Prenatal vitamins: is it worth it?

This question comes from Cheryl:

"I was wondering if taking prenatal vitamins when you are not pregnant or trying to get pregnant is dangerous? Someone who frequently does my hair recommended it to me and I have done some reading and see some people suggest it while some say there are many dangers, including death ? I am confused and was wondering if you would mind sharing you opinion."

What an important topic.  Short answer: yes, it is valuable for ALL women who might be or might likely become pregnant to take pre-natal vitamins.

Top 3 nutrients:
-Folic Acid: 400-800 mcg
-Vitamin D3: 2000-10K IU
-Zinc: 10-60 mg

Why?  Folic acid may be the most researched nutrient regarding prenatal health.  It has been shown to nearly eliminate a number of birth defects, most notably: spina bifida.  There are many other nutrients at an increased demand for a growing mother & developing fetus.

Ok, so why not wait until a pregnancy is known?  While it is still helpful to supplement as soon as the pregnancy is known, most women aren't aware of a pregnancy until 4 weeks or more into the pregnancy.  The neural tube closes development near week 6 of pregnancy.  This means that the opportunity to alter initial spinal cord, brain, and CNS development is most possible before you even know you're pregnant!  Women have to take the vitamins consistently to prepare for a not-yet-known event AND to pre-load certain molecules in their cells.  Wait until you know and you might miss the opportunity to protect your baby.

What about side effects?  Side effects are rare.  Women should seek a quality, reputable, medical-grade supplement (so many options).  I've no knowledge of risk of death.  That would seem to either be exaggerated story, an example of extreme dosage, or poor product.

Prenatal vitamins are almost completely good news: for ~ 10 cents/day, you can prevent roughly half of all birth defects.  wow!

Final thought: supplementation is a challenging topic for science.  It is a mixed bag when trying to prove the value of individual supplements, but it is very clear that women who might become pregnant should all be on a prenatal vitamin well before conception for optimal health outcomes.

Thanks, Cheryl, for the great question.

Sports Drinks & Exercise

Is Gatorade slowing you down?

What does Gatorade & other sports drinks bring to mind?  Do you think of chiseled atheletes dripping colored sweat?  Do you imagine a stained suit after the super bowl?

It is amazing how deft product marketing can be.  The insidious effect is beyond a suggestion to buy the product, rather to expect the product to always be available.  Many of us expect a sports drink at our local 5k or on the sideline of our children's game.  The product is selling (more than $1 billion annually) and our bodies are processing more sugar, salt, & phosphate than ever.

The British Medical Journal recently featured a discussion on the science of sports drinks from an evidence based perspective.  The popularity of sugary, salty drinks to "boost hydration" and "increase performance" should be questioned with evidence. http://www.bmj.com/content/345/bmj.e4737

We know obesity world-wide is surging, enhanced specifically by calorie heavy, nutrient empty, simple sugars in the diet.  We know the negative affects and perfomance limitations of dehydration have been significantly over-blown.  We know that consuming calories pre-workout leads to an energy dive, not boost, by the body.  We know that protein, not simple carbs are important tool for a post-workout recharge.

What does this mean for you and your family?  We would recommend using sports drinks only when activity is aerobic (cardio), strenous AND greater than 45 minutes.  It should be consumed in 8oz servings (for adults) with no more than 8oz for every 15min over the 45 threshold.  This means a 1 quart bottle of gatorade should be paired with a 2 hour run.  If you're drinking more--you're having a sugary treat, not a health drink.  Stick with water before and after a workout.  Look for lean protein sources post-workout to help rebound for the next day (nuts, poultry, fish, legumes).

I'd like to see your entire family exercising, free from marketing campaigns looking to push product over optimal health.

Mike's Low Back Pain story

Mike experienced 3 long weeks of intense low back pain.  We appreciate his wife's referral--the path he was headed down was concerning.

He had visited his internist after just a few days of pain.  The X-rays taken showed only mild amounts of degeneration, and he was prescribed anti-inflammatory medicine & told to stop golfing and rest in bed for a week.  Sound familiar?  Unfortunately, this continues to be a typical response, and it flies directly counter to current research & evidence.

X-rays are medically necessary in less than 5% of simple low back pain cases (even below 3% in most studies).  Most low back pain is not caused by inflammation--so an extra prescription with small but measurable serious side effects seems unwarranted.  Bed rest has been proven many times over to be an unhelpful and potentially harming answer to low back pain.

After three weeks of pain, Mike visited us at Tri-Synergy.  We diagnosed Mike with irritation in two specific small muscles in his low back, which was leading to a protection response by his brain.  As a painful cycle, his whole lower back was tight trying to protect two of the smallest muscles.  We were able to correct it using light therapy to draw blood flow to the muscles followed by gentle, specific soft-tissue treatments to calm the muscles down.  After 2 visits, he was back on the golf course, and his case was completely wrapped up by the 3rd visit.

Why do some medical providers still consider anti-inflammatories, bed rest, & restricting activity 'front-line treatment' options even though it is contrary to research?  Why are so many patients told to stop moving when that might have been the best medicine?  Why are patients offered what happens to be easiest for the insurance system--instead of what would be best for their body?

Is stretching harmful?

Could your preworkout routine lead to injury?

Have you seen runners pulling their heels back preparing for a morning jog? Have you watched a pickup basketball game begin with deep knee bends? Should we stretch before we work out? This is more complex than a yes or no--let's look at the research and the evidence:

Types: The most common type of stretching is (A) Static stretching: holding an elongated muscle for 10-30 seconds until it feels released. (B) Ballistic stretching is a bounce & repeat stretch, while (C) Dynamic stretching involves gentle motion, similar to exaggerated warm up time. Examples of this are knee lifts, long lunges, and gentle arm swings.

Risks: Static stretching has been shown to lengthen tissue, immediately decrease strength by 20-30%, and increase injury rates from 0-15% (depending on the study). Long, 2-joint muscles, are at increased risk (eg hamstrings, quadriceps, triceps). Static stretching requires multi-daily and long-term repitition to increase range of motion. Ballistic stretching has been shown to increase microtearing, & risk of injury elevates. Dynamic involves controlled motions and is less damaging to tissue, though it produces less immediate lengthening.

The most important feature of stretching is what you are telling your brain. Your brain is in control of how tight or relaxed your muscles will be. I consider static & ballistic stretching "arguments" with your brain and dynamic stretching "cooperation". Research supports calm, gradual warmup periods. Allow time for your body to get ready for activity.

Dr. Anthony's Advice: Save static or ballistic stretching for after a workout--and only targeted on areas you're looking for more range of motion, not on every sore muscle. Include dynamic stretching as part of a 5-10 minute warmup for any intense activity. Your body will be less likely to injure, and you'll be able to keep performing your best.

New Year's Resolutions

Did Santa leave extra weight under your tree?

How are your New Year's resolutions going? Did you make any? Nearly half of all Americans made a resolution this year--and two weeks in, about 70% of you are still going strong. The most popular resolution is losing weight, increasing exercise or changing eating habits. Let's look at the evidence to successfully make changes.

We need to soak in good information. We do need fats, carbs, and proteins to thrive, but we need them to accompany nutrients. This is why pop, sweet tea, and other simple carbs are "empty calories". When we take in calories without fiber, vitamins, & minerals, we miss the most important part. As Dr. Robert Lustig said, "Wherever there's fructose [sugar] in nature, there's way more fiber. The only exception is honey, and that's guarded by bees!"

Make a resolution that will last--make a lifestyle change. Most people require a change of food types, portion control, and exercise intensity. Make sure you include all three. Decide on specifically what you will eat, what you won't, and how much you're going to move in a day. Then tackle the biggest challenge of all: personal identity.

Evaluate your attitude. Are you fighting your desires? Are you leaning on your willpower, guilt, or shame to help you make new choices? Long term change requires a positive, curious view of one's self. You are encouraged to be creative about how you might succeed in the future, taking one step forward at a time.

Seek an identity shift. If you view yourself as a cookie lover, it's going to be very difficult to step away from cookies--but if you identify as a former-cookie lover, you will more easily avoid a less-healthful input. Perhaps you've experienced this with boxed mac & cheese, fish sticks, or other child-focused foods you no longer eat. If you identify as someone who loves a certain food, you will eventually breakdown and consume it. If you recognize that you are a new person--someone who is making new choices, you won't have to use willpower alone to overcome temptation.

I hope you are encouraged to make a healthy choice in this new year. If you wish you made a resolution weeks ago, tomorrow is a great day to start. Look for healthy, wise advice--and seek to be curious and positive about your new identity. You may discover that you've been hiding a love for bok choy, kale, or brussel sprouts beneath those carbs. Happy Belated New Year!