Wednesday, July 9, 2014

Exercise Routines and Their Implications

Physicians from internists to psychiatrists are now agreeing that the benefits of exercise cannot be denied. Not only can it help us maintain our physical health, exercise is also involved in mental health maintenance as well. Mental you say? Yes and all the research is pointing in that direction. In fact, some mental health professionals are prescribing exercise before they reach for the prescription pad to jot down a useful medication.

The question then becomes one of how much exercise may be too much or is exercising now becoming indicative of an addiction or variant of an eating disorder? Some believe it could be an iatrogenic illness (illness caused by the healthcare intervention).  But isn't it also tantamount to Freud attributing behavioral or personality problems to too much or too little mothering? Ah, the dilemma it can create. Remember when they were seriously discussing the "schizophrenogenic mother?"

No physician or psychiatrist knows how much is too much, really. Where do they get this information in their training? If you look at their training in nutrition, you'll have some idea that it's next to nil in time spent on the topic. How much training in exercise regimes? The answer to that one is really difficult to parse out even with a rigorous search engine. Search engines are still getting it wrong.

So, where do medical personnel get all their information about diet and exercise?  They do know about BMI (body mass index)  and, using a simple chart that is available online, they can easily calculate whether you are falling within an acceptable or outside an acceptable range.  Then, of course, comes the discussion about what you need to do in terms of your eating habits, exercise and anything else that might enter into this equation.  Easier said than done, I am sure.

Undoubtedly, you will be given a brief talk on the benefits of exercise in your efforts to maintain an acceptable BMI.  But there's one little piece missing here.  What might that be?  Are you aware that muscle is denser than fat (adipose tissue)  and that while you may begin to look slimmer, your scale will be screaming that you are NOT losing weight.  What a dilemma this will pose for you and, possibly, your physician.    Oh, and while we're on the topic of fat, let's take a quick look at one other thing which poses an incredible amount of anxiety, especially among women.

I am, of course, talking about cellulite.  What do you think that really is?  Where do you think the term came from?  Would you be surprised to find out that it actually was from people who wanted to promote their spa services in Europe and then the fashion industry latched on to it?  Yes, that's exactly where it came from because it is not a medical term and it is not a medical disorder.  Let's put that one to rest forever.  

One other tidbit of information may be useful here.  Cellulite isn't something you can massage away because it is really fibers that are holding tissue in place.  The dimpling that you see is an unfortunate natural process.  It is as they say, "disease mongering" in the service of freeing you from your money once again.

 Back to exercise.   I'm reminded of things that I have heard people say once they are convinced that something is good for you.  For example, if you tell them that exercise is good, then they will begin to exercise in earnest and, possibly, to the point of injury.  Exercise is not supposed to be something that will result in bodily harm or orthopedic surgery.  Sure, we are told that exercise should be to the point where you feel you have exercised (and that's always up in the air), but not to the point of absolute physical exhaustion and muscle pain.  When that happens, you know you've done too much.

As in everything, exercise should be done in moderation and the experts tell us it should be spaced over the week.  Now the concern is that people are compulsive exercisers and they may also be suffering from an eating disorder.  That does make sense since many people who suffer from anorexia do exercise excessively to reduce their weight.   They've even given this excessive exercising a term and it is "exercise addiction."  That actually makes more sense than you would think at first blush.

What would be the reason you would call this type of exercise and addiction?  A recent presentation at a European meeting of psychiatrists addressed this issue and attendees at the conference were asked to begin to form a means of actually conceptualizing and defining this new disorder.  The question is, do we need a new disorder?  I suppose we may, but this "addiction" may actually just be one of the symptoms found in a category of the eating disorders, namely anorexia nervosa.  Should we put it into an addiction category?

Interestingly enough, the research that was presented was based on a study of 712 patients with eating disorders who had "significantly higher scores in weight control exercise."  That stands to reason since they already had an eating disorder and we know this is something that people with eating disorders do.  No surprises here.  But the researchers also indicated that this particular study was part of a larger multi-year study that was used to develop a new scale they were introducing.

What would be the reason for this new concern about something called compulsive exercising (CE)? It really centers around the difficulties that healthcare staff have found when it comes to providing treatment for people with eating disorders.  Those who fall into the CE  group apparently require longer stays of inpatient treatment.  A quick look at what might be causing this would be useful here, I'm sure.

Are you a runner?  Do you run on a daily basis?  What's the reason you keep on running?  If you don't run on the regular basis as you normally do, how do you feel?  These are all important questions because they point to something called "the runner's high."  Here is where a really interesting bit of biology comes in.  Our bodies have evolved in a manner that allows us to produce something that affects the "endocannabinoid system."  I know you can see the clue right there looking at you now.

Yes, your body produces something that is similar to what is found in marijuana and it can have a lovely, positive effect on your mood.  Prolonged running or cycling has been found to increase levels in this system and thus runner's high. Blood samples that were taken after periods of running showed really significantly increased levels of these endocannabinoids and that seems like pretty good evidence to me.

All those people out there cycling on all of those days are really just ramping up their runner's high to make themselves feel good and, of course, it has a great effect on their musculature, endurance and good feelings about themselves. Hmmm, should physicians start writing prescriptions for bicycles? Doesn't sound like such a bad idea.

Exercise isn't only good for giving you a more sculpted body, but it may also be involved in helping your body produce more than endocannabinoids.   The very muscles that you have probably always seen as just a physiological rubber band that permits you to move as you would wish actually may act more like glands and produce a variety of helpful hormones.  These hormones are extremely important to the maintenance of your immune system and, who knows, maybe even more.  After all, we've just found out that they are involved in helping us maintain our mood and a healthy outlook on life.

Okay, go forth and get yourself a Trek or Diamondback, or Cannondale or whatever. Who cares what bike you buy. That is, of course, unless you want to impress the competition. Men, however, pay attention to that all-important saddle. If you aren't aware of its problems, do an Internet search.