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Salt When You Exercise

When you exercise for more than three hours, you should take in salt as well as fluids. A study from Switzerland followed female competitive distance runners who took in drinks with different concentration of salt during a four hour run. Ninety-two percent of those who took in plain water with no additional salt developed low blood levels of salt, which can be dangerous (British Journal of Sports Medicine, Volume 37, Issue 4, 2003).

Taking in fluid without also taking in adequate amounts of salt dilutes the bloodstream, so that the concentration of salt in the blood is lower than that in brain cells. This causes fluid to move from the low-salt blood into the higher-salt brain causing the brain to swell which can cause seizures and death. Taking in extra salt during prolonged exercise increases thirst so you drink more fluids, and prevents blood salt levels from dropping so low that you become tired, develop muscle cramps, and can even die. Furthermore, without salt you do not recover as quickly and are more likely to be injured or tired all the time. If you're concerned about the reports of deaths from over-hydration, read about hyponatremia .


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Dear Dr. Mirkin: I read that HDL injections will cure blocked arteries. Where can I get this treatment?

Thirty years ago, researchers showed that a family living in a northern Italian town lived to be very old and were extraordinarily resistant to heart attacks. These people were unusual because they had extremely low blood levels of the good HDL cholesterol that prevents heart attacks. The researchers found that their HDL cholesterol was much denser and had much larger particles than the normal HDL cholesterol, and did a better job of clearing cholesterol from the bloodstream. They concluded that the special HDL, which they called HDL-Milano, is so much more effective that these people don't need very much to prevent arteriosclerosis.

Before the discovery of HDL-Milano, researchers would not waste their time trying to give HDL infusions to prevent heart attacks because they could not patent a biological product and therefore could not make any money from their experiments. However, HDL-Milano is a specific, patentable product. The next step was to copy HDL-Milano and infuse it into people with plaques in their arteries, and show that their plaques became smaller. That has been done (Journal of the American Medical Association, November 4, 2003).

However, it will be at least six years before HDL-Milano treatments are available to the public. For now, eat lots of plants, avoid smoking and being overweight, restrict saturated fats and partially hydrogenated fats, and exercise regularly. Then you won't ever need the HDL-Milano by intravenous infusion.


Dear Dr. Mirkin: Which causes more heart attacks, shoveling snow or breathing cold air?

More heart attacks occur on the day after a snowfall, not on the coldest days, according to a study from Toronto. Your heart has to work two and a half times harder to pump blood through your arms than your legs because smaller blood vessels have greater resistance against blood flow. If you become short of breath walking, your heart could be too weak for you to lift a shovel full of snow safely. Your heart could beat irregularly and you could develop a heart attack. When you do shovel snow, take small shovel loads, rather than fewer heavy ones. Hold the shovel close to your body to lighten the load, and reach down for the snow by bending your knees, and come up by straightening them.


RECIPES for Asparagus! It's abundant (and cheap) in supermarkets now and throughout spring. Just break off and discard the tough white ends, steam for about 10 minutes in your countertop steamer (the same one you use to cook all those whole grains!), and serve with a little lemon juice. Or try these delicious asparagus soup and salad recipes:

Asparagus-Shrimp Salad
Creamy Asparagus Soup

List of Diana's Healthful Recipes

June 27th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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