Fish Oil Prevents Aging

A study from the American Journal of Medicine demostrates an association between blood levels of Omega 3 fatty acids and a lower rate of DNA ‘wear and tear’.

Antidepressants work…if you really need them

A new meta-analysis was published in the Journal of the American Medical Association that suggests that antidepressants might only be effect for moderate to severe depression.  The study used only studies that used the Hamilton rating system to determine depression severity.

Platelet Rich Plasma Therapy May Not Work

A popular treatment for tendon injuries is still under question as to whether it works or not.  This latest study compared it to salt water injections – another study that suggests that the injects alone may be what is therapeutic, not the actual agent injected.

MMR Vaccine and Autism – The Lancet takes back the 12 year old paper

The Lancet medical journal had finally taken back its 12-year old paper that suggested links between the MMR vaccine and Autism.  The backlash to this article is significant, with authorities considering legal action against the physician responsible for the article.  The avoidance of the MMR vaccine due to fears of Autism has led to an increased incidence of measles infections worldwide.

Is the Jury Still Out on a Low Sodium Diet?

This NYT article talks about the hot debate over whether ‘anti-salt’ campaigns should be increased or decreased.  Too much salt is probably bad, but too little salt is also bad.  For now, keep checking your blood pressure from time to time and watch your salt intake if your numbers start to climb.

Fitter Students do Better on Exams

A group of researchers showed that students who had better cardiorespiratory fitness also did better academically.  Reportedly, more studies need to be done to prove a causal relationship before schools start to bring back physical education into their curriculum.  In the meantime, more than 1/3 of our children are overweight or obese…but, I guess we need more proof!

Stress EKG’s Help, but Who Wants to Pay for it?

Electrocardiograms can save lives in young athletes by alerting them that they may have an unknown heart condition.  Because these heart conditions are fairly rare, screening is not advocated because it would not be cost effective.  If you perform regular, intense physical activity, the test deserves serious consideration.

Interesting Research Ties Appetite to Your Gut Bacteria

Altering the bacteria in your intestines may lead to better digestion, lower appetite, and weight loss…some day.

A Good Review of Reasons to Exercise

Jane Brody of the NYT reviews the scientific evidence that supports the use of exercise for good health.

Vit D – More Evidence

Every month or two another study comes out to reinforce the importance of having adequate Vit D.  This article highlights the mechanisms through which Vit D may be helping to prevent cancer and autoimmune disease.

PSA – Should it be Used to Screen for Prostate Cancer?

The PSA test is costing the US billions of dollars per year with limited success in fighting prostate cancer.  The author of this NYT article does a good job at reviewing the evidence.   Click here to view some of the follow up from this article.

Breast Cancer Screening Works – Rarely

“Evidence now suggests that for every 2,000 women who are screened over 10 years, only one stands to have her life saved by the mammogram program, he said, whereas the risk of getting an unnecessary breast cancer diagnosis is 10 times that”.

Following the adjustments to the recommended screening age for mammography in the US (from 40-50 years of age), some are questioning the use of mammography altogether.

Statins Become Preventive Medicine

The FDA has approved the use of Crestor, a medication used to lower cholesterol, for preventive medicine uses.  It has been long been known that statins can act like anti-inflammatories in the body with can theoretically help to prevent a heart attack or a stroke.  Crestor’s main mechanism of action is to block the body’s production of cholesterol, an essential lipid that the body uses to make cell membranes, hormones, and other things in the body.  Time will tell if this drug will do more harm than good in patients with normal cholesterol levels.

Weak Preventive Medical Screening Policies Lead to Debate

Why is there so much debate about cancer screening tests like the PSA and Mammogram?  Because they don’t seem to be very effective.  So what’s the solution?

Hormone Therapy Protects Against Colon Cancer

Another study confirms that hormone replacement therapies can protect against colon cancer.  Long term users experience over a 50% reduction in cancer rates.

Diet Prevents 40% of Alzheimer’s Cases

A diet rich in fruits and vegetables, olive oil, nuts, seeds and fish is shown to lead to less cases of Alzheimer’s disease.

Processed Meats, not Red Meats are Associated with Cancer

A new harvard study had found an association between eating processed and developing cancer.  The same study was not able to show a significant association between those that ate unprocessed meats like beef, pork or lamb and those that developed cancer.

New to 2010 is Dr Oughtred’s annual health assessment: a comprehensive health assessment that includes a medical assessment, a physical therapy type of assessment, and a fitness and lifestyle assessment. Patients will receive a 15 page booklet outlining and explaining their results, and it comes complete with a comprehensive plan that includes dietary recommendations, supplement and medication recommendations, exercise programs and tips, stretching advice, or recommendations for physical therapies or other hands on techniques.

The center piece of your assessment is the summary page, which quickly displays and colour codes your results alongside your recommended goals for the following year. This page gives you a comprehensive, yet simple ‘snapshot’ of your current state of health and fitness, and can act as a great motivator for the future.

For those of you who have extended medical insurance, your coverage will likely cover you for all, if not part of the assessment.

Assessment overview:

• Review and assessment of your current and past health concerns
• Relevant physical examination
• Orthopedic Assessment (Joint Alignment, Range of Motion, Posture, Strength, Stability)
• Fitness Assessment (Everything from grip strength and body fat to cardiorespiratory fitness and lactate threshold testing)
• Nutritional and Lifestyle Assessment
• Disease Risk Assessment (Framingham score, diet, biometrics, other)
• When indicated, referral to other health professionals, physicians or laboratories.

Your assessment acts like an annual membership, and you will be reminded when you are due for follow ups and important preventive medical screening tests and visits.

For fitness enthusiasts, the process involves measurement of lactate thresholds for precise assessment of endurance over time and selection of future training intensities. For those who want to manage their disease risk over time, the assessment gives you a framingham score, estimating your 10 year risk for developing coronary artery disease. This is the perfect annual health screen for someone who is looking for an executive health assessment with a strong focus on fitness, lifestyle, and athletic performance. Together with the advice and medical testing of your family doctor, your assessment will leave you feeling as though no ‘stone is left unturned’ with regard to your health.

Aside from your assessments with your medical doctor, all parts of your annual assessment are performed by Dr Oughtred himself which provides for a 5-star professional experience which you won’t forget. Take the time for your assessment now, and see what new avenues of health open up for you.

Lactate Testing is quickly becoming the preferred test for people that want to assess their aerobic capacity and determine how to make the most of their exercise program. I began to offer lactate testing to all of my patients in 2009 and I have found it effective not only for athletes but also for anyone that wants to take a more precise, deliberate approach to their exercise program.

Testing blood lactates is a relatively new practice in sport that has become popular in the last 10-20 years, especially in sports such as swimming, rowing, speed skating and endurance sports like marathons, triathalons, cycling, etc. At first, even the best trainers in the world were often confused with the use of lactate testing, but over the last 10 years, some consensus seems to have been reached on some topics and experts agree that lactate testing is a superior tool for 3 key purposes:

1 – Measurement of Endurance Performance:

Traditionally the preferred performance test for endurance activities has been the VO2 max test. A drawback to the VO2 max test is that it assesses aerobic power at a maximal intensity over a short period of time – this is not reflective of a true endurance activity which requires a longer duration of activity at a submaximal effort. Other downsides to VO2 max testing is that it can be very expensive (good equipment is very costly) and the devices used to breath in and out of can cause anxiety and discomfort in for the athlete. Aside from the minor discomfort of finger tip blood sampling, lactate testing suffers from none of these drawbacks, and is probably a better performance indicator at submaximal efforts.

2 – Assessment of changes in aerobic fitness over time:

The lactate test measures your lactate levels at many different levels of exertion. As you become more fit, your lactate levels will be lower at each of these individual exertion points; the test demonstrates that you are doing the same amount of work at lower intesities than before. This shift in lactate levels over time is a very sensitive indicator of training adaptation.

3 – A tool to opimize training intensities:

Because lactates can be used to estimate your intensity levels during exercise, it is probably the best method to determine and prescribe future training intensities or ‘training zones’. This is especially useful for fitness professionals so they can avoid overtraining or undertraining an athlete. Learning your ‘Lactate Thresholds’ can essentially make your training more specific to your goals. Whatever your goals, lactates can be used to help get reach them quicker; you can more precisely improve your endurance, your V02 max, your ability to heal and recover, or your ability to burn fat during a workout.

In his book, “The Science of Winning”, Jan Olbrecht talks about how he uses the lactate tests with elite athletes prior to big events in order to properly balance their aerobic and anaerobic systems. Although this use is less popular, it is very enticing; it is hard to argue with the 40 olympic medals that Olbrecht was part of in the Athens Olympics!

Understanding Blood Lactate

Lactate is a byproduct of glucose, or ‘sugar’ in your body. As lactate accumulates during exercise, we can assume that you are using glucose as an energy source. As the intensity of an activity increases, the percentage of energy that comes from glucose will increase, and you will produce more lactate, which can be measured in the blood. At low intensities of exercise, your body uses its aerobic energy systems (using oxygen for energy) which spares glucose and keeps lactate levels low. The more aerobically fit you are, the harder you can push yourself without accumulating lactate. Over time, as you become more aerobically fit, you will be able to achieve higher levels of intensity and keep your lactate levels the same. If we graphed this over time, your lactate curve would shift downwards, and to the right.

As you increase your intensity during exercise, you will eventually overwhelm your body’s ability to recycle or remove lactate from the blood. The highest intensity at which you can create lactate in the body and still remove it from your blood is called your lactate balance point. This is an important intensity to learn, and it has many other names; ‘anaerobic threshold’, ‘lactate threshold’, or just ‘threshold’ are the other most common names used. As you push yourself beyond this intensity, your body’s energy systems will actually become inhibited and your performance will suffer if you hope to perform much longer than 5-8 minutes. Getting to know this balance point is critical for everyone, not just athletes, exceeding your balance point in training could have negative effects to your health, your performance or even your ability to lose body fat.

How Lactate Testing is Done

So what does a blood lactate test look like? The most widely used method involves an endurance test that has incremental increases in intensity. Each stage can be anywhere from 2-5 minutes, and at the end of each stage a small blood sample is taken by a fingerprick and placed into an analyzer. The total test length can vary anywhere from 20-60 minutes, depending on the fitness of the athlete and the length or increments of the stages. Testing is usually performed on a bicycle ergometer or a treadmill.  As stated previously, the test is approximating intensity at all stages, and so it does not require the participant to go ‘all out’, but it does require the participant to go up to at least an 8 or a 9/10 on the exertion scale.

Becoming more popular is the FACT method, which involves an initial staged performance test as outlined above and then follows that up with a another staged approach that is thought to better isolate the balance point between lactate production and removal from the body. I utilize both methods, as I find the traditional method effectively demonstrates fitness adaptations over time and the FACT method is excellent for determining future training intensities or ‘training zones’.

Set Your Targets and Optimize Your Training Time

After your lactate test, you will have objective information from which you can set future targets for improvements. You will also have an outline of your individualized training zones that you can use to effectively target your weaknesses and make the most of your limited training time.