and assorted sports and other physical activities.
The combination of healthy nutrition and active exercise means that most visitors can expect to lose weight at a fitness resort. Specific weight loss goals will be determined by which fitness resort you pick, how long you stay, and how strenuously you want to stick to the program.
Fitness resorts (fitness retreats) are not your average “Reality TV Fat Camp.” In fact, you do not have to be excessively overweight to attend as people of all shapes and sizes benefit and enjoy the experience. Thousands of people chose to visit fitness resorts and fitness retreats every year because they are looking for a healthy alternative to a typical vacation. Instead, many want to “kick-start” a healthy lifestyle in a controlled environment.
Fitness resorts have been found to be effective for most attendees. The basic concept of combining a limited-calorie diet with daily exercise, most people will have net-negative calories every day, lose weight, and gain strength and endurance at a fitness resort—provided they stick to the program.
While some people report losing 1-3 pounds-per-week at a fitness resort, others experience much more success. Exactly how much you will lose will be dependent on a wide variety of factors, including the duration and intensity of your exercise and activities and the calories you consume. Inherently, men tend to lose weight more easily than women, and younger people typically have an easier time shedding pounds than older people.
Ideally, for long term success, a fitness resort program should be a part of a healthy lifestyle, rather than an absolute weight loss goal. Be aware that many “spas and wellness centers” entice people with lavish facilities in a beautiful environment but mostly offer passive modalities such as massage, meditation, acupuncture, manicures, pedicures and facials. While these modalities have value, if your goal is jump start on weight loss and physical fitness, a fitness resort may be a better option.
Most fitness resorts are not “diet retreats” or painful “boot camps.” With a little effort, you can easily find the right fit for you. You will not starve! While you need to limit caloric intake, you also need enough energy for the 3-6 hours of exercise and activities (swimming, biking, hiking, Zumba, Yoga) offered. There is no need to be intimidated as most attendees are like-minded people with the same goals and needs. A good resort will not only provide the right amount of calories and exercise for your goals but also educate you how to prepare meals and engage in proper exercise once you return home.
According to FitStays, most fitness resorts offer a set schedule and a camp-like experience for adults with three meals every day, usually prepared by expert nutrition staff and/or dietitians, designed around healthy foods. A typical morning begins with extended cardio exercises, such as a run, bike or hike. The afternoon may have more intense exercise classes such as strength training classes as well as more fun activities such as sports and games. Educational classes are offered throughout the day, so you can carryover the lessons from your fitness resort experience when you return home. Evenings are usually lighter to allow for leisure, rest, or spa services, which are also offered at many resorts.
NEXT WEEK: FITNESS RESORTS - PART II – A typical day at a fitness resort, recommended length stay, cost and top 20 recommended resorts.
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, please check out our exercise forum!
