Health and Fitness

Introduction

Regular exercise reduces the risk and increases the chances of a favourable outcome in a number of chronic conditions such as cardiovascular, cardiovascular diseases and diabetes mellitus. However, it has also been shown that intense exercise can be detrimental in that it can cause acute myocardial infarction, pre-mature ventricular depolarisation and a general increase in the risk of cardiovascular death. There is, therefore, a need to define the amount of exercise that can be beneficial without causing any undue disadvantage.

In the recent years, curiosity regarding the mechanisms of inflammatory processes has been on the rise due to ever increasing cases of immune suppressed individuals (e.g. elderly, HIV, other immunocompromised diseases, induced suppression of immunity for organ transplantation, development of antibiotic resistance, sepsis due to surgery or trauma and cancer therapy). Also, it is a major cause of morbidity and mortality in post surgical, trauma, burns or blood loss patients. Furthermore, uncontrolled sepsis forms the basis of multiple organ failure. One of the difficulties has been the prevention and reversal of a systemic inflammatory response.

Although there have been dramatic advances in critical and surgical care, sepsis still poses a major concern in the management of these patients. This is so mainly due to the little progress made regarding the understanding of the underlying immune mechanisms. And part of the reason is that there has been a lack of appropriate human experimental tools. Animal model have not been helpful because of interspecies differences and gross differences in the cellular physiology of the immune system. A study conducted in 1994 has noted that there is a marked similarity between the immune responses to surgery or trauma and those occurring in reaction to a single stress of exhaustive exercise or prolonged heavy training. Exercise induced immune response has therefore been suggested as a model for further research into immune mechanisms.

Definition

Overtraining is a subjective term. It means underperformance in an athlete accompanied by a general feeling of fatigue. This is caused mainly by the stress of training, be it physical or psychological. There is an alleged increase in the susceptibility to infections which is indeed reflected by short term elevation of the so called markers of exercise.

Overtraining, contrary to popular belief, is quite common. It occurs in 10-20% of elite endurance athletes. It has been referred to by various terms by different researchers: burnout or staleness, sports fatigue syndrome, chronic fatigue syndrome or simply, unexplained underperformance syndrome.

However, there is no consensus as to the definition and the diagnosis of the condition. The round table meeting held on 19 April 1999 at St. Catherine's College, Oxford came up with the definition and basis for diagnosis of chronic fatigue syndrome. Over training was defined as persistent unexplained underperformance by an athlete which is recognised and agreed to by both the athlete and the coach and does not resolve in spite of two weeks of relative rest. It is characterised by undue and uncharacteristic fatigue and sweating during training. There is a positive history of recent heavy training or participation in an important event, frequent minor infections, unusually stiff or sore muscles, loss of appetite, energy, drive, competitive edge, and mood and sleep disturbances.

Overview of the human immune system

The human immune system is divided into the innate or the inborn immunity which is present since birth and the acquired immunity which develops subsequently as the exposure to various antigens takes place during the lifetime of the individual.

Evaluation of the response to exercise

Traditionally, various studies have tried to suggest the direct relation of various parameters to overtraining viz. low Hb and ferritin concentrations, elevated uric acid, creatine phoshokinase and cortisol levels. Likewise, the increase of immune response in the form of increase in immune cell counts and elaboration of chemical mediators of inflammation has also been associated with exercise. But, concrete proof regarding definite association and mechanism of overtraining has been lacking. Treatment is in the form of relative rest and stress management.

Differential WBC count

This is a measure of the status of the immune system. The leucocytes consist of the polymorphs, and the mononuclear cells. These can be measured with the use of monoclonal antibodies. The peripheral leucocyte count during exercise can be influenced by other factors like increase in cardiac output, decreased plasma volume, stimulation of the autonomic nervous system and secretion of cortisol.

The exercise related increase in leucocyte and lymphocyte levels in the peripheral venous blood is directly proportional to the intensity and the duration of exercise undertaken. However, prolongation of the exercise leads to the migration of the monocytes and NK cells into the injured muscles and therefore a decrease in the total leucocyte count. Subsequently, there is delayed leucocytosis after about 30 min. to 3 hour following strenuous exercise. This is due to the release of cortisol and the cortisol induced secretion of white blood cells from the bone marrow. This involves granulocytes, esp. neutrophils. There is little change in the basophils while the eosinophils decrease in number. This response of the WBCs is rather vague but there seems to be an enhancement of the nonspecific immunity.

Lymphocytes are divided into two distinct types, the T cells and the B cells. These cells are responsible for cell-mediated immunity. The T cells are further sub typed according to the surface antigens present on them. The ratio of helper to suppressor T cells (CD4:CD8 ratio) is important, in the sense, that if the ratio falls below 1.5, it represents an immunodeficient state of the individual and resultant increased susceptibility to infection. Using modern monoclonal antibody techniques, it has been shown that there is an increase in the absolute number of both T and B lymphocyte following submaximal exercise.

There is a drop in the helper: suppressor cell ratio in the early stages. This is mainly due to the increased up regulation of the adrenoreceptors on the T cells than on the B cells. In the latter part of the recovery, occurring over 24 hours, elevation of the ratio occurs due probably to the cortisol induced reduction in the number of suppressor cells. Furthermore, this also suppresses the level of natural killer cells.

Natural killer cells, also called the NK cells, do not require prior sensitization to destroy tumor and virus cells. They form a part of the first defence mechanism of the immune system. These are identified using antibodies to CD16 and CD56 surface markers. The lytic activity is assessed using radioactive chromium-release assay. Increased lytic activity is a measure of either increase in the number of NK cells or increased activity of the individual NK cells.

In the early stage of moderate exercise, there is an increase in the percentage of NK cell numbers in the peripheral blood. Decreased cell margination caused by catecholamines is the suggested mechanism.The lytic activity of the NK cells is also enhanced with a 40% increase in the NK cell activity one hour after exercise. However, sustained exercise shows a trend in favour of suppression of the NK cell activity. A study in 1995, has demonstrated a marked fall both in the number as well as the activity of the NK cells for almost a week following a single bout of 90-120 min of exercise at 65% of max heartrate. Endorphin induced inhibition and a late surge in the cortisol may be the contributory factors.

Immunoglobulins are produced by the plasma cells and are of different types: IgG, IgM, IgA, IgD and IgE. Of these, IgG is the most important and possesses antibacterial, antiviral as well as antitoxic antibodies along with opsonins to enhance phagocytosis. Most researchers have found that exhaustive exercise causes a decreased concentration of immunoglobulins in the serum, saliva, and the nasal secretions. There is also a corresponding decrease in their production lasting almost 4 days.

Soluble factors of the immune system C-reactive protein (CRP), interleukins and interferons. An acute bout of severe exercise elevates CRP which in turn activates the complement system which then reacts with antibodies to form opsonins. These opsonins are responsible for the phagocytosis by the macrophages. The interleukins are responsible for producing antibodies from the B cells and also for activation of the macrophages, T cells and NK cells.IL1 levels are increased during and following endurance exercise, while the IL2 levels fall immediately after strenuous exercise but rise after 24 hour following exercise. The interferons are produced by activated T lymphocytes. Plasma ?-interferon is increased following exhaustive exercise possibly because of muscle injury stimulating interferon release.

Glutamine is a key metabolic substrate for the immune system. It acts as a precursor for nucleotide biosynthesis and a major source of energy. Glucose synthetase is the major enzyme of glutamine synthesis and is found largely in the skeletal muscle but also in the lungs, the brain and certain other tissues in small amounts. Glutamine utilization is high in the muscles and the gastrointestinal tract. Deficiency of glutamine leads to impairment of immunity and thus an increase in the susceptibility to infection.

Athletes have been shown to have elevated levels of glutamine which may represent a positive adaptation to a well designed and graded training program. However, a number of studies have suggested low levels in athletes with over training. This may well be due to detrimental effect of excess stress of overtraining or shifting of balance in the favour of increased utilisation rather than synthesis of glutamine.

Physiology of the response to exercise

It has been suggested that exercise causes a response similar to an immune reaction, albeit of a smaller degree as compared to sepsis. This has been postulated from increased plasma levels of the markers of exercise. These are: infiltration by cells of the immune system like neutrophils within a few minutes of initiation of exercise and macrophages which follow subsequently. Activation of these cells follows with a resultant release of acute phase reactants and proinflammatory cytokines like IL-1, IL-6 and TNF-?. The net effect of all these processes is that there is stimulation of the complement, coagulation and the fibrinolytic system. Also, there is suppression of the circulating levels of NK cells as well as the NK cell activity to up to seven days. The leucocytes displayed a gradual but definite increase in their propensity for apoptosis during and following exercise. This was shown by TC Tuan et al by showing a causal relationship between mitochondrial transmembrane potential and raised pro-inflammatory mediators.

Conclusion

Studies have been conducted in the hope that the alteration in the immune parameters from a resting state can be used to know when an athlete is getting overtrained. This might allow athletes to train to the optimum without risking overstretching themselves and thus affecting performance. However, it is difficult to simulate overtraining in an individual because ethically an athlete cannot be asked to push himself/herself to the limits of causing injury. In a study carried out in 1992, distance runners, were already training hard were deliberately asked to train harder by 38% for 3 weeks. It was observed that the resting mitogen induced lymphocyte proliferation increased. Also, the helper to suppressor cell ratio and the mitogen induced synthesis of immunoglobulins decreased.

Moreover, the 30 min. of sub-maximal exercise now induced 18% suppression of lymphocyte proliferation and the exercise induced synthesis of immunoglobulins never occurred. However, most of these findings were too variable to be of any consequence. Similarly in a study conducted in 1995, most of the plasma biochemical concentrations associated with exercise were found to be within normal range. Thus, the so called markers of exercise cannot be, as yet, associated with the symptoms of overtraining syndrome or an increased susceptibility to infection during intense training. The only parameter showing significant deviation from the normal in response to exercise was found to be glutamine. However, a definite correlation between reduced levels of glutamine and clinical manifestations of overtraining or the underlying mechanisms are yet to be determined.

Better tests for measuring the plasma levels of immune cells and their actions, cytokines, glutamine, catecholamines, hypothalamic pituitary axis function and getting athletes to exercise more rigorously in the presence of environmental, nutritional or psychological stress to cause a greater degree of immune response may be more forthcoming to prove the association. At the moment, psychological testing probably provides a simpler and better way of detecting overtraining in an athlete.

Thus, whereas moderate exercise is beneficial to human health and immune system, rigorous exercise for prolonged periods can be detrimental. Hence, there is a need to know the optimum level of exercise to derive maximum benefit without compromising the benefits by pushing too hard.

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Do you want to know how to beat your fastest time easily? Or do you want to know how to push that little bit extra to get that extra mile? If you do, then here are 5 secrets to increase your running endurance.

1. Breathe in and out with every step

The most important thing when running is how you breathe. The more you breathe efficiently, the better your body can run more efficient and hence make you run more longer and faster. The secret of breathing when running is to take a breath for one step you make and then one breath out with another step. You should do this rhythmically and constantly with every step that you take. Once you do this, you will be amazed how fast and long you can run.

2. Take large steps when running

When most people run or job, they tend to take tiny steps. This is inefficient way of running. The most efficient way of running is to make a big or large step as much as possible. When you do this, you will find that it takes less energy, heart beats and breath to run then if you do by taking short brisk steps.

3. Buy good running shoes with good arch support

Good running shoes with arch support makes a huge difference when running. You can potentially cut your time by at least twenty per cent by running with proper running shoes. This is because when you wear good shoes with arch support, you are able to get a firmer push off and hence acceleration when running.

4. Eat a high fibre and carbohydrate meal two hours before exercise

To run longer and faster, you need lots of fuel and energy. If you don't have enough fuel or energy in your body, your body will splutter and strain when running. Therefore, you should have lots of fuel and energy to run. The best way to do this by eating a high fibre and carbohydrate meal two hours before you exercise. A good meal to have is creamy pasta which is filled with lots of carbohydrates. This will give you plenty of energy to boost you through your run.

5. Keep your eyes looking forward

When you run, you should keep your eyes constantly looking forwards. This is because if you look down when you run, you block your airways which reduces oxygen. Therefore to prevent this, you have to keep looking forwards at all times.

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Lam Bong is an Author living in Sydney, Australia. He is interested in reading and creating websites. His latest website is about sore achilles tendon and finding the best Achilles tendon soreness on the web today.

As enjoyable and invigorating as a good cardio workout can be, it's often much longer than interval training or weight training, and they can take their toll on the system, especially for such athletes as long-distance runners and cyclists. However, it's not just the professional athletes who can benefit from reducing the impact on the body without cutting the workouts short. So what is this magic formula that can keep us exercising safely right into our later years?

Many thousands of years ago the technique of pranayama, or yogic breathing, was formulated to still the mind and relax the body in preparation for long sessions of meditation. These same techniques can be used today for easing into a workout in a blissful, relaxing way so that the heart rate is considerably lowered to allow the body to make less effort for the same amount of activity.

Apart from being a very good tool to make your cardio sessions far more enjoyable, imagine what it can do for your maximum efforts? Did you ever see Miguel Indurain's heart rate monitor on the handlebars of his bike during the Tour de France one year during the time he ruled the roost, and it read about 90bpm very soon after a huge climb in the Alps? Incredible!

Of course, it was said that Indurain had a resting heart rate of about 28bpm, so he's a bit of a superman, but imagine being able to lower yours significantly enough to make difference to even your maximum performance levels.

So, where to start?

Dr John Doullard coined the phrase 'three-phase workout' for a system he devised to do just this. After determining your Ayurvedic body type and your optimum training heart rate (OTR), the basic idea is to have three phases to your workouts...

1. The resting phase (5-10 mins) where you maintain a minimum effort at least 30bpm below your OTR, focus on your breathing, which should be slow, deep and steady and through your nose at all times! Set a breath rate per minute that will remain constant through the workout in all but maximum efforts.

2. The listening phase (15-20 mins) where you check all bodily systems and work up to your OTR. Maintain nose breathing, and be amazed at how, gradually, you are able to increase your intensity without raising your breathing rate or heart rate. What's being aimed for is breathing more efficiently and using more of the lungs rather than breathing faster.

3. The performance phase (no time limit) where you carry the coordination of mind and body developed in preceding phases into more vigorous activity. If you are in a race or competition of some sort, this should be coordinated with the start time. Stay as much as possible in the comfort zone and only pull your maximum efforts out of the bag when it's absolutely necessary. After a while you will be amazed at how much energy we actually waste, and how much can be accomplished with a lower heart rate and perfect form.

So, that's a very short introduction to the three-phase workout and what's actually possible. Of course, there's much more to it, including how to warm up, how to stretch out etc, but these ancient techniques can work absolute wonders in not only prolonging the years in which you can be active by reducing the physical stress of exercise, but actually make you more efficient in the short term. What could be better than that?

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Proper cardio training is not just about training your body and cardiovascular system, it is also about developing enough cerebral agility to sustain your motivation and mental edge throughout the training.

Therefore here are some tips and simple mind tricks that will help you get this needed mental edge.

The toward Vs. the away from strategy

Biologically, our nervous system has 2 main functions: it moves toward pleasure or it avoids pain, period. The best part about this instinctive mechanism is that we can use it consciously to achieve any objective we are struggling with.

For example next time you are feeling off and don't want to do your cardio workout, make a mental picture of what will happen to your body and overall health when the workout is done; you could also picture all the pains and misfortunes you are avoiding by sticking to your training schedule.

Anchoring

Anchoring is the process of associative conditioning. The premise of this strategy is that you can run your own emotional state on command when you become familiar with what triggers certain responses and emotional states.

I learned this technique from Neuro-Linguistic-Programming and has proved itself to be very effective at the job. What makes it very powerful is that is easy to use and do not require any understanding of human psychology.

So next time you finished a great run, try to associate something with it. It could be a sound, a picture or even an object. For me I never run outside without my hat, and as soon as I put it on, my emotional state switches instantly into training mode.

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When it comes to getting rock hard abs, the most effective way is by doing crunches. The crunch does two things it strengthens your core and also focuses the energy right to your abdomen muscles. We will go over some basic crunch exercises that you can do in your home, that are easy to do and effective. One thing to mention though is all of the crunches in the world will not matter if you don't follow a healthy diet. I hear it all the time from my dieters that "I promise you I am doing crunches every day religiously for 30 minutes and still don't see any definition in my abdomen area." See what is happening, is they are working out those abdomen muscles and they are gaining definition, however because they aren't following a healthy diet, the definition is blocked by fat. So, it's important to diet as well as exercise, to lose the extra pounds and fat so you gain that definition.

The basic crunch

This is your basic stomach exercise. If you are new to it, only do two sets of basic crunches, rest, and stretch out. (A set is eight crunch movements.) If you are used to exercise, do two sets and repeat three times, resting and stretching in between.

1. It is important that you protect your back through all these exercises. You should feel the small of your back on the floor. Do not think in terms of lifting your head, think instead of pressing your abdomen down through your spine to the floor.

2. Support your head with one hand; reach out with the other towards your knee or thigh. DO THIS SLOWLY. Do eight or six-teen, depending on your fitness, rest and repeat changing hands.

The crossover crunch

1. Lie with your head supported by both hands, leaving your neck free of tension. To test that you are not straining your neck, you should be able to count to ten while performing this exercise.

2. Inhale before you start. Exhale, and lift your upper body AT THE SAME TIME as you lift your right foot off the floor SIX INCHES. Slightly angle your opposite shoulder towards the right knee. Do six and change sides.

NOTE: If you lift your leg any higher into your chest, you will be using your thigh muscles to help you, so resist. By lifting just a few inches, you will keep all the effort in your stomach muscles.

3. Rest, then repeat sixteen times each side.

4. Turn over to stretch out.

The quarter sit-up

This is a far more advanced exercise. If you prefer, rest your legs on a chair.

1. Take starting position

2. Breathe in, then as you breathe out lift yourself up, including your shoulder blades, and lower again. The idea is to keep your legs steady and not let your knees roll in towards your chest, and to press your stomach downwards. You should try not to tug on your head or neck. Do eight or sixteen, rest and repeat.

If you feel that you could do more exercise, go through the entire sequence of exercises one more time.

Remembering to take time out to drink plenty of water and fluids and to rest if you feel light headed. Remember, that as you start working out you will these abdomen exercises will start to get easier and you will find yourself less tired and able to do more.

Finally...
here's a fail-safe way to gain muscle while losing fat...
without having to bulk up and cut down...
without spending hours in the gym...
and without restrictive dieting!
Click Here Now to find out more!

Written by, Barbara Johnson. If you enjoyed this topic you may want to consider a career in healthcare as a nurse, for more information you can visit my website which covers CNA Training and passing your CNA certification nursing exam.