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Bad Man Break

Men Need To Be More Aware Of Bone Density

Allen was getting out of his fishing boat when he twisted his left leg and fractured two bones in his ankle.  Six weeks after ankle surgery, he landed in our clinic with considerable pain and a very limited lifestyle.  Allen reported lower back pain that he attributed to his limping and use of the boot on his left leg.  On recommendation from his physical therapist, Allen had further medical assessment of his lower back pain.  An x- ray of his lumbar spine revealed two lumbar vertebrae fractures.

On a recent vacation, Mike went on a horseback ride with his grandchildren.  During the ride, he developed pain in his upper back that “took his breath away”.  A visit to the emergency room with what he thought was a cardiac issue revealed a three-level compression fracture in his thoracic spine.  Further assessment showed significant osteoporosis in his hips, pelvis, and lumbar regions.  Allen started on some bone rebuilding medications and physical therapy.  It took over four months to fully recover from this injury.

Randy was working on his garden and fell onto the lawn.  He had right hip pain and was unable to stand.  His wife called the ambulance and he was diagnosed with a hip fracture.  Four days after the surgery to repair his hip, he suffered an embolism and at the age of seventy-one, he passed away.

All three of these older guys had testing that revealed a significant loss of bone density.  Unfortunately, the tests occurred after and not before injury onset.  We are getting better at keeping men alive longer–less smoking and better medications.  As men get older, the need to monitor bone density becomes a crucial aspect of healthy aging.  Men need fewer commercials for the latest in testosterone replacement and ED medication and more awareness of how brittle their bones can become.

The general public views osteoporosis as a “women’s health issue”, but management of osteoporosis is just as important for men.  Although men are less likely than women to sustain an osteoporosis related fracture, they are much more likely to become permanently disabled or die from the fracture.  Since 2008, the rate of osteoporosis related hip fracture in the American male population is going up at an alarming rate.

Osteoporosis is a silent disease.  Most people do not realize they have a problem until something breaks and they are in the middle of a medical crisis.  Even after a fracture, many physical therapy patients are reluctant to follow up with a bone density screening.  Being proactive is the only method of managing osteoporosis.

We know that individuals that participate in consistent resistance training exercises are more likely to have better bone density.  Just like muscle, bone is a living thing that grows stronger in response to the force that is placed upon it.  The best bone building exercise activities produce a stimulus through your skeleton.  Bone building exercises are easy to understand, but they do require more effort than swallowing a pill or having an injection.  Everyone can perform some form of bone reinforcing exercise.  Proper exercise prescription and consistent progression can work wonders.  See the trainers and physical therapists at Fenton Fitness.

Jane Brody of the New York Times wrote a helpful *article on bone density testing. It covers the latest medical guidelines for testing and the when and why of testing for both men and women.

Michael S. O’Hara, P.T., OCS, CSCS

*New York Times, July 16, 2018, Jane Brody, When to Get Your Bone Density (View Article:here)

Practical Protein

During the last five years, I’ve probably written about protein more than any other topic.  That’s largely due to the fact that along with energy intake, water intake, and a solid progressive full body strength program, very little else will have such a dramatic impact on your progress, recovery, and body composition.  Most people who read fitness articles and are regular readers of our blog understand that they need to eat protein.  My experience in nutrition coaching however, shows that many people are clueless as to how to go about this.

For starters, we need to understand what our protein intake should look like.  Many studies look at minimum requirements.  This outlook is simply looking at what is needed to avoid sickness and disease.  What we want to look at is optimal intakes to improve recovery and accumulate or retain muscle mass, as these are the metrics which will vastly improve our quality of life.  Most research in this field gives protein requirements in grams per kilogram of bodyweight.  The latest and most comprehensive Meta-analysis recommends an intake of 0.73g/lb of bodyweight.  Dr. Eric Helms presents various good points in this article which shows intakes may be able to go as low as 0.63g/lb of bodyweight and some may benefit from as high as 1.3g/lb of bodyweight.  Since most people that I talk to about protein intake are struggling to get enough, I recommend 0.6-1g/lb of bodyweight.  Leaner individuals likely need to be on the higher end, while obese and overweight individuals will probably fair just fine on the lower end.  Once you know your intake goals, you simply need to divide that amount among the number of meals you eat per day.  Here is a practical guide, with simple options if you are still under on your protein intake.  These meals can be scaled up or down based on your protein needs and will also fulfill fruit and veggie requirements for the day.

Jeff Tirrell, CSCS, CSFC, Pn1

Snack Option #1

2 oz beef/turkey/venison jerky (20-25g protein, 140-180 calories)

Snack Option #2

1 scoop Whey OR Egg OR Pea protein shake (20-25g protein, 120-140 calories)

Snack Option #3

3 string cheese OR 3 hard boiled Eggs (18g protein, 150-210 calories)

Daily Totals: 108-250g protein (1140-2631 calories)

 

Practical Protein

During the last five years, I’ve probably written about protein more than any other topic.  That’s largely due to the fact that along with energy intake, water intake, and a solid progressive full body strength program, very little else will have such a dramatic impact on your progress, recovery, and body composition.  Most people who read fitness articles and are regular readers of our blog understand that they need to eat protein.  My experience in nutrition coaching however, shows that many people are clueless as to how to go about this.

For starters, we need to understand what our protein intake should look like.  Many studies look at minimum requirements.  This outlook is simply looking at what is needed to avoid sickness and disease.  What we want to look at is optimal intakes to improve recovery and accumulate or retain muscle mass, as these are the metrics which will vastly improve our quality of life.  Most research in this field gives protein requirements in grams per kilogram of bodyweight.  The latest and most comprehensive Meta-analysis recommends an intake of 0.73g/lb of bodyweight.  Dr. Eric Helms presents various good points in this article which shows intakes may be able to go as low as 0.63g/lb of bodyweight and some may benefit from as high as 1.3g/lb of bodyweight.  Since most people that I talk to about protein intake are struggling to get enough, I recommend 0.6-1g/lb of bodyweight.  Leaner individuals likely need to be on the higher end, while obese and overweight individuals will probably fair just fine on the lower end.  Once you know your intake goals, you simply need to divide that amount among the number of meals you eat per day.  Here is a practical guide, with simple options if you are still under on your protein intake.  These meals can be scaled up or down based on your protein needs and will also fulfill fruit and veggie requirements for the day.

Jeff Tirrell, CSCS, CSFC, Pn1

Dinner Option #1

2-3 cups of spinach AND/OR Kale (2-4g protein, good for you)

4-6 ounces chicken breast OR Tuna (25-44g protein)

1 ounce shredded cheese (5-8g protein, calcium)

½-1 cup other veggies: broccoli, carrots, cucumbers, pepper, onion (1-2g protein, good for you)

2 tbsp oil/vinegar based dressing (no protein)

Optional:          Glass of 2% or Whole milk (8g protein)

glass of red wine

bread or potato

Total: 33-68g protein (450-700 calories)

 

Dinner Option #2

4-8oz baked Chicken breast, Salmon, Steak (25-65g protein)

1 medium baked potato OR 1 cup quinoa OR 1 cup rice (2-6g protein)

2 cups  green beans, asparagus, brussel sprouts (4-6g protein, good for you)

Optional:          Glass of 2% or Whole milk (8g protein)

glass of red wine

Total: 31-84g protein (360-860 calories)

 

World’s Best Diet Part 9–Fasting

If you google the word diet, you will come up with over 200,000 results.  Every week, month, year, and decade a new study or article comes out claiming certain foods are killing us, or that some other food or nutritional approach will lead us to the promised land.  Unfortunately, articles are written to create traffic, so scientific research is often misreported or spun to sell magazines or generate website traffic.  The truth is, there are many ways to skin a cat.  All of the evidence on nutrition (in regards to weight loss) points to two undeniable truths.  First, that dietary adherence is king.  It doesn’t matter how perfect or evidence based a nutrition plan is, if you can’t follow it, it doesn’t matter.  Before starting any eating plan, you must ask yourself how easy it will be to maintain long term.  Second, you must achieve an energy deficit to lose weight (eat less energy than you expend each day).  Though “calories in, calories out” may be slightly over simplified, it is still the underlying rule to any weight loss success.   For any weight loss plan to work, you must consistently follow the pla, and you must be in a caloric deficit.  This series will highlight the nine most popular current nutrition approaches, and the pros and cons of each.

Fasting

Claims: There are a ton of different approaches to fasting.  The most common are ADF (alternate day fasting) and IF (intermittent fasting).  ADF simply means that one day you eat nothing, followed by a day of standard eating.  IF is a restricted eating format where you don’t eat for a given period of time (16 hours being the most popular) followed by a feeding window where you eat regularly (8 hours in the 16 hour example above).  Every person fasts when they sleep by default, the various fasting protocols simply extend this fast one way or the other.  Purported benefits include improved insulin sensitivity, improved heart health, weight loss, better brain function, and some eve claim better performance.

Reality:  There is nothing magical about fasting.  When calories are controlled for fasting protocols seem to offer many of the health benefits that other diets show (improved heart health, improved insulin sensitivity, weight loss, etc.).  One unique potential benefit is that of life extension.  Several animal studies have shown this to be the case, but more research is needed.

Pros:No off limit foods.  Even without tracking food directly many people will eat less food by reducing the window of time in which they eat food.  This is probably one of the simplest plans to follow in concept.  If you can tell the time you can follow this plan.

Cons: No emphasis on food quality, or protein intake.  May not get enough vitamins and minerals in if you aren’t sure to emphasize getting a large amount of whole and unprocessed foods since you aren’t eating on a daily basis.  May be harder to maintain muscle mass (though research hasn’t shown this yet).  Could lead to binge eating behaviors during the feeding window in some individuals.  If this is you, this plan is not right for you.

Jeff Tirrell, CSCS, CFSC, Pn1

World’s Best Diet Part 8–The Mediterranean Diet

If you google the word diet, you will come up with over 200,000 results.  Every week, month, year, and decade a new study or article comes out claiming certain foods are killing us, or that some other food or nutritional approach will lead us to the promised land.  Unfortunately, articles are written to create traffic, so scientific research is often misreported or spun to sell magazines or generate website traffic.  The truth is, there are many ways to skin a cat.  All of the evidence on nutrition (in regards to weight loss) points to two undeniable truths.  First, that dietary adherence is king.  It doesn’t matter how perfect or evidence based a nutrition plan is, if you can’t follow it, it doesn’t matter.  Before starting any eating plan, you must ask yourself how easy it will be to maintain long term.  Second, you must achieve an energy deficit to lose weight (eat less energy than you expend each day).  Though “calories in, calories out” may be slightly over simplified, it is still the underlying rule to any weight loss success.   For any weight loss plan to work, you must consistently follow the pla, and you must be in a caloric deficit.  This series will highlight the nine most popular current nutrition approaches, and the pros and cons of each.

Mediterranean

 

Claims: This diet emphasizes plant based foods such as fruits and vegetables, whole grains, legumes and nuts.  You are encouraged to use oils instead of butter, spices/herbs instead of salt, limiting red meat to 2x/month, and moderate to low red wine consumption.  The claims are that you will see reduced mortality rates, lower many cancer risks, and improved heart health.

Reality: This is another sensible eating plan that has been around for a long time.  Emphasizing whole foods such as fruits, veggies, whole grains, nuts,  and beans should be a no brainer.  There is a body of literature (albeit correlative in nature) that shows majority of health markers improve on this style of eating plan.

Pros: Fiber rich diet focusing on veggies, fruits, grains, olive oil, nuts/seeds, and legumes.  Encourages the social aspect of eating, and doesn’t directly forbid any food.

Cons: de-emphasizes lean protein consumption  by recommending fish/poultry only be eaten 2x/week, and read meat less than 2x/month.  Following this approach could lead to inadequate protein intakes.  No emphasis on food quantities, which may lead to some people over eating these “healthy” foods.

Jeff Tirrell, CSCS, CFSC, Pn1

World’s Best Diet Part 7–Paleo

If you google the word diet, you will come up with over 200,000 results.  Every week, month, year, and decade a new study or article comes out claiming certain foods are killing us, or that some other food or nutritional approach will lead us to the promised land.  Unfortunately, articles are written to create traffic, so scientific research is often misreported or spun to sell magazines or generate website traffic.  The truth is, there are many ways to skin a cat.  All of the evidence on nutrition (in regards to weight loss) points to two undeniable truths.  First, that dietary adherence is king.  It doesn’t matter how perfect or evidence based a nutrition plan is, if you can’t follow it, it doesn’t matter.  Before starting any eating plan, you must ask yourself how easy it will be to maintain long term.  Second, you must achieve an energy deficit to lose weight (eat less energy than you expend each day).  Though “calories in, calories out” may be slightly over simplified, it is still the underlying rule to any weight loss success.   For any weight loss plan to work, you must consistently follow the pla, and you must be in a caloric deficit.  This series will highlight the nine most popular current nutrition approaches, and the pros and cons of each.

Paleo

Claims: This approach purports to mimic the way of eating during the paleolithic era.  Also known as the caveman diet, the claim is that with the agricultural revolution over the last 2000 years, our diets have outpaced our evolution.  Proponents claim that that many of our health ills today are due to the fact that we have rapidly introduced too many new foods to the homosapien diet such as grains.  The benefits claimed range from reduced disease, weight loss, more/better muscle, improved performance, no need to track intake, and pretty much everything else under the sun.

Reality: Like everything else that over promises, this meal plan falls short.  Though there is nothing inherently bad or wrong with this diet plan, there is also nothing magical.  The whole premise of the meal plan according to Christina Warinner, who is an expert on ancient diets, is false as seen in this Ted Talk.

Pros: Increases protein intake in many individuals, encourages fruit and vegetable intake.  Often time leads to weight loss due to the fact that it eliminates many foods and thus calories from the diet.

 Cons: Needlessly eliminates grains, dairy, and many starches from one’s diet. This can lead to compliance issues long term and may lead to some nutrient deficiencies.

Jeff Tirrell, CSCS, CFSC, Pn1

World’s Best Diet Part 6–Vegetarian/Vegan

If you google the word diet, you will come up with over 200,000 results.  Every week, month, year, and decade a new study or article comes out claiming certain foods are killing us, or that some other food or nutritional approach will lead us to the promised land.  Unfortunately, articles are written to create traffic, so scientific research is often misreported or spun to sell magazines or generate website traffic.  The truth is, there are many ways to skin a cat.  All of the evidence on nutrition (in regards to weight loss) points to two undeniable truths.  First, that dietary adherence is king.  It doesn’t matter how perfect or evidence based a nutrition plan is, if you can’t follow it, it doesn’t matter.  Before starting any eating plan, you must ask yourself how easy it will be to maintain long term.  Second, you must achieve an energy deficit to lose weight (eat less energy than you expend each day).  Though “calories in, calories out” may be slightly over simplified, it is still the underlying rule to any weight loss success.   For any weight loss plan to work, you must consistently follow the pla, and you must be in a caloric deficit.  This series will highlight the nine most popular current nutrition approaches, and the pros and cons of each.

Vegetarian/Vegan

Claims: These diets claim to be healthier because they eliminate animal products as a food source.  Claims are vast and include: reducing cancer risk, improved bone health, lower mortality rates, protecting against chronic disease, etc.  Vegetarian diets are those which do not include flesh/meat of animals (though some do include fish) but will typically do include dairy and eggs.  Vegans on the other hand do not consume any products that come from animals (in some cases even excluding honey).

Reality: All of the claims from Vegans and Vegetarians on superiority for health come from correlative studies which do not control for confounding variables.  They simply take a survey and use correlations to draw conclusions.  Correlative research cannot draw conclusions, it can only direct us toward areas that need further study.  Of the 6 studies to ever look at health outcomes among vegetarians and vegans, 3 showed reduced mortality for meat eaters, while 3 showed reduced mortality for non-meat eaters.  The 3 studies that showed advantage to vegetarians all compared religiously motivated groups to general population (who tend not to be overly concerned about their health).

Pros: Tends to encourage the consumption of more whole grains, fruits, and vegetables.

Cons: Often leads to inadequate amounts of protein being consumed.  Anytime entire food groups are removed, there is an increased risk of deficiencies.  In this case, the following nutrients may be compromised: B12, Vitamin D, Calcium, Iron, Zinc, and Iodine.  Protein is the most satiating macronutrient, meaning it tends to fill you up more than fats or carbohydrates.  If protein levels drop, as is often the case in these diets, the chances of over consuming calories rises.  Low muscle mass levels are a risk due to inadequate protein intake.  In my experience, I have only met 2 (out of around 30) vegetarians over the last 20 years who were not either overweight and/or under muscled.

Jeff Tirrell, CSCS, CFSC, Pn1

World’s Best Diet Part 5–The South Beach Diet

If you google the word diet, you will come up with over 200,000 results.  Every week, month, year, and decade a new study or article comes out claiming certain foods are killing us, or that some other food or nutritional approach will lead us to the promised land.  Unfortunately, articles are written to create traffic, so scientific research is often misreported or spun to sell magazines or generate website traffic.  The truth is, there are many ways to skin a cat.  All of the evidence on nutrition (in regards to weight loss) points to two undeniable truths.  First, that dietary adherence is king.  It doesn’t matter how perfect or evidence based a nutrition plan is, if you can’t follow it, it doesn’t matter.  Before starting any eating plan, you must ask yourself how easy it will be to maintain long term.  Second, you must achieve an energy deficit to lose weight (eat less energy than you expend each day).  Though “calories in, calories out” may be slightly over simplified, it is still the underlying rule to any weight loss success.   For any weight loss plan to work, you must consistently follow the pla, and you must be in a caloric deficit.  This series will highlight the nine most popular current nutrition approaches, and the pros and cons of each.

The South Beach Diet

Claims: The South Beach Diet says that its balance of good carbs, lean protein, and healthy fats makes it a nutrient-dense, fiber-rich diet that you can follow for a lifetime of healthy eating.  It focuses on eliminating “bad” carbs that are high on the glycemic index scale (meaning these foods increase blood sugar quickly when eaten in isolation).  The diet also encourages the consumption of monounsaturated fats, limiting “unhealthy” fats, and consuming whole grains and other fiber rich foods.  The diet is set up in 3 phases.  Phase 1 eliminates virtually all carbohydrates and is claimed to help eliminate cravings. Phase 2 re-introduces “healthy” carbs and is the weight loss phase.  Phase 3 is the maintenance phase where you continue to use what you learned to do in the first two phases, but other foods can also be eaten in moderation.

Reality: This is another sensible meal plan which allows for eating a balance of lean protein, whole grains, and variety of fat sources.  The only fault with this program is the emphasis on low glycemic carbohydrates.  The Glycemic Index is based on what foods do in isolation.  If other foods are eaten in conjunction with these items, the blood sugar response can be greatly altered.  On top of that, even if a food does rapidly increase blood sugar, it doesn’t inherently make it a poor food choice, and weight loss can still be achieved with these foods assuming portions are monitored.

Pros: Encourages lean protein consumption, fiber rich foods, whole grains, and variety of fat sources.

Cons: Creates an undue fear of certain types of carbohydrates and doesn’t directly advise on portion sizes.

Jeff Tirrell, CSCS, CFSC, Pn1

In the April 2018 issue, Mike O’Hara discusses the benefits of the farmer’s walk exercise. Jeff Tirrell tells you how to reduce injury to your ligaments and tendons, and tips are given for getting back out into the garden.

Download Here

World’s Best Diet Part 4–IIFYM

If you google the word diet, you will come up with over 200,000 results.  Every week, month, year, and decade a new study or article comes out claiming certain foods are killing us, or that some other food or nutritional approach will lead us to the promised land.  Unfortunately, articles are written to create traffic, so scientific research is often misreported or spun to sell magazines or generate website traffic.  The truth is, there are many ways to skin a cat.  All of the evidence on nutrition (in regards to weight loss) points to two undeniable truths.  First, that dietary adherence is king.  It doesn’t matter how perfect or evidence based a nutrition plan is, if you can’t follow it, it doesn’t matter.  Before starting any eating plan, you must ask yourself how easy it will be to maintain long term.  Second, you must achieve an energy deficit to lose weight (eat less energy than you expend each day).  Though “calories in, calories out” may be slightly over simplified, it is still the underlying rule to any weight loss success.   For any weight loss plan to work, you must consistently follow the pla, and you must be in a caloric deficit.  This series will highlight the nine most popular current nutrition approaches, and the pros and cons of each.

IIFYM (If It Fits Your Macros)

 

Claims: The IIFYM diet approach shares many characteristics with Zone and Weight Watchers.  It has its roots from the bodbuilding.com forums back in the 2004-2008 time.  At this time, many forum posters would routinely ask if it was ok to eat a given food while dieting and trying to decrease body fat.  There was a notion (and still is) that certain foods are totally off limits and ignorance of the role of energy balance and protein intake on success.  IIFYM can be different for everyone, but the basic premise is the same.  You have a certain target for total calories, protein, carbohydrates, and fat that you need to hit to be successful with your weight loss goals.  As long as those numbers are hit, then the food quality and micronutrients don’t matter.

Reality: If you hit a given caloric intake target below your maintenance intake needs for long enough, you will absolutely lose weight, regardless of food quality.  If you  hit a certain protein intake this will ensure that you are less likely to lose muscle mass in the process.  Carbohydrate and fat intakes will be dictated by food preference and performance goals.  There have been countless case studies proving that calorie intake is king ( Twinkie Diet , McDonald’s Diet , 100 Day Ice cream Diet ).

Pros: Allows lots of dietary flexibility.  Gives protein minimums.  Encourages accurate tracking of foods and quantity.

Cons: Potentially ignores food quality and micronutrient intake.  Many people have taken this approach as a pass to eat low nutrient foods as long as they are hitting their targets.  Can leave people feeling trapped if they can’t accurately measure or track a food at a social event or restaurant.

Jeff Tirrell, CSCS, CFSC, Pn1

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