Cholesterol is a concern for many people. It is linked to heart disease and a target for many drugs. There are some options to consider for reducing cholesterol beyond and before medication. Simple lifestyle changes can reduce LDL (bad cholesterol) and increase HDL (good cholesterol). Good and bad cholesterol are also misleading terms as both are essential but 'bad cholesterol' is thought to damage arteries through oxidation. It is important to understand the functions of cholesterol. Our bodies produce 75% of our total cholesterol and the other 25% comes from diet. Many hormones and enzymes are synthesized from cholesterol including: CoEnzyme Q10, vitamin D, Aldosterone, Cortisol, Testosterone, Progesterone and Estrogen. Cholesterol is essential for cell membrane health, helping maintain fluidity and strength in every cell. The function of cholesterol that concerns heart disease is lipid(fat) transport in a lipoprotein. Oil and water don't mix, so your body has to transport fat to cells through blood in an emulsified form, the lipoprotein. Cholesterol is attached to fat in the lipoprotein in several forms including HDL and LDL.

One of the many benefits of exercise includes reducing LDL cholesterol levels. Having a higher HDL to LDL level is linked to lower levels of heart disease. Exercise is thought to help the liver excrete LDL through the gallbladder and also convert LDL into HDL. Research suggests that high intensity exercise is more beneficial to positively change cholesterol levels. A great way to get a burst of high intensity exercise is take the stairs instead of the elevator. 

Diet can help cholesterol levels as well, but what to eat can often be misleading. Cholesterol, saturated fats, trans fats, sugar and alcohol are things that deserve your attention. Cholesterol is only found in animal products as plants do not need it for their rigid cell walls. Cholesterol on labels can be misleading because it is not shown to directly influence blood cholesterol levels to a large degree. Your body can slow down its own production if necessary and blood cholesterol that we normally pay attention to is a large complex protein, fat and cholesterol compound that isn't immediately effected by ingestion of pure cholesterol. About 25-33% of the population has difficulty slowing down body production and are susceptible to high cholesterol if diet isn't well maintained. Trans fats have a negative impact on many aspects of health and are best avoided completely. Saturated fats used to be the bad guy, but now there is conflicting research on whether they lead to heart disease, so it is best to limit these but not completely avoid them. Unsaturated fats are the good fats like Omega 3 and 6, they are found in fish, nuts, seeds and vegetable oils. Diets high in refined sugar and alcohol can lead to LDL oxidation, which can damage arteries and lead to cardiovascular disease. Limiting refined sugar and alcohol along with quitting smoking are very positive steps for cardiovascular health.

Liver health is also important for cholesterol levels. Your liver processes sugar, alcohol, drugs (including prescription and over the counter) toxins and many vitamins and minerals. The more you stress your liver the less it can maintain proper cholesterol levels. If you are taking medication it would be a good idea to limit refined sugar and alcohol intake. 

Cholesterol is a complex and necessary system in your body that can do damage if it gets out of control. Exercise, diet and limiting stress on your liver can keep cholesterol in check. It is important to get your levels checked in your 20's if you have a family history of heart disease otherwise after the age of 35.

Dr. Nelson

An good acronym for post injury care is RICE, Rest, Ice, Compress, Elevate. This acronym is the most useful for acute muscle and ligament injuries, eg. sprained ankle or knee or a strained hamstring or quad. It is most effective if you start the process immediately, especially ice.
Rest is important for recovery however there are a few caveats. Resting too much can stiffen joints and prolong rehabilitation, the idea of weeks of bed rest are long gone. Gentle range of motion exercises can speed healing and reduce inflammation. Range of motion exercises can even begin on the same day of injury. Rest in the terms of RICE is really limit pain producing activities, don't do anything to make the injury worse.
Ice sprained joints and strained muscles during the first 48 hours post injury. Leave the ice on for 10 minutes at a time with at least one hour between sessions and limit it to 3-4 times per day. Icing beyond the initial 48 hours can actually slow healing as it limits blood flow.
Compression is one of the most under utilized strategies. Gentle joint compression with a tensor bandage or sleeve can help limit inflammation and can even help move it out of the effected joints. Be careful to not compress to the point of pain.
Elevation is also helpful for extremity injuries. The closer the injury is to your heart the less effective. Elevation helps drain inflammation and effective for wrist and ankle injuries.
Make sure you have your injury assessed for stability and function by a professional. It is important to know what you are dealing with and whether there may need further imaging assessment.

Dr. Nelson

Most of us aren't perfect and fall off our workout routines at some point during the year. Then January rolls around and we want to hit the gym again after an extended hiatus. Most of us also know that this is usually a short lived venture. But why is it? Why do we fail at something that keeps us health and feeling good. There are many reasons of course and you can probably name most of them already: not enough time, too much early and/or loss of ambition, too many people at the gym, too cold/stormy for running, no immediate benefit. The list goes on. One reason that I will focus on is doing too much too early.

Once we commit to going back to our workout routines there is usually excitement involved. Getting back into shape, feeling better and looking great are all motivating. Most people fail in not acknowledging that returning to a workout routine is more of a mental change than a physical challenge. Habits take 3 weeks to form and I would argue longer for something such as a workout because they generally happen every other day. Weekends away or other activities can easily interrupt forming the workout habit. Benefits aren't seen immediately and post workout soreness can be immediate and intense. There can also be a little shame or disappointment as we don't pick up at the same weight that we did in the past. There are techniques to get around these challenges and they vary in strategies.

First of all set goals, short term, long term, specific and general. Include all of these types as they are important for long term adherence. Plan workouts and goals in advance in your physical and/or electronic calendar. Chart your weights, don't go in haphazardly, have a plan for type of exercises, sets, reps and weights. Be kind to yourself. Our bodies change, and they can change back, but its an organic process. Switch things up if you need too, lighter weights, different exercises. Try free weights, machines and body weight exercises until you settle in to the routine you like the best. If your workout patterns change, update your goals. Eat healthy and drink lots of water, you will reach your goals faster and with less soreness. A little trick I use is topical Magnesium oil to stop post exercise muscle soreness, spray it on the muscles you exercise and wash it off 30 minutes later in the shower. Finally, know your distractions. If you make excuses to not workout, what are you doing instead? Watching TV, facebook/instagram/twitter? If you find your patterns you can undo them.

And most of all have a good time.

Dr. Nelson