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New article on reporting side effects of supplements
Just published in The New England Journal of Medicine: A recent article brings up dietary supplement issues you need to be aware of and discusses how dietary supplement side effects could be monitored better. A PDF of the April 3rd article is available free online.

3rd International Congress on Soldiers’ Physical Performance
August 18-21, 2014
The ICSPP delivers innovative scientific programming on soldiers’ physical performance with experts from around the world.

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Filed under: Exercise

Buddy up to help maximize performance

Get the most out of your workouts and maximize your performance by using the buddy system.

Working out by yourself is fine if you’re self-motivated, but getting a buddy to tag along can provide the motivation needed to really ramp up your workout. Let’s face it—a bit of friendly competition can help you push harder than if you were alone. In fact, research has consistently shown that performance is substantially improved when you exercise with someone (even a virtual partner)—unless the workout is complex or involves tasks that require coordination, when the performance can degrade (i.e., "choking under pressure"). So, for best results, practice your difficult routines with a trainer, and then engage in healthy competition to optimize your performance. Keep in mind that not just any friend will do. It’s best to get a buddy whose skill level is similar to your own.

Toning shoes: Buyer beware!

In the past, concerns about the effectiveness of toning shoes have been questioned at HPRC. Here is an important update on the issue.

If you have ever bought a pair of toning shoes, you probably noticed you haven’t developed a Kardashian-curved derrière or a Brook Burke body just from walking around in them. You’re not alone. Recent developments have brought toning shoes back into the spotlight for the media and scientific communities. An independent study by the American Council on Exercise found that these kinds of toning shoes do not increase muscle activation or caloric expenditure compared to regular athletic shoes. However, a positive outcome may be that these shoes have motivated people to get out and walk, a physical activity that has many health benefits—without special shoes! Caveat emptor!

How does air pollution affect physical performance?

It is known that exposure to air pollutants during exercise may affect your health and performance, but what can you do about it?

Inhalation of major air pollutants has been found to decrease lung function and exacerbate symptoms of exercise-induced bronchospasms, including coughing, wheezing, and shortness of breath.  In order to meet oxygen demands during light- to moderate-intensity exercise, you take in more air with each breath. And when you breathe through your mouth, you bypass the nose’s natural filtration of large particles and soluble vapors. As your exercise intensity increases, you breathe faster and deeper, which also increases the amount of pollution inhaled and the depth it travels into your respiratory system.

If you live in or near a busy city, you are exposed to even more combustion-related pollutants—such as nitrogen oxides (NOx), carbon monoxide (CO), particulate matter (PM), and ozone—that can inflame your airways and worsen asthmatic responses. Exposure to freshly generated emissions is most common near areas of high vehicular traffic.

While indoor exercise is often a good alternative to limit exposure to outdoor pollutants, some indoor conditions may be just as toxic. Nitrogen dioxide (NO2)—the more toxic NOx—is usually higher in gas-heated homes and indoor areas with poor ventilation. Carbon monoxide poisoning is also more likely to occur indoors. When carbon monoxide is in your system, the blood carries substantially less oxygen, reducing performance and eventually leading to carbon monoxide poisoning. Be sure to choose well-ventilated areas for indoor exercise.

Particulate matter and ozone are two significant pollutants you may be exposed to outdoors. Inhalation of high levels of particulates has been shown to reduce exercise performance as much as 24.4% during short-term, high-intensity cycling. Women may be more vulnerable than men to certain particulates, associated with greater decrements in performance. Ultrafine particle concentrations are highest in freshly generated automobile exhaust, and these small particles can be carried deep into the lungs. However, the further away you are from fresh exhaust, the less concentrated the particulates.

Bad ozone occurs lower in the atmosphere; it is not directly emitted into the air but is created from chemical reactions between NOx, volatile organic compounds (VOCs), heat, and sunlight. Ozone levels also are higher in summer than in winter; and especially in larger, hotter cities, concentrations tend to peak around midday when solar radiation is highest. Exposure to ozone during exercise has been found to increase resting blood pressure, reduce lung function, and decrease exercise capacity.

The risks associated with not exercising at all are far greater than the risks of exercising outdoors; it just takes a little more planning on days and in conditions when pollution is bad.  When planning outdoor exercise activities, follow these tips to limit your exposure to pollutants:

  • Avoid exercising in areas of heavy traffic, such as along highways and during rush hour.
  • During summer, exercise earlier in the morning, when ozone levels and temperatures are not as high.
  • Check the domestic or international air-quality ratings to determine if it’s safe to exercise outside. Limit your time outside on Code Red and Code Orange days. Environmental conditions on these days are not healthy, especially for children, the elderly, and people with existing respiratory conditions.
  • Exercise indoors when the air quality indicates high ozone and particulate levels.
  • Before any demanding physical activity, limit your carbon monoxide exposure by avoiding smoky areas and long car rides in congested traffic.

Food for thought: What does your brain tell you about eating after exercise?

Your brain might be the driving force behind what you eat (or don’t) after a workout.

A recent article in the New York Times looks at the combination of neuroscience and exercise. A new theory suggests that your brain, not your hormones, increases or decreases your appetite after a workout. Researchers at California Polytechnic State University studied different areas of the brain that control whether we want and like food and how these areas are affected by exercise or sitting still.

Scientists found that “responsiveness to food cues was significantly reduced after exercise.” Compared to sitting for an hour, exercisers were much less interested in food, even ice cream sundaes. The subjects in the study were in their 20s and fit enough to sustain strenuous exercise for an hour. This is in contrast to a study that found the same areas in the brain were excited in an overweight and sedentary population after exercise, causing them to want and eat more food.

While the effect is still unclear and more variables need to be tested, researchers conclude that exercise has a definite impact on how your brain responds to food.

Preparation for the PFT/PRT part 1: aerobic conditioning

The PFT/PRT is designed to test your cardiovascular endurance and muscular strength. In this three-part series, we’ll take a closer look at each component, offer tips on optimizing your training, and show you how to prevent common injuries associated with different types of training.


In a recent study investigating risk factors for discharge from Army Basic Combat Training (BCT), researchers concluded that increased risk for both men and women was associated with failure on the initial two-mile run test. The current Physical Fitness Tests (PFT) or Physical Readiness Test (PRT) use a one and a half to two-mile run test to assess cardiovascular, or aerobic, fitness.

When mapping out a fitness program, learn the components of the FITT principle and apply them for each type of training. FITT stands for “frequency,” or how often; “intensity,” or how hard; “type,” or the kind of activity; and “time,” or how long. Progression (see below) is also an important part of an exercise plan. Using the FITT Principle, here are some guidelines to help optimize your cardiovascular fitness.

Frequency. The U.S. Surgeon General and other U.S. government agencies recommend physical activity on three or more days a week.

Intensity. According to updated guidelines The American College of Sports Medicine (ACSM) recommends adults engage in moderate-intensity exercise (i.e., at 40-60% Heart Rate Reserve (HRR)) five days a week or vigorous-intensity exercise training (i.e., at ≥ 60% HRR) three or more days a week. They also recommend a combination of moderate- and vigorous-intensity exercise. You can use this calculator from Kirtland AFB to determine your HRR.

Type. ACSM defines aerobic activities as being continuous, rhythmic, and using large muscle groups, such as your lower and upper body muscles. Examples of these kinds of activities are running, biking, swimming, rowing, and jump roping.

Time. The Surgeon General, ACSM, and American Heart Association recommend expending at least 1,000 calories per week through exercise (i.e., in addition to calories burned through normal everyday activities). This can be achieved through moderate-intensity exercise, as described above, and should last about ≥ 30 minutes per day for a total of  ≥ 150 minutes per week; or with vigorous-intensity exercise for ≥20 minutes per day for a total of ≥75 minutes per week. The maximum safe duration is unknown, but exercise lasting more than an hour and a half increases risk of overtraining and/or overuse injuries such as stress fractures.

Progression. During the initial phase of an exercise program, ACSM recommends increasing duration (minutes per session) gradually. Increasing 5-10 minutes every one or two weeks over the first four to six weeks of an exercise program is reasonable for healthy adults. After an exercise routine has been maintained for one month or longer, it is reasonable to gradually increase frequency, intensity, and/or time over the next four to eight months. As a general rule of thumb, though not scientifically backed, increasing your workloads or volume by 10% will also help you gradually progress your exercise program.

Due to the repetitive and rhythmic nature of aerobic exercise, overuse injuries can occur as a result of your training. Cross training—training with a variety of aerobic exercises—is recommended. Examples of this would be alternating running, swimming, and rowing exercise sessions.

Part two of this series (upcoming) will address the muscular strength component of PFT/PRT.

Stress Fracture Prevention: Strengthening the Lower Extremity Muscles

Maintaining strength and flexibility in the lower extremities is one of the many important steps toward decreasing the likelihood of developing the small cracks in a bone commonly known as stress fractures.

There are several risk factors for stress fracture development, but a 2011 article in Medicine and Science in Sports and Exercise found that maintaining adequate muscle strength and flexibility in the hips, legs, knees, ankles, and feet is of great importance, especially for women. Here are some exercises from the American Council on Exercise that can help you build strength and flexibility:

Ankle Flexion

Single Leg Push-off

Forward Hurdle Run

Seated Calf Stretch

Standing Dorsi-Flexion (Calf Stretch)

Supine Hamstrings Stretch

Barbell Calf Raises

Jump and Reach

Agility Ladder: Lateral Shuffle

Alternate Leg Push-off

Barbell Jammers

Before beginning any exercise program, however, make sure to consult with a medical professional, especially if you are more than 45 years old.

More for National Nutrition Month

HPRC Fitness Arena: Nutrition, Total Force Fitness
The Academy of Nutrition and Dietetics offers special resources for National Nutrition Month, including healthy recipes.

National Nutrition Month is still going strong, bringing lots of healthy eating information to the attention of Americans. The Academy of Nutrition and Dietetics is weighing in with their “Get Your Plate in Shape” campaign, which focuses on getting the right nutrition without too many calories. Their Eat Right website page offers snack ideas, recipes, weight management tips, and exercise nutrition advice.

Back in motion: Can swinging a kettlebell improve back and shoulder pain?

Exercises with strength-training equipment known as kettlebells may provide relief from back, shoulder, and neck pain.

Kettlebells have been used in Europe for years in strength training, and now they’ve become a popular workout tool here in the United States too. The benefit of kettlebells is that they provide the user a wider range of motion than dumbbells do. Kettlebell workouts engage multiple muscle groups at once, making them a great option for getting a whole-body workout in a short time.

Interestingly, the January 26 edition of the New York Times Health Section reported on a Danish study that suggests kettlebell exercises are a promising musculoskeletal therapy for low-grade back and neck pain.

The study involved middle-aged women with low-grade back, shoulder, and neck pain who were randomly assigned to either a regular kettlebell workout or a general-exercise control group. The study did not include those with chronic pain.

According to the Times article, at the end of the study, the group that did the kettlebell exercises reported less pain, as well as improved strength in the trunk and core muscles, compared with the control group. Overall, the study showed exercising with kettlebells reduced lower-back pain by 57% and neck and shoulder pain by 46%.

For those with core-muscle instability or weak core muscles, kettlebells can be a great way to strengthen those muscles (back, abdominal, glutes, quads, hamstrings) and improve posture. However, along with exercise it is imperative to stretch the hamstrings, since this tends to be a major contributor to lower back pain or discomfort.

It’s important to start slow when using kettlebells and seek professional guidance. Like any other exercise equipment, if used improperly, kettlebells can cause serious injury, and their swinging motion can be difficult to control.

Working out with babies

An Army base in Germany includes babies in their workouts!

At the U.S. Army Garrison in Kaiserslautern (Germany), the base is trying to find more ways to include families in physical fitness. They are providing classes— called “Binkies and Babes” —that spouses can do with their babies. These classes are great ways for spouses to workout with their young children, socialize with other military families, and get a great individual workout!

Overseas military families can sometimes find it difficult to both exercise and manage child care. This is one way overseas bases are moving towards Total Family Fitness. Renee Champagne, the Fitness Coordinator for the Army bases in Germany (and a military spouse herself), sees how “working out and staying physically fit may help a spouse cope during a deployment… which in turn could provide peace of mind to the military member downrange.”

For more information, see the article and video on Stars and Stripes.

Runners’ trots


There’s a phenomenon runners sometimes experience that’s commonly called “runners’ trots” – otherwise known as diarrhea – that has risk factors and that can possibly be avoided. Although the “trots” usually don’t last long and are generally nothing to worry about, they certainly can be a major annoyance, causing lost time in training or competition and even embarrassment if there is literally “nowhere to go.”

The most common risk factors cited are for those who are young, female, susceptible to irritable bowel syndrome, or lactose intolerant, as well as those who have had a previous abdominal surgery. The things we do to our bodies that reportedly increase risk are high-intensity exercise, dehydration, vertical-impact sports (e.g., running vs. biking), poor conditioning, medication, and diet. Although these are stated in the medical literature as risk factors, a recent study published in the International Sportmed Journal examined the evidence behind each of these risks to see if they hold up under scrutiny – and there’s surprisingly little evidence to support many of the statements about risk factors for developing “runners’ trots.” Most of the evidence was limited and relied on either single studies or multiple studies with varying results but a tendency toward supporting the conclusion.

Here are the conclusions of this evidence-based study:

The only strongly supported evidence was for dehydration to increase the risk of diarrhea. Female gender, younger age, high-intensity training, vertical impact, and medication had limited support and could go either way. Finally irritable bowel, lactose intolerance, previous abdominal surgery, poor conditioning, and dietary factors had very weak support. Keep in mind that little or no evidence does not make something true or false; it just means we have insufficient scientific evidence for any assumption.

So, based on the studies, how can you avoid “runners’ trots?”

  1. The evidence certainly supports staying well hydrated so that the bowel gets an adequate blood supply.

Even though the evidence for doing some things is not strong, they make sense and are not harmful. These include:

  1. Avoid a large meal 3-6 hours prior to running.
  2. Avoid food or drinks that have non-absorbable sweeteners (such as sorbital or sucralose), caffeine, and/or a high fat content.
  3. Don’t ingest concentrated carbohydrates (high glycemic index) before running.
  4. Be aware that energy bars and gels may contribute to the “trots” for some people.
  5. Avoid taking anti-diarrheal medications such as loperamide (e.g., Imodium) or Lomotil, since they can affect the ability of the body to tolerate heat.
  6. Wear loose-fitting clothing to reduce irritation.
  7. If symptoms persist for more than a few days, seek medical attention to be sure there is not an underlying cause.

    Enjoy your run!

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