Dr. Kyle: High Intensity Interval Training!

I’m sure you’ve heard the hype about high intensity interval training (HIIT) – bursts of exertion separated by short periods of recovery – sound tough, right? That’s because it is. The attention around HIIT has provoked researchers to further investigate it’s physiological benefits, which have been promising.

The problem with most workout programs is lack of intensity. People putt around the gym for about an hour, jump from one machine to the next without breaking a sweat. What’s the problem? Nothing, if your goal is to build strength. But from a physical fitness and weight loss perspective, you are overlooking HIIT’s cardiovascular and fat-incinerating benefits.

HIIT is a time-efficient strategy to increase muscle and accelerate fat loss. Intervals of activity and rest can vary between 30 seconds to a few minutes. The duration and intervals can be modified depending on the individual and goal in mind. The objective is to create a fast-paced and physically demanding workout that challenges our threshold of exercise intensity.

So why HIIT vs. cardio?

HIIT is most commonly compared to moderate intensity continuous training (MICT). MICT, also known as steady state cardio, consists of long periods of activity at constant intensity. For example, 45 minutes of jogging at 5km/h is considered MICT. Although it provides significant cardiovascular improvements and may be a favourite for endurance training, HIIT can offer more!! Remember, you can’t go wrong with increasing the intensity of exercise. Let’s compare!

With regards to that pesky body fat, HIIT significantly reduces abdominal and visceral fat in both men and women (1). High intensity training, above 90% peak heart rate, was more effective at reducing whole-body adipose tissue. Many studies show HIIT is superior to MICT in improving aerobic fitness (2). Cardiovascular measures (VO2 max, contractile function, ejection fraction, respiratory fitness and endothelial function) significantly improved with 7-12-week HIIT programs. This holds true for people who have previously suffered from a cardiac incident. Implementing HIIT under supervision during cardiac rehabilitation can improve quality of life by enhancing their cardiorespiratory fitness. No deaths or cardiac events occurred during HIIT programs across all recent studies. What doesn’t kill you makes you stronger, right?

Additionally, studies have demonstrated greater improvements in insulin sensitivity, glucose regulation, HDL cholesterol, and blood pressure with HIIT compared to MICT (2,3). Improved insulin sensitivity allows the body to utilize glucose more efficiently as energy, instead of being stored as fat! By implementing HIIT with intermittent fasting, the body utilizes fat stores for energy, increasing fat oxidation and mobilization (4). HIIT is also more effective than MICT at reducing oxidative stress and inflammation (5). These benefits are observed in subjects across all age categories. HIIT doesn’t discriminate; all can experience the health advantages of HIIT.

HIIT is extremely efficient because we experience what’s known as “excess post-exercise oxygen consumption,” or EPOC – meaning we reap the calorie-burning effects hours after our workout.

During intensive exercise, energy stores are quickly depleted. Our carbohydrate stores, oxygen and other essential compounds are exhausted, resulting in an energy deficit. After HIIT, we eventually reach our normal resting level of metabolic function. Carb stores are replaced (with an appropriate diet), oxygen levels will increase, and body temperature will return to normal (6). These processes require energy, explaining why we continue to burn calories after exercise. Even though HIIT and MICT both induce EPOC, HITT increases lipid metabolism to a greater extent AND is extremely time efficient (6).

So whether you want to call it HIIT, interval training, circuit training, etc., say hello to the most time efficient and beneficial exercise available. Combining HIIT with intermittent fasting and a wholesome diet, expect accelerated fat loss and physical fitness improvements. So what are you waiting for? Let’s turn up the intensity to 11!

References:

1. Maillard F, Pereira B, Boisseau N. Effect of high-intensity interval training on total, abdominal and visceral fat mass: a meta-analysis. Sports Medicine. 2018 Feb 1;48(2):269-88.

2. Hannan AL, Hing W, Simas V, Climstein M, Coombes JS, Jayasinghe R, Byrnes J, Furness J. High-intensity interval training versus moderate-intensity continuous training within cardiac rehabilitation: a systematic review and meta-analysis. Open access journal of sports medicine. 2018;9:1.

3. Costa EC, Hay JL, Kehler DS, Boreskie KF, Arora RC, Umpierre D, Szwajcer A, Duhamel TA. Effects of high-intensity interval training versus moderate-intensity continuous training on blood pressure in adults with pre-to established hypertension: A systematic review and meta-analysis of randomized trials. Sports Medicine. 2018 Sep 1;48(9):2127-42.

4. Wilson RA, Deasy W, Stathis C, Hayes A, Cooke M. Combining intermittent fasting with high intensity interval training reduces fat mass by increasing fat oxidation and mobilization. InAustralia and New Zealand Obesity Society and Breakthrough Discoveries 2018 Joint Conference, Melbourne, Australia, 16-18 October 2018. 2018

5. Ramos, Joyce S., et al. “The impact of high-intensity interval training versus moderate-intensity continuous training on vascular function: a systematic review and meta-analysis.” Sports medicine 45.5 (2015): 679-692.

6. Ahlert M, Matzenbacher F, Albarello JC, Halmenschlager GH. Comparison of epoc and recovery energy expenditure between hiit and continuous aerobic exercise training. Revista Brasileira de Medicina do Esporte. 2019 Feb;25(1):20-3.

Dr. Phil Shares: Does Your Water Need A Boost?

Does Your Water Need a Boost?

Since the body is 60% water, drinking H20 is “crucial for so many of the most basic biologic functions. Cells need to be hydrated with water or they literally shrivel up and can’t do their job as efficiently,” says Robin Foroutan, MS, RD, a spokesperson for the Academy of Nutrition and Dietetics. That includes an impaired ability to expel environmental waste and detox; if you’re dehydrated you may feel cloudy-headed, have headaches or feel constipated, among other ills.

Plain water should always reign as your drink of choice. “It has a better capacity to usher out metabolic toxins from the body compared to liquid that already has something dissolved in it, like coffee or tea,” says Foroutan. However, there are certain additions that can make the once-plain sip seem more interesting and deliver health benefits, too.

Here, alternative hydration boosters to try (and which ones to skip):

Not only does a slice of lemon provide a refreshing taste, but “it’s alkaline-forming, meaning it helps balance out things that are naturally acidic in the body,” says Foroutan. This can have an added post-workout benefit “it can reduce lactic acid, an end product of exercising muscles,” she says.

This amino acid supplement is in a powder form, so it dissolves nicely in water and has a lemon-like taste, says Foroutan. “Acetyl L-Carnitine is a mitochondrial booster. Your mitochondria, the powerhouses of the cells that make cellular energy, help the body use fat for fuel more efficiently,” she says.

Vitamin B12 is crucial for overall health and plays a key role in keeping the brain and nervous system working. “It’s mainly found in animal products, meaning many vegetarians and vegans need to supplement with it, but even some meat eaters have trouble absorbing it,” says Foroutan. “You can have the best kind of diet and even feel OK but have a B12 level that’s less than optimal. When we bring those levels up, people tend to feel more energetic and their mood is better,” she says. Try adding a dropper-full of B12 to your glass of water once a day, suggests Foroutan.

Many grocery stores now stock bottled hydrogen water, but a less expensive solution is purchasing molecular hydrogen tablets to add to your drink. “These can be used to help balance inflammation in the body,” says Foroutan. While inflammation is a normal body process — it happens during exercise, too — low-grade chronic inflammation is damaging. One review in the International Journal of Sports Medicine concluded hydrogen may also boost exercise performance, though researchers are still examining potential mechanisms.

If you have trouble getting enough water because you don’t like the taste, then a bubbly drink (one that contains zero artificial or real sweeteners) can be a healthy way to motivate yourself to drink more. Research in the American Journal of Clinical Nutrition found sparkling water was just as hydrating as regular water. Still, there’s some concern these drinks may wear away at tooth enamel, (although the American Dental Association says they’re far better than soda), so consume carbonated water in moderation.

If you’re active, you lose electrolytes in sweat and it’s important to replace them, but in a smart way, says Foroutan. Many bottled electrolyte waters contain just a trace amount and are often loaded with added sugars, notes Foroutan, so it’s important to read the labels carefully. You can also skip the sugary drinks altogether by buying electrolyte tablets and dissolving them in water. What’s more, “you can get electrolytes from leafy greens (Think: a handful of spinach in your smoothie or a chicken-topped salad),” says Foroutan.

Alkaline water has a higher pH than regular water, but alkalized bottled water is expensive, and there just isn’t enough research to support making the investment, according to the Mayo Clinic and Cleveland Clinic. Foroutan agrees there’s no reason to buy it bottled, but if you really want to try it “you can add a pinch of baking soda to water to create alkaline water.”

Shared by Dr. Phil McAllister @ Forward Health Guelph

Rick’s Honey-Garlic Chicken Kabobs

Perfect for a summer bbq!

Instructions:

Ingredients:
1/4 Cup Extra Virgin Olive Oil
1/3 Cup Soy Sauce
1/3 Cup Honey
1/4 Tsp Ground Black Pepper
2 Cloves of Garlic Minced
1-2 lbs Chicken Breasts Cut into Bite-sized Chunks
2-3 Bell Peppers Seeded and Cut into Bite-sized Chunks
1 Red Onion Cut into Bite-sized Chunks
Any Other Kabob Vegetables You Enjoy (eg. Tomato, Mushrooms)

  • In a large mixing bowl whisk together marinade ingredients.
  • Add chicken and vegetables to the marinade ensuring that they are thoroughly coated. Place in refrigerator for 2 hours.
  • Pre-heat grill to medium (about 350-400 degrees).
  • Drain chicken and vegetables from the marinade and place on skewers.
  • Grill for 12-15 minutes. Some vegetables will cook faster than others so keep an eye on them.

Dr. Kyle: Posture Perfect

You can prevent slips and falls. You can reduce your risk of a motor vehicle accident. You can limit contact sports. One thing that you cannot avoid however, is gravity. If your body and spine are not aligned, the force of gravity will start to wreak havoc on your musculoskeletal system. Making sure we maintain proper posture throughout our work day is critical for longevity in our career. So how do we protect ourselves?

The secret to good posture is maintaining the spines natural curves. When standing, your head, shoulders, hips and ankles should all line up. When sitting, your ears, shoulders and hips should be in line and your buttocks should be at the back of the chair. Sit tall with your chest and head up.

Some tips for creating an ideal posture include:

• Stand tall with shoulders back
• Tuck your chin
• Brace the abdomen
• Squeeze your glutes
• Keep your knees slightly bent

Due to modern day technology, one of the most common signs of poor posture is anterior head carriage. This mean that the head is resting too far forward away from the body. We are not always cognisant of our head posture as we check our smart phones and work on our laptops. The farther our head protrudes forward, the greater the force on our neck. This can lead to chronic neck and upper back pain and lasting postural alterations.

One exercise I recommend to patients to reduce anterior head carriage are chin tucks. These can be done up against a wall or lying flat on your back. You simply bring your chin directly in towards the spine and hold. You can press gently into the wall or pillow to enhance the muscle contraction of your deep neck extensors. Now your spine will naturally carry the weight of your head and allow your neck and upper back muscles to relax. So keep your chin up and your pain levels down!

For more tips and tricks to enhance your posture, visit my Instagram page @drkylearam of email me at drkyle@forwardhealth.ca.

Dr. Kyle: Tips For Sleeping Better

1. Make your bedroom your oasis. If you are going to invest in something, why not invest in a good mattress and pillow that you will spend almost a 1/3 of your life on. Complete your bed with comfy blankets and sheets.

2. Keep it dark. Shut off all alarm clocks, TV’s, phones etc. Make sure no LED light is being emitted. This may require you to unplug some electronics around your room. Black-out curtains are a must.

3. Control room temperature. Make sure you are not too hot or too cold. There is nothing worse than sweating all night under the covers while your body struggles to maintain optimal body temperature.

4. Stop consuming caffeine after 2pm. This ensures that the effects of caffeine will be long gone before your head hits the pillow. Try a decaf coffee in the afternoon to fight off cravings.

5. Don’t work out within 2 hours before bed. This will disrupt hormone rhythms and deprive your body of energy stores needed to repair your body as you sleep.

6. Meditate. A simple 5-10 minutes mediation or deep breathing routine will calm the nervous system and transition you from our fight-or-flight response to your rest-and-digest state.

7. Reduce exposure to blue light after the sun goes down. Change display settings on your phone or use computer programs to block out blue light at night.

8. Have a chamomile tea or small snack with raw-honey to maintain your blood sugar levels throughout the night.

Sweet Dreams!

Dr. Laura: Is Your Thyroid Tired ?

Perhaps your thyroid needs a check-up? It does if you feel sluggish, tired, constipated, have difficult concentration, and are a wee bit depressed.

Subclinical hypothyroidism is when a patient with sluggish digestion, cognition, fatigue and weight issues has a high TSH but normal T4. It is important to look at the reasons for the symptoms, which could have multiple causes, before reaching for the thyroid hormone replacement drug.

Don’t let the sunset on your thyroid…

What nutrients help the thyroid?

Nutrition is a factor. Consider levels of zinc, iodine, selenium and iron as they all play a role in thyroid function. B12 is also an important one to look at and easy to run the labs to determine its status.  Also the health of the gut microbiome and liver needs to be healthy as a large amount of the inactive T4 converts to the active T3 thyroid hormone in the liver and the gut. So many people have issues with the balance in their microbiome.  

Does stress play a role?

Another area of thyroid health to consider is the stress axis. This involves the hypothalamus, pituitary and adrenal, or HPA. Chronic long term stress can make it difficult for optimal thyroid function. In addition to mineral level attention, it is highly important to support the adrenals and provide opportunities for stress management.  

Are there natural thyroid medications?

Finally, there are other options to synthetic thyroid. Natural desiccated thyroid (NDT) may be something to consider if diet and lifestyle changes don’t break through the fog. NDT provides both T4 and T3, which is good if there is an issue with conversion.

How can a naturopathic doctor help?

Naturopathic doctors are medical trained and naturally focussed. They can run labs for the nutrient levels, thyroid stimulating hormone (TSH), T4, T3, and any antibodies to help rule out autoimmune thyroid disease. This helps determine what nutrients might be missing and what foods or nutraceutical dose to suggest and for how long. Naturopathic doctors with education in pharmaceuticals are able to prescribe natural desiccated thyroid. They are also very good at stress management and adrenal (HPA-axis) support with both nutrition, lifestyle and stress management programs.

Dr. Laura M. Brown, ND is a board certified naturopathic doctor with advanced training in pharmaceuticals, functional medicine and stress management. She is a Heart Math Certified Practitioner, a graduate of the Kresser Institute’s Adapt Level 1 functional medicine training and is a Certified Gluten Practitioner.

Dr. Laura: Signs of Blood Clot

Swelling, tenderness, redness in the legs, shortness of breath and or chest pain are all signs of a blood clot. This is an emergent condition and needs to be addressed immediately. To prevent a blood clot, there are plenty of natural remedies that will help.

C-L-OT-S Awareness Campaign

Spread the word on the CLOTS awareness campaign. A clot in blood is the underlying cause of the top three cardiovascular killers: heart attack, stroke and venous thromboembolism (VTE). If symptoms of chest pain, lightheadedness, shortness of breath, leg tenderness and or leg swelling emerge, a visit to the emergency room is best to rule out anything serious.

C – Chest Pain

L– Lightheadedness

O– Out of breath

T- Leg Tenderness

S– Leg Swelling

Natural ways to help thin the blood

Did you know there are a number of natural health products that help thin the blood? Things taken regularly in substantial enough quantities or in combinations like fish oil, curcumin, Dong quai, dan shen, onion, reishi, papain, devil’s claw, garlic, ginkgo, feverfew, ginger, clove oil, horse chestnut, bilberry, kava kava, evening primrose oil, borage, black current, dandelion root, cayenne fruit, green tea, and vitamin  E all inhibit platelet aggregation (thin the blood). These natural remedies also have other actions on the body so you must seek professional advice for what products are right for you. Taking natural remedies to help thin the blood may help reduce the risk of cardiovascular events, and reduce the need or amount of prescription medication.

Naturopathic doctors are trained are medically trained and naturally focussed. Need relief from swelling, pain or fatigue? Call 519 826.7973 or book your appointment online

Dr. Laura M. Brown, ND is a Naturopathic Doctor, a Certified Gluten Practitioner, a HeartMathCertified Practitioner and is a graduate of Adapt Level 1 at KresserInstitute of Functional Medicine. Essentially, Dr. Brownhelps people better digest their food and the word around them.

Dr. Kyle: Torn ligament? Maybe not.

Knee pain can come in a variety of presentations. Whether from a sports injury, slip and fall, or out of the blue, no two knee injuries are completely alike. The extent to which tissues are damaged is specific to the patient’s genetics, lifestyle, trauma, and fitness level. A well-trained athlete may be quite high functioning even with a serious tear, while a mild injury may keep a very sedentary person out of commission for several months.

Often times I will hear “hey doc, I think I might have heard a pop and the inside of my knee really hurts!”. My first reaction is to suspect a ligament tear. Once examining the patient further however, orthopedic testing shows stable knee ligament testing, no swelling or redness, and no severe joint line tenderness. So what’s the deal?

Like most soft tissue injuries, ligaments can be damaged to varying degrees. In the clinical world, there are 3 grades of ligament tears. Grade 1 is mild ligament damage, grade 2 is moderate, and grade 3 is severe/ruptured ligament tear. Common symptoms of a complete tear include sudden onset of pain and severe swelling, joint instability, and impaired function. The truth is, disruption of tendon fibers can happen to varying degrees. Think of muscle strains and ligament sprains on a spectrum of structural damage from 0 to 100%. The higher percentage of damage, the longer time it will take to establish preinjury performance levels.

Fortunately, if ligament stability is determined to be adequate by a healthcare professional, a conservative trial of care will often resolve symptoms. Ligaments in the body have the natural ability to heal on their own. Healing consists of 3 distinct phases including the inflammatory phase, the reparative phase, and the remodelling phase. Simply put, fibrotic scaffolding will be laid down so newly formed collagen can connect the severed ends of the tear. It is important to seek proper medical attention so that rehabilitation can begin as soon as possible.

For injuries of this nature, treatment will often begin with controlled range of motion exercises. Other modalities such a laser and acupuncture are helpful for enhancing healing at this stage. As tensile strength of the ligament improves, the joint will be able to tolerate more load. Eventually strengthening exercises will be included into the plan of management and progressed with increasing difficulty.

So if you or someone you know is worried that their knee pain may need surgical intervention, make sure you get it assessed by a medical professional who specializes in musculoskeletal injuries. It may be quite reassuring to know that with the right tools and knowledge the body will be able to heal and adapt on its own.

For more information, please contact drkyle@forwardhealth.ca or visit my professional Instagram page @drkylearam.

References:
Woo SL, Abramowitch SD, Kilger R, Liang R. Biomechanics of knee ligaments: injury, healing, and repair. Journal of biomechanics. 2006 Jan 1;39(1):1-20.

Dr. Laura: Understand PMS

Premenstrual Syndrome, or PMS can come in a variety of patterns. A whirlwind of emotions, cravings and weight gain often come in tote with the monthly menstrual cycle. Better understand the impacts of the monthly swing in hormones and get the help you need to live a more balanced life.

PMS-A: Anxiety

Anxiety or irritability can come from estrogen excess or progesterone drops. This imbalance in the two major female hormones can make some feel like they want to crawl out of their own skin. Increased levels of estrogen in the second half of the period can allow adrenaline to build up and alter the serotonin balance. Natural treatment includes supportive measures for estrogen clearance, progesterone building herbs, regular moderate exercise, a healthy diet and stress management.

PMS-C: Carbohydrate Craving

Cravings for sweets and refined carbohydrates, feeling hangry, tired or having a headache all fall under the category of PMS-C. Abnormal variations in blood sugar may be a factor of magnesium levels – and this gives into the common cravings for chocolate as dark chocolate is high in magnesium. Noteworthy: a change in serotonin levels can also increase sugar cravings. Therefore, factors in insulin regulation are key and are a focus of treatment. Finally, herbal formulas are also available to reduce the satisfaction of sweets and crush the cravings.

PMS-D: Depression

In addition to anxiety, mood changes throughout the cycle can also lean towards depressive states. Symptoms that suggest the need to modify the stress response include crying, fatigue, headaches, feeling overwhelmed or out of control, and difficulty sleeping. Adaptogenic herbs may be helpful to support the stress response. Chinese formulas and botanical medicine formulas that include nerviness, anxiolytics and antidepressants can be very effective in PMS-D treatment. Certainly, nutraceuticals may also be helpful to modulate levels of serotonin, GABA, and dopamine and thyroid hormone levels should also be monitored, especially if the periods are heavy. Neurotransmitter hormones can be evaluated with take home urine tests called Organic Acid Tests (OATs).

PMS-H: Hyperhydration

Fluid retention is a common PMS complaint. Breast tenderness and distension, bloating, weight gain, swollen hands and feet can all be classified under PMS-H. An increase in circulating aldosterone levels is linked to decreased progesterone and magnesium with increased estrogen. Reduce salt and sodium intake (bread and cheese) and increase sources of potassium (bananas, baked potato with the skin, dandelion leaf tea). Treatment of Liver Qi stagnation with acupuncture and Chinese formulas are often very good at reducing PMS-H.

Naturally Navigate PMS

Naturally navigate your health with Dr. Laura M. Brown, ND

Naturopathic doctors can provide individualized treatment to manage hormones. The whole body is considered, the physical, emotional, cognitive and spiritual. When it comes to hormone balance, the naturopathic tool box is rich. Bring balance to your hormones and bring balance back into your life.

Start your evaluation on your own!

Start your evaluation on your own! Use Clue, the period and ovulation tracker, which is a free Ap for iPhone and Androids. Take note of your diet with the use of aps that help you track dietary, lifestyle and nutritional habits. Bring all this to your first appointment. You may also be a good candidate for a take home urine test. Stress and reproductive hormone can be assessed with an at home urine test, (DUTCH), available and interpreted with your naturopathic doctor.

Dr. Laura M. Brown, ND is a Naturopathic Doctor, a Certified Gluten Practitioner, a HeartMathCertified Practitioner and is a graduate of Adapt Level 1 at KresserInstitute of Functional Medicine. Essentially, Dr. Brown helps people better digest their food and the word around them.

Dr. Kyle: Building Stronger Bones

When discussing bone health, we often talk about proper nutrition. Adequate vitamin D and calcium intake are usually recommended to enhance bone mineral density (BMD). What is not discussed as often is the role of exercise and weight training for increasing bone strength. A holistic approach looking at what we put IN our body as well as what we DO with our body is the key for building stronger bones.

As we age our body experiences several physiological changes. Our hormone levels change, muscle mass declines, and bones become less dense. Low bone density, otherwise known as osteopenia, increases our risk of fracture. Although we can bounce back from a slip or fall in our early years, a hip fracture in older individuals can have detrimental effects on quality of life. The good news is, there are important steps you can take to prevent or slow down the decline of BMD.

Research has demonstrated that healthy individuals and patients with osteoporosis can improve BMD with high-moderate impact activities and resistance training. A few examples of high impact exercises include step classes, jogging, and jumping jacks. Resistance or weight training on the other hand can include elastic band, pully, and free-weight based exercises. To put it simply, the more force you transmit through the bone, the more the bone will remodel and grow! Clinical judgment is needed to determine the intensity of force that each patient can tolerate.

Recent studies have found that high-intensity resistance training and impact training improves BMD and physical function in postmenopausal women. Low-intensity and light-resistance exercise programs are not enough to stimulate bone remodelling and improve BMD. Heavy multi-joint compound exercises such as squats and deadlifts induce extensive muscle recruitment and transmit greater force through the bones. In particular, these exercises will apply force through the lumbar spine and femoral neck, making them stronger and more resilient to fracture. Proper form and supervision are crucial when performing any high intensity or heavy loading activities.

Talk to a primary health care provider about your BMD and if an exercise program for developing BMD is right for you. Not only will exercise strengthen your bones, but it will have profound impacts on many other systems of the body as well. As always, if you have any question do not hesitate to contact me at drkyle@forwardhealth.ca or visit my Instagram page @drkylearam!

Reference:

Sinaki M. Exercise for patients with established osteoporosis. InNon-Pharmacological Management of Osteoporosis 2017 (pp. 75-96). Springer, Cham.

Mounsey A, Jones A, Tybout C. Does a formal exercise program in postmenopausal women decrease osteoporosis and fracture risk?. Evidence-Based Practice. 2019 Apr 1;22(4):29-31.