It's been a bad autumn for deaths during U.S. running races—at least six during half marathons and one during a marathon. Although the specific causes of death aren't known in all cases, heart ailments are at the top of the list of possible explanations whenever someone dies suddenly during an athletic event, be it a road race, triathlon, or a football or basketball game. As rare as these events are when compared with deaths from car accidents, homicide, or even the flu, doctors are debating whether lives could be saved by more carefully scrutinizing athletes before they compete. Sounds good, but is it possible?
First, let's understand what problems doctors are trying to ferret out, and in whom. When a middle-aged person experiences sudden cardiac death or a fatal heart attack during athletic exertion, he is more likely to have plain old heart disease (also called coronary artery disease) caused by a buildup of plaque inside the blood vessels leading to the heart, says Euan Ashley, an assistant professor of cardiology at the Stanford School of Medicine and director of the Stanford Hypertrophic Cardiomyopathy Center. But when a high school, college or younger elite athlete collapses and dies, he or she most likely had an undiagnosed inherited cardiovascular disease, most commonly hypertrophic cardiomyopathy, in which the heart muscle thickens and can throw off the rhythm of the heart. (Other electrical malfunctions in the heart are also a possibility.)
Why are these problems an issue during sporting events or strenuous exertion? While exercise can dramatically cut the chance of heart disease, during the minutes you actually are exercising, your risk of a heart attack or sudden death actually temporarily rises, says Ashley. The long-term benefits of exercise vastly outweigh any short-term risk, so there's no excuse for not exercising unless your doctor specifically orders it. (Even 2007 research on the body-stressing marathon suggests that it's riskier to drive the course than to run it.)
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Video: The H1N1 "Swine Flu" Virus
On Sunday, November 1, some 42,000 runners will share the experience of running the ING New York City Marathon. But marathon organizers are taking special measures to make sure they won’t also be sharing the flu—specifically, the H1N1 virus, aka swine flu.
For the first time, marathoners’ goody bags—customarily filled with things like minipacks of pain relievers and samples of energy bars—will include small hand sanitizer sprays printed with the logo of the New York Road Runners, the organization that puts on the race. The official marathon program also says hand sanitizer will be available at the prerace expo and the race's start.
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Video: Grocery Shopping Tips
Is a traffic light coming to U.S. food labels? It certainly sounds like a possibility. The Food and Drug Administration said today that it's concerned about the proliferation of front-of-package nutrition labeling programs like Smart Choices, which are supposed to offer quick and easy guidance to consumers on purchasing more healthful foods. Trouble is, as the FDA said in a letter to the food industry, the different programs have different criteria, which can be confusing for consumers. They may also be violating the law if they give false or misleading information or convey an overall impression of healthfulness even if the nutritional content shows otherwise. (Hello, Froot Loops, which FDA Commissioner Margaret Hamburg described but did not specifically name as a Smart Choices-approved cereal, even though it has more than 40 percent sugar. Smart Choices, meantime, said in a statement that it complies with all laws and regulations and looks forward to working with the FDA.)
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Video: Is Your Child Overweight?
The Institute of Medicine has new recommendations for the federal programs that provide breakfast and lunch in primary and secondary schools, and for the first time, it endorses calorie limits. The IOM report says lunches shouldn't be more than 650 calories in grades K through five, 700 for middle schoolers, and 850 for grades 9 through 12. Breakfasts, meantime, should range from 500 to 600 calories depending on the grade.
The report also advises that schools offer more—and more varied—fruits and vegetables, including one cup per day of fruit at breakfast and an additional cup for high schoolers at lunch. Juice should make up no more than half of the fruit provided. More veggies should also be offered, and at least a half cup should be from the "rainbow," meaning leafy greens or orange vegetables rather than starches, such as potatoes. If kids are buying food a la carte, they should be required to take at least one serving of fruits or veggies per meal. The IOM also said schools should move toward whole-grain products rather than the refined variety, and 1 percent or nonfat milk rather than whole or 2 percent.
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Video: Arthritis: Pain in Your Joints
How well do you move? It sounds like an easy question—or one that might be answered by your performance on the dance floor. But it's neither. Whether you can perform a deep squat or leg lift, for example, can indicate areas of the body that are tight or weak and show if you're compensating in a way that might be harmful even if you aren't consciously aware of it. That's the philosophy behind the Functional Movement Screen, a tool used to root out those weaknesses before they hamper your sports performance or become full-fledged injuries.
Gene Schafer, an athletic trainer, challenged—er, invited—me to take the screening test at the rehab and training facility he owns, ARC Athletics in New York. I was fairly confident I'd ace it. After all, this test doesn't aim to evaluate your athletic performance but "movement patterns that are key to normal function," according to the FMS website. If I run, swim, and strength-train several times a week, surely I've got those basic movement patterns down pat, I thought.
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When faced with a sore knee or a back pain, the first inclination is to look to the bones and joints. And that's appropriate in some cases. But many times, the answer lies in how all of the elements of the musculoskeletal system work together, especially those often overlooked muscles, says sports chiropractor Rob DeStefano. By taking this more global perspective, you're more accurately able to treat (and prevent) nagging injuries and aches, according to Muscle Medicine (Fireside), a new book DeStefano wrote with orthopedic surgeon Bryan Kelly and health writer Joseph Hooper. It takes you on a tour of your body's trouble spots—including the lower back and the knee—and helps you tease out the roots of common problems and possibly even how to fix them yourself. I asked DeStefano about muscle medicine in a chat; here are some edited excerpts:
If you have pain in your back, knee, ankle, or other body part, whom should you turn to for help?
We're often taught to go to the top of the diagnostic chain, the orthopedist. But the truth is that most orthopedic surgeons, unless they [have some particular interest or specialty], don't want to see patients unless it's a surgical case. Otherwise, it's just evaluating and referring out. A good manual therapist who will refer out when it's necessary-whether a chiropractor, a physical therapist, or an internist who works with manual therapy—is a good port of entry.
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Nutrition and diet associations have come under fire for their relationships with food companies; most recently, the American Society for Nutrition was criticized for its role in administering the controversial Smart Choices food labeling program. Today the American Academy of Family Physicians announced its own corporate partnership program, called the Consumer Alliance, and said that the Coca-Cola Co. will be its first partner.
Under the terms of the arrangement, Coke will provide a grant—which AAFP President-elect Lori Heim says is "in the strong six figures"—annually to the group, which will develop consumer education content on beverages and sweeteners for its consumer-oriented website, FamilyDoctor.org. The AAFP, emphasized Heim, "has total control over editorial materials," which for now is the extent of the arrangement. Coke won't be using an AAFP symbol in marketing its products, for example, though the company's financial assistance will be credited on the site.
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The new season of The Biggest Loser means the popular TV show is once again a hot topic around the water cooler. Even as fans spend Wednesday morning rehashing the show, some in the fitness industry have recently criticized the show for its unrealistic depictions of weight loss. I recently caught up with Bob Harper, one of the show's trainers, to talk about what viewers should take away from the show—and what he thinks about carbs, colonics, and screaming trainers. Here are five take-aways from our chat:
- Nutrition is at least as important as exercise. People who begin a weight loss effort are often totally confused about the role of nutrition. Some think that if they work out, they can eat whatever they want. Not true! But Biggest Loser contestants often come in thinking the reverse, says Harper. "They think they'll work out a lot and won't eat at all," he says. Also not a good strategy. You need to hit the sweet spot: fueling your body enough with healthy foods to give you energy to get through the day (and your exercise routine), but not so much that you take in more than you're burning off.
[See what I wrote about diet and our 10-week workout routine.]
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Yes, you're not imagining it when you look at that receipt from Whole Foods: It seems to be cheaper to eat a less healthful diet. Spanish researchers recently published a study in the Journal of Epidemiology and Community Health that showed that the more closely people adhered to a Mediterranean diet (associated with better health), the more money they spent on food. Those who adhered to the typical Western diet (associated with poorer measures of health) had "significantly lower daily costs," the researchers said.
[Read more about how to follow the Mediterranean and three other healthful diets.]
I decided to conduct my own admittedly extremely unscientific experiment and see if the results seen in Spain also held true in my corner of Brooklyn, N.Y. So without looking at prices, I made two meal plans, each amounting to about 2,000 calories for the day. One drew from the list of foods that the researchers used to define the typical Western diet: red meat, processed meat, eggs, sauces, precooked foods, fast food, caloric soft drinks, whole-fat dairy, and potatoes. The other plan, matched to include about the same number of calories per meal, was based on the foods that define the Mediterranean eating pattern: olive oil, poultry, fish, low-fat dairy, legumes, fruits, and veggies. Only after I created the menus—which include a variety of foods but which, since I'm not a dietitian, I won't promise are nutritionally balanced—did I go out and get prices from the local Key Food grocery store, the nearby Trader Joe's, and my closest McDonald's. Here's how things stacked up, calorie- and cost-wise.
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