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Salt Restriction Hinders Exercisers

Most doctors recommend low salt diets because of the evidence that taking in too much salt can cause high blood pressure, a major risk factor for heart attacks and strokes. However, this may not be good advice for dedicated exercisers. If you exercise heavily and restrict salt, you will not replace the salt you lose through sweating, which can cause high blood pressure as well as fatigue, cramps and muscle pain. When the body is low in salt, the adrenal glands produce large amounts of aldosterone and the kidneys produce renin, which constricts arteries and can raise blood pressure.

Researchers at Albert Einstein College of Medicine showed that people on low-salt diets are actually more likely to suffer heart attacks than those on high salt diets (Journal of General Internal Medicine, June 2008). They analyzed data from the Third National Health and Nutrition Examination Survey (NHANES III) of American adults. Dr. Hillel W. Cohen, lead author of the study, stated, "Our findings suggest that for the general adult population, higher sodium is very unlikely to be independently associated with higher risk of death from heart attacks."

Many years ago, when I was competing in marathon races, I decided to try a low-salt diet. I was surprised to find that my blood pressure rose from a normal 120/ 80 to as high as 160/80, and I suffered severe fatigue and frequent injuries. When I added salt back into my diet, my blood pressure went down to normal and I was able to train and compete again. This is why I recommend a relatively high-salt diet for exercisers. If you decide to increase your intake of salt, get a blood pressure cuff and check yourself for a month. If your blood pressure goes above 120/80, you may have added too much salt. Also, if you stop exercising because of an injury or for any other reason, be sure to cut out the extra salt to keep your blood pressure under control.


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Dear Dr. Mirkin: No matter how hard I exercise, my heart rate never gets as high as my husband's. Should I be concerned?

No; it may just mean that you are in very good shape. Researchers at Liverpool John Moores University in England showed that athletes have much lower maximum heart rates than sedentary people and that female athletes have lower maximum heart rates than male athletes (International Journal of Sports Medicine, February 2008).

Most exercisers should not even bother with heart rate calculations. Your training heart rate occurs when you exercise vigorously enough to make your body require more oxygen. You can tell when this happens because you will start to breathe deeper and faster, raising your shoulders with each breath. Once or twice a week, you should try to exercise intensely enough to increase your need for oxygen. If you feel uncomfortable, you should slow down. Non-athletes do not ever need to exercise so vigorously that they become severely short of breath.


Dear Dr. Mirkin: I'm pre-diabetic; does it matter whether I exercise before or after meals?

When you eat, blood triglycerides and insulin levels rise, which can constrict arteries and decrease the flow of blood to various parts of the body. In a person who already has blocked arteries leading to his heart, a high-fat meal can cause a heart attack. Researchers at the University of Connecticut report that exercise can change this risk dramatically (Medicine & Science in Sports & Exercise, February 2008). They showed that if you exercise before eating, triglycerides and insulin do not rise as much and arteries leading to the heart do not constrict.

They also showed that exercising four hours or 16 hours before eating the high-fat meal had equal effects. This means that daily exercise can help prevent blood and artery changes that can lead to heart attacks, and it doesn't make much difference what time of the day you do your exercise.


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Ratatouille with Baby Potatoes

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June 25th, 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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