Thursday, August 18, 2011

Overweight Athletes and Heat Injuries

This is a good article warning of the potentially deadly combination of obesity and heat death in obese athletes.

The bottom line is that kids must get in shape PRIOR to the start of summer practices. This must be the responsibility of both the athlete and the parent(s). Once the summer practice season starts (usually around Aug 15th) coaches must keep a close eye on heavy kids. If they observe signs and symptoms like profuse sweating, shortness of breath, pain, headache, lightheadedness, dizziness, etc. (See the guidelines for more specifics - click here) then the athlete must be pulled from practice.

If a child is not in shape, then they must be advanced MORE SLOWLY than a child who comes in shape. You cannot get them in shape faster and should not push them harder so they can be ready for opening day. This means MORE REST and fewer "reps" each practice until they are ready.

Wednesday, August 17, 2011

Safe Weight Loss Practices - New NATA Guidelines

The National Athletic Trainers Association (NATA) has recently published new guidelines (a position statement) called Safe Weight Loss and Maintenance Practices in Sports and Exercise.

Here is NATA's list of seven basic recommendations for safe weight loss and management practice:
1.) A body-composition assessment, which is a scientific and objective method of estimating lean body mass and fat mass, should be used to determine a body weight consistent with safety, good health and optimal performance in weight-classification sports. This process takes no longer than 10 minutes, Sammarone Turocy says, and should be administered by a trained individual.
2.) Progress toward reaching the target weight based on body-composition tests should be assessed at regular intervals by repeating the tests.
3.) Weight gain or loss should not occur at excessive rates; it should be steady and at a consistent and safe rate (one or two pounds per week for weight reduction). Additionally, weight loss should not exceed 1.5 percent of body weight per week.
4.) Both diet and exercise should be used as part of the strategy to change body weight. Weight management should follow the training plans and goals of athletes and other physically active individuals.
5.) Enough calories taken in from all food groups should occur during weight change. Metabolism and energy needs for physical activity must be considered in developing the diet.
6.) Education on safe dietary and weight-management practices should be conducted on a regular and planned basis, and the involvement of trained nutrition, health and weight-management experts such as athletic trainers or other health professionals is highly recommended. Coaches, peers and family members should not provide information or participate in diet, body-composition or weight-management practices, and they should refrain from making comments about them. "Coaches can be supportive, but it is their job to bring in someone else to provide the education," Sammarone Turocy says, adding that certified athletic trainers and local pediatric or orthopedic physicians are ideal for that task.
7.) Athletes should be cautious with the use of dietary supplements and ergogenic aids for weight management, or any techniques that lead to rapidly changing body weight through unsubstantiated methods of weight reduction. Consideration of a sport's governing body's ruling on such supplements must be given. (The NATA currently is working on a position statement regarding supplements.)

Concussions......yes, concussion again!

See Testing helps change the game on youth concussions

Tuesday, August 16, 2011

Revised Heat Guidelines for Young Athletes

The American Academy of Pediatrics just published their revised heat guidelines called Climatic Heat Stress and Exercising Children and Adolescents.

Some notable comments were:
1. "Researchers have previously suggested that children are less effective in regulating body temperature, incur greater cardiovascular strain, and have lower exercise tolerance during exercise in the heat compared with adults. However, more recent studies, in which both groups were exposed to equal relative intensity exercise workloads and environmental conditions while minimizing dehydration, have compared 9- to 12-year-old boys and girls to similarly fit and heat acclimatized adults. These newer findings indicate thatchildren and adults have similar rectal and skin temperatures, cardiovascular responses, and exercise-tolerance time during exercise in the heat."

2. "Notable chronic clinical conditions and medications that contribute to decreased exercise heat tolerance and increased exertional heat-illness risk include diabetes insipidus,18 type 2 diabetes mellitus,19 obesity,20,21 juvenile hyperthyroidism (Graves disease),22 cystic fibrosis, 23 and anticholinergic drugs or
certain other medications that affect hydration or thermoregulation."

3. "A previous episode of heat stroke, however, generally does not seem to have long-term negative effects on thermoregulation, exercise heat tolerance, or exertional heat illness risk, especially for those who received prompt cooling therapy."

Here are the Action steps recommended:
  • Provide and promote consumption of readily accessible fluids at regular intervals before, during, and after activity
  • Allow gradual introduction and adaptation to the climate, intensity, and duration of activities and uniform/protective gear
  • Physical activity should be modified
  • Decrease duration and/or intensity
  • Increase frequency and duration of breaks (preferably in the shade)
  • Cancel or reschedule to cooler time 
  • Provide longer rest/recovery time between same-day sessions, games, or matches
  • Avoid/limit participation if child or adolescent is currently or was recently ill
  • Closely monitor participants for signs and symptoms of developing heat illness
  • Ensure that personnel and facilities for effectively treating heat illness are readily available on site
  • In response to an affected (moderate or severe heat stress) child or adolescent, promptly activate emergency medical services and rapidly cool the victim
Here are my comments:
WHAT A COP OUT! These are too vague and leave the MEDICAL decision making to non-medical administrators, coaches, and parents. Here are my guidelines based on my 25 years on the side-lines:

7 Year Old Boy Signs with Real Madrid Soccer Club

ARE YOU KIDDING ME! Parents, please wake up and pay attention. This is not OK! What happened to fun and childhood?

Read this article and I'd love to know your thoughts.... Click Here.

Monday, August 15, 2011

Good Health vs. How Much Can I Get Away With

As all of you know from my newsletter and facebook posts, I had a major thoracic surgery 10 months ago. I can tell you without a doubt that it has been my focus on proper diet, the proper supplements (that is supplementary to my diet and based on what I required to heal), and the proper exercise that has enabled me to have a recovery that has been nothing short of miraculous.

That said, how do we balance our need for good health with our need for FUN? Is it FUN vs. pain, suffering, calorie counting, sacrifice, and discipline or is there a way to balance our approach?

A Healthy Diet …. The Paleo Diet

I have told many of you about the Paleo diet (no grains, legumes or dairy) as a way to get you on the road to health and wellness. This lifestyle (it is really not a diet) is based on the way ancestral man ate before the advent of agriculture. This does not mean that all foods since agriculture are not tolerated; it means that you must test foods to see what foods cause sensitivity reactions, i.e. gas, bloating and just not feeling well to full blown allergic reactions. The Paleo diet seems to be the best way to have a nutrient rich, non-inflammatory diet.

Some will say, “well, there is nothing left to eat!” This is not true. It is your individual biology with which you must become familiar. For those of you into statistics, there is a bell curve of food intolerance and sensitivity which means that most of us are somewhat sensitive or intolerant to varying degrees of certain anti-nutrients in grains, legumes and dairy. Both cooking food and fermenting food get rid of or diminish many of these anti-nutrients in many grains, legumes, and dairy.

The foods recommended are:

1. Meats of all types, preferably organic (grass fed): red meat (cows, bison), pork, poultry, wild caught fish

2. Vegetables

3. Fruit

4. Roots and Tubers: Yams, sweet potatoes, carrots, turnips, parsnips.

5. Nuts and seeds (remember peanuts are not nuts, they are legumes)

The foods not recommended are:

1. Grains: all grains, not just wheat. The current research says you cannot cook away or ferment away the gluten in wheat, rye, barley, etc.

a. Rice and oats seem to have the lowest sensitivity rates so these would be the best to add back into your diet.

2. Legumes

3. Dairy

a. Organic cream and fermented dairy seem to have the lowest sensitivity rates (cheeses, some yogurts, sour cream, kefir, some cottage cheeses, cultured buttermilk, acidophilus milk, and certain soy products).

b. A certain percentage of the population is intolerant to lactose and to casein. There are those of you who are, as we say, “@#$% out of luck.” Those who are not can eat fermented dairy and organic cream and maybe some non-pasteurized, non-homogenized milk (we cannot purchase non-pasteurized milk in Maryland so I recommend the Trickling Springs Creamery Milk which is at least non-homogenized and organic).

So how do you balance FUN with good nutrition? How do you empower yourself and regenerate your body? It is all based on the choices you make.

1. Start logging in your foods to the Fate on Your Plate online software and learn exactly what nutrients are missing from your diet. For a free 7 day trial email me the word SUCCESS to Once you know what your deficiencies are, you can simply click on them and learn what to eat to put those missing nutrients into your diet.

2. In addition, with the Fate on Your Plate software, you will learn the percentage carbohydrates make of your diet (of your total caloric intake). Once you know this, you can see WHAT types of foods make up those carbohydrates, highly processed, nutrient void foods or non-processed nutrient dense foods. The bottom line is, we all must control our glucose metabolism by minimizing the need for so much Insulin release. Eat of us needs a different amount of carbohydrate, but we ALL need non-processed, nutrient dense carbohydrates in our diet. If you are an athlete, you will probably need much more than a sedentary person.

3. You can do the same with fats and proteins….learn what the percentage each is of your total calories, and what foods make up those fats and proteins. Again, the bottom line is food quality.

4. Once you really know what you are eating, you can start removing foods that can cause sensitivities. I recommend that you try going “hard core” Paleo for one month and see how you feel. Then you may add back in foods one by one and see how you feel. This is the way I learned what I am sensitive to and what I am not. For example, I have been pretty strict Paleo since about March 2011. About 6 weeks ago, I added two 8 oz servings of organic, Greek, plain yogurt with nuts and dried cherries or cranberries. This caused significant nasal congestion which used to be a problem for me before going “Paleo.” I learned that for me, I just cannot eat the yogurt. BUMMER, but it is not worth the negative effects on my body.

5. Other important factors are good sleep (try magnesium supplementation), Vitamin D, and the right type, volume, and intensity of exercise. When it comes to exercise, our Functional Movement Screen is really the sister of the Fate on Your Plate program. You must learn what your body can and cannot do and build a program based on your body’s needs and your goals.

Get started today!

Sunday, August 14, 2011

Fate On Your Plate

Fate on Your Plate: The Best Weight Loss and Nutrition for Better Health Program Ever!

Good Sunday Morning!

Yes, I finally can offer all of you the best online nutrition program for all your needs.

Take a look at this demo of the program: CLICK HERE!

I am offering all patients a FREE 14-DAY TRIAL of the Fate on Your Plate Program. If you are not a patient, and you are forwarded this post by a patient or friend of our office, you will be entitled to the same offer.

Just email me back ( with the word SUCCESS I will send you an activation code and the link to the activation page!

Everyone – please email today and get started.

“The solutions are here, they’ve always been here… every single person in the world knows what it is… YOU ARE WHAT YOU EAT…FOOD MATTERS”

Here’s how Fate on Your Plate works:

1. You enter your goals and current weight.

2. Enter the foods you eat daily. The data base is enormous and if there is a specific food that is not in the data base, the program pulls up a blank food label and you enter all the data in and the program saves it.

3. The program creates an old fashioned report card grading you A – F on total calories, fat, carbs, protein, cholesterol AND all the vitamins and minerals.

4. If you have a low grade (e.g. a “D” in Magnesium) you click on Magnesium for suggestions of foods to add to your diet to get your Magnesium grade to an A.

5. In addition, you may search the 10s of thousands of report cards with similar goals and caloric needs to see suggestions of how other people got all A’s. You may even specify specific foods. For example, if you are a vegan and only want vegan food choices.

“If we think we are going to go to the doctor and get a pill for everything, we’ve missed the whole point.” Quotes are from the movie trailer for FOOD MATTERS.

Saturday, August 13, 2011

Heart Testing Guidelines for Young Athletes 75 to 100 teenagers and young adults die each year during athletic events, primarily due to heart issues. There is some debate about using ECGs (Electrocardiogram screening) as part of the pre-participation physical examination. This issue is the number of potential false positive results.

In Italy they have been using ECG screening for years. They believe it is effective at screening for Hypertrophic cardiomyopathy, the most common cardiac disorder causing sudden death. Read more...