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Posts tagged ‘Health’

POST HOC ERGO PROPTER HOC

¨After this, therefore because of this¨ – It´s a logical fallacy that we tend to make more often than we would like to admit. I already talked about this in one of my previous posts but I would like to explain it one more time by giving 2 examples.

A lot of people don´t know what a wonderful machine our body and mind is. It is by far the best thing you will own in your lifetime. For example, did you know that roughly 50% of all illnesses for which people seek medical help are ¨self limited¨, meaning they are cured by the body´s own healing processes without assistance from medical science. Let´s see a Porsche trying to fix a flat tire or a broken suspension……haven´t seen it yet. So the body, we can safely say, is a truly amazing machine with remarkable powers to set itself right.

With the body so effective in healing itself, many who seek medical assistance will experience a positive outcome even if the therapist or doctor does nothing. In other words, even a worthless treatment can appear effective, I mean we have a 50% change that our body will fix itself. So when an intervention is followed by improvement, the intervention is said to be ¨effective¨ according to the person´s experience. Now, don´t try to convince that person that maybe it may not have been the treatment that restored his health because he will not even listen to you, you have no chance. His ¨personal experience¨ tells him otherwise.  But what about if he would have tried another treatment or even no treatment at all? Maybe he would have learned something else. This is a classic example of  Post hoc ergo propter hoc.

Regression to the mean-  Many diseases are cyclical, meaning they get worse or better temporarily, but always move back to an average severity(1). Back pain, arthritis, allergies, and multiple sclerosis are cyclical, meaning sometimes they get worse and sometimes they get better. Usually, we go to the therapist or doctor when we have the most pain, so it´s bound to get better no matter what the therapist does to you (2). So as you can see this would be another classic example of post hoc ergo propter hoc.

Things are sometimes not  as clear as they appear and looking at things from a different perspective can give us a better idea of what´s really going on.

References

  1. Streiner DL. Regression toward the mean: Its etiology, diagnosis, and treatment. Can J Psychiatry. 2001;46:72–76
  2. Ernst E, Simon S. Trick or Treatment ? Alternative medicine on trial. Transworld Publishers.London,UK.2008
  3. Gilovich Thomas. How we know what isn´t so.The free press. 1991
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The magic pill

Imagine I had something that could make a lot of your daily problems go away. Would you take it?  I think most of us would. I surely would, but guess what? That ¨pill¨ is already out there and it´s easy to get.

I´ll admit it. I have experimented with that ¨pill¨ and let me tell you something, it´s some gooodd shit, if you know what I´m talking about. This ¨pill¨ is so good it relaxes me, it makes me feel happier, it takes stress and anxiety(1,2) away from me, it makes me feel less tired and it makes me remember things better (well, that has to be a side effect).

Truth be told, sometimes I don´t feel like taking that pill, but when I do, I feel so good  that afterwards I ask myself why the hell was I even doubting to take it. But, the days that I really don´t feel like taking it, I just read the prescription. And that usually does it for me. I mean, come on, this pill has been DEMONSTRATED  to be effective against low back pain, cardiovascular disease, arterial hipertension, osteoporosis, colon cancer, breast cancer, managing your weight, knee arthritis, heart attacks, prostate cancer, hip fractures for menopausal women, depression, and most importantly ERECTILE DYSFUNCTION (not that I have any problems with that, but I´m just saying, you know, in case one of you does)(1-9). And the list goes on.

But it gets even better, this pill is not racist or sexist. Doesn´t matter if you are rich or poor, or where you live, because this¨pill¨ is free and you can take it whenever you want. If you take this ¨pill¨you will live longer and yet some people don´t take it. They complain they are too tired, or have no time, or that their knee or back hurts, not knowing that the ¨pill¨improves all those symptoms.

By now you have probably guess that the ¨pill¨ I´m talking about is called EXERCISE. I highlighted the word because a lot of people don´t know what it is, to be exact 5,3 million people, that´s the number of people that will die in 2014 from inactivity (https://sports-diet-pain.com/2013/10/18/international-chair-on-cardiometabolic-risk/). So let´s try to move a little bit more in 2014!!

This will be my last blog of the year,hopefully you have enjoyed it.  I wish you all happy holidays and a happy new year!

P.S. To all my spanish followers, here is a facebook page for all those that love sport and want to keep up with the latest information. It´s in spanish  https://www.facebook.com/#!/saludando

 

 

 

References:

  1. Martines EW. Physical activity in the prevention and treatment of anxiety and depression. Nord J Psychiatry,2008;62 Suppl 47:25-9.
  2. Hammer M, Endrighi R, Poole L. Physical activity, stress reduction, and mood: insight into immunological mechanism. Methods Mol Bio, 2012;934:89-102.
  3. Warburton DE, Nicol CW, Bredin SS. Health benefits of physical activity: the evidence. CMAJ, 2006 Mar 14;174(6):801-9.
  4. Penedo FJ, Dahn JR. Exercise and well-being: a review of mental and physical health benefits associated with physical activity. Curr Opin Psychiatry,2005 Mar;18(2):189-93.
  5. Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Health GW, Thompson PD, Bauman A. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc, 2007 Aug:39(8):1423-34.
  6. Blair SN, ChenY, Holder JS. Is physical activity or physical fitness more important in defining health benefits? Med Sci Sports Exerc,2001 Jun;33(6Suppl): S379-99.
  7. Sculco AD, Paup DC, Fenhall B, Sculco MJ. Effects of aerobic exercise on low back pain patients in treatment. Spine J,2001 Mar-Apr;1(2):95-101.
  8. Cooper R, Kuh D, Hardy R; Mortality Review Group; FALCon and HALCyon Study Teams. Objectively measured physical capability levels and mortality: systematic review and meta-analysis. BMJ, 2010 Sep 9;341.
  9. Pohjantähti-Maaroos H, Palomäki A, Hartikainen J. Erectile dysfunction, physical activity and metabolic syndrome: differences in markers of atherosclerosis. BMC Cardiovasc Disord,2001 Jun 27;11:36.

Yoga, is it really that good for you?

As I write this blog I am trembling with fear, as I am afraid that all those yoga lovers will hunt me down for even questioning if yoga is really that good for us. Because, as we have all heard or even been taught, yoga is amazing. Yoga improves flexibility, yoga improves sex, yoga improves balance, yoga reduces stress, yoga helps menopausal women, yoga lowers the risk of heart disease, yoga reduces anxiety, yoga, yoga, yoga(1-4). Whatever your problem is, yoga will have a solution. I am surprised there is not a yoga phone line to help us in the need of an emergency.

But all kidding aside, yoga is good for us, as is any other physical activity. And if someone ever asked me if they should do yoga, I will 90% of the time say yes, the same as if anyone asked me if they should start walking, or if they should sign up to the gym, or if they should do dancing, or if they should do pilates. Exercise is great and it produces a great benefit to anyone who practices it (https://sports-diet-pain.com/2013/10/18/exercise/), so if that exercise is called yoga then great, go for it, but as with any other activity it has risks, especially more in men.

Yoga plays around with different postures and in some of them you need a lot of flexibility. So yoga enhances flexibility, but we must not forget that more flexibility doesn´t mean a lower risk of getting an injury, sometimes even the opposite is true, the more flexible you are the greater chance of getting injured (5).

We all know that women are more flexible than men and this is where yoga poses some threat to men. Some of the postures that you have to do in yoga are almost impossible for some men (and even women), because of their lack of flexibility and also because of their bone structure. That bone structure will suffer if forced into a position that anatomically is not possible for them. And according to William J .Broad, ¨men will sometimes use their muscle to get into these challenging poses and this is where they get hurt and why men get injured more often than women and suffer damage that is far worse, including fractures, dislocations and shattered backs¨( 6).

But women also suffer, especially in the hip area, due to the mechanical limitations of the joint. Extreme leg motions could cause the hip bones to repeatedly strike each other, leading over time to damaged cartilage, inflammation, pain and crippling arthritis (7). This is called Femoroacetabular Impingement, and is often found in middle-aged women who do yoga ( it also happens a lot to dancers). Yoga has also been associated with a higher risk of meniscus injury compared to badminton, jogging and climbing hills (8). So you see, yoga also has its risks as with any other physical activity.

The last thing I want to touch upon before I leave is the ¨back topic¨. I always hear people say that ¨yoga is wonderful for the back and anyone who has back pain should do yoga¨, and this is not true. Exercise and movement are great for the back and those are two things you do with yoga. But with yoga you also do a lot of bending.When you bend forward, or when you move any joint for that matter, ligaments really aren’t on tension until you get to the end range, so they aren’t loaded. What this means is that when you bend forward or round your low back, you don’t really put strain on the ligaments so long as your muscles are keeping you from end range . This seems fine, right? Well, there is this thing called the flexion-relaxation phenomenon that happens when people round their lower back: the muscles relax and people end up hanging on their ligaments and discs. And this is not a good thing. As I  mentioned in one of my previous blogs (https://sports-diet-pain.com/2013/10/21/low-back-pain-part-2-herniation/), it is almost impossible to herniate yourself without being in full flexion. Well, guess what? In yoga you are doing a lot of flexion and in some cases even full flexion. Now this doesn´t mean that you should stop doing yoga, or that yoga is going to cause you a herniation. It probably won´t and I will say it again, YOGA IS GOOD, but if you have back problems, depending on your problem yoga can do more harm than good.

The good thing about yoga compared to other physical activities is that it promotes a healthy lifestyle effect like non-smoking, reduced alcohol consumption, increased exercise, vegetarianism and reduced stress, this could all be factors that lead people to say that yoga is amazing and that it does wonders. If we all changed our way of life, did more sports, ate better and reduced our stress, we would all feel much better.

 

  1. Li AW, Goldsmith CA. The effects of yoga on anxiety and stress. Altern Med Rev; 2012 Mar;17(1):21-35.
  2. Ross A, Thomas S. The health benefits of yoga and exercise: a review of comparison studies. J Altern Complement Med.2010 Jan;16(1):3-12
  3. Innes Ke, Vincent HK. The influence of yoga-based progams on risk profiles in adults with type 2 diabetes mellitus: a systematic review. Evid Based Complement Alternat Med 2007 Dec;4(4):469-86.
  4. Oken Bs, Zajedl D, Kishiyama S, Elegal K, Dehen C, Hass M, Kraemer DF, Lawrence J, Leyva J. Randomized, controlled, six-month trial of yoga in healthy seniors: effects on cognition and quality of life. Altern Ther Health Med 2006 Jan-Feb;12(1):40-7.
  5. Battie MC, Bigos SJ, Fisher LD, Spengler DM, Hansson TH, Nachemson AL, Wortley MD. The role of spinal flexibility in back pain complaints within industry: A prospective study. Spine 1.
  6. William J. Broad. www.nytimes.com
  7. Ganz R, Leunig M, Leuing-Ganz K, Harris  W. The Etiology of Osteoarthritis of the Hip.Clin Orthop Relat Res 2008 February;466(2):264-272.
  8. Zhuj JK, Wu LD, Zheng RZ, Lan SH. Yoga is found hazardous to the meniscus for Chinese women. Chin J Traumatol 2012 Jun1;15(3):148-51.
 Snook SH, Webster BS, McGorry RW, Fogleman MT, McCann KB. The reduction of chronic nonspecific low back pain through the control of early morning lumbar flexion. Spine 1998, 23: 2601-07.
Kelsey JL. An Epidemiological Study of Acute Herniated Lumbar Intervertebral Disc. Int J. Epidemiol:4;197-204

Lower back pain part 3: Prevention

Ok, so in part 2 of lower back pain I explained a little about what a herniation is, now I want to start talking about how to prevent a herniation. First, let me go into a little more detail about what a disc is. ( read https://sports-diet-pain.com/2013/10/18/lower-back-pain/ and https://sports-diet-pain.com/2013/10/21/low-back-pain-part-2-herniation/ )

A disc is the substance between the vertebrates. It has a nucleus and a annulus. The annulus surrounds the nucleus and prevents it from coming out. The nucleus is a gel like substance, and a herniation is when the annulus breaks and the nucleus comes out ( more or less). The disc varies in size depending on the time of day. In the morning the discs are usually bigger than at night, because we have been laying down for hours and the discs have absorbed liquids. That is why in the morning we are usually taller than at night and a reason why we shouldn´t be doing flexion activities in the morning. The bigger the disc, the more stress you put on it and on your ligaments. A study estimated that disc-bending stresses were increased by 300% and ligament stresses by 80% in the morning compared to the evening (1). In another study it was demonstrated that simply avoiding full lumbar flexion in the morning reduced back symptoms (2). So first factor in preventing herniation and lower back pain, don´t do flexion activity in the morning, wait at least 30 minutes to an hour, that is usually what it takes for the disc to return to normal size.

Spine has memory. The function of the spine is modulated by certain previous activity. This occurs because the loading history determines disc hydration, which in turn modulates ligament rest length, joint mobility, stiffness and, load distribution. In simple words, when we are sitting down, we are in flexion. This means that the nucleus of the disc has moved posteriorly, and we have ¨stretched¨ the posterior ligament (3). So it would be unwise to lift things after a bout of prolonged flexion, like for example when we are sitting for a long time . Then, a second factor in preventing herniation and lower back pain, don´t lift things up after being in flexion for a long time. Meaning if you have sat down the whole day, don´t go right away and try to pick up something heavy, the changes of hurting yourself are going to increase. All you have to do is stand up, wait 5 minutes, and your changes of getting hurt will greatly diminish. This can also be said to all those that play sports like for example, basketball. When you are on the bench sitting down, you are in flexion. So it would be much wiser, if you know that you are going to go into the game, to stand up, or to try sit in a way that your back isn´t in flexion.

Too much of anything is usually bad. In a study done in 1975 (4-5) , it proved that seated work posture creates an increase in lower back pain (LBP).  Another one  in 1996 (6)  also suggested that people who sit for long periods of time have a greater risk of low back troubles (8%), but what was even more interesting is that active workers, meaning people who worked moving around or standing up, reduced their probability of getting back pain by 14% if they would sit once in a while. This suggest that variable work, and not too much of any single activity is the best thing. In other words, if your job consist of sitting down the whole day, it would make sense to get up and move around once in a while. And if your job consist of being active the whole day, it would be clever to do the opposite. So any business man out there thinking of creating their own business or ones who already have one, make your workers do VARIABLE WORK, and you will save up money in the long run.

I already said how easily it is to hurt yourself from flexing your back, how you shouldn´t pick up heavy things after prolonged bouts of flexion, how the best thing to do to prevent LBP is to do variable work, but the number one thing you should really try to avoid is FREQUENT BENDING AND TWISTING (gardening is an example of frequent bending and twisting). The U.S. Department of Labor (1982) and many more studies noted the increased risk of lower back pain from frequent bending and twisting (7-8). In this report vibration was also included, especially seated vibration. So all those power plates fanatics carefull with the vibration (7,9).

80 % of us will probably get back pain at one point or another, that´s a lot! But I´m pretty sure that if we try to avoid things I have mentioned in this blog the chances of us getting hurt will greatly diminish.

Hope you enjoyed it

References

  1. Adamas M, Dolan P. Diurnal variations in the stresses on the lumbar spine. Spine 1987,12(2):130.
  2. Snook SH, Webster BS, McGorry RW, Fogleman MT, McCann KB. The reduction of chronic nonspecific low back pain through the control of early morning lumbar flexion. Spine 1998, 23: 2601-07.
  3. Mcgill S. Low Back Disorders Evidence Based Prenvention and Rehabilitation 2nd. Human Kinetics 2007.
  4. Kelsey JL. An Epidemiological Study of Acute Herniated Lumbar Intervertebral Disc. Rheumatol Rehabil 1975:14;144-5.
  5. Kelsey JL. An Epidemiological Study of Acute Herniated Lumbar Intervertebral Disc. Int J. Epidemiol:4;197-204.
  6. Liira JP, Shannon HS, Chambers LW, Haines TA. Long-term back problems and physical work exposures in the 1990 Ontario Health Survey. Am J Public Health. 1996;86:382–387.
  7. The U.S Department of Labor Report (1982)
  8. Marras WS, Lavender SA, Leurgans SE, Fathallah FA, Ferguson SA, Allread WG, Rajulu SL. Biomechanical risk factors for occupationally related low back disorders. Ergnomics 1995 Feb:38(2):377-410.
  9. Seroussi RE, Wilder DG, Pope MH. Trunk muscle electromyography and whole body vibration. J Biomech 1989:22(3):219-29.

How much water do we really need to drink?

I think we have all heard at one point or another in our life that drinking 2 liters of water per day does wonders to your mind and body. But is this really true? Let´s find out.

2 Liters per day is about drinking 8 glasses of water per day, and if you have ever tried doing that, you have realized that you spent a lot of time in the toilet. So, where did this mythical number come from? Why 2 liters and not for example 1.5 or 3 liters?  Well, it probably started from a study done in the 1940s, where researches calculated that 2 liters is how much water a person’s body consumes in 24 hours, so WALLAH, there you have it, that´s where the magical number comes from. But what also came out of that study, and what a lot of people don´t know, is that we get much of the water we need each day from our food, and this does not include the number of drinks like coffee and tea most of us consume every day. And NO, coffee and tea DON´T DEHYDRATE YOU. Although coffee and tea may act as diuretics, the amount of dehydration caused by these beverages is not equivocal to the volume of the fluid. Caffeine has been shown to cause one milliliter of fluid loss per milligram of caffeine. So let´s give an example to explain.

  • A normal cup of 260 milliliter of coffee has around 90 milligrams of caffeine, so if the caffeine causes one milliter of fluid loss per milligram you would still have 170 milliliter of liquid, So, in other words you gained 170 milliliter of liquid, that´s called hydration.

So we know half of our body is made up of water, we know water is vital to keep the important chemical reactions in our body functioning. But the idea that you should drink 2 liters of water per day has absolutely no evidence to back it up. So what should you ? Drink when you are thirsty, if you have to drink more than 8 glasses per day do it, if you have to drink less than that also do it. In other words, listen to your body and you will be perfectly fine.

References

Fink H, Burgoon L, Mikesky A. Practical Application in Sports Nutrition. Jones and Bartlett Publishers, Inc 2006.

Grandjean AC, Reimers KJ, Bannick KE, Haven MC. The effect of caffeinated, non-caffeinated, caloric and non-caloric beverages on hydration. J Am Coll Nutr. 2000;19:591–600.

Food and Nutrition Board of the Institute of Medicine. Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate (2004). Accessed October 11, 2006.

Does eating late make you gain weight?

Most people out there think that eating food quite late or just before going to bed is going to make you gain weight, but that´s really not true. You gain weight because of calories not because of ¨TIME¨. The thing is, that most people have had their share of calories during the day and that extra meal you are going to eat before going to bed is going to add to the already enough calories you have consumed during the whole day. So let me put up an example to clarify things.

Imagine your body consumes or burns 2,000 calories (2.000 in Europe) a day. This means that if you  eat  more than 2,000 calories a day you will probably gain weight and if you eat less than 2,000 calories you will lose weight. So now imagine you have not been eating anything during the whole day and just before going to bed you decide to have a burger, with bacon , fries and everything you can imagine. If that meal you are going to eat has 1,500 calories, you are still going to lose weight because you still have a 500 calorie deficit when you go bed. Now this doesn´t mean I recommend that you have a heavy meal before going to bed, and i usually never recommend this to my clients. But I want people to understand that CALORIES make you gain weight not time.

Now once this is clarified I do want to state that the body has a biological clock that helps time our sleep patterns, alertness, mood, physical strength and blood pressure. Usually we experience a 24-hour pattern of light and dark, and our clock uses this signal to align biological time to the day and night. What this means is that under normal conditions our blood pressure decreases, body temperature drops and we get tired, meaning our metabolism slows down. Which is one of the reasons why I don´t recommend eating heavy before going to bed.

So in conclusion: CALORIES make you gain weight not time, but eating heavy meals at night is usually not a good idea.

I have done 3 blogs about diet, so now I will change topics and start talking about sports, in particular about cardio training. So until next time.

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