Should You Eat Before Or After Exercise?

December 23, 2019 / Thomas Cohn, MD

Should you fuel up before hitting the gym, or is it best to burn calories on an empty stomach? That’s the question researchers at the University of Bath in England sought to answer with their latest study.

For their research, the team decided to look at the fat burning capabilities of exercise based on when the participant last ate. They were wondering if when a person ate influenced how much muscle fat was burned during activity, because muscle fat can be a key contributor to the eventual onset of insulin resistance and diabetes. For their study, the team divided 30 overweight men into three groups.

A control group that lived their normal lives.
A group that consumed a vanilla-flavored shake two hours before cycling exercise.
A group that consumed a placebo shake two hours before cycling exercise.

Participants wore monitors and masks that tracked a number of different factors, including their heart rate and the amount of fat and sugar they burned. After exercise, the participants drank the shake they had not yet consumed (placebo for the vanilla shake group, and a vanilla shake for those who consumed a placebo before exercise).

The study lasted for six weeks, and researchers drew some interesting conclusions after looking at the data. As expected, the control group’s insulin sensitivity remained unchanged, while the men in both exercise groups improved their fitness and narrowed their waistlines, although few actually lost weight. Notably, participants who pedaled on an empty stomach burned about twice as much fat during each ride as the men who consumed their shake prior to exercise. All riders burned about the same number of calories while pedaling, but more of those calories came from fat when the men did not eat first. Riders that consumed the shake afterwards also had greater improvements in insulin sensitivity and had developed higher levels of certain proteins in their muscles that influence how well muscle cells respond to insulin and use blood sugar than the other groups.

“You can probably get more out of your workout without increasing its intensity or duration by exercising before breakfast,” said Javier Gonzalez, a professor of physiology and nutrition at the University of Bath, who oversaw the study.

So if you’re wondering when the best time to exercise is, it might be first thing in the morning after you wake up. That being said, any exercise is better than no exercise, so just get it in when it works for you!

Daily Exercise The Key To Combating Chronic Pain

October 16, 2019 / Thomas Cohn, MD

As someone who has suffered from chronic back pain for more than a decade, I know just how hard it can be to manage a chronic condition on a daily basis. You have good days where you feel like you can conquer the world, and you have bad days where you don’t even want to get out of bed. No matter what kind of day you’re having, it’s important that you push through any discomfort and find time to exercise, because that’s likely your best bet at stringing together more good days than bad.

Daily exercise isn’t something that comes easy. Most of us can find some spare time throughout the week, but we can’t always carve out time every single day, and when we do get spare time, oftentimes we’d rather use it on anything other than exercise. However, it’s this consistency that might be just what you need to put your chronic pain in the past.

The Benefits Of Daily Exercise

A recent study decided to take a closer look at the benefits of moderate versus daily exercise when it comes to helping control problems associated with chronic pain. For the study, researchers conducted a small, weeklong study of 40 healthy women on their sensitivity to pain before and after exercise. The individuals were asked to walk briskly on a treadmill for their exercise, and patients were separated into three different groups. One group walked three times per week, another group walked five times a week, and the final group walked 10 times a week.

After reviewing the data, researchers found no differences in pain perception following exercise for those who exercised three times a week, but the findings were significantly different for those who exercised at least five times a week.

“We asked them to rate that pain,” said neuroscientist Benedict Kolber, lead researcher on the study. “And at the end of the study, they rated the same pressure — the exact same pressure — as 60% less painful than they rated it at the beginning of the study.”

In other words, a small dose of exercise did nothing for helping manage chronic pain, but a bigger dose worked wonders. A good motto to live by is to “Strive For Five” in terms of striving to exercise at least five times a week. However, it’s also worth remembering that you need to start slow. If you haven’t been a frequent exerciser, don’t go straight to exercising for an hour each day. Ramping up your activity too quickly can lead to overstress injuries and exacerbate inflammation. Start slow, be it 5-10 minutes a day, and work your way up from there. Focus on doing small amounts daily instead of a longer session 1-2 times a week, and work your way to longer durations.

There have been days where the last thing that I wanted to do was get up before work and work out, but I knew I needed to do it if I wanted to function at my best throughout the day. I try my best to work out every day, and my back pain has been much more controlled than in years past, even though I’m years older. Controlled exercise can be your best friend when it comes to caring for your pain condition. If you need help developing a safe exercise routine, or you want some tips on what types of activity might be best considering your condition, reach out to Dr. Cohn’s office today.

Work Can Be Exercise

June 3, 2019 / Thomas Cohn, MD

Adding an exercise to a busy person’s life is sometimes difficult. Many people claim that their daily activities give them enough exercise to stay healthy, and in some cases this may be true. Physicians are beginning to recognize that what we do as part of our regular routines may count as exercise. For meeting the goal of aerobic conditioning, the movement we do routinely is helpful.

Aerobic conditioning is one component of exercise. Any activity that increases the heart rate and increases the body’s use of energy is good. A term given to this is “non-exercise activity thermogenesis,” or NEAT. It is also the exertion of daily living for many people. People who are up on their feet and walking all day are performing exercise. Among the professions that are known to have high levels of activities include waitresses, preschool teachers, maintenance workers, and mail carriers that have walking routes. Monitoring step counts on these people, they often have well over 10,000 daily steps.

Daily Activities and Physical Fitness

Regular activities of daily living can also be helpful in aerobic conditioning. During the summer, cutting the lawn and performing yard work keeps many busy for hours on end and adds 5,000-10,000 steps to a day’s routine. Doing household chores such as cleaning, laundry, vacuuming and doing dishes all require standing and motion. When shopping, park a little further away from the nearest door and walk the extra distance. To make it worthwhile, track how much you actually do with a fitness tracker. Good fitness bands that track heart rate and steps are now less than $100, and almost every smart phone has a built-in step counter that can be activated.

If you have chronic pain, aerobic conditioning is just one aspect of needed exercise. Conditioning maintains cardiac health, improves endurance and the ability to perform activity, and increases the body’s own painkilling compounds known as endorphins. However, most with chronic pain need to do more than just conditioning and need to also do routine stretching and strengthening. Physical fitness for everyone requires the combination of the above three routines. “NEAT” is a great way to meet the conditioning component of fitness. Developing a routine to meet stretching and strengthening goals to maintain function and decrease pain can be the focus of time spent exercising beyond aerobic activities.

New Exercise Guidelines Can Help With Chronic Pain

January 4, 2019 / Thomas Cohn, MD

New federal health guidelines want Americans to move more and get kids active, and this advice can also help to prevent and treat chronic pain. The three main talking points from the new guidelines, which are the first update to government physical activity guidelines in a decade, suggest that we need to move more, sit less and get kids active at a younger age. We take a closer look at all three of those talking points below.

Get Kids Active

The biggest update to the guidelines centers around when parents should really start encouraging their kids to partake in physical activities throughout the day. The old guidelines said six was the target age to encourage kids to be active, but the updated guidelines says you should push kids to move at the age of three. There are no strict guidelines, but they said about three hours of interactive activity and physical movement of various intensity is a good start. That would put us in line with the average amount of activity observed in kids in other countries at this age.

Once they hit the age of six, the activity should be a little more vigorous. At least an hour of moderate-to-vigorous activity a day is recommended, from activities like brisk walking, biking, running or playing on a playground.

Sit Less

Another point that was stressed in the updated guidelines was to have people sit less. Sitting can be especially harmful for your health if it leads to a sedentary lifestyle, and while you don’t need to swap out sitting with activity, at least make it a point to move around regularly or consider switching to a standing option. Find ways to break up your sitting, whether that’s by taking a phone call on your feet at the office, walking around during your lunch break or simply going for a walk instead of plopping down in front of the television after dinner. Strive to sit less in the new year.

Move More

Along a similar vein, movement for adults is emphasized under the new guidelines. The duration for movement and activity remains the same – at least 2½ to 5 hours of moderate-intensity or 1 ¼ to 2 ½ hours of vigorous activity a week, but they also added that aerobic exercise, even in short bursts less than 10 minutes are helpful. Even a single episode of activity can help to lower blood pressure, reduce anxiety and improve sleep.

All of these pieces of advice are also helpful for patients with chronic pain. If we take care of our body when we are young, we can reduce our likelihood of developing a pain condition down the road. And if we pursue active treatments, like movement and exercise over options like rest and opioids, odds are we’ll see more improvement. So try to follow these guidelines in the new year, regardless of whether or not you have chronic pain, and your body will thank you for it.

How Regular Exercise Keeps Your Body Young

December 27, 2018 / Thomas Cohn, MD

New research published in the Journal of Applied Physiology revealed that regular exercise can have your muscles acting as if you are decades younger than your actual age.

According to researchers, older men and women who exercised regularly for decades had muscles that were indistinguishable in many ways from the muscles of healthy 25-year-olds. These older men and women also had much higher aerobic capacities than most individuals their age, making them biologically about 30 years younger than their chronological age, the study’s authors conclude.

Previous studies have found that older athletes have healthier muscles, brains and immune systems than individuals of the same age who are sedentary. However, those studies have concentrated on competitive athletes, not recreational exercisers. This study suggests that you don’t need to be a professional athlete to see many of the same benefits of regular exercise.

Exercise Study

For the study, researchers looked at the health of individuals who took up regular exercise during the fitness boom of the 1970’s. They were most interested in individuals who maintained that hobby through the next 40-50 years, with activities like running, cycling, jogging or swimming, even if they never competed in these activities.

28 men and women fit the bill, and they were compared to a second group of age-matched older individuals who had not exercised during adulthood, as well as compared to a third group of active young people in their 20s.

Each group was tested in a lab setting to measure their aerobic capacities, and tissue samples were also taken to look for the number of capillaries and levels of enzymes in muscles. The higher the numbers, the better the muscle health.

After looking at the findings, researchers were surprised to find that the muscles of the older exercisers resembled the muscles of the young group, and their aerobic capacities were about 40 percent higher than inactive individuals their age. They also concluded that the active older group had cardiovascular health similar to that of people about 30 years younger.

These findings are amazing, and they help us understand why regular exercise is so important. Exercise can literally roll back the clock and slow down the aging process, which can help prevent problems like pain or degeneration-related issues. So take care of your health while you’re young, and continue exercising as you get older. If you do this regularly, you can prove that age really is nothing more than a number, and we are in control of our health!