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Dizziness in Exercisers

Athletes and other very fit people may feel dizzy when they rise from lying to standing because of their slow pulse rates. Exercise makes your heart stronger so it can pump more blood with each beat and it doesn't have to beat as often. A slow pulse rate can be good. Since your heart doesn't beat as often, it has more time to rest between beats. Like a low-mileage used car, perhaps this will mean it takes longer to wear out. But a slow heart rate can make you dizzy when you change position.

When you raise yourself from lying to sitting, or from sitting to standing, the force of gravity pulls blood down from your brain towards your feet and your blood can't get back to your brain until your next heart beat. If you have a pulse rate of only 50 beats a minute, it will take more than a second between beats. That can be enough time for your brain to suffer briefly from a lack of oxygen, so you feel dizzy. You can even pass out while you wait for your next heartbeat to come along and pump blood back up to your brain.

Dizziness can also be a sign of an irregular heartbeat or blocked arteries leading to your brain, so people who feel dizzy when they get up should check with their doctors. If they are athletes, chances are that they only have a strong athletic heart with a slow rate, and all they need to do is remember to get up slowly.

Dizziness can also be caused by dehydration, particularly in those who take diuretics.

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Dear Dr. Mirkin: If I avoid all foods that contain cholesterol, will my high cholesterol return to normal?

No. Your blood cholesterol level is influenced far more by how many calories and how much saturated and partially hydrogenated fat you eat, than by how much cholesterol is in your food. Cholesterol is found only in foods from animals, such as meat, fish, chicken, dairy products and eggs. It is not found in plants. More than 80 percent of the cholesterol in your body is made by your liver. Less than 20 percent comes from the food that you eat. When you eat more cholesterol, your liver makes less.

Your liver makes cholesterol from saturated fats, which are found in most foods but are concentrated in meat, poultry and whole-milk dairy products. The saturated fat is broken down by your liver into acetone units. If you are not taking in too many calories, your liver uses the acetone units for energy, but if you are taking in more calories than your body needs, your liver uses these same acetone units to manufacture cholesterol. That explains why eating two eggs a day does not raise blood cholesterol levels in the average American. They are already taking in so much cholesterol from meat, fish and chicken and diary products, that when they take in more, they absorb less.

The average North American takes in 350 mg per day of cholesterol. If he takes in 26 mg per day, he absorbs 41 percent. When he takes in 188 mg cholesterol per day, he absorbs only 36 percent, and when he takes in 421 mg per day (the equivalent of two eggs), he absorbs only 25 percent. Some people absorb more than five times as much as other people at the same intake. So you lower blood cholesterol levels far more effectively by eating less food, less saturated fat and less partially hydrogenated fats than by avoiding foods that contain cholesterol.

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Dear Dr. Mirkin: Won't exercising increase my chances of needing joint replacement surgery when I'm older?

Actually, recreational exercisers have a much lower incidence of knee replacements than people who don't exercise. In one study from Finland, the more years a person exercised, the less likely he was to require a knee replacement. Regular exercise strengthens bones and joints and helps to prevent damage to the joints. Yet other studies have shown that former competitive athletes have the highest rate of knee replacements. Athletic competition requires a person to compete on preset days, whether he is injured or not. Competition requires year- round training and athletes hate to take days off, so they often train and compete while injured. It is amazing how many coaches preach mental toughness and the ability to exercise through pain, when this kind of thinking often results in catastrophic injuries that damage million-dollar athletes permanently. When knee pain or any other pain worsens as you exercise, go home so you can exercise again another day.

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Clementines (those small tangerine-like citrus packed in boxes) are great for snacking, dessert or in fruit salads. This year's crop is tasty, juicy and plentiful -- prices are low!. They also make a wonderful addition to almost any salad. Here are some recipes to get you started:

Clementine-Wild Rice Salad
Clementine-Black Bean Salad
Spinach Salad with Clementines
Clementine-Quinoa Salad
Fennel Salad with Clementines

For more information about clementines, read:
Basic Clementine Info

Complete List of Diana's Healthful Recipes

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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