Michael Carlston, M.D. - Family Practice & Complementary Medicine

Carlston, M.D.
Family Practice and Complementary Medicine

www.carlstonmd.com

October 23, 2008

Dear Patients,

What beautiful weather we have been having! We need the rain, but it is nice to enjoy what we have while it lasts. This newsletter includes some information about environmental health, as well as a broadly needed bit of patient education.

The office will be closed until Monday October 27. I am having shoulder surgery tomorrow and so will need some time to clear the anesthesia from my brain. Melanie will continue to answer the phones and schedule appointments during usual work hours.

Best
Michael Carlston, MD
www.carlstonmd.com

Flame Retardants Not So Hot
Strength Training and You

Flame Retardants Not So Hot
Blood levels of chemicals used to make us safer by reducing the flammability of furniture, mattresses, bedding and children’s sleep clothing are 10 times higher in the bodies of Californians than in other Americans, according to a new study. These chemicals (polybrominated diphenyl esters – PBDEs) have been used for 30 years. We learned nearly as long ago that they put us at risk for liver, thyroid, neurological and hormone-related diseases. Blood levels in children are even higher than adults, and unfortunately, they are more vulnerable to the ill effects of PBDEs. The average European has a blood level of PBDEs 1/200 that of the average Californian, because these chemicals are banned in Europe, due to safety concerns. Before the ban, from 1972 to 1997 levels of PBDEs increased 60 fold in the breast milk of Swedish women. The most commonly used high quality padding in furniture is flexible polyurethane foam, which can be over 1/3 PBDE. Two forms of PBDEs, as well as some similar chemicals, have already been banned from American made products. However, they continue to enter our bodies from imported products, do not quickly disappear from the environment, and there is still concern about the forms of PBDEs still produced in this country.

Strength Training and You
If you are not presently in a strength training program you need to start one now. How did you react to that statement? When I advise patients to implement a strength training program it feels like I am back in the 1960’s when people driving past would honk their car horns and laugh at me when I was running along the roads in Minnesota. Way too many of you have the same uninformed resistance to strength training that pervaded America about all exercise, decades ago.

In fairness, this attitude is not exclusive to Americans.

One of the delights of my work with soccer referee fitness was my interactions with experts from all over the world. Carlo Castagna, the physiologist directing training for the top referees in Italy, one of the most highly regarded professional leagues in the world, summed up poor attitudes about weight training there several years ago when he told me, “Italian referees believe in stretching more than they believe in God. However, they should believe in weight training if they are serious about preventing injuries”.

To be honest, back when I was that 127 lb marathon runner, I was ignorant about strength training as well. Sure, an experience like my feeble attempt to “influence” (foul) a bigger, stronger and younger opponent on the soccer field when I was in my 20’s showed me the advantages of strength. However lifting weights seemed creepy then. See the movie, “Pumping Iron” for a 1970’s perspective.

There are many aspects to physical fitness. Aerobic capacity and flexibility are essential, but so is strength. In many cases, strength training is the most deficient aspect of my patients’ fitness. This is most frequent among older patients and females. Maybe the fact that these two groups are the most difficult to convince of the benefit of exercise confirms they are the groups that need it the most.

In the past I’ve written to you about the superiority of strength training compared to aerobics, when the goal is weight loss. That makes sense because body composition (simplistically the relative proportion of muscle vs fat in your body) determines your metabolic rate - how fast you burn off calories. The more fat you have at any given weight, the fewer calories your body needs to maintain itself and the less it burns no matter what you are doing.

The surgery I am having tomorrow was delayed for many years because of strength training. Ten years ago, after being propelled through the air by a very big and strong opponent, I returned to earth awkwardly. Landing on my shoulder instead of my feet meant I fractured my collarbone and partially dislocated my shoulder. Within a year or two it was clear that my shoulder was not going to heal entirely. The surgeon recommended an operation. I decided to try physical therapy first. Strengthening my shoulder muscles stabilized the injured joint and eliminated my pain for many years.

Strength training is vital to the treatment of injuries, but even more important as a preventative. The controlled lifting of weights builds your capacity and gives you the strength to respond to the unexpected, without injury – to catch yourself when you stumble, or adjust when a heavy object you are moving shifts. Strong muscles also take strain off your joints and connective tissues.

Adding to the pile of positive research on the health effects of strength training, a recent study of over 10,000 men between 20 and 80 years of age found that strength training markedly lowered death rates. The weakest men had a death rate one and a half times greater than the strongest men. The risk of dying from cancer was increased one and a quarter times. The biggest difference was in risk of death from cardiovascular disease (1.6 times greater). I have a hunch that one part of the cardiovascular benefit is that weight training is very much like interval training (see previous newsletters) in its impact on the heart. I have also seen that patients with fatigue from just about any cause (low blood pressure, cancer, depression, etc) gain energy from weight training.

My favorite books to help develop your strength training program either at home or in the gym are
STRENGTH BALL TRAINING by Goldenberg and Twist
STRENGTH TRAINING FOR WOMEN <http://www.amazon.com/gp/product/0756605954> by Pagano
WEIGHT TRAINING: STEPS TO SUCCESS <http://www.amazon.com/gp/product/0736055339> by Baechle and Earle

All three books are widely available and we also have them for sale in the office.

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