After 10 minutes of exercise, hour-long boost

WASHINGTON — Ten minutes of brisk exercise triggers metabolic changes that last at least an hour. The unfair news for panting newbies: The more fit you are, the more benefits you just might be getting.

We all know that exercise and a good diet are important for health, protecting against heart disease and diabetes, among other conditions. But what exactly causes the health improvement from working up a sweat or from eating, say, more olive oil than saturated fat? And are some people biologically predisposed to get more benefit than others?

They’re among questions that metabolic profiling, a new field called metabolomics, aims to answer in hopes of one day optimizing those benefits — or finding patterns that may signal risk for disease and new ways to treat it.

“We’re only beginning to catalog the metabolic variability between people,” says Dr. Robert Gerszten of Massachusetts General Hospital, whose team just took a step toward that goal.

The researchers measured biochemical changes in the blood of a variety of people: the healthy middle-aged, some who became short of breath with exertion, and marathon runners.

First, in 70 healthy people put on a treadmill, the team found more than 20 metabolites that change during exercise, naturally produced compounds involved in burning calories and fat and improving blood-sugar control. Some weren’t known until now to be involved with exercise. Some revved up during exercise, like those involved in processing fat. Others involved with cellular stress decreased with exercise.

Those are pretty wonky findings, a first step in a complex field. But they back today’s health advice that even brief bouts of activity are good.

“Ten minutes of exercise has at least an hour of effects on your body,” says Gerszten, who found some of the metabolic changes that began after 10 minutes on the treadmill still were measurable 60 minutes after people cooled down.

Your heart rate rapidly drops back to normal when you quit moving, usually in 10 minutes or so. So finding lingering biochemical changes offers what Gerszten calls “tantalizing evidence” of how exercise may be building up longer-term benefits.

Back to the blood. Thinner people had greater increases in a metabolite named niacinamide, a nutrient byproduct that’s involved in blood-sugar control, the team from Mass General and the Broad Institute of MIT and Harvard reported last week in the journal Science Translational Medicine.

Possible to tweak metabolic process?

Checking a metabolite of fat breakdown, the team found people who were more fit — as measured by oxygen intake during exercise — appeared to be burning more fat than the less fit, or than people with shortness of breath, a possible symptom of heart disease.

The extremely fit — 25 Boston Marathon runners — had ten-fold increases in that metabolite after the race. Still other differences in metabolites allowed the researchers to tell which runners had finished in under four hours and which weren’t as speedy.

“We have a chemical snapshot of what the more fit person looks like. Now we have to see if making someone’s metabolism look like that snapshot, whether or not that’s going to improve their performance,” says Gerszten, whose ultimate goal is better cardiac care.

Don’t expect a pill ever to substitute for a workout — the new work shows how complicated the body’s response to exercise is, says metabolomics researcher Dr. Debbie Muoio of Duke University Medical Center.

But scientists are hunting nutritional compounds that might help tweak metabolic processes in specific ways. For example, Muoio discovered the muscles of diabetic animals lack enough of a metabolite named carnitine, and that feeding them more improved their control of blood sugar. Now, Muoio is beginning a pilot study in 25 older adults with pre-diabetes to see if carnitine supplements might work similarly in people who lack enough.

Next up: With University of Vermont researchers, she’s testing how metabolic changes correlate with health measures in a study of people who alternate between a carefully controlled Mediterranean diet and higher-fat diets.

“The longterm hope is you could use this in making our way toward personalized medicine,” Muoio says.

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For women, fighting flab requires an hour a day

CHICAGO — Rev up the treadmill: Sobering new research spells out just how much exercise women need to keep the flab off as they age — and it’s a lot.

At least an hour of moderate activity a day is needed for older women at a healthy weight who aren’t dieting. For those who are already overweight — and that’s most American women — even more exercise is called for to avoid gaining weight without eating less, the study results suggest.

“We all have to work at it. If it were easy to be skinny, we would all be skinny,” said John Foreyt, a behavioral medicine expert who reviewed the study but wasn’t involved in the research.

Brisk walking, leisurely bicycling and golfing are all examples of moderate exercise. But don’t throw in the towel if you can’t do those things for at least an hour a day. Even a little exercise is good for your health even if it won’t make you thin, the researchers said.

Their findings are based on 34,079 non-dieting middle-aged women followed for about 13 years. The women gained an average of almost 6 pounds during the study.

Those who started out at a healthy weight, with a body mass index less than 25, and who gained little or no weight during the study consistently got the equivalent of about an hour of moderate activity daily. Few women — only 13 percent — were in this category.

Few already overweight women got that amount of exercise, and the results suggest it wasn’t enough to stop them from gaining weight.

The results echo what gymfuls of middle-aged American women see every time they step off the treadmill and onto the scale.

“Talk to any group of women and they all say the same thing,” said Janet Katzin, 61, a “slightly overweight” marketing director from Long Island who exercises for an hour twice a week.

Thin as a younger adult, Katzin said the pounds started creeping up after she had her two children in the 1980s, despite exercising and watching what she eats. “It’s just extremely frustrating and discouraging.”

The study appears in Wednesday’s Journal of the American Medical Association. Only women were studied, so the researchers from Harvard’s Brigham and Women Hospital said it’s uncertain whether the results would apply to men.

The research “reinforces in a nice, clear way the idea of how difficult it is to maintain a healthy weight in our society,” said Foreyt, of the Baylor College of Medicine in Texas.

The results bolster a 2002 Institute of Medicine report that emphasized the importance of balancing diet and exercise and recommended at least 60 minutes daily of moderate activity for adults and children. But the study also indicates that the 2008 U.S. guidelines urging about a half-hour of exercise five days a week won’t stop weight gain while getting older without cutting calories, said Dr. I-Min Lee, the study’s lead author.

The study underscores some inevitabilities about aging. Men and women often put on weight, partly because their metabolism slows down. But that probably has less to do with it than people’s natural tendency to become more sedentary, without changing their eating habits, Lee said.

Hormonal changes in menopause also can make women prone to weight gain, especially around the belly.

Still, Lee emphasized that the benefits of exercise extend beyond what you see in the mirror, helping keep the heart healthy and protecting against chronic disease even if you don’t get enough activity to lose weight.

Katzin, a size 14, said she does an hour workout twice a week — including weights, an elliptical machine and bike. “I know I should go more, but that’s all I can swing,” she said.

She also has switched to diet soda and eating fewer treats, but that hasn’t curbed her weight. Katzin was not involved in the study.

The researchers analyzed data on women who took part in a long-running federal study. Participants were 54 on average at the start and periodically reported how much they exercised and weighed. They also reported eating habits at the start, but not throughout, a limitation the authors acknowledged. Lee said the women’s eating habits were thought to be typical of American women who aren’t dieting.

Dr. Howard Eisenson, who heads Duke University’s diet and fitness center, said it’s likely some women underestimated what they ate and overestimated how much they exercised, which could have skewed the results.

Still, Eisenson said he doesn’t encourage anybody to try to lose weight by exercise alone. To combat age-related weight gain, “you’re fighting in many cases a losing battle” if you don’t also cut calories, he said.

That doesn’t mean you have to starve yourself, but it does mean watching what you eat and avoiding frequent indulgences. People often don’t realize how quickly a bag of chips, an extra piece of cheese, a few glasses of wine or a candy bar add up.

“You can eat a candy bar in two minutes. Most are at least 200 calories,” and to burn that off requires walking for about an hour, Lee said. Knowing that equation can help people make wise decisions about activity and food choices, she said.

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50 no-sweat ways to burn calories

Women with great bodies have a dirty little secret. Sure, they work out and eat well — but they also sneakily burn hundreds more calories than everyone else. From the outside, they don’t seem to be doing anything particularly strenuous. “You wouldn’t believe how many straightforward ways there are to burn calories,” says Lauren Slayton, director of foodtrainers.net. “But it’s easy to miss the opportunities if you’re not looking for them.”

Research has shown that swapping sedentary habits, such as watching television, for pretty much anything that doesn’t involve sitting down can make a world of difference. “Most people don’t realize that a little extra effort can yield great results,” says Steven Wheelock, a trainer at Canyon Ranch in Lenox, Massachusetts.

The experts we consulted explain how to take every opportunity to flex your muscles, boost your heart rate, and eat foods that yield maximum fullness for minimal calories. Just don’t tell anyone.

1. Take vitamin D
Women who were deficient in it lost weight more slowly in a study in the British Journal of Nutrition. Stephen Gullo, a weight-loss expert in New York City and author of “The Thin Commandments” (Rodale), recommends 2,000 milligrams daily.

2. Drink coffee
Studies have found that caffeine increases the rate at which you burn calories, according to Susan B. Roberts, author of “The ‘I’ Diet” (Workman) and a professor of nutrition and psychiatry at Tufts University in Boston.

3. Sleep more
Getting fewer than four hours of sleep over an extended period of time slows the metabolism. Experts recommend aiming for between seven and nine.

4. Do things by hand
Wash your dishes, vacuum, or cook dinner. “We consider it a luxury to have tasks done for us, but doing some of these for yourself takes considerable energy,” says Slayton.

5. Wear a basic pedometer
“Every week, aim to take a few more steps than you did the last week,” says Wheelock.

6. Eat lightly and often
“For most people, the body uses up more energy digesting smaller meals every few hours than by eating the same number of calories in two or three sittings,” says Chrissy Wellington, a nutritionist at Canyon Ranch in Lenox, Massachusetts.

7. Move briskly
“Walk like you’re late for a meeting,” says Gunnar Peterson, who trains Jennifer Lopez in Los Angeles.

8. Laugh
“It burns up to 50 calories if you laugh for 10 to 15 minutes per day,” says Adelino Da Costa, owner of Punch Fitness Center in New York City.

9. Eat breakfast
“You send your body a signal that you’re not starving, so it starts burning fat — even when you’re just doing normal activities,” says Peterson. He suggests eating scrambled egg whites or oatmeal with fruit.

10. Time yourself
Spend the last five minutes of each hour (set your computer timer) up and moving around, says Kristin McGee, a New York City yoga and Pilates instructor.

11. Fill up on fiber
Low-carb, high-fiber foods take more time to digest than other foods, leaving you feeling fuller longer and less likely to snack, says Gullo. He suggests spinach, broccoli, asparagus, and cauliflower.

12. Go out of your way
At work, take the long way to the restroom — or even go up one flight of stairs.

13. Fidget
You can burn up to 350 more calories a day than someone who remains stationary, according to a study at the Mayo Clinic. The impulse to fidget may be hardwired, but nonfidgeters can imitate it: Tap your feet, pace, or move restlessly in your seat.

14. Stash flats in your bag
“My clients aren’t going to slip on sneakers to go home, but there is a happy medium,” says Slayton. “You might not run a marathon in ballet slippers, but at least you can move quickly.”

15. Don’t eat late at night
It can interrupt sleep, according to Wellington, and may induce you to skip breakfast — bad for your metabolism.

16. Straighten up
“Good posture not only makes you look taller and leaner, but it strengthens your abdominal muscles,” says Brooklyn Decker, the model on the cover of this year’s Sports Illustrated swimsuit issue.

17. Drink more
Dehydrated people experience a drop in their metabolic rate. Drinking water throughout the day caused metabolic rates to increase by about 30 percent in a German study. The goal: eight cups a day.

18. Beware of sugar
It triggers the body to release insulin, which then either transplants sugar to the cells to be used as energy — or stored as fat, according to Jorge Cruise, author of “The Belly Fat Cure” (Hay House).

19. Squat
When you pick up something from the floor, keep your back straight and bend at the knees, not the waist. “This protects your back and tones your legs,” says Peterson.

20. Chew gum
It burns a few calories — and it keeps you from mindlessly grazing, especially when you’re cooking, says McGee.

21. Sleep better
A poor night’s sleep causes people to chose less-nutritious foods, according to a study at the University of Pennsylvania. Another study showed that sleep-deprived people simply move less.

22. Walk and talk
Don’t sit still when you take a phone call. At work, wear a headset.

23. Switch sides
Whether you’re carrying a heavy bag on your shoulder or a child on your hip, “swapping sides every five minutes works more muscles,” says Peterson.

24. Pick up the pace
Listen to fast songs, such as “Closer” by Ne-Yo, says Ruth Zukerman, co-owner of Flywheel Sports, a cycling studio in New York City. “The beat forces you to keep a calorie-burning pace, especially when walking or taking stairs.”

25. Cook your own food
“It’s often healthier, and by the time you’ve made a meal and cleaned up, you’ve been on your feet a half-hour more than you would have waiting for takeout,” says Slayton.

26. Go on a date.
Women tend to order foods with fewer calories when dining with a man (who’s not a long-term significant other), compared with when they eat with other women, according to a study conducted at McMaster University in Hamilton, Canada.

27. Avoid eating lunch at your desk
If you must, have a quick bite, then go for a short walk.

28. Always carry a snack
Try nuts, low-calorie bars, or a piece of fruit. Eating frequently keeps your metabolism up (and reduces the odds that you’ll wind up a victim of the vending machine).

29. Wear stilettos
“Every few days, I’ll wear the highest heels I own,” says Decker. “It helps tone my legs, because they work different muscles in my calves and thighs.”

30. Relax
Stress causes the body to release cortisol, which causes more calories to be stored as fat, especially in your abdomen.

31. Watch less television
Adults who halved their television viewing time (by using an electronic lock-out system) not only burned an extra 119 calories per day, but did so without altering what they ate.

32. Lift up
Rise up on the balls of your feet and then lower yourself down again. “I do this little Pilates move everywhere,” says McGee.

33. Build up your abs
Do intense bursts of engaging your abs tightly. If you think you can only do 30 seconds, push for 40, says Da Costa.

34. Drink a few cups of strong green tea every day
In addition to caffeine, green tea contains catechin polyphenols, plant chemicals that may also boost metabolism, according to a study from the University of Geneva in Switzerland.

35. Heat things up
“Some studies show that spicy food can temporarily increase metabolism,” says Slayton. Try red pepper flakes on salad.

36. Work your legs a bit
“If I’m stuck in a seat, I do small knee lifts, almost like I’m marching in place,” says McGee.

37. Eat salmon
Salmon eaters lost significantly more weight than beef eaters in a study, even though the calories consumed were equal.

38. Pop a pill
People taking supplements with glutamine after meals burned an average of 20 more calories than those taking a placebo in a study at Iowa State University in Ames.

39. Keep your blow-dryer at the health club
“I have a client who swears that this motivates her to work out,” says Slayton.

40. Eat the peel
“It takes the body more energy to break down fiber-rich foods, like the skins of fruits and vegetables,” says Wellington.

41. Get busy
Most couples burn an average of 300 calories an hour while they’re having sex.

42. Go coconuts
People who replace oils and fats like animal fats and sunflower oil with those containing medium-chain fatty acids, such as coconut oil, lose more body fat.

43. Drink oolong tea
Gullo suggests this to his clients because some studies have shown it can increase metabolic activity by as much as 10 percent.

44. Don’t snack in the car
Experts say it’s a hotbed of mindless eating and excess calorie consumption.

45. Swing your arms
“The more parts of your body that you use simultaneously, the more you burn,” says Zukerman.

46. Snack when you drink
Alcohol paves the way for overeating. Snack before you go out for drinks, says Slayton — or at least eat a few olives when you’re at the bar.

47. Clean up
When you’re wiping down the counter or washing the car, really stretch out, says Peterson. “Use both hands and make large circular motions, like you’re the Karate Kid.”

48. Buy some crackers
“High-fiber, low-starch foods, such as GG Crispbreads, create a film on the intestinal lining that blocks the absorption of other calories,” says Gullo.

49. Sit up
When watching TV, “get in the habit of holding your body straight,” says Slayton.

50. Don’t forget dairy
Wellington says, “Researchers believe that low-fat dairy inhibits fats from being stored.”

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Regular workouts ward off the common cold

Working out regularly doesn’t only help tone your body and build muscle — it could also help you avoid catching the common cold, a new study suggests.

People who exercise five or more times a week get fewer and less severe colds than those who work out one or fewer times a week, said Dr. David Nieman, director of the Human Performance Laboratory at Appalachian State University in North Carolina.

“The most powerful weapon someone has during cold season,” Nieman told MyHealthNewsDaily, “is to go out, on a near-daily basis, and put in at least a 30-minute brisk walk.”

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Nieman and his colleagues found exercising stimulates the movement of immune cells throughout the body about three hours after a workout. The more often a person exercises, the more often their immune cells will be on high-alert for invading pathogens.

“It’s the frequency, and getting the cells moving,” he said. “That’s what provides the top-level protection of the body.”

The study was published online today (Nov. 1) in the British Medical Journal.

Fit findings
Researchers tracked the respiratory health of 1,000 people, ages 18 to 85, for 12 weeks during autumn and winter, and asked them questions about how often they exercised and how fit they felt.

The researchers found the length of time cold symptoms lasted was shorter by 43 percent to 46 percent in people who worked out five or more times a week, compared with people who worked out once a week or never. [Related Infographic: Colds, Allergies or Sinusitis? Here's How You Can Tell]

And people who felt the fittest had cold symptoms that were 41 percent less severe than those of people who felt the least fit.

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“We looked at diet, we looked at mental stress, weight, education levels, gender, on and on,” Nieman said. “The thing that people can do — the way they live — that’s head and shoulders above all of them, is physical activity.”

People who are older and married are less likely to get a cold than people who are young and single, the study found. Older people may have more antibodies than younger people, Nieman said. And married people may go out less or might have less exposure to other people and their germs, he added.

Confirming past results
Previous studies have suggested a link between exercise and a boosted immune system.

A 2002 study in the journal Medicine & Science in Sports & Exercise found moderate physical activity reduced the risk for an upper respiratory tract infection by 23 percent, compared with low levels of physical activity.

And a 2006 study in the American Journal of Medicine found one year of a moderate-intensity exerciseregimen could reduce the incidence of colds in postmenopausal women who were overweight or obese.

“From animal data to multiple human trials, we’ve kind of reached a point now where there’s enough evidence that this has to be real,” Nieman said.

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Want a better workout? Don’t stretch before

LONDON — Want a better workout? Then don’t stretch beforehand, some experts say.

Many people take it for granted that they should start their exercise routines with some stretching on the spot, perhaps hoping it will loosen them up for their workout. Most fitness experts now agree this kind of static stretching before exercise is not just counter-productive, but potentially harmful.

Traditional stretches, like when people bend over to touch their toes or stretch their legs on a fence, often cause the muscles to tighten rather than relax — exactly the opposite of what is needed for physical activity.

Experts say it is like extending a rubber band to its limit. When people stretch to the maximum, they are more likely to pull a muscle.

“We have developed this idea of static stretching at exactly the wrong time,” said Kieran O’Sullivan, an exercise expert at the University of Limerick in Ireland, who has studied various types of stretching and their impact on athletes.

When you stretch before exercising, your body may think it’s at risk of being overstretched. It compensates by contracting and becoming more tense. That means you aren’t able to move as fast or as freely, making you more likely to get hurt.

O’Sullivan said stretching helps with flexibility, but people should only do it when they aren’t about to exercise, like after a workout, or at the end of the day.

“It’s like weight training to become stronger,” he said. “You wouldn’t do a weight session right before you exercise, and you shouldn’t stretch right before either.”

In the last few years, several studies have found static stretching before playing a sport makes you slower and weaker.

And when experts at the U.S. Centers for Disease Control and Prevention combed through more than 100 papers looking at stretching studies, they found people who stretched before exercise were no less likely to suffer injuries such as a pulled muscle, which the increased flexibility from stretching is supposed to prevent.

Warm up with a light jog
Instead of stretching, many experts recommend warming up with a light jog or sport-specific exercise, like kicking for football or a few serves for tennis. That type of light movement increases the heart rate and blood flow to the muscles, warming up the body temperature.

“This allows you to approach your full range of motion, but in a very controlled way,” said Dr. Anders Cohen, chief of neurosurgery and spine surgery at the Brooklyn Hospital Center and former physician for the U.S. Tennis Open. Cohen said elite athletes in all sports are increasingly ditching static stretching and using other warm-up techniques instead.

But the message has yet to trickle down to legions of joggers and recreational athletes. “This is classic, old-school stretching that has been done for generations,” Cohen said. “It’s going to be very hard to convince people to start doing something different.”

There’s more news for the traditionalists: research shows static stretching doesn’t work as well as more active kinds of stretching that incorporate movement, such as lunges.

In a study published earlier this year in the Clinical Journal of Sport Medicine, Roberto Meroni of the University of Milan and colleagues found people who stretched using conventional techniques, like bending over to touch their toes, were less flexible than those who did a more active type of stretching that used more muscle groups.

Meroni said static stretching simply forces the muscle being stretched to endure the pain of that stretch. With active stretches that work more muscles, the stretched muscles learn to extend while another group is working.

Those types of stretches are commonly used in yoga, which emphasizes how the body is aligned during stretches, not just flexibility. Many yoga poses involve the whole body and focus not only on stretching a particular muscle, but the ligaments, tendons and joints around it.

Still, experts don’t discount static stretching entirely. Lynn Millar, a fellow of the American College of Sports Medicine, said they recommend people stretch several times a week and that most types of stretching work.

Maximizing the benefits of stretching may simply boil down to a matter of when you do it and how, according to Jonny Booth, a health and fitness manager at a north London branch of gym chain Fitness First.

“If you are going to stretch your muscles and then do some intense training, you’re not going to get fantastic results,” he said.

Instead, Booth recommends active stretches that mimic the movement of your intended activity, like some deep knee lunges while walking for runners.

“Stretching is vital to become more flexible,” Booth said. “But it has to be done at the right time and for the right reasons.”

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Hour of exercise? Yeah, right, many women say

>>> on your health. our lifeline report and tricky relationship between exercise and weight loss , especially for women . a major new study found without making changes in diet, women need a lot of exercise just to keep their weight stable. our chief science correspondent robert bazell has our lifeline report.

>> reporter: the results of 13 years of studying the exercise habits and weight of some 34,000 women in the anti-age sponsored women ‘s health study will come as no surprise. if the weight is already on, it’s almost impossible to lose it.

>> among the women who are overweight, obese, there was no relationship between physical activity and weight change over time .

>> reporter: researchers found in middle-aged or older women who eat a regular american diet, exercise, even 60 minutes a day, does not prevent weight gain over the years. the only exception was women who started out with what is considered ideal weight, say 145 pounds or less for a 5’4″ woman. exercise helped those who started thin to stay thin. that’s little comfort to vicki jones, who like almost everyone else seems to keep on the extra pounds no matter how hard she tries.

>> it’s frustrating because i work very hard to try to lose the weight.

>> reporter: when she was young, vicki , a pastor’s wife was rail thin, but after the birth of her son the weight came on year after year. scientists are concerned this latest news may prompt many women to give up on exercise.

>> that is absolutely not the right message to take. we have lots of studies, lots of data clearly showing any amount of physical activity is good and more physical activity brings additional health benefits .

>> reporter: vicki jones has decided she is not giving up.

>> it would be really nice to come up with a way to make this happen where i’m just not exhausting all this energy without getting the results i’m looking for. lucky shot.

>> reporter: the experts say, even though exercise is beneficial, the quest for easy weight loss remains elusive.

>> still 175.

>> reporter: robert bazell , nbc news, new york .

>> there is more on this study and this topic on our website nightly.msnbc.com. speaking of food, it may be the

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Common pain pills can put runners in world of hurt

After winning a 24-hour track run in record time, Stephanie Ehret should have been celebrating. Instead, she was in a Phoenix emergency room, vomiting up a strange substance, which a doctor informed her was part of her digestive tract lining. Feverish and nauseous, Ehret could barely move. “I’d never felt so bad,” she says. “I was pretty sure I was dying.”

A few hours later, doctors diagnosed the problem — rhabdomyolysis, a potentially fatal precursor to kidney failure. Though dehydration and overexertion contributed to Ehret’s condition, doctors told her that the 12 ibuprofen pills she’d taken during the 24-hour race had pushed her kidneys into the danger zone.

When used properly, over-the-counter pain medications can be a godsend. Acetaminophen (Tylenol) can tame many pains. And non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, aspirin, and naproxen can reduce pain and swelling in the first few days following an acute injury like an ankle sprain. The trouble comes, doctors say, when people, like Ehret, misuse these drugs.

“A couple of ibuprofens really helped, so I figured more was better,” Ehret says. Indeed, many runners treat anti-inflammatory drugs like “vitamin I,” says pharmacologist Joe Graedon, co-author of The People’s Pharmacy book series. “They think, I’m putting my body through a lot, so I’ll just dose up on ibuprofen, without appreciating how potentially dangerous this drug can be.”

Runners beware

Runners may think that as long as they don’t go overboard like Ehret, they’ll be safe. But experts say the benefits of popping even one pill before a 10K don’t outweigh the risks. NSAIDs inhibit prostaglandins, hormones that help normalize blood flow to the kidneys. Mix an NSAID with physical exertion and dehydration, and you can overwhelm your kidneys.

What’s more, NSAIDs can bump up your blood pressure, and when you add this to the natural rise that occurs when you exercise, “suddenly you have two things increasing your blood pressure,” Graedon says. If you already have high blood pressure, “you could have a mini stroke or a heart attack,” he says. NSAIDs also block an enzyme called cyclooxygenase (COX) that normally protects the heart, and this might explain why many NSAIDs, including ibuprofen, may raise the risk of heart attack.

Some forms of COX also protect the stomach lining from digestive acids, so when an NSAID blocks this enzyme, you may experience nausea, diarrhea, intestinal bleeding, and cramps. When used during a marathon or ultra, NSAIDs also seem to boost the risk of hyponatremia, an electrolyte imbalance that can cause the brain to swell. “It’s something you can die of during a race,” says Martin Hoffman, M. D., director of research at the Western States Endurance Run.

Many runners believe that NSAIDs increase their pain tolerance, but studies contradict this notion. In 2005, David Nieman, Dr. P.H., director of the human performance lab at Appalachian State University in Boone, North Carolina, examined ibuprofen use at Western States. About 70 percent of the racers said they took it to help them manage the discomfort of racing. But when he measured pain and muscle soreness in these pill poppers, he found no reduction compared with nonusers.

Worse, ibuprofen takers had more inflammation. “There’s no good reason to use ibuprofen during a race,” Nieman says. “There are too many potential negatives.” Any pain and inflammation that turns up while running is not something you should medicate but a signal that it’s time to reevaluate your training regimen, he says.

Watch the dosage

For relief during or after exercise, Hoffman recommends acetaminophen since it works via a different mechanism than NSAIDs, and the drug doesn’t have the side effects associated with aspirin or ibuprofen. “It’s a relatively safe drug, and it doesn’t present problems with the kidney or gut,” he says.

But watch the dosage. While it’s safe at recommended doses, acetaminophen can be toxic to the liver, especially when mixed with alcohol. “You can hit the tipping point pretty fast with acetaminophen,” says Graedon. Acetaminophen overdose is the most common cause of acute liver failure in the United States, in part because the drug is found in many over-the-counter cold and allergy medicines, so it’s easy to overdose if you take one of these drugs with Tylenol.

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And limit the number of days you take meds. “Studies show that NSAIDs can impair the healing process for soft-tissue injuries, so you should never use them long-term for injuries,” says Hoffman.

Since her ordeal, Ehret shares her experience with other racers. If she sees them downing vitamin I, she tells them about her ER visit. “That’s usually enough to change their habits,” she says.

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Growth hormone gives boost, first study proves

NEW YORK — Researchers are reporting the first scientific evidence that a hormone banned in sports can boost athletic performance.

The improvement from human growth hormone was modest, and only in sprinting. It didn’t increase strength or fitness. Athletes likely to benefit are those in sprint events like running or swimming that require a burst of energy, and where a split second can decide the winner, the Australian researchers said.

Human growth hormone, or HGH, is one of many substances banned by the Olympics and other sports even though there hasn’t been any good proof that it can enhance performance. Previous studies in athletes have been small and brief.

The new research tested it in about 100 recreational athletes for two months.

“This is the first demonstration that growth hormone improves performance and justifies its ban in sport,” said Dr. Ken Ho, who led the study at the Garvan Institute of Medical Research in Sydney.

Human growth hormone is made by the pituitary gland and promotes growth of bone and other tissue. A manufactured version is available, but its use is restricted to certain conditions in children and adults, including short stature, growth hormone deficiency and wasting from AIDS.

Growth hormone has been used by athletes in the belief that it builds muscle and improves performance. It’s also harder to detect than other substances because it doesn’t show up in urine tests. There’s been a blood test for growth hormone since 2004, but it hasn’t been used much outside competition.

In February, a British rugby player became the first athlete to be suspended for using growth hormone after he was tested. A few baseball players have admitted using growth hormone, including former home run king Mark McGwire who recently apologized for using it during his career.

The latest research involved 103 male and female recreational athletes between 18 and 40. For two months, they got injections of either growth hormone or salt water. Some of the men also got testosterone, which is also banned in sports and often used with growth hormone.

They lifted weights, jumped and rode exercise bikes to test their physical performance. Growth hormone didn’t improve strength, power or endurance, the researchers said. The only improvement was for sprinting on a bicycle, a 4 percent increase in sprint capacity compared to those who didn’t get the hormone. In men who also got testosterone shots, there was an 8 percent increase.

Could shave off half a second in a sprint
The researchers speculated that the boost from growth hormone alone is enough to shave off about half a second in a 10-second sprint over 100 meters. That little time “divides the winner from the last place finisher,” said Ho.

The study volunteers who took growth hormone lost body fat and gained lean body mass, but it was mostly from water retention, not from bulking up muscle, the researchers reported in Tuesday’s issue of the Annals of Internal Medicine.

Side effects included swelling and joint pain.

The researchers noted some limitations. They couldn’t test the hormone in elite athletes for ethical reasons, and they used a smaller dose for a shorter time than reported for illegal use. Larger doses and longer use might have more impact and more serious side effects, they said.

“It’s not a trivial thing to do a study like this. I think they did a very good job,” said Dr. Andrew Hoffman of Stanford University, who was involved in a 2008 review of growth hormone research.

The director general of the World Anti-Doping Agency, which helped pay for the study, said the results aren’t surprising to him and will disprove skeptics who don’t think the hormone helps.

“There’s been a huge amount of anecdotal evidence to indicate that it is of advantage, and a huge number of athletes have used it,” said David Howman in a teleconference from Montreal.

Dr. Gary Wadler, who heads the committee that decides the agency’s banned-substances list, said growth hormone usually isn’t used alone. He said he’s concerned that athletes will use the small boost from growth hormone to keep their testosterone use below detectable levels.

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Americans walk a mere 5,117 steps a day

NEW YORK — Americans have got some walking to do if they want to catch up with the rest of the world.

They are far outpaced by Australians, Asians and Europeans who walk much more, according to a new study.

Adults in western Australia average 9,695 steps a day. The Swiss followed with 9,650, while the Japanese clocked in with 7,168 steps. But Americans straggled far behind with just 5,117 steps.

“We were surprised that the levels of physical activity were that low,” said Dr. David R. Bassett, of the University of Tennessee, the lead author of the study published in Medicine & Science in Sports & Exercise.

“Five thousand steps is really pretty inactive,” he added.

Bassett said Americans need to step up for another 30 to 40 minutes per day to shrink the fitness gap. One mile equals about 2000 steps.

The researchers used pedometers to gather step data from 1,136 American adults, who varied in age, gender and geographic location, and compared the results to similar studies in the other countries.

Bassett thinks America’s car culture and lack of adequate public transportation provide fertile ground for couch potatoes.

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“People do have to exercise,” he said. “But our overall environment does not lend itself to promoting an active lifestyle.”

He attributes the more active lifestyle of adults in other countries to their greater access to mass transit.

“In Switzerland you might get enough activity just in the course of doing your errands,” he explained.

Modest amounts help

The drive-not-walk mentality has dismal consequences. In the United States, 34 percent of adults are obese. During the past decade Australia, Japan and Switzerland have reported obesity rates of 16 percent, 3 percent and 8 percent, respectively.

Bassett said research has shown that just putting one foot in front of the other can help prevent weight gain.

“Even modest amounts of walking on a daily basis can help you to maintain a healthy body weight,” he said.

Julia Valentour, who developed the walking program for the American Council on Exercise, said fit people usually take about 10,000 steps per day. But she wants everyone to do more.

“It’s low risk, easy to do, and does so much to increase health, lower cholesterol and blood pressure, increase energy and reduce the risk of developing diabetes and cancer,” she said.

The Centers for Disease Control guidelines call for 150 minutes per week of a moderate-to-intensive exercise, like walking.

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