[ORRando] [Fwd: DrMirkin's eZine: Extreme exercise, dehydration, more . . .]

[Michael R]

Another reason to keep on doing those long rides.


---------------------------- Original Message ----------------------------
Dr. Gabe Mirkin's Fitness and Health e-Zine

September 8, 2013

Extreme Exercise Associated with Longer Life

Researchers have shown that French Tour de France cyclists live six years
longer than other Frenchmen (European Heart Journal,
published online Sep 3, 2013 and presented the same day  at the
annual meeting of the European Society of Cardiology).  These
bicycle racers live longer, even though  they are far more prone to
accidents than the average Frenchman, and many have had a high
degree of exposure to dangerous drugs.

The study included 786 French cyclists who competed in the Tour de France
from 1947 to 2012.  In that time, 208 of the cyclists have
died. The bicycle racers had a 41 percent lower death rate than the
general population. The bicycle racers also suffered far fewer
cancers, heart attacks or lung diseases.  For more on the benefits of
endurance exercise, see

http://www.drmirkin.com/public/ezine052012.html

http://www.drmirkin.com/public/ezine031112.html

http://www.drmirkin.com/public/ezine091910.html

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Mild Dehydration Slows You down in Hot Weather

Drink fluids when you exercise intensely for more than an hour,
particularly in hot weather. A study from the University of
Arkansas shows that a mild one percent dehydration (loss of about
1.5 pints of fluid):

* slows down competitive bicycle racers by a mile per hour, over a
three-mile time trial course (5 kilometers),

* reduces power to drive the pedals by ten watts,

* raises stomach temperature, and

* lowers sweat sensitivity that controls body temperature.

The riders reported that they could not tell that they rode more
slowly when they were mildly dehydrated.  Their heart rates were
the same during one percent dehydration and normal hydration.
(Medicine and Science in Sports and Exercise, September, 2013;45
(9):1782-89).

You Can’t Depend on Thirst to Tell You that You are Dehydrated

If you wait until you feel thirsty, you will not know that you are
dehydrated until it is too late to catch up on your fluid loss
during competition.   The sensation of thirst comes from certain
cells in your brain called osmo-receptors.  Osmo-receptors do not
tell you that you are thirsty until blood salt levels rise very
high.   Most of your fluid loss during exercise is through
sweating.  Sweat contains far less salt than blood does, so during
exercise you sweat and lose far more water than salt, so your blood level
of salt rises constantly.   You do not feel thirsty until you have lost
between two and four pounds of fluid, or two to four
pints (“a pint is a pound the world around”).  By then, you have
already lost the race and won’t be able to catch up to competitors who
are not dehydrated.

Can You Take in Too Much Fluid?

Occasionally you will hear about a marathon runner or bicycle racer dying
from hyponatremia,  low blood salt levels caused by taking in too much
fluid and virtually no salt.  If an exerciser takes in too much fluid and
no salt, the extra fluid gets into their blood which dilutes the salt
concentration in their blood.   Since fluid moves from an area of low salt
into an area of higher salt, the fluid
moves from the lower-salt bloodstream into the higher-salt brain.
The brain swells but it is locked in a non-expandable skull, so the brain
is crushed and can cause death.

This is a catastrophe that usually occurs in poorly-conditioned
people who move so slowly in their races that they spend more time
drinking than they do running or biking.  Virtually never does it
affect well-conditioned athletes competing at high intensity
because they will become severely short of breath if they spend too much
time drinking and swallowing.  More on hyponatremia at
http://www.drmirkin.com/fitness/hyponatremia.html

How Much Should You Drink?

I recommend starting to take fluid within the first hour of a race or hard
exercise session, sooner in very hot weather. On a hot day, racers should
try to take in at least one water bottle (2 and a
half cups) per hour.  A person exercising near his capacity,
breathing hard and not slowed down by fatigue probably does not
have to worry about limiting fluid intake. He is working so hard at
maintaining intensity, he doesn't have enough time to drink too
much. On the other hand, people slowed down by fatigue or those out of
shape, should limit fluid intake, probably to less than two
large water bottles per hour. If you are exercising for more than
an hour, you should also replace salt (Clinical Journal of Sport
Medicine, July/August 2005). We eat salted potato chips when we
ride intensely for more than three hours.

Sex Before Athletic Competition OK

Muhammad Ali would not make love for six weeks before a fight and
some football players won't make love on the night before a game.
 Coach Glenn Hoddle told his players to avoid sexual relations
during the month-long 1998 soccer World Cup, However, an article in the
Journal of Sports Medicine and Physical Fitness (Sep
1995;35(3):214-217) showed that sexual relations on the night
before competition have no effect on endurance to exhaustion on a
treadmill, strength, the ability of the body to transport oxygen to
muscles, or the amount of blood pumped by the heart.

Lovemaking is not a very demanding exercise. The most aggressive
people burn about 250 calories an hour or 4 calories per minute
while making love, and the average person makes love for about five
minutes and burns about 25 calories.  That’s less energy than it takes
to walk up two flights of stairs. If you think that you
shouldn't make love on the night before a game, you shouldn't
participate in pre-game warmups; they are much more demanding than sex.

Not Making Love Can Hamper Athletic Performance

On the day before competition, most athletes usually reduce their
workouts and have extra energy. If they don't make love, they spend the
night tossing and turning and wake up exhausted. Casey Stengel, the former
manager of the New York Yankees, said “it’s not sex that wrecks these
guys, it's staying up all night looking for it.”

The Buffalo Bills football players were rumored to have been
separated from their wives before four straight Super Bowl games
(1991-1994). You know their record: zero and four.  The Minnesota
Vikings also lost four Super Bowl Games (1970, 1974, 1975 and
1977).    The directors of the 2012 Olympics in London knew better.
 They handed out 150,000 condoms to the 10,500 competing athletes.

The Scientific Data

Making love has been shown in scientific studies to have no effect on
power or endurance (Clinical Journal of Sport Medicine, October
2000;10(4):233-315).  Sexual relations do not weaken muscles (J Sex Res
1968; 4:247–248), and do not decrease endurance by reducing
maximal aerobic power or oxygen uptake (J Sports Med Phys Fitness
1995;35:214–217).

However, it is possible that the emotional effects of making love
may calm the athlete so much that he could lose some of the
aggressiveness necessary for successful athletic competition.
Nobody has measured the psychological effects that making love
could have on athletic performance.  We do know that making love
can raise blood testosterone levels, and testosterone increases
aggression to make an athlete more competitive.

Should You Make Love Before Competition?

It depends on what you believe. If you think that love making will harm an
important golf game or tennis match, don’t do it.  On the other hand, if
you believe that lovemaking has no effect on
athletic performance, go for it. At least your partner won’t be
disappointed with you.

History of Bed Rest

>From 1900 to 1940, doctors routinely put people to bed for at least two
months after a heart attack .  In the 1950s the first studies
came out to show that men who were put to bed after a heart attack were
more likely to die than those who were active.  Doctors
responded by shortening bed rest from two months to two weeks.

President Dwight D. Eisenhower

On Sept 23, 1955, the President of the United States, Dwight D.
Eisenhower was playing golf at Cherry Hills Country Club when he
complained of pain in his chest and belly.  His doctors diagnosed a heart
attack and ordered immediate bed rest and kept him in bed for several
days.  They were afraid to let the President out of bed and were very
concerned about an abnormality on his electrocardiogram.

When his doctors started to lose sleep worrying that the president might
die, they called Paul Dudley White from Boston.  The first
thing that Dr White did was check Eisenhower’s electrocardiogram and the
second thing he did was to get Eisenhower out of bed and
start him walking.   Paul Dudley White was at the Mass General
Hospital when I was there in the early 1960s.  I saw him ride his
bicycle to work during the warmer days and he continued to do so
through his eighty-fourth birthday.

The Medical Community Wakes Up

The news media of the entire world carried stories of how President
Eisenhower was told to walk after his heart attack.  Only then did most
doctors realize that they would be criticized for keeping
heart attack victims in bed when the President of the United States was
told to get up and walk around.  However, they were afraid to
change their recommendations until scientific studies told them to do so.

President Eisenhower recovered and went on to continue serving as
president for one more term. This prompted doctors to do more
studies and they all showed that bed rest afer a heart attack can
kill.  Now, doctors get people up after heart attacks as soon as
they think that it is safe to do so, and that is often within 12 to 24 hours.

Early Critics of Bed Rest

BCE 450, Hippocrates wrote that long-term bed rest can cause loss
of bone and teeth.
During World War II, American soldiers were drafted and some were
sent to do their basic training at the  Great Lakes Naval Training Center
before they were sent to fight in Europe.  A major epidemic of flu
occurred affecting almost all the troops.  Doctors set up a study of bed
rest by having half of the soldiers stay in bed, while the other half kept
up the vigorous exercise program of basic
training.  Both groups took the same amount of time to recover,
although those who had to continue their basic training (instead of
resting in bed) complained more.

Learning from the Astronauts

After World War II, researchers started to write about inactivity
breaking down every cell in your body. When an astronaut was sent
to the moon, the combination of weightlessness and immobility
caused him to come back:

* looking much older

* being much weaker, with smaller muscles and inability to walk, and

* having smaller and weaker bones that were at increased risk of
breaking.

The same things start to happen when you stay in bed more than one day.

What Happens to Your Body When You Stay in Bed?

After you have been lying down for just two hours, one liter of
fluid moves from your legs to your belly, chest and head. Your
kidneys respond by pumping fluid into your bladder.  This decreases your
blood volume and your heart doesn’t need to pump as much blood through
your body.  Therefore your heart pumps less blood with each beat. This
decreased work load causes your heart muscle to shrink
and weaken.  After a few days of staying in bed, your heart can
become too weak to pump blood efficiently when you walk, so you
feel dizzy and have difficulty walking.  After several weeks of
staying in bed, you continuously lose the maximal ability to take
in and use oxygen.  The least bit of activity will make you feel
tired. (JEPonline 2007;10(3):32-41).

Bed Rest Does Not Help Heart Attack Victims

More than fifty years after President Eisenhower’s heart attack,
researchers reviewed the medical literature and found no difference in
healing between heart attack victims assigned to a short bed
rest (averaging six days) and those assigned to long bed rest
(averaging 13 days) (Cochrane Database Syst Rev, Apr 18, 2007 and J Clin
Epidemiol, 2003 Aug;56(8):775-81).  Further studies showed
that there is no advantage  to extending bed rest beyond two to 12 days. 
Today, the American College of Cardiology/American Heart
Association) recommends at least 12 hours bed rest in patients with
uncomplicated heart attacks.

Bed Rest Not Good for Most Cancer Patients

A study in the Physician and Sportsmedicine (May, 2000) showed that
exercise helps cancer patients recover faster and improve their
lifestyles and attitudes.  These studies do not suggest that you
should exercise when you feel miserable. They do show that there is no
evidence that staying in bed helps you to heal faster.

Bed Rest Also Not Good for Other Diseases

A review of the medical literature from 1966 forward found no
evidence that bed rest helps you heal faster from any medical
condition (Lancet October 9, 1999;354:1129-1233).  Researchers
found only 39 studies testing whether bed rest benefitted any
medical condition, and 24 of those studies showed that bed rest was of
little or no benefit in preventing side effects of medical
procedures such as spinal anaesthesia, spinal fluid withdrawal or
multiple x ray procedures. Fifteen studies showed no benefit in
treating medical conditions such as low back pain, spontaneous
labor, high blood pressure during pregnancy, uncomplicated heart
attacks, rheumatoid arthritis or infectious hepatitis.

The next time you feel sick, you can stay in bed if you like, but
bed rest will not help you to heal faster.



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