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

Magnesium is an important mineral that is often over looked. It is used in over 300 enzymes in the human body. Including every enzyme involved in the energy systems. It is bound to ATP which is the basic currency of energy in our bodies. It's even needed for DNA and RNA synthesis. It is a necessary element for every cell in your body. As a result magnesium deficiency can present in many different ways: muscular symptoms (cramps, spasms, weakness), fatigue, depression,  insomnia, irritability and poor memory. Magnesium is also important in Calcium absorption and utilization, which of course is vital to bone health. It is found in nuts, beans, whole grains and green leafy vegetables. Excessive sugar and alcohol intake can deplete your body of magnesium.

Determining magnesium levels isn't so simple as a large majority is inside bone and cells. Serum levels are tightly controlled at 0.75-0.9 mmol/L by your kidneys. There are a wide variety of supplements that offer differing benefits and drawbacks. Magnesium absorbtion rates tend to be low 20-40% and not all supplements contain the same amount of elemental magnesium. Magnesium oxide is poorly absorbed but high levels of elemental magnesium. Magnesium citrate is absorbed at much higher rates, but the citrate molecule is large compared to magnesium resulting in a smaller portion of elemental magnesium. Large amounts of magnesium citrate can cause diarrhea and is often used as a laxative. Magnesium glycinate, taurate and threonate are forms of magnesium bond to amino acids (proteins). Magnesium taurate is beneficial for heart function as the taurine is known to enhance heart contractions. Magnesium threonate is a new form that is supposed to have an advantage crossing the blood brain barrier. The final forms of magnesium are topic, Magnesium sulfate and chloride. Magnesium sulfate is found in epsom salt and relaxes muscles. Magnesium chloride is often found in oils or lotions and can be used to target specific muscles.

The recommended daily intake of magnesium for a healthy adult male is 400mg/day and for a healthy adult female 310mg/day, however pregnancy can increase demands. 

Dr. Nelson

     There are different reasons for stretching: injury prevention, improved flexibility, and injury recovery. Each of these goals will have a different routine of timing, type and frequency. For all three, consistency is very important.
     Stretching to prevent injury works on two levels. The first is a warm type stretch which will increase circulation and bring blood to muscle you intend to use. The second is greater overall flexibility can reduce injury frequency. I will discuss this under the improved flexibility goal. A warm up stretch is of course best done before any vigorous exercise. The type of stretching is the key. Static stretching, eg the sit and hold a pose, is not the best choice before exercise. When your muscles are cold they have less flexibility and blood flow. You won't gain much in terms of flexibility stretching cold, and you won't get the blood flowing in a static posture. Dynamic stretching is best pre-exercise. Leg and arm swings anterior/posterior and lateral, shoulder shrugs, high knees and leg kicks are all good examples of dynamic stretches. Focus on the muscle groups you intend to use, start slow and build up intensity for 5 to 10 minutes. 

      Stretching to improve flexibility comes in different forms. Many people think of yoga or ballet and the extremes of flexibility. Increasing your flexibility can reduce injuries, up until a point. There is a trade off of strength for flexibility. Think of it as a bell curve, or inverted U curve. Inflexible people are prone to injury because their limit of flexibility is low and they push their boundaries easily. Extremely flexible people can give up strength for more range at their end limits which can lead to injury as the muscles become a larger portion of stability than the joint capsules and ligaments. More is not always better. That said, extreme flexibility is far less of an issue than limited flexibility. The best time to increase flexibility is when muscles and ligaments are already warm. Traditional static stretching will receive the most benefit following exercise. Balance is key, if you stretch your hamstrings, stretch your quads as well. Also, do not stretch into pain. Dynamic stretching such as during a yoga class is a great way to increase flexibility. If you have attended a class before you may have noticed that they generally start out light and build in intensity. The most vigorous stretching is near the end where you will get the most benefit. Yoga also incorporates balance work, which I personal feel is a great attribute to improve. Consistency is important which ever method you choose. If you stretch once a week then you may see benefits a year later. If you stretch 3 times a week or do a 40 day yoga challenge you may see benefits much more quickly. Everyone's body composition is unique and will progress and different speeds.

     Stretching is a vital component of recovering from injury. After an injury your body lays down scar tissue to hold together the damaged tissue. Initially scar tissue is disorganized and has a random arrangement. Movement breaks through that randomness and helps your body remodel the scar tissue to have a similar function to the tissue it is replacing. It is best to stretch without pain and at a mild or moderate level. The key for injury recovery is consistency. Stretching 3 or 4 times a day will help the tissues regain their former flexibility. It is an organic process that can take up to a year or more depending on the age and severity of the injury. Chiropractic care can facilitate this process by breaking scar tissue in difficult to stretch areas.

Dr. Nelson

     Maintaining a health weight is important for many aspects of health. There are main differing points of view on the definition of a healthy weight. One reason is that there are many ways to measure a healthy body weight. BMI is a simple measure of height vs. weight but isn't particularly valid for muscular people. Body composition is a better measure but skin fold testing is rarely done outside of personal training. Body composition can be measured by electrical current and is included in some scales, however hydration levels can create inconsistency. And some people just have a gut feeling that they are in at unhealthy weight. But that's all for another time, including the reasons for maintaining that healthy weight.

      This post is about losing weight. It doesn't matter if your goals are motivated by health or vanity. You have decided to lose some amount of weight. I have a bachelor degree in kinesiology and plenty of personal experience in many types of exercise so of course I get questions about exercise and weight loss. There are many great benefits of exercise and weight loss is one of them, but, and this is a big but, it doesn't guarantee success. Many people who exercise end up eating more. Depending on your cravings, will power and an underestimation of the actual calories burned during your workout, you may actually wipe out all of the weight loss benefits of exercise. Running 1 mile will, roughly speaking, burns between 100-150 calories depending on your speed, weight and efficiency. A little more for men, a little less for women. How many calories were in that can of coke or beer you had after your workout, or even with lunch or dinner? 150-200? In my opinion it is much easier to eliminate excess empty calories than to tack on an extra mile in a workout. 

     Alcohol is particularly troubling because of it's effect on metabolism. Your body can burn alcohol for 7 calories per gram. More than sugar and protein at 4 calories per gram and less than fat at 9 calories per gram. Alcohol is not useful for anything other than those calories and the byproducts of metabolism cause a hangover. Your liver has to process alcohol, but your liver also works on many other metabolic pathways. Your liver is critical in many forms of sugar metabolism: fructose processing (a form of sugar naturally in fruit among other things), storage of glucose as glycogen and maintenance of blood glucose levels. Nonessential amino acids are synthesized in the liver and ammonia, a toxic byproduct of protein metabolism, is converted to urea.  The liver is responsible for a large amount of fatty acid metabolism as well. Your liver has all the protein machinery present to convert alcohol into fatty acids, which then go into your blood stream and to surrounding muscle and fat cells. So not only are you taxing your liver with extra work, which may slow down the good metabolic processes, you are also giving it a lot of energy to create the fat you are trying so hard to lose.

     In the ideal world you can employ all 3 strategies: Exercise, eat well and save alcohol only for special occasions. But if you can't do all 3 at once start with nutrition and reducing alcohol consumption.

Dr. Nelson

Vitamin D is important for good overall health including healthy muscles, heart, lungs, brain and bones. Winter typically brings less sunshine and we also cover our skin to stay warm.  Your body makes its own Vitamin D from exposure to sunlight and it is supplemented in our diet. I became interested about the role of Vitamin D after I heard that most of the 2009/10 Stanley Cup Champion Chicago Blackhawks prescribed 5000IU daily by their team Doctor.

Vitamin D is an oil soluble vitamin that is created when your skin is exposed to ultraviolet light but can also be ingested in a small number of foods or as a supplement. UVB is the specific wave length that stimulates the production. UVB is partially absorbed by cloud cover, pollution and sunscreen and it is completely blocked by glass and most thick winter clothing. This reaction can create a lot of vitamin D for your body; 15 minutes full body exposure (without sunscreen) can create 25,000IU during peak sun hours. There are different forms of vitamin D that are present in your body that become active when processed by your liver and kidneys.

Vitamin D is actually a hormone and is important in many bodily functions. It is well known for increases calcium absorption in the gut and it also helps your bones utilizes the calcium. Vitamin D is linked to reduced rates of colorectal, prostate, breast and pancreatic cancer, but it is not a clear relationship. Lesser know functions of Vitamin D are that it modulates cell growth, neuromuscular function, enhances the immune system and reduces inflammation. These are the reasons that the Blackhawks are taking Vitamin D: decreased healing times, increased athletic performance and a boosted immune system.

The most studied function is that of bone health. It is well understood and documented that decreased levels of vitamin D cause Rickets in children and osteomalacia (soft bones) in adults. The levels of serum 25(OH)D, a form of Vitamin D in your blood that has the longest half life(15 days), can predict these conditions quite accurately. When looking at cell growth (healing), neuromuscular function (physical performance), immune function and reduced inflammation, the minimal serum levels of 25(OH)D are more vague and less understood. Compounding this problem is the fact that vitamin D is oil soluble and there are consequences of ingesting too much, such as soft tissue calcification, heart arrhythmia and kidney stones. These are typically reported in cases where people take a supplement of 10,000+ IU daily. Extended exposure to the sun does not cause vitamin D toxicity because heat from the sun increases the breakdown rate of the Vitamin D created in the skin.

Recently the recommended daily intake was increased from 400IU to 1000IU, which is a step in the right direction but with the northern climate it may be not enough, specifically in winter.

Vitamin D3 can be found in most fish and fish oils, especially deep-water fish, and in liver, beef and egg yolks. Many dairy products and orange juices are fortified with vitamin D2. However, the liquid form of Vitamin D3 is the most bio-available supplement.

In summary Vitamin D is an important aspect of maintaining health. In our climate it is readily available in the summer but should be supplemented in the darker winter months. Supplementation for adults between 1000-4000IU per day with D3 in liquid form is optimal depending on lifestyle, activity level and sun exposure.


Dr. Nelson