HealthCare

How do you know when to train though illness or when to rest?

Listen to Your Body: Training Through Illness or Resting?

So would you recommend someone train of sick? At what point should you rest? Excellent question. And I know that there's been certainly a lot of debate about this especially when we've seen risks of more serious illness from patients after recovering from COVID and all of that. And so generally speaking, you should let your body be your guide. And so if you're feeling a little bit unwell but you don't have a fever, you don't have any GI upset, you feel like you could do something, I certainly wouldn't push myself. But it might be reasonable to do something very gentle, like maybe a little bit of recovery resting. Definite no nose for exercise would be fever. So fever is a temperature greater than 100.4. If you're really have deep chest congestion, something like pneumonia, you've been diagnosed with or if you have lower GI symptoms. And so a good rule of thumb is that if it's generally relatively mild and above the head, then it would be fine to do some gentle activity. If it's below the diaphragm, then I would definitely stay away from that. Nobody wants to work out when their stomach is really bothering them. And then when you get back into exercise just as importantly, when you start to feel well, you don't want to go immediately back into full activity. And so making sure that you're gradually-- just listening to your body and gradually increasing your intensity.

When you are feeling unwell, listen to your body and if it's relatively mild and above the head then doing some gentle activity like rest may be fine. If it's below the diaphragm, then stay away from any exercise. When you start to feel well, don't go back into full activity immediately, but gradually increase intensity.

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Knowing when to train through illness or when to rest is an important consideration. Generally, it's best to let your body be your guide. If you're feeling slightly unwell without a fever or gastrointestinal issues, you might consider engaging in gentle activity like recovery resting. However, it's crucial to avoid exercise if you have a fever (temperature greater than 100.4), deep chest congestion, diagnosed pneumonia, or lower gastrointestinal symptoms.

A good rule of thumb is that if the symptoms are relatively mild and above the head, gentle activity may be acceptable. But if the symptoms are below the diaphragm, it's best to refrain from exercise, as no one wants to work out with a bothersome stomach.

When you start to feel better and decide to resume exercise, it's important to do so gradually. Listen to your body and gradually increase the intensity rather than immediately jumping back into full activity.

Siggi's Coconut Yogurt: The Perfect Plant-Based Option with Low Sugar and High Protein!

So what is the best yogurt? Well, for me, I'm going to give you a plant-based approach because I am a plant-based person. So for me the best yogurt is actually Siggi's coconut yogurt. And the reason that I like that is a lot of your plant-based yogurts are going to be a little bit higher in sugar. And so I really like the Siggi's because the total sugar is actually just 9 grams. And so it ends up being about with a gram of dietary fiber. So I think it ends up being about 11 or 12 grams of like, actual net carbohydrates. And then the protein is actually 11 grams of protein. And so for a plant-based product, this is a really good ratio of sugar to protein. And so the other reason that I really like that is that you have a pea protein that's in there, coconut milk, so your medium chain triglycerides, which are great sources of energy and really not a lot else. So it's a pretty clean source of yogurt. So that's my go to.

I like Siggi's coconut yogurt because it has a good ratio of sugar to protein, and the ingredients are clean and simple.

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For me, the best yogurt is Siggi's coconut yogurt. As a plant-based person, I appreciate that it has a lower sugar content compared to many other plant-based yogurts. Siggi's coconut yogurt contains just 9 grams of total sugar, along with 1 gram of dietary fiber. This results in around 11 or 12 grams of net carbohydrates. Additionally, it provides 11 grams of protein, which is a great ratio for a plant-based product.

What I like about Siggi's is that it includes pea protein and coconut milk, offering medium chain triglycerides for energy without many additional ingredients. It's a clean and satisfying choice for yogurt.

What do you think of energy drinks? Are they all bad?

Are energy drinks all bad? The surprising truth revealed!

So what do you think of energy drinks? Are they all bad? That is an excellent question. And I think energy drinks can mean any one of a number of things. And so like coffees and energy drink, it has caffeine and it's going to help you work out. The truth is that caffeine is an ergonomic aid. So it is something that helps us to perform better. Obviously there's a bell curve there and if you have too much caffeine then you're going to feel jittery and anxious and won't be performing well. So maybe a cup or two is probably what's reasonable for most people. And I think absolutely, it definitely gives you that edge. It makes it feel easier to perform. When they look at studies with cyclists and caffeine, they find that there is prolonged time to fatigue ability, so people feel like they can exercise for longer and that the perceived workload is reduced and so it doesn't feel like you're working as hard. The other thing that I'll point out though is that they find that if people use caffeine chronically, like you drink coffee every day, probably the benefits of that on race day are reduced. And so it might be something if you're trying to get that extra little boost from the energy drink that you actually don't drink it every day and just take it 30 minutes before your competition. That being said, obviously there's oftentimes a lot of other things in all of those energy drinks that are of more dubious benefit. And so there can be a lot of sugar and a lot of carbohydrates in those drinks. They oftentimes will be somewhat of a diuretic and so you really have to be careful about consuming an energy drink and making sure that you don't get dehydrated, especially with a prolonged endurance thing. They may include B vitamins which can sometimes improve our sense of energy or certainly some of the amino acids. So I don't think they're all bad. I think you do have to look though at what the ingredients are and how much you're consuming. And again, if you want it to actually be a boost, it probably shouldn't be something that you're drinking every day in order to actually get that ergonomic benefit.

Energy drinks can be beneficial in providing an ergonomic aid, such as caffeine, however it is important to look at the ingredients and consumption of them. It may be best not to drink energy drinks every day if you want them to actually be a boost.

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What do I think of energy drinks? Are they all bad? That's a great question. Energy drinks can vary in their composition and effects. Like coffee, energy drinks contain caffeine, which can enhance performance. However, it's important to note that caffeine is an ergogenic aid, meaning it helps us perform better, but there's a limit. Too much caffeine can lead to jitteriness and anxiety, negatively impacting performance. For most people, a cup or two of caffeine is reasonable.

Energy drinks can provide an edge and make tasks feel easier. Studies on cyclists have shown that caffeine can prolong time to fatigue and reduce the perceived workload during exercise. However, chronic caffeine use, such as daily coffee consumption, may reduce the benefits on race day. To maximize the boost from an energy drink, it may be advisable to consume it only 30 minutes before competition and not on a daily basis.

It's important to consider the other ingredients in energy drinks. Many contain high amounts of sugar and carbohydrates, which may not be beneficial for overall health. Some energy drinks also act as diuretics, so staying hydrated is crucial, especially during prolonged endurance activities. Some energy drinks include B vitamins or amino acids, which can contribute to a sense of energy.

In summary, energy drinks are not inherently bad, but it's essential to examine the ingredients and quantity consumed. If seeking a performance boost, it's best to avoid daily consumption and be mindful of the overall impact on hydration and health.

What do you recommend for immediate recovery post workout (30 min)? And is 30 min really the magic time?

Maximize muscle recovery with post-workout fuel in 2 hours

So what do you recommend for immediate recovery post-workout? And is 30 minutes really the magic time? So I think it depends to some extent on how long you've been working out and the kind of working out that you're doing, like whether it's more of an endurance-based workout or you might be working out for longer, or if it's more of a power-based workout. Regardless, we know that muscle protein synthesis is increased in the 24 hours after exercise, and so you have this, kind of, magic window. Really, we recommend that you try to fuel within 2 hours of a workout. So you don't have to get it all in right away, but within that first 2 hours really helps to boost that muscle protein synthesis so that you're actually building muscles instead of just breaking them down. Typically, especially if you're doing more of a power-based workout and to replenish those muscle [? storage, ?] we recommend like about 0.25 to 2.3 grams per kilogram of body weight in terms of your protein repletion afterwards. And that should be, you know, like, complete amino acid protein. So typically like a protein shake is a great option for people who do dairy because they will contain all of those essential amino acids. If somebody is a plant-based person, then you can do, kind of, a mix of like lentils and rice. Something like that would be a great option. In terms of carbs, again, it kind of depends on how long you're exercising. If you're exercising for a prolonged period of time, like more than an hour or 2 hours, then your carb repletion-- like, people who are exercising that long, their carbohydrate intake should be like 6 to 10 grams of carbs per kilogram of body weight a day, which can be quite a lot. And so, you know, what that works into is, like, probably 60 or 70 grams of carbs, especially if you're doing more of a prolonged workout. And so energy bars can do that. Again, like a protein shake is a great way to do that, if you like that. So I guess it depends on what your palatability and your and your tolerability is. Another kind of neat trick is that if you boost the protein a little bit but it's hard for you to get that amount of carbohydrates and you're like, gosh, you know, Dr. [INAUDIBLE] how are you going to get-- like, I can't eat 70 grams of carbs after a workout. If you boost your protein a little bit, it can help you to take more advantage of carbs. You can eat a little bit less carbs if you have more protein. So those are some of my tips. But I think really the magic number is, if we're thinking about is the proteins, and so figuring out what your body weight is in kilos and 0.25 to 0.3 grams per kilogram protein in those 2 hours after a workout.

The recommended immediate recovery post-workout includes consuming 0.25 to 0.3 grams of protein per kilogram of body weight within 2 hours after working out. This helps to increase muscle protein synthesis, which aids in building muscles. Carbohydrates should also be consumed in the form of energy bars or a protein shake, with the amount varying depending on how long the workout was. Boosting the protein intake can help to reduce the amount of carbohydrates needed.

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So, what do I recommend for immediate recovery post-workout? And is 30 minutes really the magic time? Well, it depends on the duration and type of workout you've done. For optimal muscle protein synthesis, it's recommended to fuel within 2 hours of your workout. This helps in building muscles instead of breaking them down.

For power-based workouts, it's suggested to consume around 0.25 to 0.3 grams of protein per kilogram of body weight for muscle repletion. Complete amino acid proteins, such as those found in protein shakes, are great options for dairy consumers. Plant-based individuals can opt for a combination of lentils and rice.

Regarding carbohydrates, if your workout lasts for more than an hour or two, it's important to replenish your carb stores. This can range from 6 to 10 grams of carbs per kilogram of body weight per day. Energy bars or protein shakes can help meet these requirements.

If consuming a large amount of carbs is challenging, increasing protein intake can help enhance carb utilization. So, boosting protein slightly can allow for a reduction in carb intake while still benefiting from their effects.

Ultimately, the key is to focus on protein intake within the first 2 hours after a workout. The recommended range is 0.25 to 0.3 grams per kilogram of body weight.

Should athletes include intermittent fasting into their routines?

Unlocking the Potential: Intermittent Fasting for Athletes

So should athletes include intermittent fasting into their routines? This is a great question, and the question that I get asked a ton because, obviously, there's been a lot of research and a lot of media press coverage about this idea of intermittent fasting. And intermittent fasting has been around since the 1940s. They've done a ton of research looking at longevity in its health benefits. So it seems to improve our liver processing. It seems to improve our ability to regulate glucose. It seems to help with weight management. And so a number of health benefits that are very important. Less research has been done looking at athletics and the effect of intermittent fasting on athletics. But there have been a few studies looking at the idea of exercising while fasted versus exercising while fed. And so we can extrapolate those research studies to this idea of intermittent fasting. So when I'm talking to athletes, I find that the easiest way to engage in intermittent fasting and probably the most reasonable way for most of our performance athletes and endurance athletes is going to be this idea of eating for eight hours and then fasting for 16. And so you are fasting for 2/3 of your day and eating for a third, essentially. And the reason that I recommend this is that, when we look at exercise performance and athletic performance during the fasted state versus the fed state, in the fasted state, you're able to maintain athletic performance at less than 70% of your VO2 Max, so that moderate intensity physical activity. You can do that forever. But people really have trouble getting access or pushing beyond that 70% VO2 max. And so for athletes who need to be engaging in anaerobic workouts, lactic threshold workouts, workouts where you're really trying to get close to that VO2 max, and of course-- and our athletes where they're trying to actually compete, and so wanting to get access to that, pushing really close to that VO2 max or that lactic threshold, you need to be fed. And you're not able to get into that maximal state of exertion if you are not fed, at least looking at the studies that they've done so far. And so what I would say is that, certainly, athletes can include intermittent fasting. There's a number of health benefits and reasons that people may want to do so. But you have to time your workouts appropriately. And so if you're doing more of an endurance-based workout, fine, it may be fine to do it when you're when you're in that fasting period of time. But if you're trying to achieve the benefits and the gains of doing an anaerobic or, like I said, a lactate threshold, a maximal effort workout, then you should really do it in that fed state so that you can get the benefits of that workout. And certainly, if you're going to compete in an event, you want to be fed. So that's my answer.

Intermittent fasting can be beneficial to athletes, but they should time their workouts carefully. For more intense workouts, athletes should be sure to be in a fed state to ensure that they receive the best performance benefits.

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Should athletes include intermittent fasting in their routines? This is a common question, and while there is extensive research on the health benefits of intermittent fasting, there is less research specifically focused on its impact on athletic performance.

When it comes to athletes, I find that a practical approach is to follow an eating window of eight hours and fasting for the remaining 16 hours of the day. This allows for a balance between fasting and eating. However, it's important to consider the type of exercise and performance goals.

Studies have shown that exercising in a fasted state can maintain athletic performance at moderate intensity levels (less than 70% of VO2 Max). However, it becomes challenging to push beyond that threshold and reach maximal exertion without being fed. This is particularly relevant for anaerobic workouts, lactic threshold workouts, and competitions where athletes need to access their maximum potential.

In summary, athletes can incorporate intermittent fasting into their routines, considering the health benefits it offers. However, it's crucial to time workouts appropriately. Endurance-based workouts may be suitable during the fasting period, but for anaerobic or maximal effort workouts, it is recommended to be in a fed state to achieve optimal benefits. Additionally, when competing in events, being properly fed is essential.

Ultimately, athletes should find a balance that works for their individual needs and goals.

As a fit, 37 year-old man, should I be concerned if my HRV is consistently less than 40?

Low HRV: Should fit men worry? It's just one fitness marker.

So, as a fit 37-year-old man, should I be concerned if my HRV, or my heart rate variability, is consistently less than 40? HRV is something that has been discussed as yet another marker of physical fitness. And so we see that, in athletes, like really highly trained endurance athletes, there's a little bit more HRV. And HRV is the beat-to-beat variability. And so studies have shown that in just patients in general, and across populations, people with lower beat-to-beat heart rate variability, may be at increased risk of cardiovascular disease or heart attacks, strokes, those sorts of things. That being said, the way to measure heart rate variability, truly, in the way that they used what they use to actually calculate heart rate variability in all these studies, is an EKG readout. And so you're hooked up to an EKG machine, and somebody goes through with calipers, and measures the variability from beat-to-beat. Obviously, most of us don't do that. We're using a watch of some sort, or fitbit, or some sort of heart rate monitor. The reason that I bring that up is that these monitors are less accurate at detecting that beat-to-beat variability, and so it is easy for a monitor to under or over calculate that variability. If you notice that that heart rate variability is consistently lower and you're concerned, one of the things that we know that can drive down that variability is certainly stress and poor sleep. And so looking at lifestyle and saying, I may be fit, but my stress levels are off the chart, or I'm really not sleeping well, those can contribute to that variability. And then it may be reasonable to address that. That being said, I don't think-- If otherwise, workouts are going well, you're feeling well, you're sleeping well, I wouldn't get too hung up on that HRV being a little bit on the low side, because it's just one of a number of markers of fitness. And again, you might not be measuring it as accurately, or your electronic device may not be measuring it as actively as you would like.

If you're feeling fit, sleeping well, and your workouts are going well, then it is not necessary to be too concerned if your HRV is consistently lower than 40. This may be due to stress or poor sleep, and addressing those lifestyle factors can help improve your HRV. It is also important to note that heart rate monitors may not be accurately measuring the beat-to-beat variability, so it is possible that your HRV is actually higher than reported.

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As a fit 37-year-old man, if your heart rate variability (HRV) is consistently less than 40, should you be concerned? HRV is often considered a marker of physical fitness. Studies have shown that individuals with lower beat-to-beat heart rate variability may have an increased risk of cardiovascular disease, heart attacks, and strokes.

However, it's important to note that the most accurate way to measure HRV is through an EKG readout, which is not typically accessible to most people. Consumer devices like watches or fitness trackers provide HRV estimates that may be less accurate.

If you notice consistently low HRV and are concerned, it's worth considering factors that can influence HRV, such as stress and poor sleep. Lifestyle factors like high stress levels or inadequate sleep can contribute to lower HRV. Addressing these factors may help improve HRV.

However, if your workouts are going well, you feel good, and sleep is not an issue, there may not be a need to overly focus on a slightly lower HRV. HRV is just one of many markers of fitness, and consumer devices may not measure it as accurately as desired.

It's always a good idea to consult with a healthcare professional who can provide personalized advice based on your specific situation.

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Katherine Wojnowich, MD, is a board-certified physician and director of Bayfront Health St. Petersburg Medical Group Sports Medicine. She specializes in sports medicine and caring for active patients. She is board certified in family medicine, holds a CAQ in sports medicine, and is a fellow of the American Academy of Family Physicians (FAAFP). She is a member of the American Medical Society of Sports Medicine, American Association of Family Physicians, and Florida Association of Family Physicians. She is team physician for Eckerd College and serves on the medical staff for many area sports teams and race events.

Neither AnyQuestion nor its Experts provide medical advice, diagnosis or treatment or otherwise provide professional healthcare services.

Dr. Katherine Wojnowich, MD