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Germs At The Gym

Germs at the GymPutting in time at the gym is supposed to make you healthier, but if you’re not careful, it could be the cause of an unexpected surprise—sickness.  The gym is one of the best places for pathogens (germs) to hide.  It provides germs exactly what they need to thrive and multiply:  dampness, darkness, and warmth.  While other body systems and tissues may be affected, skin is the primary site of exogenous infection.

Although the exposure of athletes to various routes of physical insult has been recognized since humans ran from predators, only in modern times has attention been paid to the specifics. That covers everything from respiratory irregularities to athlete’s foot.  Most common, however, are attacks on the skin, and these account for more than half the outbreaks of infectious diseases that occur among participants in competitive sports. It’s been noted that, “viral, bacterial and fungal infections are common in athletes due to heat, friction and contact with others,” in a study reported in Canada. (Conklin. 1990)  Lesions from herpes, tumors from molluscum, and painful plantar warts may be transmitted from surface-to-person and from person-to-person at the gym. On the upsides, there is hope because “antibiotics are effective against mild infections.”

Do you pay attention to your skin after a day at the gym?  Probably not.  You might wash it, but do you examine it? In the worst possible scenario MRSA, methicillin-resistant staphylococcus aureus, may appear.  This germ is usually associated with hospitals and nursing homes, but of late has been associated with schools, playgrounds, and your gym, but thankfully not as an epidemic.  MRSA can start as a tiny pimple and grow to the size of a softball in a short time, requiring hospitalization, surgical cleaning of the wound, stitching, and a course of antibiotics. MRSA infections commonly start at sites of visible skin trauma, such as cuts, scrapes, and abrasions, but also show up at places where there is hair, such as the back of the neck, armpit, and groin.  There have been cases of MRSA beginning on feet.  That makes sense because you tend to go barefoot in the locker room…when flip-flops are more in order.  Direct and indirect contact with the lesions and seepages of others make the skin vulnerable to a host of problems.  While MRSA may be the worst, it may also be the least likely of our worries. (Ryan. 2011)  More common are athlete’s foot, jock itch, impetigo, herpes simplex, and ringworm, among a few others.

There are preventive steps you can take. Covering any breaks in the skin is of paramount importance. It doesn’t take much for an opportunistic bacterium to worm its way in.  Do not shave prior to visiting your gym. That goes for gals as well as guys. Razor nicks open the door for infections. Do not go barefoot. The heat in the shower room, the darkness of the area, and the dampness provide the ultimate environment for the propagation of fungi and other pathogens. Wear flip-flops or water shoes. Besides, they’ll keep you from slipping on wet tiles.

It’s a nice courtesy for your gym to provide disinfectant sprays that you can use before attacking a machine or stretching on a mat. If it doesn’t, bring your own, along with paper towels.  What’s wrong with a rag?  It’ll transfer germs from one place to another.  Or bring disposable wipes.  More men than women shower at the gym. Make sure your towels are clean, and try not to use the one from your feet on the rest of your body if you’ve been barefoot or if it fell onto the locker room floor.  Don’t share towels, either.  Nor soap, unless it’s a liquid in a pump bottle.

Be religious about doing your laundry.  Don’t let wet stuff sit in your gym bag to ferment.  No matter how clean you think you are, stuff will grow there.  If you have kids, be especially vigilant.  Molluscum contagiosum is commonly seen in youngsters, usually being spread from skin to skin, but also by sharing a towel.  Meticulous hygiene is imperative.  Lots of men—more than women—walk around the locker room in the buff.  Wearing a towel places a barrier between you and the bench or any other shared surface.  The last place you want an itchy infection is where you sit.

References

Sports Med. 1990 Feb;9(2):100-19.
Common cutaneous disorders in athletes.
Conklin RJ.
Department of Dermatology, University of British Columbia, Vancouver, Canada.

Am J Infect Control. 2011 Mar;39(2):148-50.
Are gymnasium equipment surfaces a source of staphylococcal infections in the community?
Ryan KA, Ifantides C, Bucciarelli C, Saliba H, Tuli S, Black E, Thompson LA.

AJIC: American Journal of Infection Control. Vol 37, Iss 6 , Pp 447-453, Aug 2009
A critical evaluation of methicillin-resistant Staphylococcus aureus and other bacteria of medical interest on commonly touched household surfaces in relation to household demographics
Elizabeth Scott, PhD; Susan Duty, RN, ScD; Karen McCue, BS

J Am Acad Dermatol. 1980 Oct;3(4):415-24.
Dermatologic aspects of sports medicine.
Levine N.

Adv Dermatol. 1989;4:29-48; discussion 49.
Sports-related skin injuries.
Basler RS.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Who Needs Electrolytes and Why?

Many people talk about electrolytes but do you have any idea what electrolyte really is? Being among the smallest of chemicals important to a cell’s function, electrolytes are crucial to the manufacturing of energy, the maintenance of membrane stability, the movement of fluids in the body, and a few other jobs, such as contracting a muscle, like the heart.

No Sweat

You know that you’ll taste salt if you lick the back of your hand after jogging or cutting grass on a hot summer day. Sodium is one of sweat’s main ingredients, along with chloride and potassium. All three are carried to the surface of the skin by the water made in sweat glands and the salt stays after the liquid evaporates. The purpose of sweating is regulation of body temperature, which is achieved by the eccrine glands that cover much of the body. An adult can easily sweat two liters an hour (Godek, 2008), up to eight liters a day (Vukasinovic-Vesic, 2015). It’s the evaporation of the water that has the cooling effect. Some animals do not have efficient sweat glands, such as dogs that have to pant to cool down, or hogs that needs to wallow in mud or cool water.

After exercise — or other cause of heavy perspiration — it’s important to restore fluid balance, especially in hot weather when it is easy to get dehydrated. Rehydration occurs only if both water and electrolytes are replaced. The amount of electrolytes lost through sweat varies from person to person. Accurately matching beverage electrolyte intake with loss through sweat is practically impossible. If you are eating at the same time as drinking plain water, this may suffice for rehydration. Otherwise, inclusion of electrolytes is essential.

What Are They and What Do They Do?

In the body, the electrolytes include sodium, potassium, calcium, bicarbonate, magnesium, chloride, and phosphate. Not all are contained — or needed — in an electrolyte replacement beverage. Sodium, the main cation outside the cell, controls total amount of water in the body, regulates blood volume and maintains muscle and nerve function. You need at least 500 mg a day. The suggested upper level is 2300 mg, but most Americans ingest more than 3000. Chloride, also from table salt, is an anion. Found in extracellular fluids, chloride, in the company of sodium, helps to maintain proper fluid balance and pressure of the various fluid compartments.

Potassium is the major cation inside the cell, where its job is to regulate heart beat and blood pressure while balancing the other electrolytes. Because it aids in transmitting nerve impulses, potassium is necessary for muscle contractions, actually the relaxation half of the contraction. Deficiency of potassium is more common than overdose, and may arise from diarrhea or vomiting, with muscle weakness and cramping being symptoms. Intake of potassium is generally much lower than the recommended 4700 mg a day, which is not surprising in light of the deficits in food caused by insulting agricultural practices. Perhaps the most under-appreciated mineral in the nutrient armamentarium is magnesium, not only a constituent of more than three hundred biochemical reactions in the body, but also a role player in the synthesis of both DNA and RNA. As an electrolyte, magnesium supports nerve and muscle function, boosts immunity, monitors heart cadence, stabilizes blood glucose, and promotes healthy bones and teeth. With half the U.S. population deficient, Mg is the orphan nutrient that is able to prevent elevated markers of inflammation (such as CRP), hypertension (It’s called nature’s calcium channel blocker), atherosclerotic vascular disease, migraines, asthma, and colon cancer (Rosanoff, 2012). Supplementation with magnesium is uncertain because absorption is inverse to intake.

Like the others, calcium is involved in muscle contraction and the transmission of nerve messages, but also in blood clotting. Calcium tells sodium to initiate a contraction so that you can pick up a pencil or scratch your nose. In opposition, magnesium tells potassium to let the pencil go or to move your arm back down. Because the heart needs calcium for a strong beat, it will pull the mineral from bone if dietary sufficiency is missing. After calcium, phosphorus — phosphate — is the most abundant mineral in the body. This anion helps to produce energy inside the cell besides being a bone strengthener. It’s a major building block of DNA and the cell membrane. Bicarbonate keeps pH in balance and is important when muscles make lactic acid from work.

Where Can I Get the Electrolytes I Need?

There are scores of electrolyte replacements on the market and entirely too many with sugar or additives. The issue with electrolytes is, in all honesty, that they taste bitter and salty. The fact that sugar is a carbohydrate hinders the processing of a hydration drink because absorption is slowed. That’s what carbohydrates do. Sugar concentrations in many sports drinks are higher than that of body fluid, so will not be readily absorbed. Plain water passes through too fast; carb-laden drinks pass too slowly. Therefore, an electrolyte balanced drink will do the job better and faster. Sodium and potassium, after all, encourage fluid retention and help to reduce urine output.

It is common knowledge that most of us gravitate to sweetness in times of dehydration; saltiness less so. But when you need rehydration, choose the real stuff, BodyBio’s E-lyte and E-lyte Sport, two electrolyte replacements that copy the mineral balance of the body. Elyte may be used as a daily addition to the diet, and is effective to restore homeostasis in times of virus-induced gastrointestinal distress for adults and children, in electrolyte deficit from uncontrolled diabetes and even for restless leg syndrome. When sodium loss is high from exercise, chose Elyte Sport.

References

Coyle EF.
Fluid and fuel intake during exercise.
J Sports Sci. 2004 Jan;22(1):39-55.

Robert W. Kenefick, PhD and Michael N. Sawka, PhD
Hydration at the Work Site
J Am Coll Nutr. October 2007; vol. 26 no. suppl 5: 597S-603S

Meurman JH, Härkönen M, Näveri H, Koskinen J, Torkko H, Rytömaa I, Järvinen V, Turunen R.
Experimental sports drinks with minimal dental erosion effect.
Scand J Dent Res. 1990 Apr;98(2):120-8.

Noble WH, Donovan TE, Geissberger M.
Sports drinks and dental erosion.
J Calif Dent Assoc. 2011 Apr;39(4):233-8.

Sports Med. 2002;32(15):959-71.
Hydration testing of athletes.
Oppliger RA, Bartok C.

Sawka MN, Montain SJ, Latzka WA.
Hydration effects on thermoregulation and performance in the heat.
Comp Biochem Physiol A Mol Integr Physiol. 2001 Apr;128(4):679-90.

Convertino VA, Armstrong LE, Coyle EF, Mack GW, Sawka MN, Senay LC Jr, Sherman WM.
American College of Sports Medicine position stand. Exercise and fluid replacement.
Med Sci Sports Exerc. 1996 Jan;28(1):i-vii.

Rehrer NJ.
Fluid and electrolyte balance in ultra-endurance sport.
Sports Med. 2001;31(10):701-15.

Maughan RJ, Shirreffs SM.
Dehydration and rehydration in competative sport.
Scand J Med Sci Sports. 2010 Oct;20 Suppl 3:40-7

Gal Dubnov-Raza, Yair Lahavb, and Naama W. Constantinic
Non-nutrients in sports nutrition: Fluids, electrolytes, and ergogenic aids
e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism. 6(4); Aug 2011: pp. e217-e222

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Child Athletes Nutrition

children-sportsA child is not a miniature adult. His or her nutrition and hydration needs are not exactly the same, especially in sports participation.  With the growth and availability of sports opportunities, you’d think that related nutrition needs would be a concern. To the contrary, sports nutrition for youngsters receives less attention than it deserves.

“Most children and adolescents who are strongly committed to sports are not concerned about nutrition as it relates to energy balance and obesity,” states a report from a 2004 issue of Nutrition.  The interactions among nutrition, growth, and development deserve attention if a participant expects to achieve optimal performance and to avoid the injuries and problems that stem from nutritional deficiencies.   Daily fluid turnover in adult athletes has received intense study, but that for children and adolescents hasn’t.  That of adults may be two to three liters a day, but in youngsters has only been estimated at half that—and that has been based on sedentary youth.  Although “sweating capacity is typically reported to be lower in children,” there is an increase in sweat rate when adjusted for body surface area.  Besides the energy needed for normal growth and development, children athletes need to accommodate the greater expenditure from physical activity.  That can vary from one sport to another.  (Petrie. 2004).

Besides the fun, kids participate in sports to hone their skills, to experience the excitement of competition, to be part of a team, and to stay in shape, among other reasons.  But they pay little or no attention to fuel and hydration needs.  Parents and coaches, on the other hand, do.  At least they should.  Hectic schedules, availability of foods, limited time and extended days interfere with choices and timing.

Even though the number of kids playing organized sports is on the rise, fitness levels are on the decline, and are much lower than in previous decades.  This partially explains the spate of sports-related injuries.  (Cordelia. 2011).  Targeted intervention strategies include ample hydration and nutrition.  Because of maturation differences, kids need more protein to support growth, more calcium to support bone, and more attention to the prevention of hypohydration.  (Bar-Or. 2001).

Sweat helps to cool the body, and what comes out has to be replaced, otherwise performance suffers and health is at risk.  To prevent the dizziness, fatigue, nausea, and cramps that characterize dehydration, the young athlete should drink one or two cups of water or electrolyte within four hours of an event.  If no urine has been passed, or if urine is bright yellow and minimal, another 1 ½ cups is suggested within two hours of the game.  During the event, try to replace fluids as they are lost to sweat, about a cup every fifteen or twenty minutes if possible.  Plain water will do, but if the event is longer than an hour, use an electrolyte replacement.  Recovery is just as important to a preteen or teen as it is to an adult.  The best way to determine post-exercise hydration needs is to weigh the child to compute weight loss, and to replace fluid at one and a half times the volume lost to sweat.  One ounce of water (sweat) weighs one ounce, so the math is simple.  A kid’s thirst mechanism is not well-developed, so you’ll almost have to force him to drink…but do it.

The nutrients in which young athletes are most deficient include carbohydrates, calcium, vitamin B6, folate and iron, the last being especially important to girls.  Carbohydrate inadequacy leads to shortened glycogen stores and premature fatigue, especially if the game is sixty minutes or longer.  Once glycogen is gone, fat gets mobilized and the child will “bonk.”  The last thing you want is for the young athlete to burn protein for fuel. An active child will need as many as 500 to 1500 more calories a day than his inert peers.

Two to three hours before an event, give your athlete a light, carb-rich meal:  carrot sticks and a piece of cheese; a little pasta; a small sandwich.  Have him exert himself on a slightly empty stomach to avoid cramping, even fatigue.  Chips, cakes or cookies, and candy are out.  The protein your child needs will not build bulk.  That comes with age.  Normal muscle development will require as much as one and a half grams of protein for each kilogram of body weight, but need not be much more than fifteen to twenty percent of daily calorie intake.  Reduce that during the off season. Thirty percent fat in the daily intake will help to supply needed calories.  Reduce that off-season, too, lest you greet Tweedledee one morning.

The matter of iron deficiency is a particular concern for girls, especially after the onset of menarche, which can be a couple of years late for an iron-fisted ball player.  Iron-deficiency anemia is a real threat for female athletes.  Besides affecting performance and recovery, low iron stores impair immune function and may initiate other physiological problems.  Supplementation is not intended to replace food as a source of nutrients, but in the case of iron deficit, it may be recommended.  (Beard. 2000).  There’s no need for your daughter to join the 50% of the world population who are deficient in iron.  (Ahmadi. 2010).  Raw meat probably won’t help, but getting 15 mg a day from supervised supplementation will.

Youngsters are often grossly misinformed about what they need and don’t need.  Their peers and the internet are not always reliable sources of information.  Some young athletes need only a minor tweak to their diets; others need a complete overhaul.  If you feel inadequate, don’t be embarrassed.  There are dietitians and sports nutritionists who can help.

References

Petrie HJ, Stover EA, Horswill CA.
Nutritional concerns for the child and adolescent competitor.
Nutrition. 2004 Jul-Aug;20(7-8):620-31.

Cordelia W Carter, Lyle J Micheli
Training the child athlete: physical fitness, health and injury
Br J Sports Med 2011;45:880-885

Bar-Or O.
Nutritional considerations for the child athlete
Can J Appl Physiol. 2001;26 Suppl:S186-91.

Beard J, Tobin B.
Iron status and exercise.
Am J Clin Nutr. 2000 Aug;72(2 Suppl):594S-7S.

Ahmadi A, Enayatizadeh N, Akbarzadeh M, Asadi S, Tabatabaee SH.
Iron status in female athletes participating in team ball-sports.
Pak J Biol Sci. 2010 Jan 15;13(2):93-6.

Koehler K, Braun H, Achtzehn S, Hildebrand U, Predel HG, Mester J, Schänzer W.
Eur J Appl Physiol. 2011 May 19. [Epub ahead of print]
Iron status in elite young athletes: gender-dependent influences of diet and exercise.

Committee on Sports Medicine and Fitness
AMERICAN ACADEMY OF PEDIATRICS
Intensive Training and Sports Specialization in Young Athletes
Pediatrics Vol. 106 No. 1 July 1, 2000 : pp. 154 -157

Martinez LR, Haymes EM.
Substrate utilization during treadmill running in prepubertal girls and women.
Med Sci Sports Exerc. 1992 Sep;24(9):975-83.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Athletes And Fuel – Feeling Fuelish?

runnerWhen it comes to fueling an athlete, there had been as many approaches as there are sports to play. Several respected bodies have merged philosophies to incorporate and publicize nutritional recommendations that can be adapted to most athletic pursuits. There is much about diet that is common sense, but the habits cultivated from family traditions just might fly in the face of that. Ethnic or regional cuisines may feature foods that upset the balance of both macro- and micro-nutrient intake. There is no doubt that the physiological needs of serious athletes have to be the first consideration in finding and combining the right fuels.

Optimal nutrition is mandatory if an athlete wants to realize his full potential during an event. Not only performance, but also recovery, is enhanced by food intake. A position paper issued jointly by the American Dietetic Association, the Dietitians of Canada, and the American College of Sports Medicine, states, “Energy and macronutrient needs, especially carbohydrate and protein, must be met during times of high physical activity to maintain body weight, replenish glycogen stores, and provide adequate protein to build and repair tissue,” continuing that, “Adequate food and fluid should be consumed before, during, and after exercise to help maintain blood glucose concentration during exercise, maximize exercise performance, and improve recovery time. Athletes should be well hydrated before exercise and drink enough fluid during and after exercise to balance fluid losses.”  (Rodriguez. 2009)

Your performance will be affected by genetics (over which you have zero control), training (over which you have total control), and diet (ditto). If you fail to consume enough energy, the body will use both fat and lean tissue as fuel. Strength and endurance will then suffer, and the immune system and endocrine glands will pay a stiff price. If you’re trying to lose weight, you still have to pay attention to energy intake. It takes calories to burn calories. This is especially true for women, who may experience amenorrhea and osteoporosis if they aren’t careful.

You can store about 400 to 600 grams of carbohydrates, or 1600 to 2400 calories’ worth. These glycogen stores can be burned in 1 ½ to 2 hours, after which fat is mobilized and you “hit the wall.”  You don’t want to get more than about 60 grams of carbohydrates (CHO) an hour while in a marathon, for example, or you might cramp, but your daily intake could be 5-7 grams per kilogram a day (about 3 grams per pound) for moderate exercise that lasts less than 1 ½ hours. For more intense exercise, like that marathon or a cycling event, that lasts more than a couple hours, you’ll need 8-12 grams of CHO a day per kilogram of body weight. Do this prior to, not during, an event. (Burke. 2011)  You might as well convert your body weight to kilograms now. Divide pounds by 2.2 and you’ll have it.

Eating before an event will enhance performance compared to fasting. Common sense says to eat lesser amounts an hour before an event than you would eat four hours ahead of a strenuous workout. Traditional wisdom says that consuming up to 1 gram of CHO per kg is fine one hour before the start; Consuming 4.5 gm/kg is O.K. four hours before. Take it easy on the fiber and fat, though, or you might experience GI distress. During practice sessions is the time to experiment with different foods to come up with effective refueling strategies that fit you.

Protein intake depends on the type and duration of exercise. 0.8 gm/kg/day is fine for the general public, but you’ll probably need more. An endurance athlete will need 1.2-1.4 gm/kg/day, while a weight lifter needs up to 1.7 gm/kg/day. More than 2.0 mg/kg can tax the kidneys and won’t make much physiological difference. It’s important to get protein right after exercise. There’s a 15 minute to 2-hour window during which muscle balance can be increased and muscle tissue can be repaired. Protein supplements are nothing more than a convenience. Besides, such supplements can become delivery systems for things you neither want nor need, like steroids and other illicit substances.

At the end of your performance you need to refill your buckets. That’s called recovery. Adding protein to your carbohydrate intake at a ratio of 3:1 or 4:1, CHO:Pro, can enhance recovery. (Ivy. 2001)  We know of a few marathoners who eat tuna sandwiches with chocolate milk. You might opt for a bowl of Cheerios and a banana, or a yogurt-fruit smoothie and pretzels. Listen to your body. You might end with steak and potatoes. Lemon meringue pie, and carrot cake, and oatmeal cookies, and…  Dream on….PSST, you can do without the sugar.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.