By Michael Stanclift, ND You’re feeling that rush as you catch your stride on your morning run. The air is perfect. Suddenly a cramp or muscle ache stops you dead in your tracks. You try to shake it off, but it just grabs more. Ah! We still don’t completely understand why muscles tighten up involuntarily. Exercise, pregnancy, electrolyte imbalances, nerve compression, and diminished blood supply to the muscle all may contribute.1,2 So what can we do to combat these harmless but pesky discomforts? In this article we’ll look at what the research says. Surprisingly, some popular natural remedies don’t shine through in the current medical evidence. What might not help with cramping Magnesium and Epsom salts: A Cochrane Review found that oral magnesium wasn’t likely to help with muscle cramps in older people, and the findings were inconsistent in pregnant women.3 A recent randomized, placebo-controlled trial in pregnant women found no difference in leg cramps with magnesium compared to placebo.4 Epsom salt (magnesium sulfate) baths have long been a go-to for muscle relaxation, and “float” centers with sensory deprivation tanks full of the magnesium-rich water have popped up as an urban refuge from the constant stimulation of modern life. A study in nonathletic healthy men found a one-hour float (in magnesium sulfate) after exercise reduced pain perception compared to one hour of passive recovery.5 However, these findings are tough to attribute to magnesium, as the study’s control didn’t match other potentially therapeutic factors, such as body positioning and sensory deprivation.5 So a relaxing bath may help with cramping and muscles, but it’s unclear if adding Epsom salt makes a significant difference. Active cool-down and static stretching: Many believe after exercising intensely a period of low-to-moderate intensity will prevent muscle soreness and injuries, but this doesn’t appear to be true.6 A 2018 review found evidence on active cool-downs shows it doesn’t significantly reduce soreness, stiffness, or range of motion and may inhibit muscular glycogen resynthesis (energy storage).6 This same review found that static stretching before or after exercise didn’t reduce muscle soreness.6 What might help with muscle cramping: Foam rolling: This surprisingly simple tool can be valuable if you suffer from muscle soreness and cramps. Using a foam roller after exercise can reduce muscle soreness and improve athletic performance the following day.6 Physical therapists from Harvard agree that 30-120 seconds per area can be helpful in relieving sore muscles and preventing cramps.7 Muscle soreness: Tart cherry or pomegranate juice: A small randomized, double-blind, placebo-controlled trial found 355 ml (~12 oz.) of tart cherry juice drunk twice a day for a week before a 26 km (16-mile) run reduced the amount of pain reported from participants.8 A research review found similar effects from drinking tart cherry juice twice a day, and one study found pomegranate juice reduced soreness.9 But the research on these two drinks in relation to muscle soreness has shown mixed results.9 A recent study compared tart cherry, pomegranate, and placebo drinks to analyze the impact on muscle soreness in nonresistance trained men.10 In this study, the researchers were surprised to find that neither of the fruit drinks appeared to help with muscle soreness when compared to placebo.10 Ginger: In a small double-blind, randomized, placebo-controlled trial in experienced runners, 5 days of powdered ginger supplementation (1.4 g/day) moderately reduced muscle soreness from a run (on day 3) during the supplement period.11 A review of randomized clinical trials found that consuming up to 4 g of ginger postintense exercise can reduce muscle soreness and improve muscle recovery.12 Lower single dosages of 2 g ginger did not help with muscle soreness when compared to placebo.12 This suggests it may take multiple days or higher doses to get the effect. Curcumin: It’s no surprise that curcumin, a bright orange compound from the spice turmeric is making news again. A research review found curcumin in a wide range of doses (150 mg-5,000 mg) can reduce muscle soreness after exercise.13 Curcumin can work when used on an “as needed” basis, with even a single dose (150-200 mg) showing effectiveness for muscle soreness following exercise.13 Interestingly, in this review they found small doses (90 mg twice a day) of curcumin taken for 7 days before exercise had no effect on postexercise soreness, while the same dosage taken after exercise for 4 days was effective.13 Other studies in the review at similar doses did not find curcumin improved muscle soreness compared to placebo, so differences in the trial participants and types of exercise may influence the effects.13 Conclusion:Cramping and muscle soreness can ruin a good exercise session, but they don’t have to. When it comes to combatting these annoying aches, you have numerous options—but beware that some popular natural treatments might be more hype than help.
References: 1. Young G. Leg cramps. BMJ Clin Evid. 2015;2015:1113. 2. Mayo Clinic Staff. Muscle cramps. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/muscle-cramp/symptoms-causes/syc-20350820#:~:text=Overuse%20of%20a%20muscle%2C%20dehydration,Inadequate%20blood%20supply. Accessed February 11, 2021. 3. Garrison SR et al. Magnesium for skeletal muscle cramps. Cochrane Database Syst Rev. 2012;2012(9):CD009402. 4. Araújo CAL et al. Oral magnesium supplementation for leg cramps in pregnancy-An observational controlled trial. PLoS One. 2020;15(1):e0227497. 5. Morgan PM et al. The acute effects of flotation restricted environmental stimulation technique on recovery from maximal eccentric exercise. J Strength Cond Res. 2013;27(12):3467-3474. 6. Van Hooren B et al. Do we need a cool-down after exercise? A narrative review of the psychophysiological effects and the effects on performance, injuries and the long-term adaptive response. Sports Med. 2018;48(7):1575-1595. 7. Harvard Health Staff. Roll away muscle pain. Harvard Health Publishing. https://www.health.harvard.edu/staying-healthy/roll-away-muscle-pain#:~:text=Foam%20rollers%20are%20easy%2Dto,from%20exercise%2C%20and%20reduce%20injury.&text=As%20you%20age%2C%20occasional%20muscle,lightweight%20cylinder%20of%20compressed%20foam. Accessed February 11, 2021. 8. Kuehl KS et al. Efficacy of tart cherry juice in reducing muscle pain during running: a randomized controlled trial. J Int Soc Sports Nutr. 2010;7:17. 9. Bowtell J et al. Fruit-derived polyphenol supplementation for athlete recovery and performance. Sports Med. 2019;49(Suppl 1):3-23. 10. Lamb KL et al. No effect of tart cherry juice or pomegranate juice on recovery from exercise-induced muscle damage in non-resistance trained men. Nutrients. 2019;11(7):1593. 11. Wilson PB. A randomized double-blind trial of ginger root for reducing muscle soreness and improving physical performance recovery among experienced recreational distance runners. J Diet Suppl. 2020;17(2):121-132. 12. Rondanelli M et al. Clinical trials on pain lowering effect of ginger: A narrative review. Phytother Res. 2020;34(11):2843-2856. 13. Yoon WY et al. Curcumin supplementation and delayed onset muscle soreness (DOMS): effects, mechanisms, and practical considerations. Phys Act Nutr. 2020;24(3):39-43.
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By Cassie Story, RDN
We are social creatures. Hardwired in our being is the desire to belong, fit in, and play with our fellow humans. In fact, survival depends on our ability to bond. So what happens to your mental state when you remove yourself from others over the course of a year and a half? While long-term data on the mental health implications of isolation are currently being studied, we do have short-term studies emerging, which evaluated mental health concerns over the past year. A new phenomenon has occurred for workers who have been utilizing online video platforms for a majority of their day-to-day work. “Zoom fatigue” may have inadvertently activated the fight or flight system within the brain.1 This is according to a recent report from Stanford that offers four potential aspects of Zoom fatigue and the unintended psychological consequences that follow.1 With this knowledge, it is important to recognize the spectrum of emotions that you might be feeling as you prepare to “get back” into the real world—to step out from behind the screen and live life again. This article identifies common emotions that you may be experiencing, effective mantras for change, and supportive nutrients that can play a role in taking you from feeling blah to rah! Emotional state: fear & anxietyIt is understandable to have some lingering fear and anxiety about social reentry. Due to our constant connection to news and information, many people have likely experienced some level of fear and anxiety that is atypical for themselves over the past year. It wouldn’t be realistic to expect yourself to go from living in that state of mind, to complete joy and jubilation. Mantra: I am safe Supportive nutrients: palmitoylethanolamide (PEA) and hemp PEA is a bioactive lipid molecule that the body produces naturally and is found in the lipid extracts of foods.2 PEA has been researched for over 70 years and has a wide range of clinical applications from mild bodily discomfort and immune system support to mood and neurological health.2-6 Full-spectrum hemp is sourced from aerial plant parts including the stalk, stems, seed, and flower of the hemp plant and contains beneficial phytocannabinoids and terpenes. They work together to produce a synergistic effect on the endocannabinoid system, which has been found to support a healthy stress response and has positive neurological benefits.7 Emotional state: stressLoneliness and isolation have been found to increase stress levels in the body.8 Couple that with uncertainty about the future and worry for your own health and wellbeing, as well as that of your friends and family, and this creates a perfect brew for stress to thrive. Are you ready to reclaim your balance? Mantra: I am at peace Supportive nutrient: phosphatidylserine Phosphatidylserine is an important phospholipid in the brain and a key building block of nerve cell membranes.9 Research suggests that it may support mental focus and help support a healthy endocrine response to acute mental stress.10 Emotional state: low self-confidence or decline in body imageFor most people, due in part, to our society’s environmental factors of convenience foods and little built-in day-to-day movement, maintaining health and wellbeing requires routine and planning. Removing ourselves from typical day-to-day activities, and increasing a sedentary lifestyle, may lead to undesired weight gain. If you have experienced an increase in body weight, first remind yourself, you are not alone. Second, find something about your body to be grateful for right now. Third, speak kindly to yourself. If you have now found that a majority of your “real life” clothes no longer fit, maybe it is time to implement a supportive weight-loss routine. Mantra: I am strong (or flexible, sexy, healthy) Supportive nutrient: meal replacements Meal replacements are reduced-calorie portion-controlled products often fortified with micronutrients. Studies show that replacing just one or two meals per day with a meal-replacement product produces greater total weight loss, and a greater proportion of participants meet their total weight-loss goals both in the short- and long-term, compared to a low-calorie diet without the use of meal replacements.11 Emotional state: lack of motivationSpending the majority of your time in a seated position, whether the couch or an office chair, can wreak havoc on motivation levels. Going from staring at one screen to the next, between your computer, TV, and phone, can cause a numbness of sorts and lead to lack of desire or motivation to try new things. We are hardwired to want to try new things. Being limited from participating in your favorite activities may have decreased your motivation without your realizing it. Mantra: I enjoy new experiences Supportive nutrients: holy basil, ashwagandha, amla fruit These are a classic blend of Ayurvedic herbs. Holy basil (Ociumum sanctum) leaves and stems contain a variety of compounds including triterpenes (oleanolic and ursolic acid), saponins, flavonoids, and phenols.12 Roots of ashwagandha (Withania somniferum), an herb grown in India, contain withanolides.13 Amla fruit, or Indian gooseberry (Phyllanthus emblica), is rich in vitamin C, a potent antioxidant.14 Research suggests these adaptogens may support the body in adjusting to various stressful environmental challenges.15 These herbs may help reduce some of the challenges associated with stress.16 Emotional state: excitementPerhaps you are experiencing a different type of emotion than those listed above. Maybe you are excited and “champing at the bit” to get back out into your typical social life. If you feel that you need some calming support because you just cannot wait to get back out there, here are some things to consider: Mantra: I am calm Supportive nutrients: folate, magnesium, vitamins B12 and B6 Folate & vitamin B12 are cofactors in the synthesis of neurotransmitters, including serotonin.17-18 Serotonin is associated with mood, sleep, and relaxation.19 Vitamin B6 is a factor in the body’s conversion of glutamate, which is a stimulatory neurotransmitter, into gamma-amino-butyric acid (GABA), which is associated with calming and relaxation.20 Magnesium is an essential mineral and acts as a cofactor in numerous metabolic processes. There is evidence that specific nutrients, such as magnesium, may help to promote muscle relaxation and restfulness—possibly playing a role in reducing daily stress levels.21 Conclusion However you are feeling in any given moment is okay. As humans, we experience a multitude of emotions that change throughout the day. If you’ve noticed you haven’t felt yourself lately, remind yourself that every day is a new day—filled with opportunities for growth and change. Be kind to yourself, use the mantras within this article or create your own that speak to you and consider adding the supportive nutrients listed above to your routine if you are seeking nutritional support for your emotional state. References: 1. Bailenson J. Technology, Mind, and Behavior. 2021;2:1. 2. Beggiato S et al. Front Pharmacol. 2019;10:821. 3. PubChem, U.S. National Library of Medicine, National Center for Biotechnology Information. https://pubchem.ncbi.nlm.nih.gov/compound/4671. Accessed September 20, 2019. 4. Passavanti MB et al. Syst Rev. 2019;8(9). 5. Hesselink JM et al. Int J Inflamm. 2019;2013(9). 6. Hesselink JMK. J Pain Res. 2013;6:625–634. 7. Tagne AM et al. Pharmacol Res. 2021:105545. 8. Hwang TJ et al. Int Psychogeriatr. 2020;32(10):1217-1220. 9. Kim H et al. Prog Lipid Res. 2014;56:1-18. 10.Benton D et al. Nutr Neurosci. 2001;4(3):169-178. 11. Heymsfield S et al. Int J Obes Relat Metab Disord. 2003;27(5):537-549. 12. Cohen MM. J Ayurveda Integr Med. 2014;5(4):251-259. 13. Mirjalili MH et al. Molecules 2009;14:2373–2393. 14. Mindell E. New York, NY, Hachette Book Group, 2011. 15. Panossian AG et al. Med Res Rev. 2021;41(1):630-703. 16. Panossian A. Pharmaceuticals. 2010;3:188-224. 17. NIH Office of Dietary Supplements. Office of Dietary Supplements – Vitamin B12. https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/ . Accessed: August 5, 2021. 18. NIH Office of Dietary Supplements. Office of Dietary Supplements – Folate. https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/ . Accessed: August 5, 2021. 19. Young SN. J Psychiatry Neurosci. 2007;32:394-399. 20. Dakshinamurti K. Adv Nutr Res. 1982;4:143-179. 21. de Baaij JH, et al. Physiol Rev. 2015; 95:1-46. By Michael Stanclift, ND
Since the 1950s we’ve associated HDL cholesterol with being a positive for our health, and to a large extent, that’s true.1-6 However, more recent studies show us that elevated HDL cholesterol can actually be cause for concern.7,8 So what do we think is going on here? Well, first we have to look at what we’re actually measuring when we look at HDL and why we have assumed that was protective for our cardiovascular systems. For years I taught patients that they can remember the “H” in HDL means that’s the “healthy” cholesterol. While this is mostly a good rule of thumb, the HDL letters actually stand for high-density lipoproteins. High-density lipoproteins are like tiny little garbage trucks that take excess cholesterol out of our system so we can get rid of what we don’t need. And when we measure HDL cholesterol, we’re basically looking at how much “garbage” (cholesterol) is inside those little trucks. It would make sense that the more garbage we find, the more we would assume the trucks are picking up. Unfortunately, this is making a lot of assumptions based on just one finding. We’re assuming that we have enough garbage trucks, that everything on them is working, and that they’ll be dumping that garbage as soon as they get to the landfill (our livers). As you might suspect, those aren’t always the case. Sometimes our HDL particles contain a lot of cholesterol because there are just not that many little garbage trucks to handle all the cholesterol that needs to be transferred.9 Our HDL garbage trucks may also be loaded with cholesterol because they just aren’t unloading it well, which is akin to them driving around full and not picking up more garbage—not useful.10 So what we really want to know when we look at HDL and use that to predict cardiovascular health, is how much healthy HDL function does the patient have? This has been a tricky measure to pin down, but researchers and laboratories are looking to create tests that will give us a clear indication of healthy HDL function and bring that to us as patients. There are a few advanced tests available that can help give indications of our HDL function, but they still need more refinement.9 You’re probably thinking, “Are there ideal HDL levels? When should I seek more investigation?” We do have some indications of ideal levels that suggest our HDL is likely functioning well. One study found the following ideal HDL ranges:9
If your HDL levels fall within these ranges, it’s likely functioning as it should, protecting your cardiovascular system and cleaning up other various things your body no longer needs.9 These ranges show us that there is likely an upper limit to what is healthy and ideal and that we might need to rethink the “more is always better” axiom we’ve followed for decades. References: 1. Barr DP et al. Am J Med. 1951;11(4):480-493. 2. Gordon T et al. Am J Med. 1977;62(5):707-714. 3. Castelli WP et al. JAMA. 1986;256(20):2835-2838. 4. Cullen P et al. Circulation. 1997;96(7):2128-2136. 5. Sharrett AR et al. Circulation. 2001;104(10):1108-1113. 6. Di Angelantonio E et al. JAMA. 2009;302(18):1993-2000 7. Madsen CM et al. Eur Heart J. 2017;38:2478-2486 8. Hamer M et al. Arterioscler Thromb Vasc Biol. 2018;38(3):669-672. 9. Khera AV et al. Circulation. 2017;135(25):2494-2504. 10. Hancock-Cerutti W et al. Molecules. 2021;26(22):6862. Deanna Minich, PhD
Have you ever felt like reaching for the pint of strawberry ice cream after a long day at work? Or eating potato chips after an argument with a loved one? Or even craving chocolate when feeling bored or isolated? If you answered “yes” to any of these questions, you might be “stress eating,” or what is commonly referred to as “emotional eating.” Stress eating is turning to food in times of psychological distress as a form of comfort rather than in response to hunger. Whether it’s stress or a specific emotion, like sadness, we may develop a coping response by eating, either overeating or under-eating. In general, emotional eating involves eating nutrient-poor foods, is often repetitive and automatic, and is not connected to body senses of physical hunger, but to an emotional stimulus.1 Some of us are more prone to being high reactors to stress and may be more vulnerable than others.2 Here’s a quick checklist to see whether you might be engaging in stress eating:
Here are some things you can do to break the cycle of stress eating:
Stress eating can be a challenging cycle to break. There are several ways to address the cycle, whether through body awareness, emotional expression, alternative options, better choices, or simply, brain chemistry balance through nutrient sufficiency. Try out a variety of these approaches to see if you feel more empowered in your eating in times of distress. References:
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