In This Issue
As you probably know, spinal discs consist of a hard outer 'ring' (nucleus pulposus), with a softer, pulpy interior (annulus fibrosus). So development of artificial, replacement discs attempts to follow that same pattern.
In Europe some spinal disc replacements have been done for about 10 years. The most successful device currently used is the SB Charite III Intervertebral Dynamic Disc Spacer (that's a mouthful). It is constructed of endplates made of cobalt chromium alloy (also biologically unreactive) with a polyethylene core between them. They aren't available in the U.S., of course.
At any rate, there are numerous problems having to do mainly with fit and longevity that are still being worked on. There are also 'preferred candidates' for disc replacement, so not everyone will be able to get one even when they are finally available. Fusion, with all its faults, still seems to be the preferred choice as a last resort to simply living with pain.
NO PAIN, NO GAIN; or TRAIN DON'T STRAIN - have you ever heard those phrases related to exercise? Catchy, but in my estimation, they need some clarification.
First, "No Pain, No Gain" is true in one sense, but not in another. You have to put some effort into your training or your results will be disappointing. You may feel discomfort from lactic acid buildup, but you should not tolerate sharp pains, which commonly signal damage, not just effort.
"Train, don't Strain," on the other hand doesn't mean to train at an easy level - you basically get back according to what you put in. You may in fact strain to accomplish a lift, but not the sprain, strain, tear type.
Missing gallbladder? Not lost, but removed. What are the ramifications? It seems that there are people who have had their gallbladders surgically removed - usually because of gallstones - but who have no related health problems afterward. Is it a throwaway body part? Not exactly, but like the tonsils or appendix, one can live without them.
What is the gallbladder that we can live without, but would prefer to keep? It stores bile, which is manufactured in the liver (one of its 500+ functions) and is used to help with fat digestion. Bile is continually manufactured in the liver and sent to the small intestine, but it is diverted to the gallbladder on its way. It is stored in the gallbladder for use when fatty food goes into the digestive system, at which time it (bile) is "squirted" into the small intestine.
So, how about those people who have had their gallbladder removed? How do they digest fat? During removal of the gallbladder, the duct that diverts bile to the gallbladder is "tied off" and bile goes directly from the liver to the small intestine. And in some cases the bile duct enlarges and actually stores bile just like the gallbladder did.
In most cases the body is able to adapt to this new way of doing business relatively quickly, but there can be problems with fat metabolism. For some people, fat just charges right through their systems, making them reluctant to go very far from a bathroom - a problem of bowel incontinence. There can be other side effects that are more an annoyance than a health hazard, but most people survive gallbladder removal very well. Even the surgery itself is much easier now that a gallbladder can be removed through a very small incision, just like "key hole" heart surgery.
On calcium and bone health: Only about one out of three people who break a hip will ever regain their independence. Not a good outlook. Nor is the likelihood that one out of four will die within the year of their fracture. Nor is the prospect for the survivors - about half will not be able to walk again without some aid - cane, walker, etc. Furthermore, a broken hip is the second highest cause of admission to a nursing home; otherwise known as a "Guilded Cage", rest home, etc.
Broken hips mainly show up in women in the over-65 age group, but not exclusively. Osteoporosis is the leading cause of hip fractures, and it begins well before age 65.
Roughly 80% of women aged 75 or older, when asked whether they would prefer a nursing home or death, chose the latter. Women are the most frequent victims of a hip fracture, but men are not immune to it. It is estimated that 10,000,000 Americans can be diagnosed as having osteoporosis. Bone loss is at an epidemic state in those over 65. We have previously reported in this newsletter about bones being a living entity, under constant change - osteoclasts remove aged or damaged bone; and are followed by osteoblasts which repair the holes. But there are factors which can cause the osteoblasts to slow down, resulting in bone density loss - osteoporosis. One's risk depends on peak bone density achieved earlier in life, and, of course, women have a higher risk than men simply by virtue of size, and their loss of estrogen (a bone "saver", among other things) at menopause. The bad news for men is that they are twice as likely to die within the year of the fracture as women.
The question is: what can you do about this "epidemic." Nothing much, if you are a woman, over age 65, have dementia, are frail or in poor health, are Caucasian, have a family history of fractures, or had a previous fracture as an adult. But, there are some risk factors that can be controlled, including smoking cigarettes, low estrogen level, weigh less than 127 pounds, have a chronic low calcium intake, alcoholism, impaired vision, repeated falls, too little physical activity, . . .
Calcium, or rather lack of it, can be significant - it is estimated that the average American takes in only 600 micrograms a day, as opposed to the 1000 mg recommended daily for adults under age 50 , and 1200 mg for those over 50 (recommendation of the National Academy of Sciences. [If you are 50, I guess you're on your own.] Getting an adequate amount calcium can slow down, but not stop, osteoporosis. Note that for men it is recommended that they don't get more than 2000 mg per day because there is some evidence that high doses may increase the risk for prostate cancer.
In addition to proper calcium intake, it is crucial to take an adequate amount of vitamin D, which strongly aids calcium absorption. Vitamin D is synthesized by the body from UV rays in sunlight; but sunscreen interferes with synthesis, and at latitudes north of Los Angeles or Atlanta the sun's UV rays are inadequate between late fall to early spring. Take a multivitamin with 400 IU of vitamin D. If you are over 70, take 700 IU. There is a recommendation that women over 70 take 800 IU.
Sufficient protein is another bone health factor. Women should ingest 0.4 grams for each pound of body weight. As a reference, that's 50 grams of protein a day for a 120 pound woman.
Exercise, that universal palliative, also helps protect against bone loss. Weight bearing exercise helps retain bone density - maybe even increases it. And there are some medications that can help, although many people don't want to take another pill.
Following is a second article submitted by Dawn MacLear. This article addresses yoga and energy. Her previous submission dealt with exercise motivation (in the November/December 2001 issue).
It is said that Yoga changes one's energy. The way that Yoga tells this story is very mystical. Yoga says that doing Yoga poses allows a person to tap into boundless energy, the universal energy. Is this true? How can we explain this in actual terms? Does this make sense?[Many yoga "masters" make a number of assertions about mysterious entities (The Basic Grid, Chakras, Auras, Meridians, Celtic Weave, the Five Rhythms, Triple Warmer, and Strange Flows (that may or may not exist)) that can positively affect the immune system, promote healing, affect personality, emotions, and general health. Most of this I consider to be hocus pocus, but yoga can produce a number of positive effects on health and well-being. In addition to increased strength and flexibility, there can be a more serene sense of being. ]First let's look at the human body as an energy-using unit. Then let's look at other forms of exercise and their effect on energy. Then let's look at the Yoga poses and let's see if we can find anything that isn't pretend.
Everything we are made from, from the first cells we were forming in our mommies, is made from food. The human body converts food, ultimately, to energy. Food is the fuel for the machine. Food is the source for the fuel we burn to create energy. Food is also the way we get molecules for repair and maintenance. If you don't eat, first your body stops doing things like repair, and then your body starts burning away at itself (and not just the fat parts!).
If you do not eat appropriately, your body burns (cannibalizes) itself; i.e., food molecules from some eating done before, in the past. Every blink, every heart beat, every gesture and every breath all use muscular contraction that burns calories from food as fuel. Humans burn about 100 calories per hour awake and about 50 calories an hour asleep. The brain uses sugar. That sugar comes mainly from carbohydrates, such as potatoes, wheat, rice, broccoli, oranges, beer (not an optimal choice!!). Many foods transform into sugar once they are digested. The brain's need for sugar is a priority in the body. So much so that if we eat only protein the body will take the protein molecules and make a kind of sugar out of them. This is not optimal. Protein molecules are the molecules for repair and maintenance.
The left over molecules from this protein-to-sugar process are not easy for the body to use. The left over molecules are practically poisonous. The all-protein diet is a no-no. Some people think of the human body as perfect. It is not perfect. The human body is amazing, but not perfect.
If we are to talk about energy use in the human body, first we must understand what happens at the molecular level.
The human body stores sugar as fuel in muscles. It stores fat as fuel too. Can you guess where? Perhaps you can pinch around on yourself and find the answer. The exact chemistry is beyond the scope of this article.
Fuel gets to muscles and fat cells from blood flow from the small intestine during digestion of food. Molecules for repair and maintenance get to your body in the same manner. Food is used by your body and stored in muscles as fuel for exercise and the activities of daily living. Exercise can enhance the food storage. Yoga, as exercise, can only do a minimum of this.
Now let's look at how some types of exercise affect energy storage and usage.
Building muscles, primarily through weight lifting, to a stronger state allows more food to be stored in the larger muscle fibers. This makes muscles a little bigger and a lot firmer. Weight lifting does not make a person big if they are not genetically big already. If one is born to be big, firm is a better way to live and age. Weightlifting allows for energy storage improvements and energy burnability improvements.
Stamina exercise (aerobic or cardiovascular/cardiopulmonary exercise), like walking, running, rowing and stepping, strengthens the heart muscle and lungs giving the body a greater ability for long bouts of any effort. If one has developed muscles and does stamina exercise one uses more fuel than if one has very small muscles and does stamina exercise. [This is the reason that lifting plus cardio training is a great way to burn fat.]
Stamina exercise creates heart/lung strength; i.e., makes the heart use energy better and deliver energy better and "teaches" the lungs to put more oxygen onto the blood. This improves fuel use (energy use) because fuel burning in the body is, like fire, done with oxygen.
Many forms of primitive exercise like dance, calisthenics and Yoga, give some bit of muscle growth. If one has never exercised before, this new strength will feel very different. Any exercise feels better than no exercise.
Stretching exercise of any sort cannot make the majority of people into contortionists. Stretching loosens tight muscles. Tight muscles pinch off circulation and nerve messaging. When we do anything that stretches the muscles (even if it is unsafe for the joints) we allow better blood flow to the individual muscles. This allows more fuel to be utilized for any tiny or large body action from a blink to a run to picking up something heavy to a facial expression. If a person knows nothing about anatomy, fuel or blood flow but is very spiritual, as were most people in the past, the feeling that happens after stretching might be described as Yoga describes it: the energy was hidden and now it is free. We feel the flow from the universe and we are boundlessly free to move. Yoga is sadly primitive in it's understanding of the human body but not the human feelings. However if we describe things the way Yoga did originally many people will think us foolish and will not join us in Yoga.
The human body uses food for repair and fuel for all human action. Strength training increases fuel storage. Stamina training increases heart/lung strength and function. Stretching loosens tight muscles increasing blood flow, nutrient and fuel delivery and nerve messaging. None of these types of training are superior to the others. Each performs entirely different and necessary tasks.
Yoga poses are a primitive form of stretching, give very minor strength gains and very little heart strength.
The feeling of energy change in Yoga is from how we feel our bodies and the calming of the autonomic nervous system, not from any "tapping into" of universal energy.
This way of describing the change of feelings after doing Yoga comes from a time before there was clear study of exercise science.
All human action is fueled by food. The three basic forms of exercise, strength training (weightlifting is the more effective forms), cardiovascular/cardiorespiratory training, and stretching each do different things to the complex human form. Yoga does not give humans fuel from any other source than food but Yoga shifts human focus like shifting gears in a car.
This feeling of energy change from doing Yoga is no less wonderful when we describe it precisely. Yoga does, actually, factually, provably, molecularly change the human energy that comes from food. Yoga poses are still not safe enough (see Note 1). We need to change the Yoga poses and keep the Yoga goals.
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Note 1 - Note that some yoga poses violate some exercise imperatives; for example, the "shoulder stand" and the common advice to "keep your neck in line with your spine." There are others as well; but yoga practitioners (indeed, all exercisers) need to take some responsibility for their own physical wellbeing. Yoga should not cause pain. If it does, stop.
Exercise Corner in this issue addresses Power Cleans and the closely related Hang Cleans. Cleans are an excellent multi-joint exercise, using many of the major muscles of the body - a little less so in the case of hang cleans, which have less involvement of the legs than with power cleans. They can be used as the end part of a warm-up, or can stand alone as an exercise to promote power and speed, in addition to strength. The initial position for power cleans is to assume a stance with feet about shoulder width apart, knees and hips bent so you can grasp the bar (which is on the floor), back is "flat", shoulders are over or slightly ahead of the bar, chest is up and out, and the head is tilted up slightly (but without looking up). There are five following phases: 1) Upward Movement: First Pull, 2) Upward Movement: Scoop, 3) Upward Movement: Second Pull, 4) Catch, and 5) Downward Movement (return to initial position).
(Q) I fast occasionally to detoxify my system and lose weight, although I haven't lost any weight, and have no idea what might have been detoxified. What do you think of fasting?
Anonymous, Los Altos, CA
(A) Not much. Fasts don't cleanse a body of toxins. There is no evidence to support the need for cleansing toxins from one's body, or that we need to "rest" our digestive system. It is quite adept at cleansing itself. As far as weight loss from fasting goes, one might experience a brief, initial loss that is principally water loss, and if the fast continues, you will lose fat along with a considerable amount of muscle (including heart muscle) and minerals. Few people who lose weight by fasting manage to maintain the loss. After starting to eat again the lost weight tends to come back with a vengeance; not to mention that the muscle loss decreases your resting metabolic rate (RMR), making future weight gain easier.
Don't forget that the name for fasting more than a day or two is STARVATION.
(Q) I have been using a "natural" supplement, kava, to help me sleep. Is there any problem with that?
A.Q., Battleford, Alberta, Canada
(A) Only if you consider that in Germany and Switzerland there have been 30 cases of severe liver damage linked to use of kava, and that many European countries have banned it or are investigating doing so.
(Q) I would like a slightly more youthful look. I'm not that old, but have quite a few facial wrinkles that exaggerate my age. I am thinking about using Botox to help, but the fact that it is botulism toxin, which can be deadly, makes me cautious. Is it really safe and effective as claimed?
M.G., Rifle, WY
(A) It seems to be perfectly safe. The amounts used are quite small, and it is now used for treatment of migraine headaches, as well as for excessive sweating. Also, it has been used for decades for treatment of muscle disorders.
It works to reduce wrinkles and smooth the skin by paralyzing small facial muscles that allow us to show a variety of facial expressions, but doesn't affect wrinkles caused by sun damage.
It is not a permanent "fix" however, it lasts about three to six months before the treatment needs to be repeated (it is given by injection), and it is expensive - $300 to $3000 per session.
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