Tuesday, May 31, 2016

Myofascial Release

You see them everywhere- in the gym, the physical therapist office, your friends apartment. If you’re a runner or athlete, you’re likely to have a variety of them in your home too- massage sticks, foam rollers, lacrosse balls and other self-massage tools. Many of us use these tools religiously to roll our muscles and achy body parts and lament that it “hurts so good”. But do you know why?

This practice of self-massage is actually called self-myofascial release. Myofascial is the connective tissue network that runs through your body. It wraps around your internal organs and muscles and holds it all into place. When this system is healthy, it distributes strain evenly so that you don’t end up excessively loading one part of your body and causing injury. Think of myofascial like a spider web. If one part of the web is broken or damaged, the web doesn’t fall down, Instead, strain or tension has to be distributed across the web differently to account for the weakened section. In other words, other parts of the web picks up the slack of the weekend section.

There are many benefits of self-myofascial release:

- Increase blood flow

- Improves muscular range of motion

- Reduce muscle soreness

- Maintains normal functional muscular length

- Encourages movement of you lymph- the lymph system relies on movement pressure to move the fluid.

Ultimately, this means that you’ll move better, recover faster, perform better and have less pain so that you can continue to be active and do what you love to do.

Monday, May 30, 2016

Avocado and Lump Crab Salad

This light crab salad is made with lime juice, olive oil, cilantro and red onion, then stuffed into an avocado. It’s light, refreshing and perfect for the summer as a lunch or salad if your having guests and you want to impress! You can easily double or triple this recipe, make the salad ahead and assemble just before serving.

1 medium Hass avocado (about 5 oz avocado)
4 oz lump crab meat
2 tbsp chopped red onion
1 1/2 tbsp fresh lime juice (from 1 lime)
1 tbsp chopped fresh cilantro
2 grape tomatoes, diced
1/2 tsp olive oil
1/4 tsp salt and fresh black pepper
2 leaves butter lettuce (optional)


In a medium bowl, combine onion, lime juice, cilantro, tomato, olive oil, 1/8 tsp salt and fresh pepper, to taste. Add crab meat and gently toss.

Cut the avocado open, remove pit and peel the skin or spoon the avocado out. Season with remaining 1/8 tsp salt and fill the avocado halves equally with crab salad. This makes 2 servings, place on two plates with lettuce if you wish and serve.

Saturday, May 28, 2016

Lean For Life!

Maintaining a healthy body weight throughout your life could help you live longer while the other end of the spectrum, carrying excess body fat, might do the opposite. Now, this hardly seems monumentally news-breaking given the amount of research we have that links obesity to numerous health-related conditions that decrease mortality. But maybe it is a good thing that researchers continue to probe these relationships as it seems that quite a large portion of our population still hasn’t made it a priority to keep their weight under control. Not only does it affect the individual from a personal health perspective, but it also affects everyone from the standpoints of increased medical costs and dollars being spent on diseases that are largely preventable with proper lifestyle modification.

In one study from Harvard’s T.H. Chan School of Public Health in Boston, U.S. scientists found that slim people had the lowest risk of dying over a 15-year period -- 12 percent for women and 20 percent for men. Meanwhile, obese men and women had the highest risk -- 20 percent for women and 24 percent for men. The underlying effect here is that preventing obesity may also prevent its consequences, which include diabetes and heart disease. The data collected from 116,000 participants in 2 prior health studies showed that people who maintain the leanest body shape have the lowest risk of dying prematurely. Participants were asked to recall their body shape at ages 5, 10, 20, 30 and 40. They also provided their weight at 50. They were followed from age 60 over an average of 15 to 16 years. In addition, participants completed questionnaires on lifestyle and health every two years and on diet every four years.

Another group of researchers analyzed 230 previously published studies that included more than 30 million people and nearly 4 million deaths. What they found was that among people who never smoked, the leanest lived the longest, and that gaining weight over time was linked with higher risks of premature death. While this also underscored the mortality risk that one incurs from smoking, it did reinforce the importance of weight management throughout life.

Ideally, the process should start early since adult obesity could be prevented by managing weight in childhood and adolescence. Once good habits are set at an early age, it is more likely that they will continue on in adulthood, when losing weight becomes less easy than it was during the younger years. Therefore, parents need to help instill good eating practices in their children while also setting a good example by the diets they eat themselves. And if those practices are repeated generation by generation, we just may see a decline in obesity related deaths and health issues. Lean and healthy is the way to go!

In Health, 

Dr. Brad Niewierowksi

Thursday, May 26, 2016

Is There Such a Thing as Too Much Protein?

Protein is an essential nutrient that plays a huge role in helping to keep you healthy and is essential to building muscle mass. And those statements about bone strength and kidney function? Totally untrue, in fact the opposite is true.

Protein actually plays a role in preventing osteoporosis and strengthening bones. And there is no evidence that a healthy person will get kidney damage from a typical high-protein diet.

-Protein builds muscle mass

-Adequate protein is needed for post workout recovery

-Protein in the diet supports fat loss

-Protein is important for a healthy immune system and connective tissue

-Insufficient protein skews body composition

So, we know protein is good and necessary, especially if you’re active. But can there be too much of a good thing? Sure, too much of anything is always possible, but with protein, that danger level is much higher that most people realize. While helping people figure out how much protein to eat, it is important to keep in mind that too much protein can be harmful for anyone with kidney disease. Unfortunately, chronic kidney disease is known as “silent disease.” Symptoms are hard to detect, but you can get some simple test done at your doctor’s office to find out if you have any issues with your kidneys.

Now that you have some more info regarding protein intake, you can make better choices about protein, now go forth and change some minds!

In Health,

Lisa Medina 

Tuesday, May 24, 2016

Pesticides on Fruits and Vegetables

“Eat your vegetables!” We’ve heard this countless times beginning with mom at an early age when we are children through adult life coming from our doctors and healthcare providers. And we do need to eat plenty of fruits and vegetables in our daily diet as they provide countless varieties of important micro-nutrients that help promote health and fight disease. On average, we should be eating about 9-13 servings of (ideally) fresh fruits and vegetables every day, favoring the vegetables as our most abundant food choice. Numerous studies have shown that the people who have the highest consumption of produce on a daily basis have the lowest risk for, and incidence of, most of the major diseases that are prevalent in our country such as diabetes, cardiovascular disease and diabetes. Therefore, we should just load up our grocery carts in the produce section and start stuffing them in, right? Well, maybe not. We need to be a little more discerning than that given the state of our current agricultural system. If we were down on grandpa’s farm where he raised everything in an “uncontaminated” manner, it would be a no-brainer. But because chemicals are so prominent in the agricultural process now, we have to be more careful with our food selections.

Herbicides and pesticides are the biggest issues with our produce, aside from the concerns of trying to avoid genetically modified varieties. Many of the chemicals used on our foods are touted to be 100% safe by the companies that produce them, but research has shown that many act as hormone disruptors and possible carcinogens when ingested regularly. Not exactly what you want to hear when you’re trying to make food choices to IMPROVE your health. However, there is a way to hedge your bets on getting the most benefit and least risk: choose organic. The largest study of its kind found that people who "often or always" ate organic food had about 65 percent lower levels of pesticide residues compared to those who ate the least amount of organic produce.

Probably the biggest detractor from people making more organic choices is the issue of cost. If this is a concern, then here is a strategy to help maximize your budget while not sacrificing quality. Not every fruit or vegetable needs to be organic. Many that have thick or inedible skin or peels (avocados, pineapple, onions, etc.) or that aren’t subjected to heavy spraying are usually fine since the edible portions aren’t contaminated. Every year the Environmental Working Group puts out a list ranking tested produce from most to least contaminated and you can use this as a guide for the ones that should be bought organic. Here is their most recent list of the “dirty dozen” that have the highest content of pesticide residue, with 1 having the highest amount:

1. Strawberries

2. Apples

3. Nectarines

4. Peaches

5. Celery

6. Grapes

7. Cherries

8. Spinach

9. Tomatoes

10. Sweet bell peppers

11. Cherry tomatoes

12. Cucumbers

You can also visit their website at https://www.ewg.org/foodnews/list.php to see all 48 fruits and vegetables with pesticide residue data so that you can make the best decisions when stocking up on your health-boosting produce. 

In Health, 

Dr. Brad Niewierowski

Friday, May 20, 2016

Benefits of Foam Rolling

There are so many benefits to foam rolling. The benefits of foam rolling have to do with the mobility of the fascia. Fascia is a layer of the connective tissue that surrounds all of the muscles in our body. Without proper mobility, fibers of the fascia become cross linked and they bind to the muscles and nerves. Many runners will stretch to try and keep their muscles healthy, but is stretching really enough?

Much of research has come to suggest that static stretching prior to exercise is not beneficial and could lead to injury. Many people suggest that static stretching after the workout when muscles are relaxed and returning to normal length. The result of the study suggest that it might be even more beneficial to precede that post exercise static stretch form of foal rolling.

When you are foam rolling, you want to make sure you roll along the whole length of the tissue that you are working on. If it’s your hamstring, you are going to roll from hip to hip to knee. The same goes with your quads or IT band. There will be some tender spots along the way and that’s ok. Go over them, they will eventually decrease with regular foam rolling.

It’s like anything else, the more you do, the better you will feel!

In Health, 

Lisa Medina
IFFH Personal Trainer

Thursday, May 19, 2016

Saturated Fats and Prostate Cancer

Balance in our diets is important when looking at the overall picture of what we are eating on a daily basis and how it affects are health. Gone are the thoughts that fat in general is a bad component of the diet. What we have learned is that the TYPES of fat we consume are more important than the overall fat content. Trans fats and hydrogenated fats are a definite must to keep out of the diet, but heart-healthy unsaturated fats should be eaten regularly. Saturated fats can be eaten in moderation if they are from healthy sources and aren’t prone to exacerbating a health condition as they are good for cooking because they are less damaged by heat. But there may be certain cases where they should be limited.

Researchers at the Gillings School of Global Public Health at the University of North Carolina looked at a correlation between saturated fat in the diet and men who have prostate cancer and found that high dietary saturated fat content is associated with increased prostate cancer aggressiveness. They looked at more than 1,800 men who had been diagnosed with prostate cancer and asked about their eating habits and other factors at the time of their diagnosis. A higher intake of saturated fat from foods such as fatty beef and cheese was linked with more aggressive prostate cancer, suggesting that there may be a correlation between the two factors.

The study also found that higher levels of polyunsaturated fats, found in foods such as avocados, fish and nuts, were associated with less aggressive prostate cancer. We already know that these types of foods are important for other functions such as brain and nerve health and they promote healthy levels of HDLs in the body, the “good” cholesterol that helps protect our blood vessels by removing excess cholesterol and fats. The omega 3’s (EPA and DHA) are also necessary because they help fight inflammation. With prostate cancer and any other type of cancer, damage has occurred on a cellular level. While steps need to be taken either surgically or pharmacologically to remove or eradicate the cancer, the body still needs support from the diet to assist in the healing and regeneration process. Or, at the very least, not to make the situation worse. An intake of the healthy dietary fats while limiting the ones that may be aggravating the condition is an easy way to take a step in the right direction.

Beyond that, high levels of protective antioxidants from fruits and vegetables or proper supplementation will benefit in further care in helping to restore a healthier state to the body. Natural components such as saw palmetto and pygeum bark have also been shown to be supportive for prostate health, but speak to a doctor who is familiar with a nutritional approach to improving your health so that you can find the best means to help you achieve your health goals.

In Health, 

Dr. Brad Niewierowski

Wednesday, May 4, 2016

What Is Hypertension?

Hypertension affects approximately 70 million Americans each year, quadrupling the chance of a person dying from a stroke and tripling the chance of dying from heart disease. While the addition of lifestyle modifications offers several benefits to decreasing hypertension, many people are given only medications to lower blood pressure but with limited effect. Some people do not see the benefit, some may suffer unwanted side effects and others may hear stories about adverse effects that cause them to discontinue treatment. For many, it may be that the treatment is not targeting the underlying cause.

Over 90% of people with high blood pressure have primary hypertension. It can progress gradually over the years as a result of lifestyle factors such as inflammation levels, too much salt, lack of exercise, obesity, heavy alcohol consumption and hereditary factors. Hypertension that results from a medical condition, such as obstructive sleep apnea, adrenal gland tumors or thyroid problems, is called secondary hypertension. Secondary hypertension usually starts suddenly and causes higher blood pressure than primary hypertension. But there can also be neurological reasons that would account for increases and understanding the basics of physiology may help offer another tool for management.

Ask any person on a daily basis if they experience “stress” and you can get varying responses from only minor issues to being overwhelmed with it. When we are stressed, the sympathetic nervous system, sometimes called the "fight or flight," response system, kicks in. The adrenal glands produce more of the neurotransmitters epinephrine (adrenaline) and norepinephrine (noradrenaline), and extra blood is pumped to the muscles through the vessels, which delivers additional nutrients and oxygen until the crisis is over. The nervous system is connected via nerves to the heart and every blood vessel in your body. Through these nerves, it can increase heart rate and narrow blood vessel diameter. Both cause blood pressure to go up. This should be a transient response and clear as the stresses pass.

Therefore, neurogenic hypertension, which is related to excessive and abnormally high sympathetic activity from chronic and prolonged stress, can be another area of lifestyle that would need to be addressed. Research has also been done that demonstrated abnormally high amounts of norepinephrine and epinephrine in people with normal blood pressure but whose families had a history of hypertension. These "sympathetic bursts" have also been seen in patients with high BP and it was concluded that high BP can also result from a dysfunction in the autonomic nervous system.

If that is the case, then also being aware of family history is another item that can help someone assess whether they are at higher risk for a cardiovascular incident. In our office, we utilize The Boston Heart Study as a tool to screen for risk factors such as inflammation levels, genetic tendencies, lipid profile and blood sugar management. If there has been a family history of cardiovascular accidents and surgeries, diabetes and/or hypertension (or if you have experienced any of those first hand), you are a prime candidate to have this type of assessment performed. Not only will it help you understand where you are now, but it will also let you know about your risk level for those conditions in the future.

In Health, 

Dr. Brad Niewierowski

Added Benefits of Increasing Your Water Intake

We regularly discuss with patients the many benefits that water offers to the body. Water keeps the body temperature normal and lubricates and cushions joints. It protects the spinal cord and helps us get rid of waste through urination, perspiration and bowel movements. Based on the fact that about two thirds of our bodies are comprised of water, it may seem obvious that consuming water is important for our health. But a new study finds that by increasing plain water consumption, we can control our weight and reduce intakes of sugar, sodium and saturated fat.

Prof. Ruopeng An from the University of Illinois had the study published in the Journal of Human Nutrition and Dietetics. He noted that most people will meet the majority of their body's fluid requirements by drinking plain water and other beverages, but also through certain foods, such as soups, celery, tomatoes and melons. Keep in mind though that some liquids such as tea, coffee and soda also have caffeine in them, which has a diuretic effect on the body. This was not accounted for in the study. The researchers asked participants to recall all foods and drinks they consumed on 2 days that were between 3-10 days apart and then calculated the amount of plain water that each participant consumed as a percentage of daily dietary water intake from both foods and drinks.

For most people, water consumption was below adequate levels. As a general rule of thumb, one should try to consume about half of their body weight in ounces of water daily. For an average 160 lb individual, that would be 80 ounces of water, or 10 cups. On a daily basis, the participants consumed an average of about 4.2 cups of plain water, which accounts for just over 30% of their total water consumption.

The average calorie intake for each participant was 2,157 calories which included 125 calories from sugar-sweetened beverages and 432 calories from "discretionary foods" - desserts, pastries, snack mixes and other foods that are not essential. The results of the study revealed that people who increased their consumption of plain water by one to three cups daily lowered total energy intake by 68-205 calories each day and their sodium intake by 78-235 g each day. Further results showed that the people who increased their water consumption also consumed 5-18 g less sugar, as well as 7-21 g less cholesterol.

So not only did people improve their hydration levels, but they also ate less unhealthy foods, which contributed to an overall lower calorie intake and less metabolic stress on the body! Looking to lose a little weight, increase energy or decrease stress on the body? Increase your water intake as a quick and easy first step and see what benefits you experience.

In Health, 

Dr. Brad Niewierowski

Brain Fog After Poor Sleep: Too Little Oxygen Or Too Much Cortisol?

Ever have one of “those” days after a night of poor sleep? Your memory doesn’t seem to be at its best and your thoughts are sluggish. It has been demonstrated that sleep deprivation strongly impairs memory and learning, but the actual mechanism causing these deficits has not been definitively identified. Now, a study from the University of California, San Diego done on persons with sleep apnea may provide some much-needed answers as to why.
The researchers checked 55 sleep apnea patients’ blood cortisol levels every two hours for 24 hours. The patients underwent sleep studies the following night and then took a battery of tests to assess cognitive function. The researchers looked to see how many times they stopped breathing, and how often their oxygen levels dropped in response to airway obstruction. Previous research has assumed that sleep-related memory problems are caused by a drop in oxygen. But this study found that it was elevated cortisol levels that best predicted cognitive dysfunction.
Prior studies have revealed adverse effects of elevated cortisol on the brain’s hippocampus. The hippocampus is a structure that resides in the temporal lobe of the brain and is intimately involved in acquiring information and consolidating that information into long-term memory. This is important because it may explain why sleep-deprived individuals frequently exhibit poor memory and concentration abilities.
We know that people who have insomnia and those who chronically get inadequate sleep because of personal lifestyle choices have elevated levels of the stress hormone cortisol. These people do not have sleep apnea or low nighttime oxygen levels, yet they frequently exhibit cognitive dysfunction similar to patients with sleep apnea, so the common link may be the cortisol. We know that overstimulation of the adrenal gland produces the excess cortisol and the common thread is stress, produced by either insufficient sleep, or in the case of sleep apnea, fragmented sleep. Therefore, reducing cortisol output would be the base strategy to improving sleep quality and subsequent brain function.
First, adequate attention should be paid to maintaining a proper sleep environment. Keeping the room as dark as possible, noise- and distraction-free, and typically not warmer than 69 degrees will help promote proper rest. Avoiding stimulants such as caffeine, alcohol and high sugar foods, as well as television and other bright visual stimuli, prior to bedtime will also keep the body in a more relaxed state. (However, eating a healthy snack with some protein and fats 2-3 hours before bedtime will help keep the body from going into a hypoglycemic state overnight that triggers a release of cortisol.) Finally, find a way to mentally wind down before going to bed. Clear your mind of all the issues for tomorrow that you can’t do anything about tonight (except cause yourself more stress and poor sleep!). Take a hot, relaxing shower or bath, meditate or enjoy some quality family time. Take the steps to set yourself up for lower stress and a good night’s sleep, including planning enough time to actually sleep, and see if your mental function doesn’t improve as a result.

In Health, 
Dr. Brad Niewierowski

Avoid Those Energy Boosters!

Many people would like to have more energy on a daily basis. Time demands, family commitments, work pressures and inadequate amounts of sleep all contribute to those feelings of sluggishness or fatigue. Unfortunately, one of the “solutions” is the “quick fix” of consuming an energy drink or energy booster that are commonplace in stores today. Many people are using these as their go-to way to get through a day, but unfortunately there are costs associated with this band-aid approach to low energy. As the popularity of non- alcoholic "energy" drinks continues to rise, so do related health problems.

In 2009, U.S. emergency rooms treated almost 10 times more cases of reactions to beverages such as Monster and Rock Star than they did in 2005, according to a U.S. government report. More than 13,000 ER visits related to the highly caffeinated drinks were reported in 2009, said researchers from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). Nearly half the emergencies occurred after the beverages were mixed with alcohol or other drugs, and young adults aged 18 to 25 accounted for more than half of those cases, the researchers found. Men were twice as likely as women to use alcohol and drugs along with an energy drink. But, more women than men combined energy drinks with pharmaceuticals, the researchers reported.

The drinks contain stimulants such as caffeine, and the amount of caffeine in a can or bottle varies by brand. Whereas a five-ounce cup of coffee contains about 100 milligrams (mg) of caffeine and a 12-ounce cola about 50 mg, some energy drinks contain about 80 mg, others as much as 500 mg, according to the report. High doses of caffeine can cause abnormal heart rhythms, high blood pressure, dehydration and other serious conditions. This is due to the effect that it has on the adrenal system.

Our adrenals help us manage stress, whether it be from a physical, emotional or chemical source. They kick in our “fight or flight” mechanisms, which is why we see the reactions as noted above. For the short term, this is not a bad thing as it is one of the body’s natural survival tools that helps us adapt to and deal with stresses as they are presented. What we don’t want is this system firing off more than it has to, either with large caffeine surges at one time or from continual bombardment day after day (the people who drink multiple energy drinks to “get by” every day). Over time, this can contribute to taxing the body’s own coping mechanisms and can actually lead to more fatigue as well as sleep disturbances and blood sugar imbalances.

In order to maintain proper energy levels, we have to pay attention to our daily activities that support normal function. We need to get adequate sleep each night so that our bodies can heal, repair and recover. A healthy diet will keep blood sugars balanced and even throughout the day so that we don’t experience highs and crashes in energy. We also need to make sure we are keeping emotional stresses in check so that the adrenal system is not in high alert mode more than it should be. If these basic strategies don’t help to correct a lack of energy, an assessment of hormone levels such as hemoglobin A1c, cortisol and thyroid levels may be necessary.

In Health, 

Dr. Brad Niewierowski