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Ibuprofen Harms Intestines during Exercise; Aspirin Does Not

A study from the Netherlands shows that taking Ibuprofen before intense exercise increases bleeding from the intestines (Medicine & Science in Sports & Exercise, December 2012). This can interfere with a person's training program by delaying recovery from intense exercise.

BLOOD TEST MEASURES INTESTINAL DAMAGE: When intestines are damaged, blood leaks from the intestines into the bloodstream. This can be measured by a blood test called "Intestinal Fatty Acid Binding Protein I-FABP). The author demonstrated that blood levels of I-FABP rise during intense exercise and remain elevated only for up to one hour after a person finishes exercising intensely. This shows that the damaged intestines heal within an hour.

STRENUOUS EXERCISE CAN DAMAGE INTESTINES: Strenuous exercise itself, without Ibuprofen, can damage the intestines. For example, cyclists who rode hard and fast for an hour immediately developed elevated blood levels of I-FABP (PLoS One, July 2011;6(7):e22366).

During intense exercise, large amounts of blood must be pumped to bring oxygen to muscles. The body gets the extra blood by shutting off blood flow to the intestines. The decreased blood flow to the intestines deprives intestinal cells of oxygen and they are damaged and not able to absorb food inside the intestines. This also explains why intense exercise can cause abdominal cramps, nausea, diarrhea and gastrointestinal bleeding in some people.

HOW IBUPROFEN DELAYS MUSCLE RECOVERY FROM EXERCISE: Knowledgeable training for sports is based on a stress-and-recover program. You take a hard workout that is intense enough to cause muscle damage, as evidenced by muscle burning during the workout and soreness eight to 24 hours afterwards. Then you take less intense workouts until the soreness goes away. Then you take your next intense workout.

Skeletal muscles are composed of thousands of muscle fibers. Each fiber is a long rope made up of a series of thousands of similar blocks called sarcomeres, lined end to end to form a long chain. Each block attaches to the next sarcomere at the "Z line". Muscles function by shortening a little bit at each of the thousands of "Z lines". The "Z lines" all shorten simultaneously and the entire muscle then can contract. The "Z lines" are where muscles are damaged. It is damage to these "Z lines" that causes muscle growth after healing, which makes muscles stronger. (Diagram at )

Muscles recover much faster from intense exercise when you take sugar and protein within one hour after finishing exercise. Exercise markedly increases sensitivity to insulin for about an hour after you finish exercising. This effect tapers off rapidly after that. Taking sugar causes a rise in insulin. Insulin drives amino acids from protein into muscle cells to help them heal faster.

The intestinal damage caused by Ibuprofen can interfere with absorption of food from the intestines and delay recovery and healing.


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Why Diet and Exercise Help to Prevent and Treat Diabetes, while
Liposuction Usually Does Not

Liposuction means that a surgeon cuts fat from your body or removes it with a suction machine. Liposuction does not treat or prevent diabetes because it usually removes fat from underneath your skin, which does not prevent diabetes; and not from around your organs, which would help to prevent diabetes. Removing fat from underneath your skin causes the fat to return later around your organs and in your belly. (Obesity, May 2011;19:1388-1390).

Your body stores fat:
• around and in the organs,
• in your belly,
• underneath your skin, and
• in your muscles.

Excess fat around the organs in your belly and in your liver, prevents your cells from responding to insulin to cause diabetes, heart attacks and premature death. Excess fat underneath your skin or in your muscles has not been shown to increase risk for diabetes and its complications.

Surgically removing fat around your organs inside your belly helps to prevent diabetes, while surgical removal of fat underneath the skin of the belly, or anywhere else, does not prevent diabetes or lower high blood pressure, high blood sugar or insulin. Liposuction usually takes out fat underneath your skin. This has not been shown to have any benefit for treating or preventing diabetes.

HOW FULL FAT CELLS INSIDE YOUR BELLY CAUSE DIABETES: Almost everyone with a fat belly and small hips either has or will soon develop diabetes. Fat cells in your belly turn on your immunity to cause inflammation, while fat underneath your skin turns off your immunity to decrease inflammation. Inflammation contributes to diabetes, heart attacks and premature death.

Fat around the organs in your belly is like a giant gland that sends out hormones called pro-inflammatory cytokines, such as TNF-alpha and IL-6, that turn on your immunity to prevent your body from responding to insulin. Belly fat:
• is associated with lower testosterone in both men and women
• is associated with higher levels of hormones that cause inflammation: growth hormone, IGF-1 and insulin
• increases with excessive intake of carbohydrates or saturated fat
• is associated with lack of exercise
• is associated with aging
• is associated with high levels of small-dense LDL-cholesterol particles that are linked to diabetes
• is associated with high blood levels of triglycerides
• is associated with low levels of HDL-cholesterol

STORING FAT IN YOUR THIGHS AND BUTTOCKS IS GOOD: Having fat in your hips and upper legs (instead of your belly) helps to prevent heart attacks and diabetes. It is associated with decreased formation of plaques in your arteries. Small hips or buttocks are an independent risk factor for diabetes, even if you are not overweight.

EXERCISE REDUCES BELLY FAT: Both lifting weights and continuous aerobic exercise reduce belly organ fat. Most fat lost during the first two weeks of calorie restriction or exercise is from around belly organs.


Clogged Arteries

Please take a minute to watch this short video of plaque
being removed from an artery
. I hope it will encourage you to make
some New Year's Resolutions about your diet and exercise program.


This week's medical history:
What Killed Alexander the Great?

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


Recipe of the Week:

Pink Beans and Brown Rice

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


December 30th, 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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