Your getting sleepy, very sleepy...

One important health habit that often gets overlooked is getting enough sleep. Some surveys reveal that upwards of 60% of Americans have some sleep difficulties at least a few nights a week or more. Writing about sleep is always an interesting topic, because if it is uninteresting it might put you to sleep. So we will see if we can keep your interest just long enough to learn why getting enough sleep is so important to your health.

So why is sleep so important? Of course there is the obvious, the day after not sleeping enough you will experience moments of drowsiness and may fall asleep or have slowed performance while doing important tasks. According to the DOT (Department of Transportation) 25% of all highway crashes are due to sleepiness. It is estimated that there is around $50-100 billion in indirect costs each year due to sleepiness with decreased productivity and other related costs. But there are other physiological changes that happen when we don’t sleep enough. A research report that came out in the July issue of the journal of Sleep showed that a decrease in sleep also affects our immune system. Our immune system will react to various physical stresses (i.e. flu virus, strained muscle, etc.) that are placed on it. Lack of sleep acts as a physical stress to our bodies and thus kicks in our stress response by increasing activation of our immune system with the granulocytes. This long term increase in immune system stress response has been linked to future health problems such as: obesity, diabetes and high blood pressure.

So how much sleep do you need? On average most people will require 7-8 hours of sleep, but some can do fine with as little as 6 hours and others need up to 10 hours. After a nights rest you should be able to work the next day without any bouts of sleepiness or drowsiness. If you do experience this then it would be a sign that you may not be getting enough sleep and starting to kick in your immune system a little extra as a response to the extra physical stress you’re placing upon it. If you do have difficulty sleeping you may want to consult a health professional to look at treatment for it. Often times our thought is that getting a sleeping pill is all we need. But a research article in The Archives of Internal Medicine published in October of 2004 showed that Cognitive Behavioral Therapy (CBT) actually outperformed the sleeping pill. So keep that in mind when looking at treatment options.

So hopefully you were able to make it to the end of this and not fall asleep and learned why getting good rest is so important. If you did fall asleep, it may be a sign you are not getting enough sleep at night; or we need to make the article more interesting.

Superman's cape vs. Batman's utility belt

Another guest post on my blog.  Today's post comes from John Rounds, SPT.  John currently is doing one of his eight week clinical rotations with me as part of his final year of Doctor of Physical Therapy schooling through the University of South Dakota.  As with any guest post I want writers to write what they think, not what they think I want them to think, think about that!!!  Enjoy, I like his thinking...

A common theme being displayed among health gurus and marketing agencies is the term "superfood." But what are we really getting with these that we aren't with everyday "regular" healthy foods? Many media outlets have been filling our minds with ideas that by consuming "these 7 foods regularly, you can reduce your look of aging or lose 10 pounds in 10 days." Unfortunately, what holds true for most things that sound too good to be true, so are a lot of these.

Now don't get me wrong, if you are researching "superfood" lists (which I have) you will find apples, oranges, broccoli, avocados, nuts, salmon, etc. But you will also find other items like acai berries, raspberry ketones, mangosteen and noni berries, and supplements such as fish oil. A lot of these foods and supplements also claim to have scientific research backing them. However, the validity behind this research is lacking in practical use.

According to a study published in the Hawaii journal of medicine and public health, it looked at the research backing these "superfoods" and supplements, and discovered that much of the research done was comparing their product to a placebo group, and not revealing the side effects noted by the participants in these studies. Most side effects were minor, with the occasional headache, dizziness, or fatigue being noted; however, one study found in a follow up study, that the amount of the supplement needed to produce the beneficial effects in these commercialized products was leading to hepatotoxicity in some people taking them. This would be reason enough for me to avoid these foods, let alone I can eat an apple for lunch and feel more energized rather than fatigued and not have to worry about getting a headache.

Additionally, on a recent Dr. Oz episode they were pushing raspberry ketones as a "miracle" fat loss supplement. Fortunately, a member of the audience asked why they can't just eat fresh raspberries, and we're answered with, “it will take 90 pounds of raspberry to get the same amount of ketones that you will get in this one small supplemental pill." As far as I know, if it is going to take me 90 pounds of raspberries to get the amount of ketones in these pills, there may be a reason for that. Potentially, that amount of the supplement at one given time may not be healthy.

Thus, if you are looking for that new miracle pill to make you look younger or thinner, it's simple, EAT HEALTHY! Remember the old adage, "an apple a day, keeps the doctor away"? Well, that may be true, but it has been shown to give you just as much if not more energy than a cup of coffee, not to mention, that apples along with most fruits and vegetables actually have negative calories, meaning that you burn more calories eating them, than they actually contain.

Therefore, I return to how I began, "Superman's cape" or "Batman's utility belt." As hard as it is for me to say, as I prefer Superman, in this case I'd go with the "regular" utility belt. Just because these foods have been dubbed "super," there still isn't sufficient scientific evidence that show they are better than a "regular" apple or celery stalk. Essentially, the choice is yours; however, know your choices.

Exercise: Have your cake and eat it!

We have all heard the benefits of exercise for long term health: reduce risk of heart disease, certain cancers, type 2 diabetes, stroke, and the list goes on. But let’s be honest the immediate gratification of sitting on couch with a bag of potato chips a large ice cold pop and vegetating out for a couple hours while watching a marathon of Pawn Stars seems a lot more enticing. Here in lies the challenge we face every day: the immediate gratification of poor health choices over long term benefits of exercising.

We live in a mostly immediate gratification society here in America. If I want to watch a good movie I can go to the Movie Theater and pick from 12 different flicks each having 3 or 4 different times to pick from. If I want a bigger selection and don’t want to wait for the times it is offered, I can go to the video rental store and pick from 100’s of titles. Heck I don’t even have to go out of my house or worry the movie I want is being rented by someone else; I can just get Netflix and have the movie delivered instantly right to my TV. I don’t even need to be tied to my TV to watch the movie I can get it on my phone and go where ever I want and still get the movie I want when I want it. Now that is instant gratification at its best.

So we can see that we are used to instant gratification and benefits from the things we do these days and exercise doesn’t seem to fit into that category, so no wonder we like to skip past it. But actually it does give us some instant benefits!

Immediately following your 30 minute walk (or whatever form of exercise you choose) you will start to experience some very enjoyable effects to your body and brain. You will produce an increase in the “happy” neurotransmitters serotonin and dopamine. These neurotransmitters will improve your mood and reward/pleasure centers of the brain and reduce stress and anxiety feelings you may have. Insulin sensitivity improves so your muscle cells take in glucose (the energy molecule your body uses) floating through the blood stream. This makes your pancreas (what produces insulin) happy since it doesn’t have to work as hard to produce as much insulin (the chemical that allows for the absorption of glucose into the muscle cells). You will also get an increase in HDL-cholesterol, which is the good cholesterol that we want. You will see a reduction in blood pressure immediately following your exercise bout. Heck even your bowels will move better after you exercise.

So if immediate gratification is what you like, then exercise may be just the thing you need instead of being a couch potato and eating junk food. Immediate and long term benefits with exercise, how cool is that. Maybe I can have my cake and eat it too, as long as that cake comes in the form of exercise.

Exercise, sclerostin and bone health what do they have in common?

Exercise is probably one, if not the greatest medicine, we can give our bodies. The benefit list is almost endless and the side effects are minimal to none when done appropriately. This week we will highlight one specific benefit that some new research showing how exercise benefits bone health in pre-menopausal women.

A study that will be coming out in the October issue of Journal of Clinical Endocrinology and Metabolism details some of the specific effects of how exercise improves bone health in pre-menopausal women. Bone, just like your muscles and other tissues in your body, is living tissue and constantly changing. Also just like muscles the more you exercise the stronger and healthier they become. Bone loss is a major concern with pre-menopause and menopause for women, which can lead to osteopenia and osteoporosis. Weakened bones (osteopenia and osteoporosis) can play a role in increasing your fracture risk as you age; they are not the only factor but an important one we need to be aware of. Sclerostin is a known bone growth inhibitor, by its action on a hormone IGF-1 (Insulin-like growth factor 1). Our bodies when working properly have a steady balance of hormones and proteins to assist metabolic pathways to keep our various systems in check and balance between anabolism and catabolism. Anabolism is the process of building up new tissue; while catabolism is the breaking down older tissue. During injuries, illnesses or other body changes such as menopause these systems might not stay as balanced and we can get an increase in catabolism.

The study showed that over an 8 week period those pre-menopausal women that performed in a supervised exercise routine of more than 2 hours per week had "significantly" lower sclerostin levels and higher IGF-1 levels. So even relatively low levels of exercise, normal exercise guidelines of 30 minutes a day 5-6 days per week, was enough to start seeing biological changes in crucial markers in just 2 months’ time to assist with normalizing hormonal controls of bone formation.

So what type of exercise do you need to do? Simple weight bearing exercises (any exercise that you move against gravity) such as walking and weight lifting. Things like swimming and bike riding; while great exercises for your cardiovascular system are not weight bearing exercises so will not help as much to build your bones.

So the research shows that exercise is an important part of long term bone health, but don’t forget some of the other things you can do for a complete program. Make sure you have a good diet rich in calcium and Vitamin D along with avoiding lifestyle choices such as smoking and excessive alcohol intake.

Ergonomics

Ergonomics is defined as: the applied science of equipment design, as for the workplace, intended to maximize productivity by reducing operator fatigue and discomfort. It is interesting how posture, lifting techniques and body mechanics have often times drifted into ergonomic analysis. There have actually been a fairly large number of research articles that point out there is no causality relationship between awkward postures in the work place to pain or injury and that training on lifting techniques and body mechanics have no reduction on injuries or pain in the work place. So if ergonomics is truly about applying science, then we need to get rid of old dogma and established beliefs about posture and body mechanics that have not held up to the rigors of science and study.

How can that be you might ask? You mean I won’t get pain in my neck or hands if I sit at the computer with poor posture, and that if I lift with poor body mechanics that I won’t injure my back? No, what the research/science is telling us is that for the entire population of people those that use proper posture and body mechanics have just as much risk for injury or pain as those that don’t. This is in part because the entire population of people has large variability (tall/short, thin/wide, strong/weak, etc.) we cannot predict what "proper" posture or body mechanics are for any one specific individual and thus relate that to a direct cause of their pain or injury. There are lots of variables that come into play with injury or pain and picking out just posture or body mechanics is rather useless in preventing pain or injury.

So what should you do when it comes to posture and lifting techniques when it comes to the ergonomics of your job? Do I need good posture or not? Do I need to lift with good body mechanics or not? Dr. Nortin Hadler, an expert in work related musculoskeletal disorders and author of many research articles and books including Occupational Musculoskeletal Disorders puts it best:

“Work should be comfortable when you are well and accommodating when you are ill.”

Basically the posture or lifting mechanics you choose to do your job should be comfortable to you. If they are not then you need to adjust and accommodate to a new position that you find comfortable. If good posture and body mechanics feels comfortable, use it. But if it is uncomfortable, accommodate to something different. If what some call poor posture or body mechanics feels comfortable to you, use it. But if it starts to be uncomfortable, accommodate to something different.

We have all seen the posters and info on “proper” lifting or sitting posture, which can work for many and probably a good starting point if you don’t know how to set up a work station. But remember even if those “proper” positions feel uncomfortable or awkward to you; then change them to a new more comfortable less awkward position for you. If your work station is comfortable, even if you have what some might consider poor posture or body mechanics, don’t worry about. That set up is right for you, even though it might not be right for someone else. But realize also, what feels right today, may not be right tomorrow and if something becomes uncomfortable then change to a new position.