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As always, I hope this has been healthful. 

Are protein supplements really the whey to go?

Is it healthful?

Protein shakes have divided nations! Some will be critical of the singlet toting gym junky’s protein shaker and others will feel inspired to shake themselves. So should you protein shake?

To shake or not to shake?

One quality scientific review, found protein supplementation with resistance training to increase muscle mass more than resistance training alone. Additionally, in conjunction with a healthy diet protein supplementation can aid in fat loss (1). A further review study found protein ingestion with resistance training to increase muscle mass, strength, explosive power and power during endurance based tasks more than resistance training alone (2). This tells us you should get shaking!

What, when, how to shake:

If it is an entire protein supplement you are consuming such as whey powder, then consuming the product within 30 minutes post workout appears to offer maximal strength and muscle mass benefits (3). Consuming protein…

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Intermittent fasting: dispelling the BS (bad science)

What do Miranda Kerr, Ben Affleck and Christie Turlington have in common?  Apart from being really, really ridiculously good looking, that link is intermittent fasting. Yes intermittent fasting is the new black and if you ain’t intermittent fasting, well you ain’t…….

A simple Google search on intermittent fasting finds it to be overwhelmingly positive – curing your cancer and making you saucily slim at the same time. You ripper! Unfortunately that’s probably since you’re coming across the websites of spruikers with an interest in intermittent fasting related products, or those without a health research background, who seem to promote anything slightly absurd and sexy. So, is intermittent fasting all it’s cracked up to be? Or is it just another crock?

What is intermittent fasting?

Before science gives you its definitive answer, what exactly is intermittent fasting? Broadly speaking, intermittent fasting refers to any dietary regimen where you stop eating or limit your calories for a defined period of time before returning to eating. There are various different timing ratios, but the most popular is the 5:2 pattern, where you eat normally for five days and for two days restrict your daily caloric intake to only 500-600 calories. Because you’re not really changing what you’re eating, but simply the timing, the diet’s proponents say it isn’t actually diet.  But does this mean it works?

Why it might work?

There are several theories as to why intermittent fasting might work. A major one is that having small breaks from eating will lead to less eating overall – because you’re not eating during fasting and when you return to eating your stomach is smaller and you have less of an appetite.

Another proposed mechanism is that when you’re not eating, you’re not putting glucose into the bloodstream. This then means you don’t produce insulin in response to clear that glucose. Insulin causes you to preferentially burn glucose over fat. Therefore, if you fast you should, in theory, be burning fat instead of sugar, causing you to be less fat, more skinny and objectively more handsome/saucy/sexy. Hallelujah!

Does it actually work?

Theory is all good and well, but if this theory doesn’t translate to actual health improvements in humans then it don’t mean jack, Jack. Well, here we go then.

A review of various human based studies on time restricted feeding, a component of most intermittent fasting eating regimes, found it to lead to: weight loss, decreased LDL (bad) cholesterol, triglycerides and increased HDL (good) cholesterol in most, but not all cases (1).  Looking fairly promising thus far.

Another review study, compared the benefits of intermittent fasting to standard caloric restriction: decreasing how many calories you eat. Standard caloric restriction was more effective than intermittent fasting for weight loss. But both equally decreased insulin resistance and visceral fat (2), which could prevent diabetes and various other chronic diseases. So if caloric restriction may be very slightly more beneficial than intermittent fasting, then why don’t you just eat less? Well, read on, my wayward son.

Why don’t you just eat less?

Yes, a major theory as to why intermittent fasting may work, is that you actually consume fewer calories. There is minimal to no scientific evidence surrounding this topic, but intermittent fasting may lead to an overall reduction in caloric intake and it may be easier to adhere to intermittent fasting than an overall low calorie diet in uncontrolled, non-scientific circumstances. It’s your classic occasional Ben and Jerry’s versus no Ben and Jerry’s type scenario!

Are there any negatives to intermittent fasting?

Before we provide our verdict, are there any negatives to intermittent fasting?  So many questions!

A common concern surrounding intermittent fasting is that it will make you feel terrible and impair your: cognitive function, athletic performance and even sleep.  Well, we can’t deny that it might make you feel lacklustre, especially initially.  However, there is good evidence that intermittent fasting does not effect, or very modestly negatively effects athletic performance. Suggesting you would have to be a very high level athlete for it to impair your performance (3). As for sleep, it doesn’t appear to substantially negatively effect sleep (4) and finally, in terms of cognitive function, it may actually make you a little bit sharper. This is since the lack of food is said to stimulate hunter gatherer instincts and in turn raise cognition (5).

However, before you go out and stop eating, fasting regimens have not been tested in: diabetics, children, the very old and underweight individuals, and it is possible that this dietary routine may be harmful to these populations. If that describes you, maybe give it a miss for the time being.

Is it healthful?

Current scientific evidence is limited, however, intermittent fasting looks to be beneficial for metabolic health and weight loss, with no significant substantiated negative effects reported in the scientific literature yet.  If you’re already healthy and have no problem restricting your calories, then based on current data it’s unclear if intermittent fasting will be of benefit to you. In contrast, if you struggle with metabolic health, weight loss and limiting calories, then intermittent fasting may be a good strategy.

Finally, whether you’re fasting or not, there is no replacement for good diet and you should try to eat healthy, nutritious foods.

Our verdict: moderately healthful. 

We’d love to hear your opinion on intermittent fasting, please comment below.

I hope this has been healthful!

The information on inflammation: science on the anti-inflammatory diet

Bitumen on a sweaty, sultry summer’s day.  Doesn’t get much hotter, right? Wrong!  Right now the anti-inflammatory diet is hotter than Hades. Heck, it’s hotter than Hansel, who as you know, is so hot right know.  As the anti-inflammatory diet’s popularity reaches fever pitch, we ask ourselves is this just another fad diet, or is it the answer to all the our problems?

Why?

Before I even answer that question, why should you even consider consuming an anti-inflammatory diet? Well, inflammation in one way or another, has been found to be consistently associated with nearly every single chronic disease.  However, just because something is associated with something else doesn’t mean it is definitely the cause.  But it is a cause for concern! So, that brings us to the age old question, does it work?

Cardiovascular health:

The Mediterranean diet, which is remarkably similar to the anti-inflammatory diet, has been demonstrated to decrease the risk of heart attack and other major cardiovascular complications by 30%. Also, unsurprisingly, it improves markers of cardiovascular health such as blood pressure (1). Promising signs!

A review paper of multiple studies found that the nutrients promoted in the anti-inflammatory diet are consistent with those that have improved outcomes in patients with peripheral artery disease, another cardiovascular condition. Also, the anti-inflammatory diet does not contain the nutrients that are harmful to this condition (2). You beauty!  So, while we can’t directly prove that the anti-inflammatory diet is effective in improving cardiovascular health the results look very promising – even sexy, some might say!

Inflammatory bowel disease (Crohn’s disease and ulcerative colitis):

A hallmark of inflammatory bowel disease is…. you guessed it, inflammation.  So you’d think an anti-inflammatory diet would probably work. And it appears it does. A study found that 100% of individuals suffering from inflammatory bowel disease who followed the anti-inflammatory diet decreased medication use after following the anti-inflammatory diet. All 100% also had a reduction in symptoms (3). Similarly, in another study on Crohn’s disease patients, the anti-inflammatory diet improved markers of inflammation. Shocking, I know. (4). So again, it looks really, really promising but there isn’t the stone cold science there just yet to make us 100% confident in this diet’s effects.

Musculoskeletal health:

What about musculoskeletal problems – back pain, neck pain, broken bones? Funny you should ask. In a group of patients with low back pain, supplementation with fish oil tablets was compared to taking anti-inflammatory drugs (Voltaren, neurofen, etc.). It was found that fish oil supplementation was as effective as taking anti-inflammatory drugs for decreasing back pain (5).  While fish oil tablets aren’t the same as consuming an anti-inflammatory diet, they provide one of the key nutrients of the anti-inflammatory diet: omega-3 fatty acids. Good stuff.

Somewhat similarly, in a group of patients with rheumatoid arthritis, consuming an anti-inflammatory diet decreased pain and symptoms compared to consuming a normal western diet. It also augmented the effects of consuming fish oil tablets (6).  Good again.

Last, but most certainly not least, consuming an anti-inflammatory diet decreased inflammation in ankylosing spondylitis patients and reduced the number of flare ups and time to flare up for this condition. Ankylosing spondylitis is an autoimmune disorder where the spine stiffens – prolonged systemic inflammation is present in this condition (7).  So, all in all, the anti-inflammatory diet looks good at managing chronic musculoskeletal complaints where inflammation is present.

Is it healthful? 

For inflammatory gastrointestinal issues, chronic musculoskeletal conditions and cardiovascular health it looks like the anti-inflammatory diet helps.  There has not yet been enough good quality research to 100% confirm this, but if you look below, it’s an extremely healthy diet which ain’t going to do any harm. Give it a try!

Our verdict: Slightly healthful. Likely to be proven moderately to very healthful with further research.

What to eat if you’re going anti-inflammatory?

1. Eat plenty of fruits and vegetables.

2. Eat good sources of omega-3 fatty acids, such as fish or fish oil supplements and walnuts.

3. Eat plenty of whole grains such as brown rice and bulgur wheat (see this link, to determine whether its a wholegrain or not – packaging can be misleading).

4. Eat lean protein sources such as chicken; cut back on red meat and full-fat dairy foods.

5. Minimize saturated and trans fats. Except maybe a spoon of coconut oil daily!

6. Avoid refined foods and processed foods.

7. Consume alcohol and caffeine in moderation

8. Eat a variety of spices, especially ginger and curry.

I hope this has been healthful.

Should you quit Crossfit? The UNBIASED scientific facts!

The first rule of Crossfit: you always talk about Crossfit. Accordingly, it did not take me long to hear about Crossfit, and boy did it change my life! Not as a Crossfit participant, but as a health professional. You what now?!

Yes, as a physiotherapist I would often loiter out the front of Crossfit gyms as I knew I would drum up some business. And business had never been better! Deconditioned bodies being thrown into Olympic style lifting with minimal rest, heck I couldn’t have written a better recipe for injury myself.

As you can now tell, it’s exceptionally easy to poke fun at the Crossfit cult. But does Crossfit actually deserve all the flack it gets? Or is it truly an innovative, superior form of exercise? To find a definitive, unbiased answer, I have based this research on peer reviewed scientific articles, rather than those published in the unbiased- extreme sarcasm alert – Crossfit Journal.

Injury rate:

Was business really that good? The science says maybe not. About 73% of individuals sustained an injury performing Crossfit. Yes that does sound high, but this rate of injury is comparable to that of: power lifting, Olympic lifting and gymnastics, and even lower than contact sports like rugby (1).

Surely that study was an anomaly? Nope, in a group of soldiers, half were asked to perform normal training, while another half performed high intensity functional training similar to Crossfit. Injury incidence did not differ between the two groups (2). Back to the rugby club for me!

Enjoyment and motivation: 

Another suggested benefit of Crossfit is that it motivates people unlike other forms of exercise. A study compared a group of people who started an average gym based exercise program to those who started a Crossfit exercise program. Those that performed the Crossfit program were more likely to continue exercising after completion of the study, suggesting it likely is a more motivation yielding form of exercise (3). I can’t believe what I’m reading. Crossfit is winning.

 

The physical benefits: 

Alright, alright, alright let’s not get carried away, we haven’t yet demonstrated the physical benefits of Crossfit – the most important part. So let’s have a look. Let’s have a  bloody good look!

Aerobic fitness:

A Crossfit program was shown to improve aerobic fitness and decreased body fat percentage (4). A further study mimicked these findings in a group of individuals performing high intensity interval training, like that utilised by Crossfit (5). So while you’re performing resistance exercises you are actually getting a response like you would get performing cardiovascular exercise. Not bad, Crossfit!

Strength, power and muscle mass:

Do these aerobic benefits come at the cost of: strength, power and muscle mass? Probably. While not directly proven, rest periods of 30 seconds or greater have been demonstrated repeatedly to maximise muscle hypertrophy (size), while rest periods of 3-5 minutes have been shown to maximise muscular strength and power (6). So while Crossfit will no doubt improve strength, power and muscle mass, larger rest periods would likely further these increases to levels seen in traditional resistance training programs.

Overall efficiency:

Unsurprisingly, Crossfit is quite efficient overall. When it was compared to traditional gym exercise: two cardio sessions and three gym sessions (60 minutes each), Crossfitters spent less time exercising (30 minutes per session) for fairly similar benefits (3). 

 

Is it healthful? 

Yes. I wouldn’t get your grandma to dive straight into Crossfit straight away, but with common sense and slow progression it is safe. Despite its high intensity, Crossfit may motivate you to stick with it for longer than other forms of exercise. Additionally, while you won’t get as ripped as doing well programmed weights, or as aerobically fit as a marathon runner, you will get a nice combination of both for less of your time invested.

Our verdict: I hate to say it, but moderately to very healthful! Although, you could probably perform a similar style program in a gym with professional guidance. 

I hope this has been healthful.

To joe, or not to joe? The science surrounding coffee.

As I finish what will be my last sip of coffee for the day I feel nearly superhuman. I’m happier, my productivity is at a Ryan Seacrest like levels (apparently the man is quite productive) and heck, if the New York City marathon were held today I’m pretty confident that I would win, easily. Yes, coffee truly is the nectar of the Gods. But – very big but(t) – is it actually good for me? Or is my three a day routine a recipe for an early death? Science, take it away:

The Good:

Exercise and fat burning:

Drinking coffee one hour before endurance exercise improves times by approximately 5% and this leads to the preferential burning of fat as an exercise fuel (1).  It’s uncertain though whether coffee actually aids in fat-loss. Looking good so far, coffee.

Blood pressure, cholesterol and cardiovascular health:

Anti-coffee people, AKA tea drinkers, will often criticise coffee because it raises blood pressure.  Guess what? They’re wrong. A review of studies to date on coffee and blood pressure found that there was no evidence that coffee drinking in moderation (three cups or less) had any negative effect on blood pressure. In fact, coffee reduced blood pressure in non-smokers (2).

Another criticism of those retched tea drinkers is that coffee raises cholesterol. Sadly, they could be right on this front.  Drinking moderate amounts of coffee (2-3 cups plus daily) can increase cholesterol levels (3). However, this doesn’t appear to increase the risk of cardiovascular disease. In fact, cardiovascular disease risk is reduced in those that consume coffee (4). This indicates that unless you have high cholesterol, drinking coffee in moderation should have no detrimental cardiovascular effects and may in fact be beneficial.

Other diseases: 

A high quality review study, reported that the risk of type-2 diabetes decreased 12% for every two cups of coffee consumed. Another study found that consuming three cups of coffee a day maximally decreased the risk of Parkinson’s disease (5).  Coffee, you’re the best.

The great

It gets even better, coffee drinkers.

Life expectancy: 

If you thought coffee was good already, you’re about to think it’s great! A review paper analysing the results of studies on over one million people, found that those that consumed coffee regularly were less likely to die of any cause than those who did not regularly consume coffee. Specifically, those that consumed between 3-5 cups daily had the lowest risk of dying (6).  Not convinced yet? Another study found coffee consumption to decrease the risk of death from any cause (7). Oh, and what’s this? Yes, a further study found coffee to decrease the risk of death, although this time four cups daily was the sweetest at reducing death risk (8). So this leads me to ask, is there anything coffee can’t do?

The bad:

Unfortunately, yes there is.

Pregnancy:

Consuming moderate to high levels of coffee during pregnancy is associated with an increased risk of delivering a low birth weight baby. Although, consuming low levels of coffee appears to be safe (9).

The undecided:

While excess coffee is definitely bad news in pregnancy, whether it increases stress, anxiety and headaches is unclear.

Stress, anxiety, headaches:

Believe it or not, there is actually not a great number of studies on this topic. The most relevant for stress is a study from 1984 (too old to be accurate) which found no link between coffee and anxiety (10). For headaches, there was found to be only a very small risk of headaches at extremely high consumption levels (11).  All in all, the science isn’t clear on this one, but if you’re consuming six cups a day you might be a bit stressed and have a sore head, so drink (coffee) in moderation.

Is it healthful:

Most people: Coffee may improve exercise performance, enhance cardiovascular health, decrease type-2 diabetes and Parkinson’s disease, and it may even let you live a longer life.  Java up!

Our verdict: Very healthful. 

If you’re pregnant: If you’re pregnant limit your coffee intake to very low levels, it could cause premature birth!

Our verdict: Unhealthful.

If you have high cholesterol, anxiety, or get headaches: If you have high cholesterol, get headaches, suffer from anxiety or are highly stressed maybe limit your coffee intake to low-moderate levels, although the scientific evidence isn’t entirely clear on this just yet.

Our verdict: Moderately healthful in moderation, unhealthful in excess.

I hope this has been healthful.

DOMS for dummies: the top five scientific muscle soreness cures!

You walk into the office and are faced with a flight of stairs. Normally you would ascend those stairs with ease and a certain amount of grace.  But not today. No, yesterday was leg day and you climb those stairs like a drunken elephant on rollerblades. You are experiencing DOMS (delayed onset muscle soreness) and you are experiencing it bad.  Is there anything you can do about it? Yes. Yes there is. So, without further ado here are the top five science based cures for DOMS.

What doesn’t work:

I lied, a bit of ado first. Stretching (see my other blog), ultrasound therapy, fish oil supplementation and magnet therapy have all been shown to have no effect on DOMS (8, 9, 11). Protein supplementation appears to improve muscle mass gains in the short-term, but sadly it has no apparent effects on muscle soreness (10). Rats.

What might work:

Here, have some more ado. Branched chain amino acid supplementation shows a lot of promise. Currently the scientific evidence is mixed – likely due to different dosing regimens and study designs. One study found branched chain amino acid supplementation to have no effect on DOMS pain and recovery (12). One study reported it only decreased DOMS in females, while another reported it to decrease DOMS pain by 10% in all individuals (14). Because of these mixed results, we can’t yet put branched chain amino acids in the top five. Sorry.

Number five: 

Coming in at number five is massage following exercise. Massage therapy has been found to definitely improve DOMS. Oh, but only by half a point on a 10-point pain scale. It’s unlikely that this change in pain has any effect on athletic performance in the coming days (1). Despite its humble benefits, this still appears to be the fifth best treatment for DOMS based on current scientific evidence.

Number four:

Ice packs have a very slight effect on muscle soreness, but scientific evidence indicates they don’t improve performance in the days following exercise (2). Slightly better, or possibly even on par with massage. Let’s look elsewhere.

Number three: 

It gets a bit better at number three. Cold water immersion which can refer to having an ice bath, taking a dip at the beach, or soaking the limbs in cold water helps. It has been found to decrease DOMS slightly, reducing fatigue during exercise by 20% and overall pain levels (3). Contrast therapy, swapping from hot to cold water repeatedly, appears to have similar effects, so we’ll put this under the same category at number three for you (7).

Number two: 

Not number one, but not far off. Compression garments decrease muscle soreness moderately and improve muscle power and strength when compared to no compression in the days following exercise (4). Yes, that means both pain and performance improvements. Here’s a tip, try wearing your compression tights the night of exercise and the following day(s), as this may lead to even further benefits. Obviously wash them at some stage during this period.

Number one: 

And the number one cure for DOMS is………..foam rolling. Yes, foam rolling. It has been demonstrated in two different studies to decrease muscle soreness moderately and in one study to also improve performance moderately (5, 6). For maximum effect roll immediately after exercise.

Why this is so much more effective than massage is unclear? Perhaps it’s the fact that the roller is more able to get into fascial tissue (superficial gluey tissue). Or maybe it’s that foam rolling can be performed straight after exercise more easily than massage. Who knows? It appears to work, so I ain’t gonna question it.

Tips, hot hot tips:

So you know what works, but how about trying combining foam rolling, wearing compression garments and immersion therapy, the top three.  The combined effects could be quite substantial.  Also, I would try supplementing with branched chain amino acids after exercise, as they likely aid in increases in muscle mass and with further studies could be proven to decrease your deadly DOMS.

I hope this has been healthful.