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Rules for Sunscreens

If you use sunscreens, be sure to reapply them frequently. Many sunscreens contain the filters octylmethoxycinnamate, benzophenone-3 or octocrylene, which reflect ultra violet rays away from your skin to protect it only when they are on the surface of the skin. However, when these sunscreens are absorbed and the skin is not re-coated, they increase skin production of harmful oxidants that can cause skin aging and cancer (Free Radical Biology & Medicine, September 2009). Reapplying the sun screen so some remains on the skin's surface can prevent this damage.

• Before you go out in the sun, apply sunscreens to the areas with the most exposure to sunlight over your lifetime: the top of your ears, your face, the back of your neck, and your arms and hands. It is the cumulative exposure to UV light that increases skin cancer and aging.

• To meet your daily vitamin D requirements from sunlight, expose your legs or other areas of your body that have received little cumulative sun exposure over your lifetime. Take care to avoid sunburn.

• Reapply sunscreens every hour or two, particularly when you are swimming or sweating.

• Some sunscreens contain stronger UVA filters (avobenzone, mexoryl, titanium dioxide or zinc) that are less likely to be absorbed into the skin. You do not need to reapply these if they leave a visible white paste on your skin. Check the list of ingredients.

Every year the Environmental Working Group conducts a review of sunscreens and their ingredients. Their findings, with brand name listings and recommendations, are available at


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Dear Dr. Mirkin: What can I do to prevent muscle cramps?

Most older textbooks explain that muscle cramps are caused by lack of water (dehydration) and lack of salt. However, studies on endurance athletes show that athletes who cramp do not have less body water or sodium than those who do not cramp (British Journal of Sports Medicine, June 2009). So the current explanation for muscle cramps in conditioned athletes is that prolonged, intense exercise damages muscles, which can cause sustained contractions or cramps.

Cramps may occur as a side effect of drugs used to treat high cholesterol, high blood pressure or diabetes. Oral contraceptives, various other drugs or alcohol can also cause muscle cramps. If you suffer from recurrent muscle cramps that cannot be explained, check with your doctor. Possible causes include pinched nerves, Parkinson's disease, hypothyroidism, diabetes, narrowed arteries, low blood mineral levels, or metabolic diseases that cause muscle damage. However, these diseases are rarely the cause of cramps in athletes.

Cramps can often be prevented by slowing down when a muscle starts to feel tight. However, athletes usually are not willing to do this during competition or hard training, so they will continue to suffer from occasional cramps and work them out as they occur. You can help to prevent cramps with a training program that includes both hard days and recovery days. We do this by cycling at 18-20 mph pace on Tuesdays, Thursdays and Saturdays and 10-12 mph pace on the other four days.


Dear Dr. Mirkin: Will coenzyme Q10 relieve muscle pain caused by statin drugs?

We do not know. Statins cause muscle pain in almost all competitive athletes, 3-5 percent of exercisers, and almost no non-exercisers. Because statins lower both cholesterol and coenzyme Q10 (ubiquinone), some people think that taking coenzyme Q10 could treat the muscle pain associated with taking statins. I found only three studies:

• 18 patients had a 40 percent reduction in pain (Am J Cardiol, 2007;99:1409-1412)
• 44 patients - no benefit (Am J Cardiol, 2007;100:1400-1403)
• 49 patients - no benefit (Atherosclerosis, 2007;195:e182-e189)

Since coenzyme Q10 appears to be fairly safe, you can try it and see if it helps. Statins include Lovastatin (Mevacor, Altocor); Simvastatin (Zocor); Atorvastatin (Lipitor); Fluvastatin (Lescol); Pravastatin (Pravachol); and Rosuvastatin (Crestor).


Recipe of the Week:

Spaghetti Squash Soup

You'll find lots of recipes and helpful tips in The Good Food Book - it's FREE

June 22nd, 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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