Cris LaBossiere

Cris LaBossiere
Strength training and mountain biking. My two favorites

Saturday, May 28, 2011

Too Tired To Be Healthy

While a complete understanding of how sleep affects our health is lacking, we know enough to dismiss the myth that sleep is an inconvenience that interferes with life productivity.

How many times have you heard the axiom, "I'll sleep when I'm dead"?  Usually this boisterously pronounced phrase is used to convey that we're so important, and so bent on being productive 24/7 that we treat sleep like cheap date by only giving it the minimal attention needed to fulfill a rudimentary need.

Research tells us that if we don't enough sleep we'll die earlier, be sick more often, reduce cognitive function, reduce coordination, reduce athletic performance, and gain fat.

Sleeping in isn't the greatest thing either.  Getting too much sleep on a regular basis causes many of the problems getting too little sleep is known for.

A study from Finland (1) concluded that all-cause mortality (dyeing from any cause) increased for men and woman who slept less than 5 hours or greater than 10 hours, and that risk of cardiovascular disease was greater for men, but not for woman.

The Centers for Disease Control and Prevention in the US estimates that 50-70 million US adults have chronic sleep and wakefulness disorders, and that sleep difficulties are associated with chronic diseases, limitations of daily functioning, and mortality.  The report (2) cited 38% of those reporting less than 7 hours sleep (37% of adults) fell asleep unintentionally at least once in the past 30 days.

So around a third of people don't get enough sleep and one third of those fall asleep unintentionally at least once per month. Doesn't sound like too many people are nodding off uncontrollably, but I suppose if you fall asleep at the wheel or during operating on a brain it might not be a good thing.

Recently the American Journal of Clinical Nutrition published a German study (3) that found one night of sleep depravation reduces energy expenditure in men by up to 20%. It wasn't that the study subjects moved around less, rather metabolism was slowed as an acute response to sleep depravation.

An earlier modest study (4) found that men who experienced one night of sleep deprivation consumed an extra 550 calories the next day, presumably due to alterations in hormones regulate hunger and satiety.

There's a certain amount of alarmism that accompanies reports of dying or developing disease from sleeping too much or too little, but in contrast I believe that most of us are too dismissive when it comes to making healthy sleep a priority.

It isn't all about death and dying though, cognitive function and daily productivity is reduced from not getting enough shut-eye.  The odd all-nighter might be needed to get the job done but overall regular healthy sleep will make our awake hours far more productive so we're more likely to get more done in less time, making the last minute all-nighter crunch unnecessary. When tired it takes longer resolve cognitive challenges and the error rate increases. Working too late will decrease total productivity due to poor decisions and creating more work to correct errors.

If you're falling behind on a project you're more likely to become more productive by getting consistent quality sleep rather than extending work hours so long that sleep is sacrificed.

Take home? Work longer if you need to, but not at the expense of quality sleep, or exercise for that matter.  A good nights sleep and 45 minutes of exercise is like pressing the turbo-boost on your brain.

A Korean survey (5) on sleep deprivation effects on cognitive function of residents and interns concluded that 41% of those studied were sleep deprived, sleeping around 5 hours each night.  These medical professionals were more stressed and experienced attention deficits as well as difficulty in learning.

So really the best way to get more done in a day is to get a good nights sleep as often as possible, making an effort to maintain our sleep cycle on weekends as well.

To get a good nights sleep:

Go to bed and wake at the same time every night as much as possible
Avoid eating a heavy meal 2-4 hours prior to going to bed
Make the room you sleep in dark, cool, and quite
Avoid using an alarm to wake you, and never use the snooze button
Use your bedroom for sleeping, not working or TV watching
Exercise regularly

(1) Self-reported sleep duration, all-cause mortality,... [Sleep Med. 2011] - PubMed result

(2) Unhealthy sleep-related behaviors--12 States, 2009. [MMWR Morb Mortal Wkly Rep. 2011] - PubMed result

(3) Acute sleep deprivation reduces energy expenditure... [Am J Clin Nutr. 2011] - PubMed result

(4) Acute partial sleep deprivation increases food intake in healthy men

(5) A survey of sleep deprivation patterns and their e... [Sleep Med. 2011] - PubMed result

Supporting literature

Sleep and Obesity in Children and Adolescents. [Pediatr Clin North Am. 2011] - PubMed result

Sleep's effects on cognition and learning in adole... [Prog Brain Res. 2011] - PubMed result

Neuropsychological Effects of Sleep Loss: Implicat... [J Int Neuropsychol Soc. 2011] - PubMed result

Sunday, May 22, 2011

Coffee and Cancer

Two studies investigating the connection between coffee consumption and cancer have received a lot of press coverage.  One on prostate cancer in men (1), the other on breast cancer in woman (2).

In both studies high coffee consumption, 5, 6 or more cups of coffee was associated with a significant decrease in prostate and breast cancers.

These aren't the only studies to show the chemo protective effects of coffee, there is a fairly large body of evidence supporting this.  So yes coffee drinkers, there appears to be strong evidence supporting anti-cancer benefits from coffee consumption.

The study on prostate cancer also tested decaffeinated coffee and the same anti-cancer effect was found.  Researchers believe that compounds in coffee, perhaps the antioxidants, are responsible for the possible cancer prevention effect.

Diet and exercise also have strong anti-cancer effects as well so let's not forget about that.  Diet and exercise overall have a more rewarding and profound positive effect on all aspects of health and fitness than coffee consumption does so if you're a regular coffee drinker but are lacking in the diet and exercise realm, start exercising.  Coffee does not make you more fit, stronger, more flexible, or increase bone density, but exercise can do all those things.

When we hear about coffee having positive effects we celebrate the news, but many of us lament hearing about the greater positive effects of healthy living.  We like habits that have a negative association, and tend to resist habits that are truly good for us.  I think the reason is healthy living ironically get's a bad rap: it's hard, it's boring, it's time consuming.  Really healthy living is invigorating, stress relieving, and very rewarding.  How many healthy fit people have you heard say they hate being healthy and fit?

Researchers aren't yet prepared to recommend starting coffee consumption to prevent prostate or breast cancer, conversely though, the pro's give the nod to starting exercise and making healthy food choices to reduce risk of cancer, and risk of other diseases such as type two diabetes and cardiovascular disease.

Recently I wrote about research that demonstrated coffee and fat consumption increases blood sugar response to sugar intake, with an endpoint recommendation for those with type two diabetes to abstain or at least reduce coffee consumption (3).

Anecdotally I can say that of those who I have known to either cut down or cut out coffee consumption completely, all of them have said they feel better.  They talk about being free from the daily cycle of feeling agitated and brain dead until they get their java fix.  Now they are naturally alert and are able to cope with daily stress better than they did when dependant on coffee.

I think the take home message here is that coffee does have some legitimate positive health effects, some legitimate negative health effects, and that comparatively, healthy diet and exercise have a far greater net positive effect on our health and well being.

(1) Coffee Consumption and Prostate Cancer Risk and Pr... [J Natl Cancer Inst. 2011] - PubMed result

(2) Coffee consumption modifies risk of estrogen-recep... [Breast Cancer Res. 2011] - PubMed result

(3) Live Healthy: High Fat Intake Increases Blood Sugar; Adding Coffee Doubles Blood Sugar Rise

Saturday, May 21, 2011

Muscle Pain and Fatigue from Exercise Makes you Clumsy

This may be another one of those "Duh!" scenarios where research proves the obvious like, "study shows placing hand on hot stove causes burns".

Nevertheless, much of the time we don't make the practical application connection to things that we usually ignore, and for exercise management, fatigue is often viewed as something to conquer by pushing through it rather than resolving through rest, or perhaps by putting a piece of tape on your muscles.

DOMS; delayed onset muscle soreness.. your muscles feel stiff and sore in the days following exercise.   A study in the journal Medicine & Science In Sports & Exercise (1) showed that 48 hours after training muscles with DOMS had a strength reduction of about 21%.  While this has training implications (do you need to rest until you return to full strength before considering training again?), there was another interesting finding.

The study concluded, "Reflex activity in leg muscles elicited by rapid destabilizing perturbations is reduced after exercise-induced muscle soreness."

Translation, you will have less functional stability.  Your ability to respond to high stability demands like playing sports will be reduced, which would increase your risk of injury.

While recovery days can include light or moderate exercise, it's not a good idea to train hard with weights, then play hard in sports the next day.

In another study, this time from the journal Gate and Posture (2), researchers found placing a piece of tape on the ankle of fatigued study subjects allowed them to maintain ankle control.  When no tape was applied, fatigued subjects demonstrated "degraded postural performance", they lost balance more easily. 

How does this work?  Researchers suggest that local muscle fatigue impairs the ability to send relevant postural position information to the brain, and that the skin, if stimulated, can take up the communication corridor slack. 

Does this mean we should keep training and simply tape up our skin to maintain coordinated movement?  I wouldn't go that far.  There is still muscle recovery that requires more time to recover from, and there might be a problem with masking reduced coordination as it may prompt people to train weak and unrecovered muscles, but this information can help therapists and coaches understand and design appropriate recovery protocols. 

(1) Delayed-Onset Muscle Soreness Alters the Response to Postura... : Medicine & Science in Sports & Exercise

(2) Degraded postural performance after muscle fatigue can be compensated by skin stimulation

Saturday, May 14, 2011

Right? Or Righteous? Defending what we eat

Something funny happens quite often when I talk about healthy eating and healthy living in general.  This "something" happens not only with myself, but almost every time I hear a conversation that raises the subject of healthy eating.

It goes something like this;

"I think I'd like to start eating healthier.. might be good for me"

.. is followed by;

"I'll tell you what healthy is! A big juicy steak!"

Sometimes the person will try to tempt and tease.. "mmmmm.. don't you wan't a big chocolate donut? How about a bacon double cheeseburger... mmmm.. you know you waaant it!"

The following are also fairly predictable;

"You're going to die anyway, might as well enjoy yourself and eat what you want."

"I ain't eating no cardboard/ rabbit food/ hippie food/ nuts and berries!"

Can we have a conversation about this without going there?  What is so wrong about eating right?

There's the rub.  Many cannot get passed their perception that eating healthy is about being controlled, being restricted, being told what to do, and making eating into a boring, tasteless, and unrewarding experience.

The conversation is hijacked and turned into a personal defence of ones basic right to be autonomous in their decisions rather than talking about the factual virtues of healthy eating, and more importantly how much quality of life increases with healthy eating, and quality of life decreases with avoiding healthy eating.

The end game is not so pleasant. Over my lifetime I've witnessed so many people, including some friends and family, develop type two diabetes, increase blood pressure, increase cholesterol, have heart attacks and strokes.. all due to unhealthy lifestyle habits.

Ostensibly many will say that these illnesses can occur even with living healthy so what's the point of living healthy?  Of course it is true that no matter how healthy we live, through no fault of our own we can become ill.  Really though, it's understood that at least one third of all cancers are preventible through healthy living.

I've written about research that demonstrated exercising 4 - 5 times per week results in 40% fewer colds, and the duration and intensity of cold symptoms are reduced as well.

All the evidence clearly shows healthy living is factually better for us in all possible ways objectively, and subjectively I have yet to meet someone who has adapted to healthy living express regret for doing so.  If anything they may regret holding on to their previous beliefs and habits so tenaciously.

Why is the most common response to raising the topic of healthy living spiteful or some kind of derogatory joke?

Seems to me that we simply get wrapped up in established habits, engrained sense of reward, and keeping up social norms.  It's normal to overeat. It feels good to eat things that we know are bad for us.  Doing so fulfils some kind of rebellious self control reward; or worse, we simply perceive the reward and don't stop to think about what we're doing to ourselves.

Seriously.. How many readers out there have had personal experience with their own health or the health of family and friends, co-workers, or someone you know?  And how many times has that health problem been related to unhealthy living?

I read an interesting article on a study recently.  Go here if you're interested.

The study asked young adults about their health and how risky behaviours effect their health.
The short story is many young adults, even if they currently had health problems, did not believe their lifestyle habits would negatively effect their health.

In this study the risk of stroke was being assessed.  Living healthy can reduce risk of stroke by 80%.

I guess because stroke and other illnesses seem to be abstract in nature if you currently are not experiencing them, that many cannot connect to the risk.  Stroke and illness is something that happens to other people, "not me".

Aside from all that abstract serious risk stuff, healthy living habits have immediate positive outcomes.

Right away you feel better, have more energy, sleep better, think better, and feel more positive more of the time.

Let's move away from the seemingly preprogrammed rejection of healthy living and start reaping the benefits.  An orange is more rewarding than an donut. No really, it is : -)

Saturday, May 7, 2011

Binge Drinking

I had a conversation with a university student about binge drinking last week.  The student mentioned he would rather not drink as much as he did, and predicted once out of university he might cut alcohol all together.

Given his preference not to drink I was curious as to why he drank anyway.  His answer was he felt peer pressure to drink, and that in order to be with his friends having a good time, drinking was necessary.

He said he felt this was his own perception as none of his friends try to provoke him into drinking, or admonish him for not drinking, nonetheless, there seemed to be an assumed behaviour; if you want to hang out with friends, drinking is an important part of making that happen.

Moreover was the purpose of drinking.  The student explained to me that the reason for drinking was strictly for the purpose of getting drunk, and not for casual use.  I can identify as for a time when I was between the age of 17 and 22ish, that's what I used to do.

I never actually liked drinking; didn't like the flavour and didn't really like the buzz.  Wasn't for me.  Except brown cows, I liked those because they tasted like chocolate milk.  Now I just do the chocolate milk.

There is some academic disagreement as to how binge drinking is defined, but in general 4-5 drinks over an hour or two is where "binging" starts.  Some skilled drinkers will scoff at that boasting they can do that in minutes or even seconds.  To qualify as a binge drinker you'd have to engage in binge drinking chronically once or twice per week.

A recent study (1) found that 63% of female and 83% of male college students were binge drinkers.  This particular study was looking at the co-occurance of disordered eating along with binge drinking and found that 48% of the students also reported binge eating habits.

A story in the Washington Post (2) tells of a multi-universtiy initiative in the US to curb binge drinking has had some success, reducing from 59% in 1997 to 43% (2009) of students reporting they had binge drank in the previous two weeks.

Will certain sights and sounds stimulate you crave alcohol? A study done in 2010 at the University of Central Missouri (3) did a small study (15 binge drinking college students and 8 nonbingers), used a head mounted virtual reality device to expose students to either a "nutral-cue" environment of underwater scenes, or "alcohol-cue rooms" with a bar, party, kitchen, or argument scene.

The binge drinkers reported significantly higher cravings for and thoughts of alcohol than the nonbinge drinkers.  A question often raised, but still not completely answered, is where does the desire to binge drink start?  Do movies that depict wild college parties create the expectation that binge drinking is simply part of the expected college experience?  Or has this always been the way it is and the movies simply play off this established social norm?

Both schools and booze have been around for a long time, so who knows.  It appears though that regardless of why a person becomes a binge drinker, they may be more susceptible to social cues that stimulate the desire to drink indicating that perhaps once you start binge drinking there's a greater likelihood of feeling compelled to keep doing it.

We've all heard about the negative effects of alcohol, liver, mouth, and stomach cancer as well as the challenges of alcoholism and drunk driving.  Hard to so say no when drinking is so socially established.  Focusing on the negative outcomes of over-doing booze has some effect, but we all know that being told not to do something often provokes a person to do it anyway.

Maybe a better step would be to place more of a focus on the positive outcomes of not binge drinking; better sleep, better grades, not being hung over, saving money etc..

Overal binge drinking is a serious problem on campuses all over the world and it might benefit us to take a sober step back and reconsider how binge drinking causes harm, both short and long term, and not binging is ultimately more rewarding.

Always a good reference for learning about alcohol: Mothers Against Drunk Driving

FYI: British girls worst binge drinkers in the western world The Telegraph

(1) Binge drinking and disordered eating in college st... [J Am Acad Nurse Pract. 2011] - PubMed result


(3) Virtual reality cues for binge drinking in college... [Cyberpsychol Behav Soc Netw. 2010] - PubMed result