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Heavier Weights or More Repetitions?

Older people gain more muscle strength by spending more time lifting weights, whereas younger people gain more muscle strength by lifting heavier weights. In younger men, doubling exercise volume by spending more time lifting weights produced limited added muscle enlargement. In older men, it resulted in much larger muscles and far more strength (The Journals of Gerontology, August 2012).

EVERYONE LOSES MUSCLE WITH AGING: Everyone becomes weaker and loses muscles with aging. You can slow down this loss of progressive weakness and even enlarge muscles by exercising against resistance as you age (The Journals of Gerontology, August 2012), but not by eating more protein (Clin Interv Aging, July 2012;7:225 - 234).

Expect to lose strength and muscle size as you age. Muscles are made up of thousands of individual fibers, like a rope that is made of many threads. Each muscle fiber is innervated by a single nerve. With aging you lose nerves, and each nerve that you lose also causes you to lose the muscle fiber that is innervated by that nerve. When you were 20 years old , the vastus medialis muscle in your thigh had 800,000 fibers. At age 60, it will have fewer than 250,000.

HOW YOU CAN MAKE MUSCLES LARGER. Just exercising does not make you stronger. You cannot grow a lot of new muscle fibers as you age. However, you can markedly enlarge the existing muscle fibers that you have by lifting heavy weights or pressing against progressively greater resistance. When you press against increasingly heavier weights, you damage your muscle fibers and feel sore on the next day. Then you lift very light weights for as many days as it takes for the muscles to heal and the soreness to go away. Only then do you lift heavy again.

OLDER PEOPLE SHOULD JOIN A GYM AND LEARN HOW TO USE STRENGTH TRAINING MACHINES. First check with your doctor to make sure you do not have a condition that will be harmed by vigorous exercise. Then join a gym and ask for instructions how to use the weight machines.

As a general rule, on each machine, you will try to lift a weight 10 times in a row, rest a minute, and then do two more sets of 10. In the beginning, you should lift very light weights and go home without your muscles feeling sore. However, after a few weeks of lifting weights three times a week (never on consecutive days), you should be able to add more weight to each lift. Eventually you should feel some muscle soreness during and after lifting, and the soreness should go away in 48 hours and before your next workout.

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Chocolate Milk Is Not the Best Exercise Drink

Recent research show that drinking chocolate milk immediately after exercising can help you recover faster from workouts (Int J Sport Nutr Exerc Metab, 2006 Feb; 16(1):78-91; J Strength Cond Res, 2011;25(5):1210-1224). That is true, but chocolate milk is not more effective than any other source of sugar, protein and caffeine.

Chocolate contains epicatechin, which increases endurance in mice (J Physiol, July 25, 2011). Milk contains the double sugar lactose (glucose and galactose bound together into a single molecule), so you absorb these sugars which cause a rise in blood sugar and the pancreas responds by releasing large amounts of insulin.

Insulin drives amino acids into muscle cells to help them recover faster from hard exercise. Chocolate milk contains a small amount of caffeine. Caffeine markedly increases the absorption of sugar from the bloodstream into muscle cells, but you can get this benefit from any source of caffeine. You must take sugar, amino acids and caffeine within an hour of finishing exercise to gain maximum benefit in recovering faster from hard exercise. Chocolate milk offers no benefits over any other food source of carbohydrates, protein and caffeine. You can get sugar from fruit; protein from meat, fish ,chicken, or corn and beans; and caffeine from tea, coffee, colas or chocolate.

POTENTIAL HARM FROM CHOCOLATE MILK WHEN YOU ARE NOT EXERCISING: You certainly should not drink a lot of chocolate milk when you are not exercising. Pure chocolate is very bitter, so manufacturers add sugar and saturated fats that should not be taken when you are not exercising. Eating refined sugar when you are not exercising causes a high rise in blood sugar that can damage every cell in your body. Milk also contains saturated fats from animals that can block insulin receptors to prevent insulin from clearing sugar from your bloodstream, to raise blood sugar levels even higher.

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Does Eating Eggs, Fish or Chicken Increase Heart Attack Risk?

Most recent research suggests that dietary cholesterol is not a major risk factor for heart attacks while dietary saturated fats are; and that eating meat is a major risk factor for heart attacks, while eating chicken or fish are not. However, two new studies raise fresh concern about eating eggs, poultry and seafood.

• In one study, the authors reviewed most of the world's literature and found only eight adequately controlled studies out of 124 that measured the effects of meat, fish and chicken on blood cholesterol levels (J Clin Lipidol, July 2012;6(4):352-61). Blood cholesterol levels were the same for those who ate beef, poultry or fish.

• A Canadian study shows that eating egg yolks increases risk for plaque buildup in neck arteries, a major risk factor for heart attacks (Atherosclerosis, published online August 14, 2012). Neck artery plaque buildup increases with aging, and the more egg yolks a person ate, the greater the increase in plaques.

EGGS: Eggs increase the good HDL cholesterol that protects against heart attacks, as well as the bad LDL cholesterol that increases heart attack risk. The National Heart Blood and Lung Institute recommends limiting dietary cholesterol less than 300 mg/day (one egg yolk has 250 mg). We have no data today to show that eating eggs occasionally is harmful, but we do not know how many eggs a week a person can eat without increasing risk for a heart attack.

POULTRY: We do not have the extensive data on the harmful effects of poultry that we have against red meat, so doctors cannot reasonably tell you to avoid chicken. It is reasonable to include chicken in your diet as long is it is not fried. Burning fat causes the formation of aromatic hydrocarbons that are known carcinogens.

SEAFOOD: Most research shows that eating deep-water fish is healthful, but this study suggests that eating fish may raise cholesterol. Deep water fish contain omega-3 fatty acids that help to prevent clotting and heart attacks. Omega-3 fatty acids come from algae, and the only fish that contain omega-3 fatty acids are those that eat algae or other fish that have eaten algae. Farm-fed catfish or tilapia that are raised on corn instead of fish meal have no more omega-3's than chicken. I think that it is reasonable to eat deep-water fish, but not to eat large amounts of catfish or tilapia.

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Injections of Hyaluronic Acid into Knee Joints Do Not Relieve
Pain Significantly and Do Not Delay Knee Replacement

Hyaluronic acid injected into the knee joint to relieve knee pain is called viscosupplementation. A review of 89 different studies involving 12,667 adults shows that viscosupplementation is associated with a small and irrelevant relief of pain and an increased risk for serious adverse events such as increased pain and infections (Ann Intern Med, 2012 Aug 7;157(3):180-91).

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Sugared Drinks Linked to Heart Attacks, High Blood
Pressure and Gout

The authors evaluated 2727 adolescents in 36 Junior High schools in Taiwan. They found that 87.7 percent of adolescents drank sugar sweetened beverages and 25.1 percent drank more than 500 ml per day. The more sugared drinks an adolescent drank, the greater the increase in waist and hip circumferences, body fat, percent body fat, blood pressure, and blood levels of uric acid that cause gout (International Journal of Obesity, published online Aug 14, 2012).

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This week's medical history:
How Did Stalin Die

For a complete list of my medical history biographies go to Histories and Mysteries

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Recipe of the Week:

Trail Mix Bars

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

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August 19th, 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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