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How to Recover Fast from Grueling Endurance Exercise

Bradley Wiggins, the winner of the just-completed 2235- mile, 21-day 2012 Tour de France, states that the most important way to recover from grueling endurance sports is to eat as much as you can, as soon as you can, after you finish each competition.

That does not mean that you have to spend your money on expensive special recovery drinks or foods. A study from Oxford University in England shows that advertised claims about performance-enhancing sports drinks are usually not supported by scientifically relevant studies and that more than 84 percent of studies mentioned by the product sellers are studies supported financially by the sellers. (British Medical Journal Open July 18, 2012).

DEFINITION OF FATIGUE: The horrible muscle tiredness that you feel after a day pedaling on the roads in a race like The Tour de France is caused by:
• using up the sugar stored in your muscles and
• damage to your muscle fibers themselves.

THE ROAD TO RECOVERY: To recover the fastest from a hard exercise session, you have to take in huge amounts of fluids and eat huge amounts of food containing:
• carbohydrates,
• protein and
• salt during your race and immediately after you finish exercising, and continue to eat for several hours after that (J Strength Cond Res, 2011 Nov; 25(11):3198-204).

REFILLING MUSCLE GLYCOGEN: Exercise fatigue is caused by using up your stored muscle sugar called glycogen. The faster you refill your muscles with their stored glycogen, the faster you recover for your next intense exercise session (J Strength Cond Res, 2003 Feb ; 17(1):12-9). You will recover much faster if you take carbohydrate drinks and foods early during and throughout your race, than if you take the carbohydrates only late in your race (Med Sci Sports Exerc, 1996 Oct; 28(10):1300-4).

CAFFEINE: Taking caffeine, found in coffee, tea, and chocolate, markedly increases the rate that your muscles replace their used up stored glycogen (J Appl Physiol, 2008 Jul; 105(1):7-13). Caffeine increases the rate that carbohydrates travel from your intestines into your bloodstream. That's why several recent studies show that chocolate milk is an excellent recovery drink, because milk contains sugar and protein, and chocolate contains caffeine.

PROTEIN: You also need to take in foods that contain protein to supply the amino acids that are necessary to heal muscles damaged by hard exercise. (J Appl Physiol, 2002 Oct; 93(4):1337-44). You do not need any special protein supplements as the "Addition of protein and amino acids to carbohydrates does not enhance post-exercise muscle glycogen synthesis" (J Appl Physiol, 2001 Aug; 91(2):839-46). It is well established that refilling muscles with glycogen depends on eating a huge amount of carbohydrate-containing foods. Muscles did not replenish their stored glycogen any faster by adding supplementary protein and the amino acid, arginine (MAGMA, 2000 Dec; 11(3):114-21).

WHY RECOVERY FOODS MUST CONTAIN BOTH PROTEIN AND CARBOHYDRATES: Carbohydrates are just single sugars and chains of sugars. Before any carbohydrates can be absorbed into your bloodstream, the chains must first be broken down into single sugars. The sugars cause a high rise in blood sugar. The sugar goes into your bloodstream and then into your muscles where they quickly form stored sugar called muscle glycogen. The rise in blood sugar also causes the pancreas to release large amounts of insulin. Insulin drives the protein building blocks called amino acids into your muscles and helps the damaged muscle fibers to heal faster.

WHAT SHOULD YOU EAT TO RECOVER FASTER? As soon as you finish a long, hard race, immediately start to eat huge amounts of fruits and vegetables. They are loaded with sugar and fiber. You can also get all the protein you need from beans and whole grains. You do not have to eat meat, fish, or chicken for protein. In the 1970s, Wayne and Dale Stetina from Indianapolis, Indiana were among America's greatest bicycle racers. They were vegetarians. You also need to replace large amounts of salt, so salt everything you eat.

EAT PLANTS TO PREVENT BELLY CRAMPS: You should eat lots of foods from plants since all plants contain carbohydrates. A great advantage of eating lots of plants in your recovery meal is that all plants are rich sources of fiber. Fiber is the broom that sweeps your colon. Belly cramps during racing are almost always caused by residual food in the colon. Cramps in exercisers almost always have nothing to do with your stomach. Eating a diet loaded with foods from plants fills your colon with fiber. The next morning, get up early and eat breakfast. Food in your stomach causes the gastro-colic reflex that forces your colon to contract. Then go to the bathroom and you should have no difficulty emptying your colon. This should prevent belly cramps.

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If You Don't Exercise, Check with Your Doctor and Start an
Exercise Program Immediately

A single exercise session increases insulin sensitivity in non-exercising adolescents (which can lower high blood sugar levels) (Pediatr Diabetes, Jul 23, 2012). This is incredible! Forty percent of all North Americans now become diabetic.

As you age, your fasting blood sugar rises. Up to age 35, fasting blood sugar levels are the same for people who exercise regularly and those who do not. However, after age 35, the more you exercise, the lower your fasting blood sugar levels, and the more protected you are from the side effects of high blood sugar levels, including dementia, heart attacks and certain cancers (Ann Epidemiol, July 13, 2012).

Diabetes means that your blood sugar rises too high after you eat. A high rise in blood sugar causes sugar to stick to the outer surface membranes of cells and destroy them to damage every tissue in your body.

Resting muscles draw no sugar from the bloodstream. So if you sit around all day long, you have no protective mechanism to prevent your blood sugar from rising too high and damaging your cells. On the other hand, contracting muscles can draw sugar from the bloodstream without even needing insulin. This effect is maximal while you exercise and up to an hour after you finish exercising and disappears complete after around 17 hours. So to prolong your life and help prevent heart attacks, cancers and premature death, keep your muscles moving.

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HIV and HPV: Increased Risk from Having Multiple Sexual Partners

Risky sexual behavior among U.S. high school students is very common. At the International AIDS Society's annual conference in Washington DC (July 24, 2012), the National Youth Risk Behavior Survey by the Centers for Disease Control and Prevention showed that 47 percent of high school students have sexual relations and that fewer than 40 percent use condoms.

The number of students who admitted to having multiple sexual partners has not dropped in the last 15 years. Almost 50 percent of new cases of HIV infections occur in people under 30 years of age, and 1.1 million North Americans are infected with the virus that has no cure, and causes almost certain premature death. Most people with multiple partners carry Human Papilloma Viruses (HPV) that cause virtually all cases of cervical cancer and many cancers of the skin, vagina, penis, anus, mouth, nose, lymph nodes, head and neck.

HOW DO YOU GET HPV? You acquire HPV through direct skin to skin contact with an infected person, usually through vaginal, penile, oral, or anal sexual contact, even if a person has no warts. The more sexual partners you have, the more likely you are to be infected. Using condoms helps reduce your chances of becoming infected, but does not offer complete protection. Six million North Americans are newly infected with HPV each year, Twenty million are infected now with HPV, and more than 80 percent of sexually-active men and women have been infected.

GENITAL WARTS ARE CAUSED BY HPV. There are more than 150 different types of HPV. Infection with one type of HPV makes you immune to that virus so that once you clear that virus, you are not likely to ever become infected with that specific virus again. However, being infected with one type of HPV does not protect you from developing any of the other types.

Each additional sexual exposure increases your chances of acquiring additional HPV viruses and the specific viruses that are most likely to cause cancer. You can have several different HPV virus types at the same time. Infected people who continue to have the most sexual contacts are the ones most likely to continue to be infected with HPV, as each new exposure carries risk for a new infection.

THE NATURAL COURSE OF HPV: Doctors cannot cure HPV, they can only destroy the warts caused by these viruses with chemicals or remove them with surgery. Most people clear a specific HPV within 6 to 9 months of becoming infected (Am J of Ob and Gyn, 2000;183(3): 561-567). However some people never clear the high- risk HPV types and it is the persistent infections that can lead to cancers (Trends in Microbiology, 2011(Jan);19(1):33-39).

WHICH HPVs CAUSE CANCER? Of the more than 150 different HPV viruses, the ones most likely to cause cancers are types 16, 18, 52 and 59. They are also the ones that persist the longest, and are most likely to cause cancers and abnormal PAP smears. Most women who are infected with HPV will not develop a positive PAP test.

IMMUNIZATION: Immunization protects you from infection with the viruses in that vaccine. It does not protect you from the more than 150 HPVs not in the vaccine. High-risk HPV subtypes are associated with most cervical cancers. Each of the two vaccines against HPV contains two of the high risk HPVs.

HOW COMMON IS HPV? It is the most common sexually transmitted disease. Your risk for acquiring HPV can be as high as 15 percent per sexual contact. More than 90 percent of sexually- active people have been infected with HPV, and more than 50 percent of people infected with HPV have more than one HPV virus (The Journal of Infectious Diseases, published online Nov. 4, 2011).

MOST PEOPLE WITH GENITAL WARTS DO NOT DEVELOP CANCERS. Fewer than five percent of the 49,000 people with genital warts developed cancers over 30 years of follow-up. However, men with genital warts had a 21-times increased risk for anal cancer. One percent of those with genital warts developed non-melanoma skin cancer.

NOT ALL HPV VIRUSES CAUSE CANCERS. Genital HPV are classified as low-risk and high-risk for causing cancers. Low- risk HPV types (6, 11, 42, 43, 44, 54, 61, 70, 72, and 81) are virtually never found in cancers. High-risk HPV types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, and 82) have been found in cancers of the cervix, vagina, vulva, anus, and penis. More than 80 percent of cervical cancers are caused by types 16, 18, 31, and 45.

WHY MOST PEOPLE INFECTED WITH HPV DO NOT DEVELOP CANCERS: Most infected people clear HPV from their bodies in six to nine months. Continued exposure to new partners brings new infections with new viruses. The more contacts you have, the more viruses you acquire.

We do not have strong data to explain why some people clear HPV from their bodies while others continue to be infected. We do know that 6.9 percent of North Americans, 14 to 69 years of age, are now infected with HPV in their mouths and that the more cigarettes you smoke, and the more sexual partners you have, the more likely you are to carry these viruses (JAMA. 2012;307(7):693- 703). Having infections with other germs increases cancer risk. For example, being infected with chlamydia as well as HPV increases cancer risk (Cancer Epidemiol Biomarkers, published online October 12, 2011).

WHAT YOU SHOULD DO IF YOU ARE INFECTED WITH HPV: The vaccine against HPV is totally ineffective if you already have those specific HPVs. However it can help protect you against the viruses that you have never had. Those who are infected with HPV should do everything they can to help strengthen their immunities to help it clear the virus from their bodies. The following steps have not been proven to protect you against HPV, but they have been shown to strengthen your immunity and to help protect you against certain cancers, heart attacks and premature death:
• exercise,
• eat lots of fruits and vegetables,
• treat any other infections (genital symptoms are often caused by genital infections),
• limit the number of sexual partners,
• do not smoke,
• do not take more than two alcoholic drinks a day,
• restrict sugared drinks and foods with added sugars,
• restrict red meat,
• restrict fried foods,
• avoid overweight.

For my previous reports on HPV see:

Multiple Partners Increase Risk of Oral HPV

The More Sexual Partners You Have, the More HPV You Acquire
(second section)

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Recipe of the Week:

Mediterranean Seafood Stew

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

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July 29th, 2012
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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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