Sick middle age woman blowing her nose

Client Question: Should I Exercise When I’m Sick?

Another great question from one of our exercise physiology clients in St Lucia:

Should I exercise when I’m sick?

In broad terms, moderate exercise and good fitness support good health. But improving your fitness levels doesn’t guarantee that you’ll never catch a cold or the flu. Here are your science-supported guidelines for exercising when you’re sick.

  • Consider how sick you actually are. If your illness is moderate to severe, with an associated fever, aching muscles, extreme fatigue, or swollen glands, skip your workout and rest up. Do what you would normally do to get yourself better, whether that’s heading to the doctor or heading to bed with some extra vitamin C.
  • If you are severely ill, with the above symptoms, you may need as much as two to four weeks away from moderate to intense exercise. Illness and exercise both stress the immune system in the same way, and depending on what type of viral or bacterial infection, pushing through to work out when you’re sick can actually make your illness worse. In extreme cases, this can lead to lasting damage to your heart or lungs.
  • If your illness is minor, without any associated fever, muscles aches or fatigue, or swollen glands, you might be ok to exercise. General guidelines suggest that:
    • If your symptoms occur above the neck (stuffy or runny nose, dry cough, or sore/scratchy throat), you’re safe to start with easy exercise or activity – think short sessions that are low intensity, like heading out for a walk. If you find your symptoms get worse, stop exercise until they improve.
    • If you’ve got symptoms below the neck (fever, aching muscles, vomiting, diarrhea, or anything else to do with your digestive tract), rest up until your symptoms go away.
  • Use your common sense. Do you feel too tired to work out, or otherwise just don’t feel up to it? Your body is giving you the answer right there! You wont make any gains when working out under fatigue or illness, and in fact you may prolong your recovery. Get some extra sleep and get back to quality exercise when you’re feeling ready for it.

Putting your workouts on hold can be frustrating, especially when you’re working hard to build your momentum and maintain your progress. If you’re feeling this, take a minute to step back and look at the big picture: You could push through and do your workout, but will it be worth it? You’re unlikely to make any gains in fitness, and may prolong your illness and recovery. We all need more sleep anyway, so indulge in that, get better faster, and get back to life as you want it!

For more information:
Gleeson, M. (Ed.). (2006). Immune function in sport and exercise. Sydney: Churchill Livingstone Elsevier.
Plowman, S. A., & Smith, D. L. (2017). Exercise Physiology For Health, Fitness, and Performance (5th ed.). Philadelphia: Lippincott Williams & Wilkins.

 

 

Get started with a safe exercise that will improve your health and fitness with an in-home exercise physiology program from HealthFit Coaching. Regardless of your current health levels, you can safely work out to improve your health, fitness, energy levels, and quality of life. Contact us now to find out how.


Body composition scans showing lean muscle and body fat

What’s More Important, Body Weight or Body Composition?

Both body weight and body composition are important in developing and maintaining good health. Does one deserve more attention than the other?

When you step onto the scale, the number you see accounts for the weight of all the tissue in your body. Body composition breaks down your weight into percentages of fat mass and lean tissue mass, providing a much clearer picture of what’s inside your skin. When it comes to health risks and rewards, it’s the percentages that count.

Your overall weight can provide insight into how high your health risks are, but there’s more to it than simple cause and effect – that number can be completely misleading. Compare a 100kg/220 pound bodybuilder to an inactive office worker who is exactly the same height, and also happens to be the same weight. You’re probably imagining two very different looking bodies with very different levels of health, fitness, and overall wellbeing – all due to the amount of body fat each person carries.

Fat cells are as active as any other cells in your body, producing a variety of hormones and other molecules that can increase your blood pressure, lead to insulin resistance, diabetes, atherosclerosis, and can have a negative impact on your cholesterol and triglyceride levels. Abdominal fat cells appear to have a greater influence on these health markers. In addition, increased fat mass leading to high body weight can be hard on the body as whole, increasing stress on the heart, lungs, and joints, reducing sleep quality, and increasing mental and emotional stress. Lean body tissues, on the other hand, overwhelmingly provide support and protection to the body and your health, giving you the ability to cope with physical stress.

While there are no universally agreed upon standards for healthy body fat percentages, we do know that healthy levels vary by age range and sex. Body fat levels typically increase with age, and women generally have a higher body fat percentage than men, likely due to the role body fat plays in reproduction. The published research on body fat norms generally suggests that for health benefits, men should maintain 10-25% body fat from the age of 35 onwards, and women should maintain 23-38% body fat for the same age ranges.

There are a number of techniques available that can provide a basic body composition measurement, though these vary in ease of access, accuracy, and cost. Bio-impedance devices, like the hand-held machines or scales that provide a body fat estimate, are by far the most common commercially available options. These devices have varying degrees of accuracy, but in general are a good option for at-home measurement. Other methods include skinfold measurement, air or water displacement techniques, and the DEXA scan – the same one that is used to provide measurements of bone density for those at risk of osteoporosis.

Regardless of what method you choose, you need to stick with that method or machine to get the most accurate picture of progress, as different techniques use different equations to get your percentage. And for health reasons, it’s the fat percentage that counts. While excessive body weight is associated with many chronic health conditions, poor quality of life, and often to an untimely death, you’ll have much better control over your risk factors by keeping the body fat percentage low and not worrying as much about overall weight!

 

For more information:
Pescatello, L. S. (Ed.). (2014). ASCM’s Guidelines For Exercise Testing and Prescription (9th ed.). Philadelphia: Lippincott Williams & Wilkins.
Plowman, S. A., & Smith, D. L. (2017). Exercise Physiology For Health, Fitness, and Performance (5th ed.). Philadelphia: Lippincott Williams & Wilkins.
Trefethen, L. N. (n.d.). New BMI ( New Body Mass Index). Retrieved March 03, 2018, from https://people.maths.ox.ac.uk/trefethen/bmi.html

Microscopic view of heart muscle cells

If exercise and high blood pressure both lead to an enlarged heart, why is one good and the other bad?

Before we get into the answer, it’s helpful to remember that your heart is actually a muscle, and like any other muscle, it responds to the demands of hard work by getting stronger and larger. So while an enlarged heart – known clinically as cardiac hypertrophy – might not sound good, it can actually be great for your long term heart health.

Let’s break down the anatomy and physiology:

The heart has four chambers, and the size of these chambers determines how much blood the heart can pump with each beat (volume). The thickness of the chamber walls determines how forcefully the heart can beat, or to think of it another way, how fast the blood is moving when it is pumped from the heart. The elasticity of healthy blood vessels helps accommodate changes in heart beat volume and blood speed, allowing the whole system to work efficiently with minimal health risk.

Regular cardiovascular exercise stimulates changes in both the chamber size and the wall thickness of the heart, as the working muscles will need more oxygen and nutrients to continue exercise and the heart will beat faster to accommodate. This stress can be good for your health, as over time, these changes allow the heart to pump more efficiently, using fewer beats to move the same amount of blood.

High blood pressure can also cause heart enlargement, however in this situation only a thickening of the walls occurs. This is primarily seen in the left ventricle, the last chamber of the heart before the blood is pumped into the vessels. This specific enlargement is called left ventricular hypertrophy, and is actually stimulated by a loss of elasticity in the blood vessels. Stiffer blood vessels require the heart to pump harder to move the blood, as there is more resistance from the blood vessel walls that prevents the blood from flowing as easily. Because the overall needs of the body don’t change, the volume of blood pumped per beat will remain the same and no change in chamber size will occur. Overall, thicker walls without a concurrent change in chamber size will complicate good heart function, as the heart chambers may not fill as well and the volume of each heart beat will be decreased.

If you have might blood pressure, it’s worth talking to your doctor about your risk of left ventricular hypertrophy, as it has been associated with sudden cardiac death. If you already have this condition, it’s really worth talking to your doctor because there is evidence that exercise and changes to your diet and body composition can have a positive impact on the heart structure, and you want to be able to make these changes safely.

 

References
Cohen J. L., Segal K. R. (1985) Left ventricular hypertrophy in athletes: an exercise-echocardiographic study. MSSE, 17(6):695-700. 
Pluim, B. M., Zwinderman, A. H., Laarse, A. V., & Wall, E. E. (2000). The Athlete’s Heart : A Meta-Analysis of Cardiac Structure and Function. Circ, 101(3), 336-344. doi:10.1161/01.cir.101.3.336
Smith, D. L., & Fernhall, B. (2011).  Advanced cardiovascular exercise physiology.  Champaign, IL: Human Kinetics.

 

Image by OpenStax College [CC BY 3.0 (http://creativecommons.org/licenses/by/3.0)%5D, via Wikimedia Commons

Vitamin B12 rich salmon for lunch or dinner

Fast Facts: Vitamin B12

Vitamin B12 is also referred to as the “energy vitamin” thanks to key contributions to energy production. While daily requirements are quite low and your body can easily store large amounts of B12, some conditions and dietary choices can lead to low B12 levels. It is essential for red blood cell formation (needed to transport oxygen to the brain and all other body parts) and helps prevent nerve damage and peripheral neuropathy.

Without adequate B12, your body will struggle to produce energy at a cellular level, as the vitamin is active in many steps in this process. As well as nerve protection, a good B12 supply also acts to decrease the risk of stroke and other cardiovascular disease.

Dietary intakes in western cultures usually provide an adequate to abundant supply of B12, and in fact, deficiencies often stem from problems absorbing the vitamin rather than not eating enough of it. However, if you normally take certain medications or eat a primarily plant based diet, you may want to talk to your doctor to find out if a supplement will be worthwhile for you.

Vitamin B12 is involved in:
  • Production of red blood cells
  • DNA synthesis and production
  • Protection of the myelin sheath, the protective covering around nerves that helps transmit nerve signals
  • Support of the cellular processes that produce energy
  • Maintaining low blood levels of homocysteine, a protein that in high levels is linked to stroke and cardiovascular disease, including coronary heart disease and peripheral vascular disease
Food sources of vitamin B12 include:
  • Fish and shellfish, especially salmon, sardines, tuna, cod, scallops, and shrimp or prawns
  • Lamb and beef, especially liver
  • Dairy products
  • Mushrooms
  • Fermented foods like tempeh
Getting too much vitamin B12 can lead to:

It’s almost impossible to get too much B12! There are no known signs of excessive levels.

Not getting enough vitamin B12 can lead to:
  • Neurological problems, including memory loss, dementia and Alzheimer’s disease, mania, and psychosis
  • Neuropathy, or tingling, burning, or loss of sensation in a part of your body (often in hands or feet)
  • Multiple sclerosis (MS)
  • Depression
  • Migraine
  • Macular degeneration
  • Kidney disease
  • Shingles
  • Megaloblastic anemia, a condition where red blood cells are poorly formed
  • Fatigue and weakness
  • Loss of appetite and weight loss
More on vitamin B12:
  • Plant based diets, especially vegan diets, are at higher risks of B12 deficiency as most food sources are animal-based. You may want to consider a supplement.
  • If you have acid reflux, and especially if you are taking an antacid, a proton pump inhibitor (PPI) like Nexium or Prilosec, you may not absorb B12 from your diet. Talk to your doctor. You may want to consider a sublingual supplement (placed under the tongue to absorb).
  • Your ability to absorb B12 decreases with age, in part due to changes in digestion.
  • Some research has shown that vitamin B12 may help maintain bone density and generally support bone health. However, additional research is needed to confirm this.
Vitamin B12 combined with other medications and health conditions:

Taking vitamins may have adverse effects when combined with some over the counter or prescription medications, and some medications can decrease vitamin absorption. Some health conditions can be impacted by high vitamin B12 intakes. Talk to your doctor prior to increasing your vitamin B12 intake if you have or are taking:

  • Anticonvulsants
  • Some chemotherapy medications. While B12 can interfere with the actions of some chemotherapy drugs, it can also protect against chemotherapy-related neuropathies. It’s highly recommended to have a conversation with your oncologist about whether you can take B12 supplements as a preventative measure for neuropathy.
  • Colchicine (also known as Cilicaine or Colcrys), used to treat gout.
  • Cholesterol lowering drugs
  • Medications used to treat high stomach acid, including proton pump inhibitors like Nexium, Prilosec, and Prevacid, or H2 blockers like Zantac, Pepcid, or Pepzan
  • Metformin, used to treat diabetes
  • Tetracycline-type antibiotics

Fast Facts: Magnesium

While present in only small amount in the body, magnesium is nonetheless one of the most important dietary micronutrients. In over 300 of the chemical reactions required to sustain life, it acts a co-factor – essentially a “helper molecule” that is needed for an enzyme to carry out its function. Many of these reactions have a key role in creating your body’s energy and in efficient nervous system function. On a whole-body level, many people report that magnesium has a calming effect, helping to manage anxiety, decreasing muscle cramps, and can lead to better sleep.

Men tend to need more than women, thanks to a generally larger body size, however most people have a much-lower-than-recommended intake daily basis. In Australia, a national health survey in 2011-2012 showed that anywhere from one-third to one-half of the population did not meet the required intake, depending on age group (older adults are at higher risk.) A 2005-2006 survey in the United States found that a majority of Americans did not meet estimated average requirements (EAR) of magnesium, and it should be noted that the EAR measure is the intake level estimated to meet the requirements of 50% of healthy individuals, which may be a lower level than your individual requirements. In short, most of us don’t get adequate magnesium supplies from food.

This can be due in part to food choices (some are more magnesium-rich than others) as well as the impact of other nutrients on the body’s ability to absorb magnesium. Additionally, some diseases and health conditions can impact the body’s ability to absorb the mineral, and some lifestyle choices – like higher levels of physical activity or exercise – can lead to higher intake requirements.

 

Magnesium is involved in:
  • Cellular energy production via carbohydrate and fat metabolism
  • Protein and DNA synthesis
  • Regulates transport of ions (chemical molecules) across cell walls, plays a large role the muscle cells ability to contract and relax
  • Chemical reactions that create cellular “second messengers” that send signals within a cell
  • Movement of cells to damaged areas, and wound healing
  • More than 300 enzyme-driven chemical reactions all over the body
Food sources of magnesium include:
  • Dark leafy greens, especially spinach and Swiss chard
  • Nuts and seeds, especially pumpkin and sunflower seeds
  • Beans and legumes
  • Whole grains, especially quinoa, buckwheat, brown rice, and barley
  • Potatoes
Getting too much magnesium can lead to:
  • Diarrhea
  • Fatigue, weakness, and sleepiness
  • Shortness of breath
  • Very low blood pressure
Not getting enough magnesium can lead to:
  • Abnormal heart rhythms
  • Muscle cramps or twitching
  • Nausea and loss of appetite
  • Problems with moods, thinking, and memory
More on magnesium:
  • The body has complex controls to help regulate magnesium levels. You may absorb more of the mineral from food if your intake is low, and excrete more if your intake is high. (Even with high absorption, you can still have inadequate intake.)
  • Role in bone integrity: Up to 60% of your magnesium is stored in your bones, and as such, it plays a key role in bone metabolism. Studies have shown a low levels of long-term magnesium deficiency can lead to a significant amount of bone loss.
  • Role in blood sugar control: Studies have found that low magnesium can worsen blood sugar control, and that improvements in control are seen when low magnesium levels increase.
  • May help decrease risk of Type 2 Diabetes: Diets high in magnesium are associated with a significantly lower risk of diabetes.
Magnesium combined with other medications and health conditions:

Taking vitamins or minerals may have adverse effects when combined with some over the counter or prescription medications, and some medications can decrease absorption. Some health conditions can be impacted by high magnesium intakes. Talk to your doctor prior to increasing your magnesium intake if you have or are taking:

  • Diabetes
  • Alcoholism
  • Nutrient interactions: Very high doses of fiber, protein, and zinc supplements may make it more difficult to absorb magnesium, and Vitamin D and calcium may help absorption. More research is needed to confirm this though, especially outside of laboratory conditions (i.e. in the real world).
  • Bisphosphonates: Medications or supplements that are high in magnesium can decrease oral bisphosphonates absorption, such as medications used to treat osteoporosis.
  • Antibiotics: Magnesium can prevent the absorption of some antibiotics.
  • Diuretics: Long-term use of some diuretics can increase the loss of magnesium in urine and lead to depletion. In contrast, other diuretics can reduce magnesium excretion.
  • Proton pump inhibitors (used to decrease stomach acid): When taken for prolonged periods (typically more than a year) these drugs can cause low magnesium levels.
Reference List
Lukaski, H.C. (2001). Magnesium, zinc, and chromium nutrition and athletic performance. Can. J. Appl. Physiol. 26(Suppl.): S13-S22.
Berardi, J., Andrews, R., St. Pierre, B., Scott-Dixon, K., Kollias, H., & DePutter, C. (2017). The Essentials of Sport and Exercise Nutrition, Third Edition. Toronto: Precision Nutrition, Inc.
ODell, B. L., & Sunde, R. A. (1997). Handbook of nutritionally essential mineral elements. New York: Marcel Dekker.
Office of Dietary Supplements. (2016, February 11). Office of Dietary Supplements – Magnesium. Retrieved October 16, 2017, from https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/

Fast Facts: Vitamin C

Vitamin C is one of the best known micronutrients. However, the average daily intake is often lower than expected. You might not be getting as much as you think.

Vitamin C is perhaps best known for immune system support. Interestingly, while some immune cells need vitamin C to function (and you may be more susceptible to illness if deficient), there is no concrete scientific proof that increasing your intake makes a significant difference in the duration or severity of colds. Of course, if you’re otherwise generally healthy, it’s also not likely to do you any harm, as our bodies are excellent at secreting excess.

Vitamin C is also an antioxidant, working to help balance the body’s chemical reactions and prevent cellular damage from free radicals. It helps your body absorb iron and protects levels of vitamin E, and is needed to produce collagen (a key structural protein) and several neurotransmitters (the chemicals that carry signals throughout your brain and nervous system). It also plays an active role in cholesterol management, helping to convert cholesterol to bile acids, which in turn lowers cholesterol levels.

Much of the research on vitamin C has shown greater health benefits when you get your C through food rather than tablets or pills. Of course, eating whole foods provides you with many other nutrients as well, so food is almost always a better option than supplementation. Individual variation exists of course, so it’s worth trying a few approaches to find the right method for you.

Vitamin C is involved in:
  • Protecting cells from free radical damage, as an antioxidant
  • Improving dietary iron absorption
  • Regenerating vitamin E levels
  • Building collagen, an important structural protein
  • Production of norepinephrine and serotonin
  • Chemical transformation of cholesterol to bile acids
  • Maintaining the functional ability of some immune cells
Food sources of vitamin C include:
  • Citrus fruits (lemon, orange, lime, tangerine, etc.)
  • Cruciferous vegetables (cauliflower, broccoli, Brussels sprouts, cabbage, etc.)
  • Leafy green vegetables
  • Berries and melons
  • Squashes and carrots
  • …and most other fresh fruits and vegetables!
  • Organ meat, if that’s your thing
Getting too much vitamin C can lead to:
  • Diarrhea
  • Gas and/or upset stomach
  • Increased risk of kidney stones

There is little to no evidence that high vitamin C intake from food sources leads to any signs and symptoms of excess intake.

Not getting enough vitamin C can lead to:
  • Poor wound and structural repair
  • Poor dental health
  • Poor immune response
More on vitamin C:
  • Vitamin C levels in food are quickly reduced by heat, oxygen, and storage. You can slow these losses by refrigerating your fruit and veggies and storing them whole.
  • Nicotine decreases the effectiveness of vitamin C, and smoking in particular leads to higher levels of free radicals, so tobacco users may need greater dietary intakes of vitamin C
  • Some research has shown that vitamin C may help slow plaque buildup in arteries and keep blood vessels more elastic, leading to decreased risks of heart attack and stroke. However, this research needs more support, and there is no evidence that taking vitamin C supplements will help (it needs to come from food sources to be protective).
  • Evidence also shows that people who eat diets rich in vitamin C are less likely to be diagnosed with arthritis, though there is no specific evidence that vitamin C supplements will help treat or prevent this.
Vitamin C combined with other medications and health conditions:

Taking vitamins may have adverse effects when combined with some over the counter or prescription medications, and some medications can decrease vitamin absorption. Some health conditions can be impacted by high vitamin C intakes. Talk to your doctor prior to increasing your vitamin C intake if you have or are taking:

  • Kidney problems
  • Regular use of aspirin and non-steroidal anti-inflammatory drugs (NSAIDS) like ibuprofen – These can increase vitamin C excretion. Somewhat confusingly, high vitamin C intakes can decrease drug excretion, leading to increased blood levels of the drug.
  • Regular use of acetaminophen (Tylenol) – High vitamin C intakes can decrease drug excretion, leading to increased blood levels of the drug.
  • Antacids containing aluminum – Vitamin C can increase aluminum absorption, which can make medication side effects worse. Aluminum-containing antacids include Mylanta, Maalox and Gaviscon.
  • Barbiturates – Including phenobarbital and others, these may decrease vitamin C effectiveness.
  • Chemotherapy drugs – Vitamin C may interfere with some chemotherapy drugs, though it is also speculated that vitamin C may make them more effective. Don’t increase vitamin C intake (or any other supplement) without talking to your oncologist!
  • Oral contraceptives (birth control pills) and hormone replacement therapy (HRT) – When taken with these drugs, vitamin C can increase estrogen levels; Oral estrogens can decrease vitamin C effectiveness.