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Exercise Choices for the Out-of-Shape

Sixty-five percent of people who start an exercise program drop out in the first six weeks, often because of injuries. Jogging and running are high-injury sports because your feet hit the ground with a force greater than twice your body weight. This force can injure muscles, joints and bones. Pedaling and swimming are safer because you pedal in a smooth rotary motion and when you swim, the buoyancy of the water dampens forces on your muscles.

The safest and most comfortable way to pedal is on a recumbent stationary bicycle. On a conventional bike, the pedals are below you, so you perch on a narrow seat and put pressure on the nerves in your crotch. When you pedal a recumbent bike, your legs are above your pelvis, so you can sit in a chair that does not pinch nerves. You lean against the seat’s back support, so it’s comfortable for anyone with back problems. Even a 90-year-old with poor coordination and weak muscles can use a recumbent bike.

Don’t bother looking for an exercise machine or sport that stresses more than one group of muscles at the same time, such as a stationary bicycle that also moves your arms. Your brain will make you concentrate on the muscles that are doing the most work (in this case, your thighs that are moving the pedals), and the muscle groups that don’t need to exert force will just flip along for the ride. A better choice would be an ordinary stationary bicycle plus a separate weight training program to build muscles in your arms.

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Dear Dr. Mirkin: My doctor says the bone-strengthening medicine I take is also good for my heart. Is this true?

Almost all treatments for osteoporosis help to prevent arteriosclerosis also. A study in QJM helps to explain why (Volume 98, 2005). Statins such as Pravachol, Zocor and Lipitor, used to lower cholesterol, strengthen bones. Bisphosphonates, such as Fosamax and Actinal, used to treat weak bones, also help to lower cholesterol and prevent heart attacks. Drugs such as Actos, used to treat diabetes and lower triglycerides, also help to strengthen bones.

Osteoporosis occurs when fat cells replace bone cells in bones. Stem cells in bone marrow can form either bone or fat cells. We do not know the signal that encourages bone marrow stem cells to form fat instead of bone, but this recent data show that factors that help to prevent arteriosclerosis may also help to prevent osteoporosis. This is one more reason to eat a diet rich in plants, exercise regularly, and treat osteoporosis and high cholesterol vigorously.

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Dear Dr. Mirkin: Do you burn the same number of calories if you run or walk the same distance?

It depends on how fast you walk. When you run, you burn about 100 calories per mile, no matter how fast you go. You keep the same form at any speed. When you walk slowly, at 3 miles an hour, you burn about 65 calories per mile. When you walk fast, at 5 miles an hour, you burn about 128 calories per mile. The faster you walk, the more energy you use with the exaggerated side-to-side motion. Fast walking can be even more vigorous than running, and you are less likely to be injured.

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Dear Dr. Mirkin: Should I follow a low-salt diet, even though my blood pressure is normal?

Many people do not suffer high blood pressure when they eat salt, and severe salt restriction can harm you. Low salt levels can raise blood pressure by causing the adrenal glands to release large amounts of aldosterone and the kidneys to release renin, and these hormones constrict arteries. Athletes who do not take in enough salt can suffer severe fatigue, and muscle damage and cramps.

A diet that is based primarily on plants (fruits, vegetables, whole grains, beans, nuts and other seeds) is naturally low in salt, even if you cook with salt or add salt at the table. Animal products are high in sodium, and processed foods and restaurant meals contribute almost 80 percent of the salt in the American diet. If you eat healthfully, exercise regularly and do not have high blood pressure, high cholesterol, diabetes or other risk factors for heart attacks and strokes, there is little evidence that you will benefit from restricting salt. Future research may change this recommendation.

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Recipe of the Week:

Portobello Mushroom Stew

List of Diana's Healthful Recipes

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June 26th, 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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