We often jokingly call ourselves “Weekend Warriors” if we are mainly sedentary from Monday to Friday and engage in strenuous athletic activity on Saturday and Sunday.  While this may sound like a good way to get the benefits of exercise, this is also a good way to get injured.  In my practice, I have seen several patients hobble into my office on a Monday morning with a sprained ankle, shin splints, or fatigue from dehydration.  While some of them are caused by accidents, many of them are caused by overexerting themselves. Our bodies are finely tuned machines and they need to be maintained regularly.  Think of an athlete in any professional sport.  During the off season, they still need to do training.

Think about your typical workday.  You wake up, you eat breakfast and commute to work.  During the work day, most of us are sitting at our computers for more than 10 hours with very little time away.  At the end of the day, you get back in the car or train and head back home for dinner.  Very few of us get exercise during the work week. Some people feel guilty about this and feel they need to “make it up” on the weekends, so they engage in extra rounds of tennis or run extra long distances.  This can cause injuries that can sometimes be severe such a muscle or ligament tears.

The best way to avoid injury is to become a “Weekend AND Weekday Warrior”.  What I mean by this is to incorporate some type of exercise at least 2-3 times a week.  I would recommend a type of exercise that works out muscle groups that complement the muscles used on the weekends or perhaps use the muscles in a different way.  For example, many professional football players used to take ballet to increase their agility and balance.  If you do a lot of running, perhaps take a spinning (cycling) class or swim a few laps during the week.  In fact, you may notice your running time may actually improve with the “cross-training” during the week and you will feel less fatigue. Even some simple 15-20 minutes of stretching or yoga before bedtime can help you tremendously.

Diet is also very important for the Weekend Warrior.  I believe strongly that the body is like a car; the fuel that you put in is very important.  You need good quality “fuel” in the form of a low fat, low carbohydrate, high protein, and high fiber diet.  Fruits and vegetables which are high in antioxidants, such as those with bright colors (blueberries, raspberries, cherries, kale, tomatoes, carrots, etc.), are also important to incorporate into your diet.  Limit your alcohol intake.  Alcohol is known to cause decreased absorption of many vitamins and minerals including Vit B and calcium, both of which are very important to the athlete’s body.

When I think of the term “Warrior” I often think of the Spartans.  In ancient Greece, Sparta was known for its tradition of training soldiers in a harsh manner so they would “toughen up” and be prepared for pain during battle.  The soldiers were often told to ignore the pain.  Needless to say, the Spartans, as intimidating as they were, lost many battles to the Athenians.  The lesson from the Spartans:  Don’t ignore the pain!  Pain in your body means something is inflamed or injured.  It is your body’s way of saying stop what you’re doing or you’re going to get hurt, like the pain you feel when you accidentally touched a hot stove.  Your hand pulls away.  When you are playing a sport or working out, if you feel pain, stop immediately.  If you continue, you may end up with a torn ligament or muscle.  After the game or workout, you may need to ice the area, apply a compress such as a knee brace or ace bandage, and elevate the area with a pillow.  Most importantly, make sure to rest the muscle or joint.  Do not attempt to do the activity the next day!  That’s when serious injuries can occur.

There are many benefits to exercise including feeling better, lowering your risks of cardiovascular disease, losing weight, and getting better sleep.  30 minutes per day is ideal, but trying to squeeze in all the exercise in 2 days every week is not and could be possibly dangerous.  So be an “Everyday Warrior”, and not a “Weekend Warrior”.

A recent article published in the New England Journal of Medicine, titled “Primary Prevention of Cardiovascular Disease with a Mediterranean Diet” created many waves in the world of nutrition.  The researchers from Spain who conducted the study had assigned two groups of people to a control group that ate a traditional “low fat” diet and an experimental group that ate a “Mediterranean” diet.  Some of the main differences include:  Encouragement to consume more than 4 tablespoons of olive oil per day, more nuts and beans in the Mediterranean group, Wine (no more than 1 glass/day) was allowed in the Mediterranean group, but none in the “low fat” group.

Though there was little observed weight loss in either group, the researchers saw dramatic reductions in heart attacks and strokes in the Mediterranean diet group.  In fact, the study was halted early because the researchers believed it was unethical to allow the control group (low fat) to continue because there was overwhelming evidence to show that the Mediterranean diet could make an impact on the participants’ health.

I believe the study reinforces many aspects of nutrition that we already know.  We know that olive oil, tree nuts (such as almonds and walnuts), red wine, and fish oils can raise HDL (“good”) cholesterol and that in turn has a cardioprotective benefit.  The diet also emphasized increasing intake of foods with antioxidants, such as fruits and vegetables.  I was a little surprised that weight was not as much of a factor.  Perhaps, it is the quality of the calories in the diet that makes a bigger difference.  However, I do think it is still important to maintain a good BMI.

The study also included a spice mixture called “sofrito” which is ubiquitous in Spanish cuisine.  It contains tomato, onion, garlic and olive oil. Previous studies have speculated that garlic can be helpful for lowering LDL (“Bad”) cholesterol and lower blood pressure.  Before you go out and buy that large bottle of olive oil, be sure that you purchase extra virgin olive oil, as use of the the refined variety (low in polyphenols) was discouraged.  Overall, I believe there is no downside to following the Mediterranean diet.  Many people have already adopted it or some aspects of the diet already. I am ectstatic to see that there is more evidence that diet can change your medical conditions and hope that one day a prescription for the “Mediterranean Diet” will be more commonplace than drugs for high cholesterol and high blood pressure.

Here are the actual daily recommendations for the Mediterranean diet group in the study:

Recommended

• More than 4 tablespoons of extra virgin olive oil
• 1 serving of nuts per day (30 grams total with 15g walnuts, 7.5g almonds, 7.5g hazelnuts)
• More than 3 servings of fresh fruit per day
• More than 2 servings of vegetable per day
• More than 3 servings of fish per week (fatty fish was recommended)
• More than 3 servings of legumes (beans) per week
• More than 2 servings of Sofrito (sauce made with olive oil, tomatoes, garlic, and onions)
• White meat instead of red meat
• 1 glass of wine with meals (optional, only for people who usually drink alcohol)

Discouraged

• Soda
• Commercial bakery goods, sweets, pastries
• Spread fats (i.e. butter)
• Red and processed meats

For people with seasonal allergic rhinitis (also known as “Hay fever”), the itchy eyes and runny noses are sometimes unbearable during the period between spring and fall.  Antihistamines are generally effective, though they are associated with sleepiness and dry mouth.

A new study published in the Annals of Internal Medicine titled “Acupuncture in Patients with Seasonal Allergic Rhinitis” showed promise in the ancient form of Chinese traditional medicine.  They found that people who underwent acupuncture had required less antihistamines and had fewer symptoms than the control group after 8 weeks.

I have always had a positive opinion of acupuncture.  Think of all the health fads in recent years that have come and gone.  Acupuncture has lasted over 5000 years and is practiced by over a quarter of the world’s population.  If it wasn’t effective, wouldn’t people have stopped believing in it?  If you are afraid of needles, you should know that the average acupuncture needle is many times smaller than those used for drawing blood or giving injections (which can sometimes hurt), and is about the thickness of a human hair.  Most people who have had the therapy will tell you they don’t feel pain, just a slight pressure with acupuncture needles.  In addition, there are forms of acupuncture which use small beads applied to the surface of the skin.

I do have some warnings about acupuncture.  Make sure you are going to a reputable, licensed practitioner.  Be sure that all needles used have been sterilized.  You should not be afraid to ask about sterilization practices, and your practitioner should not be offended by the question.  Many offices use only disposible needles.  Finally, if you are on a blood thinner such as coumadin, you may want to alert your practitioner and perhaps opt for acupressure.

My grandfather, who lived to be 101 years old, always used to say the phrase, “Early to bed, early to rise, makes the man healthy, wealthy, and wise.” As a non-native English speaker, it was quite impressive he knew that phrase and spoke it quite well, but even more impressive because that is just what he practiced and what I believe contributed to his longevity.  More and more, we are finding that sleep has innumberable benefits to the body, from preventing insulin resistance, boosting the immune system, and reducing stress.  Just as the body has needs for food, oxygen and water, we all have a sleep requirement for maintaining good health.  We have all heard of how famous people, like Thomas Edison, survived and even thrived on extremely minimal or no sleep.  While this may be true for some people, they are the exception rather than the rule.  The average adult requires 6-8 hours of sleep on average.

Find out how much sleep you need.  Ask yourself, do you wake up refreshed in the morning?  Are you having to turn to caffeinated drinks to stay awake in the afternoon?  Another possiblility is that you are not getting good quality of sleep.  Medical conditions such as sleep apnea (an extreme form of snoring where you stop breathing) can cause frequent disruptions in the sleep cycle.  Contrary to popular belief, you cannot “bank” sleep.  It is not something that you can really catch up on.  It is very important to address sleeplessness with your physician as this can lead to frequent infections and fatigue, which are signs your body is not functioning well.

Here are some tips for getting good sleep:

• Set aside enough time for sleep.  It is always tempting to surf the net or keep reading that next chapter on your e-reader.  If you find it difficult to stop, set a “bed time alarm” for the evening.  When the alarm goes off, it’s time to stop what you are doing and go to sleep.
• Invest in a good mattress and “flip and turn” it regularly.  Mattresses sag over time.  I recommend turning the bed so that the part under your legs is now under your head every 6 months.  If your mattress can be flipped, do this as well.
• Replace your pillows regularly.  Your head is about 10 pounds.  If your pillow is flat like a pancake, it is not supporting the weight of your head.  That means your neck takes on the extra weight.  If you wake up with neck pain, it may be time to change your pillow
• Buy earplugs.  You may not wake up fully from noises from the street or outside, but even small noises can disrupt sleep.
• Buy good curtains/shades that block out light.  In cities, the outside lights can get very intense and prevent you from getting your “zzz’s”  Also, most people are able to shut the mind off better in complete darkness.
• Turn your alarm clock so that it faces the wall.  Clock watching can cause more anxiety with thoughts like “It’s 3 AM,  I can’t get enough sleep and I’m not going to do well on my presentation at work tomorrow.” This becomes a self fulfilling prophecy.
• Maintain the same sleep schedule on weekends.  Avoid sleeping in.  The human body is used to routines.
• Limit the amount of alcohol.  Contrary to common belief, alcohol does not give good restful sleep.  It can help initiate sleep, but it can actually worsen conditions such as sleep apnea.
• Exercise regularly.  If your body is not tired, it will not want to sleep.  Just be sure you don’t exercise too close to bedtime.
• Limit the amount of water your drink at bedtime.  Waking up to urinate is a disruption in sleep.  If you must take medications at bedtime, take them with a sip of water.

Here in the Northeastern U.S., winter has finally come with temperatures below freezing for the past few days.  Keeping warm is very important to maintain your immune system and prevent hypothermia.  Here are some tips to help you survive the winter.

• Drink plenty of warm liquids.  Cold air is often dry air, which can dry mucus membranes in your nasal passages and make your skin dry and scaly.  Rehydration is just as important during the winter as the summer.
• Make sure the air in your house  is humidified.  I generally recommend against using humidifiers with tanks as these can be breeding grounds for mold and bacteria.  Instead, you can place bowls of water on top of the radiator.  Having plenty of houseplants around can also accomplish this goal.
• Moisturize your skin regularly.  I keep small bottles of lotion and lip balm in each jacket pocket and in every room so that I remember to keep the skin moist.  Minimize the number of showers you take each day.  Dry skin can lead to cracks and bleeding.
• Cover up when going outdoors.  Every inch of bare skin exposed to the elements loses body heat and you can develop frost bite.  Gloves, hats and warm socks are important items of clothing, as these are usually the coldest parts of the body and lose the most heat.  Put these on about 10 minutes before you head outdoors to build up heat and you will stay warm longer.
• Heat packs can be great if you must be outdoors for a long time.  Some are instant/disposable packets that you “break and shake”.  Another version is a plastic gel pack that you can microwave and is reuseable.
• Avoid alcohol and tobacco.  In many cultures, people drink alcohol to stay warm.  While alcohol initially makes you feel warm and can dilate blood vessels so that you appear flush, in the long run it can actually lower your body temperature.  Nicotine can cause blood vessels to contract and hasten frost bite.  Smoking can also cause bronchoconstriction along with the cold air and cause an asthma attack.
• Do not use your stove to heat your home.  Many areas, especially those affected by Hurricane Sandy, are still without heating systems.  Heating your home with gas heat is a potential for fires and carbon monoxide poisoning.
• Exercise regularly.  As I mentioned previously in my blog, cold weather is no excuse to stop exercising.  You can do yoga, crunches, push-ups, and exercise DVD’s in the comfort of your home.  Exercise raises the body temperature throughout the day.