5 Tips for Training in the HEAT

I just got back from a great trip in NYC over the Memorial Day Weekend. The weather was classic summer city weather; hot, hazy and humid. Still, I was able to get my traditional runs through Central Park in, and live to tell about it. It got me to thinking about how best to deal with the upcoming summer training season. Here are a few tips.
Please help me out and add to them in the comments!



1. EASE INTO IT!

If it's your first "hot" run of the year, cut down on your intensity/distance.  Heat and humidity are draining, and it's important not to kill yourself the first time out. Treat the change in weather like you've been off for a week.
Go easy and build up your stamina.

2. HYDRATION.

As a sport medicine physician, I try to recommend taking in at least 500 ml (2 cups) of water about an hour prior to going out. If this isn't possible, drink frequently to thirst, out on the run. It's NOT necessary to go crazy doing this, as drinking EXCESSIVELY can cause its own problems (like exercise induced hyponatremia (CJSM, 2008). A good method to sort out how much fluid you are losing is to weigh yourself naked prior to, and just after running. A one pound loss would be about the equivalent of 16 ounces of fluids (2 cups).

Despite what Gatorade/Powerade/whoever advertises, water is always the best choice for your fluid, UNLESS you are going out for longer than an hour, at High Intensity. If you are going longer, then adding 4-6% glucose, and a little bit of salt is worthwhile.



3. HIGH TECH CLOTHING

I'm a big fan of high tech stuff in general, and in this case, technology in clothing is important. Synthetic clothing, like Coolmax or similar, wicks sweat away much better than cotton, which tends to just retain the moisture.
Lighter colored clothing reflects most of the heat, and using a cap will keep some of the rays off your face.

4. TIME OF DAY

Pretty obvious, but getting out early in the morning, before the sun really heats things up is the best choice. It also tends to be best for lower humidity, smog, pollution, traffic and allergens. If the morning doesn't work, then the next best choice is during evening hours, after the sun has gone down.
Don't forget, even though it may seem fairly light out, have reflective gear somewhere on your body. Drivers can be pretty distracted (what with phones, texting, etc!)

5. IT'S THE HUMIDITY, NOT THE HEAT!!

Pay really close attention to the HUMIDEX reading, not just the temperature. When looking at weather reports, look at the Humidex reading, NOT the temperature. The humidex reading gives a "what it feels like" reading, by combining the straight temperature with the humidity reading. If this number gets too high for comfort, pack it in, and work out indoors that day!


Again, I appreciate all the great commentary, and would love you to add to the list! Cheers, and enjoy the heat!

The "SUNSHINE" Vitamin - Vitamin D

There has been a lot of news over the last year or two about the benefits of Vitamin D. A lot of this is potentially exciting, but medical bodies have been at odds over how MUCH exactly to recommend. A lot of the benefits are NOT YET 100% factual, but derived from observational trends.  This is potentially promising and exciting, but we physicians tend to err on the side of caution, rather than go overboard too early. (That can get embarrassing, if the evidence shows us to be wrong down the road. . .)


Let's try and sort out what's worth doing. . .

What does Vitamin D do?
Vitamin D, like all vitamins, is a nutrient that our body can NOT produce on its own, so we need to get it from outside sources.  It has a number of functions in our body:

• Helps the gut to absorb Calcium
• Plays a definite role in Bone strength and structure
• May be cardioprotective. (Low levels increase risk of heart attack and stroke)
• May DECREASE the risk of Colon Cancer
• May Prevent Multiple Sclerosis
• May Prevent Viral Infections like the Flu
• May Decrease the risk of Diabetes.

HOW DO WE GET OUR VITAMIN D?

1.  SUN EXPOSURE
Uncovered skin to sun allows UVB rays to convert Previtamin D to Active Vitamin D3. There are a lot of factors that affect the amount of conversion including the time of year, time of day, skin tone, geographic location, pollution, sunscreen etc., but scientists estimate that anywhere from 5-30 minutes of sun exposure to face, arms and legs twice a week would be more than enough to maintain adequate active Vitamin D stores. The downside is, obviously, that too much sun exposure is a significant risk factor for skin cancer!

I should make special note that in Northern Climates, (including northern U.S. States, and Canada), during winter, an adequate supply from sun is NOT available, and supplements should be considered, especially for infants and young children.




(Yes, that is Canadian Milk in a Bag on the right!)


2,  FOOD SOURCES


Other than some fatty fish, very few foods contain any significant levels of Vitamin D. Given this, some foods are fortified with Vitamin D, the most important being MILK. Some juices, yogurt, cereals etc are also fortified, but you need to look carefully to ensure this.

ALL infant formulas in the US and Canada are fortified by law. (Please note, although I strongly encourage breast feeding, the amount of Vitamin D in breast milk is NOT adequate on its own).


(chart from NIH, Office of Dietary Supplements)  - NIH

Table 3: Selected Food Sources of Vitamin D [11]

Food	IUs per serving*	Percent DV**
Cod liver oil, 1 tablespoon	1,360	340
Swordfish, cooked, 3 ounces	566	142
Salmon (sockeye), cooked, 3 ounces	447	112
Tuna fish, canned in water, drained, 3 ounces	154	39
Orange juice fortified with vitamin D, 1 cup (check product labels, as amount of added vitamin D varies)	137	34
Milk, nonfat, reduced fat, and whole, vitamin D-fortified, 1 cup	115-124	29-31
Yogurt, fortified with 20% of the DV for vitamin D, 6 ounces (more heavily fortified yogurts provide more of the DV)	80	20
Margarine, fortified, 1 tablespoon	60	15
Sardines, canned in oil, drained, 2 sardines	46	12
Liver, beef, cooked, 3 ounces	42	11
Egg, 1 large (vitamin D is found in yolk)	41	10
Ready-to-eat cereal, fortified with 10% of the DV for vitamin D, 0.75-1 cup (more heavily fortified cereals might provide more of the DV)	40	10
Cheese, Swiss, 1 ounce	6	2

* IUs = International Units.
** DV = Daily Value. DVs were developed by the U.S. Food and Drug Administration to help consumers compare the nutrient contents among products within the context of a total daily diet. The DV for vitamin D is currently set at 400 IU for adults and children age 4 and older. Food labels, however, are not required to list vitamin D content unless a food has been fortified with this nutrient. Foods providing 20% or more of the DV are considered to be high sources of a nutrient, but foods providing lower percentages of the DV also contribute to a healthful diet.

How Much Should I Take?


Various Governing Medical Bodies have come out with recommendations based on the available incomplete evidence and studies. Many studies are currently underway trying to come out with an appropriate safe number while maximizing benefit. Given that toxicity is unlikely to occur below an intake of 10,000 IU Vitamin D a day, I believe the Canadian Guidelines (CMAJ, Sept 7, 2010) of 1000 IU of Vitamin D/ day is an appropriate place to start. Here is the equivalent link for the U.S. (US Preventive Task Force, Dec 2011)



Bottom Line: Get a little bit of sun, drink your milk, and in the wintertime take 1000 IU Vitamin D supplement.

Please let me know what you think of the blog so far. Loving the comments and suggestions!

(Special Thanks to the SE Water Cooler)

Can't Wait for REAL Strawberries!

Local strawberries will be ready to pick in the next month, and I can't wait. (Right Heeman's ?) Heeman's farm is  our local pick-your-own farm, and we've taken the kids there every June to get real strawberries. 

I used to eat the giant mutant strawberries from the grocery store, but realized I don't like the taste of cardboard when I eat my fruit. So, I put off my addiction for the luscious berries for the few weeks in June that we can get our own locally in Southern Ontario.

I finally realized that washing, stemming and freezing them in a single layer in a freezer bag allows me to extend the joy into the depths of winter, but nothing beats the warm juicy first ones of the summer.

A great article from the NPR last week ("The Secret Life of California Strawberries"), provides some nice insight into the massive tasteless strawberries we get the rest of the year. Although these berries have been bred to be big, disease resistant, colourful and productive, it is at the expense of taste. In the case of strawberries, big and beautiful is NOT always better.


Nutritional Benefits


Strawberries are an excellent source of Vitamin C, folic acid, antioxidants and fibre. These vitamins may help  boost the immune system, lower blood pressure, lower LDL cholesterol, and improve GI function, not to mention helping to manage weight by making you feel full longer.


RECIPE: STRAWBERRY COMPOTE.

Use this recipe as a topping for ice cream, a spread on toast, or just eat it out of the jar! Just promise me you'll use fresh, local strawberries.

6 Cups Strawberries

1 Cup Sugar

1 Cinnamon Stick

1 Tbsp Balsamic Vinegar

1 Tbsp Grand Marnier

Splash Vanilla (after)

Hull and Halve Strawberries

Mix with Sugar, cinnamon, balsamic and let berries macerate 1 hour in Heavy Saucepan

Stir over medium heat x 20 minutes.

Add vanilla after off heat.

Do you wait all year for local berries, or do you cave in and buy whatever's available?
Let me know!

Longing for the Return of the CANADA FITNESS TEST

The CANADA FITNESS TEST. If you were a kid in the '80's you know exactly what I'm talkin' 'bout.
The words either put a nostalgic smile on your face or send a shiver down your spine. In the States, the President's Fitness Challenge would be very similar.



Back in the '70's and '80's, the Canadian Government deemed childhood fitness poor (is anything different now?), and after a run of "Participaction", created the "CANADA FITNESS TEST". The program ran from 1970-1992, with Hal and Joanne encouraging us with their "Bodybreak".




The test (here), was administered to unwitting Canadian students in Grades 3-8 and involved 6 gruelling, peer-revealing tests and an endurance run. They were:

1. Push-Ups
2. Shuttle Run
3. Partial Curl-Ups
4. Standing Long Jump
5. 50 m Run (about 150 ft. for the Americans)
6. Flexed Arm Hang
7. An Endurance Run of between 1500-2300 m. depending on how old you were.

Your ability was scored on a table, assessed on a standardized grid, and you were awarded an achievement crest based on how well you did overall. 

These levels were:

• Award of EXCELLENCE
• GOLD
• SILVER
• BRONZE
• Participation Pin

No matter how badly you did, everyone received a participation pin, in addition to their crest.

The benefit of the program was a national standard to shoot for, as well as encouraging all students to pursue some degree of physical activity. 

The flaw, in hindsight, was to potentially embarrass or humiliate kids who were not able to meet the standards. 

I understand the reasons behind discontinuing the program (costs, publicly embarrassing some kids), but I think the overall concept was sound. With this program, there was a national standard for all schools, and a goal to aim for. The removal of the program allowed standardized physical activity in schools to wither away in Canada.

I know that, at least in Ontario, where I, and my kids live, the daily requirements for activity are supposed  to be 20 minutes EVERY DAY (Ontario Government's statement), but this rarely actually occurs. There is now NO end assessment, and if a kid wants to just stand around, they do. We wouldn't want to make them feel bad, right?

I know this is a bit of a rant, but as a physician, childhood obesity is a big concern of mine. It very clearly leads to an increased risk of Diabetes, Heart Disease, Stroke, and lack of physical activity in childhood is strongly associated with lack of activity as an adult. The amount of time kids spend in front of a screen is upwards of SIX HOURS PER DAY (!) (Sun News, April 2011); time which, when we were kids, was at least time spent running dangerously in the streets, without helmets, supervision, and cushy padding under the jungle gym.

GET OUTSIDE WITH YOUR KIDS!!

Let me know what you think! Should we bring back the CANADA FITNESS TEST?

Is Coffee Good for You?

Interesting question. I'll admit, I'm a bit biased, as I love a strong black coffee. Luckily though, the venerable New England Journal of Medicine has weighed in with an unbiased observational study. (article here. NEJM, May 17, 2012).




Worldwide, coffee is usually NOT considered as a healthy beverage, but still remains one of the most WIDELY consumed drinks in North America, if not the world. We all know about the caffeine in coffee, but coffee also contains many other bioactive compounds, including anti-oxidants and anti-inflammatory compounds that may positively affect health.

This study followed the lifestyle of Americans, aged 50-71, for up to 13 years, monitoring their coffee intake, as well as an overwhelming number of other potentially confounding factors (like TYPE of coffee - ground vs. espresso vs instant) as well as other health indicators like smoking, alcohol, activity level, etc.

RESULTS

The study showed that coffee drinkers tended to be MORE likely to smoke, drink alcohol, and eat red meat than non coffee drinkers! They also tended to be LESS active, have lower education levels, eat less fruits and veggies as compared to those who did NOT drink coffee.

HOWEVER, after controlling for these variables, coffee drinkers were MORE LIKELY to Live LONGER than non coffee drinkers! Interestingly, the benefits remained, whether the coffee was caffeinated, or NON-caffeinated.



There might be some other, as yet, unrecognized reason for this association, and an observational study is not the best way to test an hypothesis, but this study certainly provides some reassurance that morning cup of joe is OK!

BOTTOM LINE: This well done prospective cohort study showed a benefit in drinking coffee with respect to overall mortality, and specifically in heart and stroke mortality, diabetes and infection.

Have a great day, and let me know what you think!!

Some Shoe Advice

I frequently get asked for shoe advice. This comes from walkers, new runners, friends, competitive athletes cross-training, kids; you name it.




Surprisingly, the most common question I get is,"What brand do you recommend?"
My answer is always the same. The brand doesn't matter. It's the TYPE of shoe you need to look for. And that depends on your FOOT TYPE.




What Foot Type Do I Have?


You can go see a certified pedorthist, a sport medicine doctor, or you could start by "getting your feet wet".
That's right, go wet the bottom of your feet and walk on a dry sidewalk, floor, or nice wet beach to leave an impression on the surface. What do you see?





A FLAT FOOT (pes planus), or Pronator, will tend to leave a lot of impression on the ground, as the arch "falls" to the surface when you step down.

A HIGH ARCH (pes cavus), or Supinator will tend to leave a large gap between the heel and the balls of the feet, as the arch does NOT touch the ground with foot strike.

A NORMAL ARCH, falls somewhere in between.

Each foot type benefits from a more specific shoe, and certain people are much more sensitive to these changes.




THE FLAT FOOT
So, generally speaking a FLAT FOOT tends to require a "motion stabilizing" shoe. This support aims to keep the medial (arch) part of the foot from falling inward. Each company has it's own version of this, calling it a "stability" shoe, "motion stabilizer", or some variation on this theme. You can assess it's ability in controlling the shoe by looking at TWO AREAS - THE HEEL SUPPORT, and the MEDIAL ASPECT of the shoe.

HEEL SUPPORT - Squeeze the heel cup. It should be rigid, to keep the flat foot from rollling inward (pronating). If it doesn't look for another shoe.

MEDIAL SUPPORT -Take the shoe in both your hands with the toe facing you, and the laces up. Try twisting the shoe along the longitudinal axis. If it stay rigid, good. This will keep your arch from falling when you run. IF it twists easily, again, keep looking.



DON'T BUY THE HYPE!



People with Normal or Higher Arches can get away with a wider variety of shoes and should "test" them out for cushioning, comfort and fit. If these things are present, then I tend recommend the lightest shoes you can get away with, while providing cushioning.
Most reputable shoe stores will let you take them outside for a quick run around the block, and provide a generous return policy if something isn't right.

We all tend to get excited about certain colours, styles etc, whether we're a pre-teen, a novice runner or even the most seasoned athlete. Shoe companies definitely know this and spend a mind boggling amount (advertising expenditures, from Fortune Magazine, Feb 2012) of money trying to convince you that this year's model is a must have. The technology they come up with can sometimes rival NASA!

In the end, try to ignore the flash, and make sure you find something you'll be comfortable training with on a daily basis. After all, the goal is fitness, NOT fashion (mostly!). If you MUST have the fashion, some of the companies DO allow you to customize your shoe (NIKEiD, for example).
Try to visit a store that specializes in the footwear you are intending to buy, as their sales staff tends to be much more knowledgeable, and truly keen to help you, rather than sell you. It's worth the extra couple of dollars over a big box store. Trust me.


In future posts, I'll try to address other aspects, including "barefoot" style shoes, etc.

Let me know what you think and what you'd like to see in the future!

Roasted Chickpeas

Chickpeas are pretty fantastic. The name is great to say; it`s alternative name, Garbanzo Beans, is just as great to say!
They`re an excellent source of fibre, protein, iron and folate.

A 100g serving of them provides 165 calories, 7.6 g fibre, 8.9 g of protein, almost 3mg of iron, and .1 mg of folic acid. Outstanding. And they taste great.

Most of the production and consumption occurs in India, the Mediterranean, and Western Asia, but we should really follow their lead. Eaten on their own as a snack, simply made into hummus, transformed into falafels, socca flatbread, or, as in this post, roasted for a healthy treat!

Eat as much as you like! They`re great for you - easy to make, easy to eat, easy to change up.

RECIPE - ROASTED CHICKPEAS

1 can chickpeas (796ml)
1 tsp olive oil
Generous amount of Kosher salt
Generous amount of Smoked Paprika

Heat oven to 400 F. Rinse chickpeas and pat dry with paper towel. Spread evenly on cookie sheet. Pour olive oil over chickpeas and massage lovingly. Sprinkle salt and smoked paprika and shake to distribute evenly.
Bake for 15 minutes, shake pan to redistribute, and return to oven for another 15-20 minutes, until just turning brown.

Let cool for several hours, to allow the chickpeas to get a nice crunch on, and enjoy!.

VARIATIONS

Try subbing in sugar and cinnammon for the salt and paprika for a sweet treat.
Try switching paprika for onion powder, dill and a little balsamic vinegar!
The possibilities are endless. (Liv wants to try cake mix and sprinkles :) )

Let me know how this turns out for you, and if you try anything different!

QUICK HIT: Dirty Reusable Grocery Bag Causes Soccer Team to Get Sick

How often do you clean your reusable grocery bags? Never? Once a month? Once a year?
Maybe you should do it more often.
In a nice piece of detective work, the Journal of Infectious Disease found that a girls' soccer team was made ill when one member of the team transmitted the Norwalk Virus by contaminating food being kept in a reusable grocery bag (in the bathroom). I'll spare you the gory details, but you can hit the link above if you want to see.

Essentially, though, the index case was vomiting and having diarrhea in the bathroom where the eventual culprit snacks were being kept in a reusable cloth grocery bag (? Food being kept in the bathroom?).  Consumption of snacks (including pre-packaged cookies, chips and grapes) from the bag, was strongly linked to getting ill with the same strain of Norwalk as the initial case.

NORWALK VIRUS is often referred to as "cruise-ship diarrhea", as there have been several outbreaks on cruise ships recently. It is hightly infectious, and once aerosolized (in this case, through throwing up) is very readily spread through touching contaminated surfaces. The more confined the space, the more easily spread.
Symptoms onset rapidly with vomiting and diarrhea lasting 24-48 hours.


TAKE-AWAY MESSAGES

• When travelling as a team, family, or other group, if one person is suspected of having Norwalk, best to isolate them. 
• Be diligent about keeping counter-tops, etc extra clean. 
• Keep your hands clean!
• WASH YOUR RE-USABLE Grocery Bags.
• It seems redundant to say, but Keep Your Food OUT OF THE BATHROOM!!

Let me know what you think of this!

10 Tips to Getting Fit Forever

Everyone loves Top 10 lists. I'll write the list, you add to it, and I'll try to expand on some of the points in future posts.  Let's go.

1. Set A Long Term Goal
2. Set A Short Term Goal
3. Be Consistent
4. Take It With A Grain of Salt
5. Fluids
6. Just Go Do It.
7. Make It From Scratch
8. Go Harder.
9. CHANGE something.
10. Smile.

So, how do we get to long lasting fitness? Let's try to expand a little on these points.

1. SET A LONG TERM GOAL

This is critical. It isn't good enough to just say "I want to be healthier", or "I want to lose weight", or "I want to start running". How will you know if you've accomplished this? Answer: You never will.

Try to come up with something more concrete, like, "I want to lose 20 lbs", "I want to run a half-marathon", or "I want to be able to play with the kids without getting tired". With a clearly defined goal, you have a real target to shoot for. If you don't do this first, you won't know if you've made it.


2. SET A SHORT TERM GOAL


Once you have a target, breaking things down into more manageable pieces makes that goal more easily attainable. Whether you're working out at the gym, starting to run, bike, or swim, take a minute or two before EACH session, to decide on one or two things you want to focus on TODAY.

Are you working on your strength, your endurance, your speed, or something else?
Try picking ONE of your exercises and really focus on PERFECT technique.
Try doing ONE more REP of your training.
Try BEATING your lap time by just a bit.
Try going a minute LONGER on your run.

You get the idea. Having a short term goal, every day, that is achievable and attainable, brings the long term goal closer to being fulfilled!


3. BE CONSISTENT


The American Academy of Sports Medicine recommends 30-60 minutes of moderate activity 5 days a week (here.) I would encourage you to aim for as close to EVERY DAY if at all possible. The more you can make exercise a daily routine, like brushing your teeth, or having a shower, the more likely it is you will continue.

4. TAKE IT WITH A GRAIN OF SALT


CHOCOLATE is GOOD FOR YOU!  RED WINE is GOOD FOR YOU!  GO GLUTEN FREE!
GET MORE VITAMIN D!

Yes, But. . . Chocolate has an awful lot of fat. Wine has a huge amount of empty calories. Going gluten free is important for people with Celiac Disease. Gluten free does NOT equal fat free, calorie free etc. Most gluten free food tastes awful (although this has improved dramatically over the last 10 years).

Vitamin D has been shown to be protective against a number of cancers, and is important for bone strength,
but sitting in the sun to get it for extended periods can cause skin cancer.

I think you get my point. The breathless articles in the news focus only on the purported benefits, without mentioning the down sides.

Everything in moderation, OK?



5. FLUIDS


We used to go on and on about getting 8 glasses of water a day, more if you were active. Even more if you were drinking any significant quantities of caffeine. Times are changing.
Using 8- 8oz glasses a day is a nice, simple thing to remember, but necessarily correct for everyone.

New guidelines, based on drinking in response to feeling thirsty is becoming the new normal.
Another means of checking hydration is comparing naked body weight before and after exercise.
The difference can estimate fluid losses from sweating and is a good starting point to rehydrate back to.
Watching urine darkness before and after exercise is another broad estimator of fluid loss, although a lagging indicator (ie. if the urine is dark, you already getting dehydrated). Here's a nice summary.

I hope to delve into this topic in much greater detail in a later post.

6. JUST GO DO IT.


Very often, the most difficult part about exercising is just getting started. Even the most die-hard athletes have days when they just don't feel up to it. On these days, I encourage you to promise yourself to at least lace up your shoes at the door. If you get this far, and honestly can't push yourself out the door, then go back to bed.

90% of the time, getting this far will get you going. And if you get out the door, it's surprising how much more you will be able to do. Just go.

7. MAKE IT FROM SCRATCH


Whether we're talking about brownies, pizza, burgers or smoothies, make your own if you can!
Why? You're in control of what goes into it. That means the amount of sugar, salt, fats, everything.
When reading ingredient labels of store bought or restaurant bought foods, the preservatives, sodium, chemicals, and calories can be shocking.

Homemade almost always means lower sodium, lower fat and certainly fresher ingredients. It also is a cost saver, as well as being more enjoyable, tastier, and a tendency to eat less. Need I say more?

8. GO HARDER


Try this. During your next workout, for the last minute of the exercise, go as hard as you can. For example, sprint the last minute of your run, get up out of the seat of your bike and go as hard as you can, whatever.
As your fitness level improves, try adding little accelerations DURING your exercise (ie, interval training).

The benefits are multiple. You are working in an anaerobic range (making all your muscles work harder). This is what causes "the burn" when you go hard.

You are increasing your heart rate, which then compensates by getting stronger.

You release more endorphins (the body's morphine), making you feel better when it's all over! This is what gives "the runner's high".

Try it. You'll like it!


9. CHANGE SOMETHING.


Every week, shake your routine up a bit.

Add in a new exercise. Try using a different machine at the gym.
Increase the weights you've been using by 5-10%.

Go a different route on your walk/ride/run.

Ask someone new to run with you this week.

Find a new recipe to try out on the kids tonight.

Changing things up, even a little, keeps things fresh and keeps you motivated.



10. SMILE.


Studies show (somebody actually studied this??) that smiling lowers blood pressure, relieves stress, and releases endorphins.

Next time the workout gets tough, try smiling. If nothing else, the guy you're racing is gonna worry what you've still got left.


That's it. In the coming blogs, I'll try to expand a little more on some of these points, and make them as practical as I can. In the meantime, give them a go.

Let me know what else should be on the list, and what you think so far!

Is Frozen Yogurt Better For You?

Sometimes research is fun.

Willing Participants.

Those are my kids, double blinded, randomized, and placebo controlled; ready for a taste test of frozen yogurt tonight. More on that in a moment. . .

First, a little more on Frozen Yogurt and its' counterpart, Ice Cream.

We seem to take it for granted that Frozen Yogurt wears a halo of health, and is "good for you". Is it?

Well, maybe.

Ice Cream, by definition is a frozen dairy dessert, comprised of milk fat (10-16%), milk solids (9-12%), sweeteners, and stabilizers.

Frozen Yogurt, on the other hand, is composed of yogurt cultures, milk fat (0.5-6%), milk solids (8-15%), gelatins, sweeteners, and flavours. Frozen yogurt, in general, then, tends to have lower fat content, but also tends to have higher added sugars.  Since yogurt is made by adding live bacterial cultures, which may be of benefit for our guts, this might be considered beneficial. Additionally, the lactose present in yogurt is more easily digested than that in traditional ice cream. 

When we think of yogurt, being low or no-fat, we start to think we can eat as much as we want, right?

Not necessarily. The TOTAL calories in a similar cup of frozen yogurt and ice-cream may not be that different.

Although the fat content of the ice-cream will be higher, the total number of calories may actually be fairly close, due to all the added sugars in the frozen yogurt. Don't forget, excess calories, whether from fat or sugars, are all converted to fat if not metabolised.

So, where does that leave frozen yogurt, on the scale of  "healthy"?  Probably middle of the road.

Certainly, the lower fat is a plus over ice cream. The live bacterial cultures may also provide the gut some additional benefit. The added sugars and similar calories, not so much. The best choice, as with so many other things, is all in moderation. Enjoy it as an occasional treat, and feel good about yourself.

P.S. There is something to be said about the  "pull your own" Fro-Yo stores. If you have reasonable self-control, this is a great way to indulge in a nice treat!

Just a word of caution - the Mix-ins can add HUNDREDS of extra calories, and defeat any health benefits the yogurt may have. 

Now, for the Fun Stuff!

We tested 3 versions of No-Fat Vanilla Frozen Yogurt. Both of my kids were blindfolded and tested each brand after sitting in a freezer at home for 1.5 hours, then taken out to sit on the counter for 10 minutes at room temperature. They were then fed exactly 15 ml of each fro-yo from an identical stainless steel spoon. They then rinsed their mouths with distilled room temperature water, before testing the next sample.

After all samples, they independently made their decision, and the winner was . . . 

Our Local KIWI KRAZE!

Let the debates begin. What's your fave?

By the way, after all the gruelling testing, the kids went to town with mix-ins.!

Again, I'd appreciate any comments you have, either about the Fro-Yo, or especially about your thoughts on the Blog!

Short on Time? Try a Fartlek!

In our hectic lives, what with work, kids, driving kids, feeding kids; well you get the idea. . .

Although it's hard to find the time to stay active and fit, a "Fartlek" might be just the ticket.

What's a Fartlek?


Fartlek is a Swedish word, which literally means "Speed Play". Coined by Swedish running coach, Gosta Holmer, in the 1930's, the training method focuses on both speed and endurance.

The beauty of the method is that is rather unstructured, with intensity and/or speed varying based on the indiviudal's desires and time. So, if you've only got a half hour at lunch, an hour after work before taking the kids to hockey practise, or only 20 minutes in the morning, you can still get a good fartlek in.

How to start.


Once you've decided to go, just go!

1. Warm up. Easy jog for a few minutes.

2. Increase Pace. Get to about 60% of your maximum pace. A good way to determine this is a pace where you would find it hard to speak a full sentence without stopping to catch your breath.

3. Speed Play. The FUN PART. Pick a distance, and GO FOR IT.  If you're on the roads, sprint 'til the next street light, mailbox, or until the end of the guitar solo on your IPod.

4. Easy Jog. Recover and catch your breath, but don't stop jogging.

5. Go back to #3 and Repeat #'s 3 and 4, until you run out time.

As you get more comfortable and confident, increase the speed part, and decrease the recovery. You'll find you get a lot more out of your workout, and perhaps even enjoy it more!

Let me know how it goes!

Torn ACL. Now What?

I was saddened to hear last week that Mariano Rivera, one of the greatest closers in baseball of all-time (Rivera career stats), tore his ACL in a freak accident shagging fly balls in the outfield.

We hear commentators on SportsCentre talk about ACL injuries fairly frequently in various sports, and you may hear guys throw the term around as well, but, really, what the heck is an ACL anyway?

Some Basic Anatomy.


The ACL, or anterior cruciate ligament, is the critical ligament that prevents the shin bone from separating from the thigh bone above. Secondarily, it also keeps the lower leg from twisting too much.  Think of it like a rope that keep the bones from separating. Too much strain on it, and the ACL might tear.

The "anterior" part of the acronym is because it sits in front of the PCL (posterior cruciate), and "cruciate", which means "cross", because the ACL and PCL criss-cross each other in the centre of the knee.

There you go. Might win you a bar bet some night.

Epidemiolgy.


So, who typically tears their ACL? And how? And how often?
Well, ACL tears certainly are common. 1 in 3000 people tear their ACL per year, and appproximately 70% of those occur during some sort of sporting activity.

For whatever reason, Females tend to tear the ACL significantly more than men. For example, Linendfeld et al (http://ajs.sagepub.com/content/22/3/364.short)  reported a SIX-FOLD increase in ACL injuries in female soccer players than men, and Ferreti et al, (http://ajs.sagepub.com/content/20/2/203.short) noted a FOUR-FOLD increased incidence in women Volleyball players.

Mechanisms of Injury.

When I'm taking a history from a patient about their injury, if I've done my job right, I usually have a pretty good idea of what they might have done to themselves, even before examining them. This is crucial in eliciting the history of a possible ACL injury, as they can be easily missed, if you're not careful.

The classic injury, is very much what Rivera did. The athlete will describe a non-contact, sudden decelerating move. Very often the player will plant their foot and hyperextend and/or twist the knee, while trying to cut, or change direction. If the foot doesn't slide, (ie, a cleat or shoe gets stuck), the knee may strain and injure the ACL.

The patient may describe a "POPPING" sensation, as the ACL finally gives out and tears. If the injury is isolated, there may be very little swelling associated.

In this case, raw video footage demonstrates one of the mechanisms of injury; hyperextending the knee.

It's Torn. Now What?


At our sport clinic, after the diagnosis is made, the question then becomes, should this be fixed or not?
Watching ESPN, or TSN, or any of the other SN's, you'd think it's "to the operating room as soon as possible".

It actually shouldn't be. The human body is a funny thing. For some people, their proprioceptive ability (or position sense), can compensate for the loss of the ACL dramatically. If their activity or sport consists mostly of straight ahead running only, they may do ok without fixing it. I'm thinking of runners, cylcists, swimmers, and perhaps a few others.

However, sports that are stop and go, like basketball, soccer, football and the like, do depend on the ACL greatly, and probably require fixing, no matter how good your proprioception is.

Our usual protocol following an ACL injury, is quieting the knee down (ie getting any swelling settled),
getting as much range of motion back, and getting the knee (especially the hamstrings) as strong as possible, before an operation. A good physiotherapist is your best friend.

The operation to fix the ACL, usually involves replacing it with a hamstring or part of the quadriceps tendon from the patient. This can be done as day-surgery, but then the true work for the athlete begins.

Rehab should be intensive, with reasonable time lines being about 3 months to get back to straight ahead activity, and 6 months to stop and go sport.

Best wishes to Rivera. I'd hate to see him end his career this way.