Tag: auto-immune disease

Don’t Forget Your Back

Most of us spend a large portion of the day hunched forward.  Think about when you are working on the computer, cooking, driving or even relaxing.  Your typical posture during these activities is head and neck forward, shoulders rounded forward, back curved and hips flexed.    When you remain in this position for an extended period of time, the muscles in the front of the body tend to shorten or contract, while the muscles in the back of the body tend to weaken.    This can be a set up for back, neck and shoulder problems and in addition, tends to make you look shorter, heavier and less confident.

Stretching before and after exercise as well as during the day is often overlooked in the rush to “get your workout in”.   Stretching however, has numerous benefits.   According to a study published in the Annals of Physical Medicine and Rehabilitation Medicine in September 2016, by I Fekhfekh, et al, dynamic muscle stretching of the knee musculature actually resulted in an increase strength gain in those muscles.  Interestingly, this study also found a decrease in the postural stability of the knee after stretching.    In English, it appears that stretching helps your to build strength, but may decrease the stability of the muscles you stretch at least temporarily.

In general, stretching helps to improve flexibility, joint range of motion, and usually is helpful for injury prevention.    Stretching helps by increasing blood flow to the muscles stretched.  This increased blood flow carries important nutrients to your muscles to allow for muscle growth and repair.  In addition, the increased blood flow helps to wash away muscle “waste” which leads to decreased soreness and inflammation of the muscle.

If allowed to remain in a contracted position for a prolonged period of time, our muscles will shorten.  For example if you spend a large portion of your day sitting in a chair or driving, the muscles in the front of the hips, your hip flexors will shorten.  These muscles have a direct effect on both your posture and your back health.

 

So what should you do?

It is important to stretch the muscles in the front of the body at least daily.

Exercises that focus on the hip flexors:

-Kneeling hip flexor stretch  – in the position of a lunge, allow your back knee to touch the floor and drive the hip of your front leg forward.  This will stretch the hip flexor of the knee on the floor

–Pigeon stretch – extend your right leg straight back and bring the heel of your left leg underneath your right hip.  Then drive your hips forward towards the ground.  Stretch and repeat on the other side.

– Yoga poses such as: low lunge, crescent lunge, upward facing dog, and revolving side angle pose

 

Stretches that focus on the chest muscles and prevent rounded shoulders:

– Door Frame stretch- stand in a doorway or at the corner of a room with your arms up like you were going to stop traffic.  Line your arms up from the elbow to the hand with the doorframe or in the corners of the wall.   Step towards the door and you should feel a stretch in your chest (pectoralis “pec” muscles) and hold for 20-30 seconds.

– Wall slides – stand with your back to the wall and keep your shoulders against the wall.  Walk forward 1-2 steps and slide your arms up and down the wall and squeeze your shoulder blades together.  You should feel a stretch in your upper chest muscles.

–Shoulder squeeze stretch –  clasp your hands together behind your back and slowly try to lift your hands.  Squeeze your shoulder blades together to stretch out the chest wall.

– Yoga poses include : bridge pose, camel pose, cobra pose and cow face pose

 

Stretches for your neck:

– Chin Tucks (Neck Retraction) – keep your shoulders back and your head in a neutral position (eyes facing forwards, chin level) slowly move your head backwards until you feel a slight stretch in the back of your neck.  Hold for 10-20 seconds and repeat.  If needed you can apply a gentle pressure on your chin with your fingertips to press your chin backwards and deepen the stretch.

Incorporating these exercises into your daily routine will help to prevent shortening of the muscles in the front of the body which leads to poor posture and often pain of the neck and back.  As always, if you are having pain which persists you should be evaluated by a certified health care professional to ensure that these exercises are safe for you.

This week we primarily discussed stretching exercises to prevent muscle contraction, and next week we will discuss the importance of strengthening the back muscles to further combat the issues of a hunched posture.

Exercising With Arthritis

 

We have all different levels of fitness. Some individuals have been exercising for years, while other individuals have never exercised a day in their lives.  We are all at different levels in terms of our cardiovascular fitness, our muscle strength and flexibility and our overall health.   It is quite important to remain active in spite of arthritis.  In fact, movement in people with arthritis is crucial to health and well-being.

Despite what we once thought, it is my experience that it is possible to modify the severity of certain types of arthritis.   In my mind, arthritis, chronic pain and other autoimmune diseases are the result of multiple factors.  All these factors such as genetics, environmental exposures, nutritional deficiencies, dietary influences, and gut health to name a few factors, all line up as if you were to “win” in the slots.  When this potent combination occurs in your body, havoc ensues.   The result is inflammation and chronic disease.   While you can’t change your genes per se, it is now thought that you can change or modify your gene expression.  In addition, you can certainly modify some of the other risk factors just mentioned to offset the severity of your debility.

In most cases, moderate exercise is essential to health and well being.  Proper, varied forms of exercise raises heart rate, raises endorphins, improves muscle strength, improves balance, improves flexibility and increases blood flow throughout the body including the muscles and joints.  In the case of arthritis, there is inflammation in the joint capsule and the bones themselves which leads to severe pain and often deterioration.     The nerve endings in the joint become super sensitive and pain can be unbearable.

Believe it or not, your choice of diet can directly impact your ability to exercise. When you consume an Anti-Inflammatory Diet, often you will notice you will able able to exercise with less pain is because this diet eliminates many known triggers for arthritis.

 

Some examples of arthritis triggers include:

  • Fried and processed foods
  • Thought to be due to compounds called AGE – (advanced glycation end products) These products are the result of heating, grilling, and frying foods.  The body utilizes pro-inflammatory molecules called cytokines in an effort to break them down and the result is excess inflammation in general as well as in the vascular system (blood vessels).
  • Sugary foods
  • Dairy
  • Alcohol
  • Foods/Oils with Omega-6 fatty acids – such as vegetable oil (safflower), corn oil, fried foods, certain nuts and seeds, mayonnaise

 

Some examples of beneficial foods include:

  • Foods containing high levels of Omega-3 Fatty acids – (ex. salmon, herring)
  • Avocados
  • Flax seed
  • Cherries and other berries (contain anthocyanins that are thought to be anti-inflammatory)
  • Leafy vegetables, broccoli – contain vitamin D
  • Green tea – has EGCG (epigallocatechin-3-gallate) a powerful antioxidant
  • Vitamin C containing foods (ex. papaya, brussel spouts, broccoli, citrus fruits)
  • Garlic, onions and leeks

 

It is very important to listen to your body.  Pay attention to the foods you are eating and the way you feel.  Often times, foods that are considered healthy may cause issues for you.  If you suffer from arthritis, try rotating your foods (i.e. do not eat the same food everyday).   If there are certain foods you think might bother you, wait 3 days in between eating them.  Then pay attention to the way you feel when you re-introduce those foods.  If you notice you have more difficulty with pain or decreased ability to exercise try eliminating the offending foods for a week or two.

Typically, it will take several weeks of following the diet closely before you see results with regard to decreased pain from inflammation.

When exercising with arthritis, it is important to modify your exercises as per trainer recommendations.  If exercises hurt, if possible, discuss with your trainers to find another way to exercise that muscle group.  In the beginning, there may be some exercises you simply cannot do.  What is important is that you are attempting to exercise.  With each passing week you will find that you can do a little more than the previous week.  Progress may be slow, with ups and downs.  As always, if despite closely following the diet, you are still having issues, it might be time to seek the advice of a health care professional.

What’s the Deal with Aspartame and Diet Soda?

I suffered from chronic daily headaches for about 8 years. The headaches were never terrible nor debilitating, but always present. It was as if I was in a constant state of fogginess. During medical school, I drank about 1 liter of diet soda every day while I studied. In residency, I switched to Crystal Light Iced Tea because I decided I needed to cut down on my soda intake. During one particularly busy week in residency, I ran out of my iced tea and was unable to make it to the grocery store. I didn’t realize it at first, but over the course of the week my ever-present headaches disappeared. By the end of the week, I was noticeably better and my fogginess had lifted completed. I wasn’t sure the reason, but I was certainly thrilled. Fast-forward to the next week when I was able to get to the grocery store, and all of a sudden my headaches returned.

It took me a while to make the association, but I ultimately figured out that 8 years of suffering, in my case, was due to aspartame consumption. I now avoid it like the plague and have had a negligible number of headaches over the last 12 years. That’s not to say that I don’t get headaches here or there but many of them I can trace back to eating foods, sweets or drinks which I didn’t realize at the time, contained aspartame.

Aspartame is one of the artificial sweeteners found in many diet sodas but is also being utilized as a sweetener in many foods such as:

  • Powdered drinks
  • Flavoring syrups for coffee
  • Sweetened iced teas
  • Fruit and vegetable juices
  • Flavored waters
  • Gums
  • Candies
  • Yogurt
  • Certain condiments and desserts
  • Meal replacement bars

Why is this an issue?

Aspartame is broken down by enzymes in our body into phenylalanine, aspartic acid, diketopiperzine, and methanol. These breakdown products can have significant effects of on our bodily functions and metabolism.

According to a review article published in the European Journal of Clinical Nutrition in 2009, aspartame can:

  • Disturb amino acid metabolism
  • Disturb protein structure and metabolism
  • Impair neuron functioning
  • Cause endocrine imbalances
  • Change the concentration of neurotransmitters in the brain
  • Cause excessive nerve firing in the brain
  • Compromise the function of the blood brain barrier
  • Affect fertility

In certain individuals, a byproduct of aspartame breakdown, methanol, can cause a toxicity that mimics fibromyalgia. Symptoms can include spasms, shooting pains, numbness in legs, cramps, vertigo, dizziness, headaches, tinnitus, joint pain, depression, anxiety, slurred speech, blurry vision and memory loss.

It is very important to prevent toxic substances from entering into our brain where they can cause inflammation and damage neurons. This is the role of the blood brain barrier. This barrier has transporters that allow important amino acids to cross into our brains to be used to make needed substances called neurotransmitters. These neurotransmitters are chemicals that allow communication between brain cells to control everything from our moods, and emotions to our sleep-wake cycles.

Essentially, what happens is that when we eat and drink foods with aspartame our bodies digest the aspartame into its components. The high levels of these breakdown products (particularly phenylalanine) can flood or overload the transporters in the brain and allow too much phenylalanine to get into the brain and prevent other needed amino acids from entering. This can lead to too much of certain neurotransmitters being produced while inhibiting the formation of others. These imbalances may influence or worsen diseases such as Parkinson’s, Multiple Sclerosis, and Epilepsy.

In addition to the neurological effects described above, multiple studies have shown that daily consumption of diet soda results in an increased risk of metabolic syndrome (a group of symptoms such as abdominal obesity, elevated blood pressure, elevated fasting blood sugar levels which raise your risk for heart disease) as well as type II diabetes. Specifically, a study done collectively by Columbia University and the University of Miami, published in the Journal of General Internal Medicine in Sept 2012, followed diet soft drink consumption over 10 yearsand found that daily diet soft drink consumption led to an increase of vascular events such as stroke, heart attack or vascular disease. There was however, no increased risk seen with regular soda consumption or infrequent diet soda consumption.

Therefore, the take home message is that very infrequent diet soda and artificial sweetener consumption is probably okay unless you are like me and can’t tolerate even small amounts. If you suffer from chronic daily headaches, seizures, chronic fatigue, chronic pain, infertility, neurological diseases, or even autoimmune diseases, consumption of artificial sweeteners may be exacerbating your conditions. A trial of elimination of all artificial sweeteners may help to alleviate or even in some cases eliminate some of your symptoms.