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Over-the-counter medicines are a lucrative business for the pharmaceutical industry. Americans make 2.9 billion trips to pharmacies to purchase over-the-counter (OTC) drugs every year, spending a whopping $34.3 billion dollars! (1, 2)

While most OTC drugs have long been considered relatively harmless, recent research suggests otherwise; in many cases, the long-term consequences of taking OTC drugs were inadequately explored before their release on the market, and we are only now beginning to understand their numerous adverse effects. Read on to learn about the health risks of common OTC meds, including ibuprofen, aspirin, acetaminophen, decongestants, antacids, and antihistamines, and discover safe alternatives to these drugs.

Short on time? Use these links to skip ahead!

• Why OTC drugs aren’t as safe as you may think
• Ibuprofen
• Aspirin
• Acetaminophen
• Decongestants
• Proton pump inhibitors (PPIs)
• Antihistamines
• Alternatives to OTC medications
  • Ibuprofen and acetaminophen
  • Aspirin
  • Decongestants
  • PPIs
  • Antihistamines

Why Over-the-Counter Drugs Are Not as Safe as We’ve Been Led to Believe

The public perception of over-the-counter medications is that they must be safe, since they are purchased without a prescription, and frequently without any advice or restrictions. However, a growing body of research shows that OTC drugs are anything but harmless. Ibuprofen, aspirin, acetaminophen, decongestants, and antacids make up most of the OTC drug market and, unfortunately, our overuse of these products is damaging our health.

Over-the-counter medicine can hurt your gut health, your heart, and your immune system. Check out this article for more of the serious, even deadly, side effects of OTC medicine, and get natural alternatives. #healthylifestyle #functionalmedicine #chriskresser

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The Truth about Ibuprofen

Non-steroidal anti-inflammatory drugs, or NSAIDs, are among the most commonly used drugs worldwide, with 70 million prescriptions and 30 billion over-the-counter doses sold annually in the United States. (3)

It Carries Cardiovascular Risks

The cardiovascular risks of NSAIDs, including ibuprofen, were first identified decades ago. (4) Inexplicably, this information has remained mostly undisclosed to the public, causing millions of people to take a drug that could potentially compromise their heart health. In recent years, several studies have finally grabbed the attention of the medical community; in 2017, a study published in the European Heart Journal – Cardiovascular Pharmacotherapy associated ibuprofen consumption with a 31 percent increased risk of cardiac arrest, while several others linked the drug to non-fatal myocardial infarction, congestive heart failure, and high blood pressure. (5, 6, 7)

Ibuprofen and other NSAIDs inhibit cyclooxygenase, an enzyme that produces inflammatory mediators, called prostanoids, from arachidonic acid. While NSAIDs inhibit the production of inflammatory, pain-inducing prostanoids, they also inhibit beneficial prostanoids that promote vasodilation (which helps reduce blood pressure); inhibit platelet aggregation (necessary for the blood to clot); and maintain a healthy vascular system. The reduction of beneficial cardioprotective prostanoids explains the increased risk of cardiovascular complications observed with ibuprofen use.

It May Cause Gastrointestinal Problems

The gastrointestinal complications of NSAIDs are also well recognized. Ibuprofen harms the gastrointestinal (GI) tract by reducing beneficial prostanoids that maintain the integrity of gastric tissue and the intestinal barrier. GI complications are exceedingly common; 60 to 70 percent of individuals who take NSAIDs long term develop intestinal inflammation, increased intestinal permeability, mucosal damage, gastric ulcers, diverticulitis, blood loss and anemia, and nutrient malabsorption. (8) Ibuprofen also alters the gut microbiota. (9, 10, 11) Furthermore, by damaging the intestinal barrier, ibuprofen allows for the transfer of inflammatory bacteria from the intestine to the liver, causing liver inflammation and promoting the development of nonalcoholic fatty liver disease. (12)

Ibuprofen Could Harm the Liver, Kidneys, and Immune Function

Ibuprofen damages the liver and raises levels of the enzymes AST, ALT, ALF, and bilirubin. (These are the primary markers in liver function testing.) Researchers are still trying to understand precisely how ibuprofen causes damage to the liver, but it could be, in part, an immune reaction to the drug or the body’s response to toxic byproducts produced when it attempts to metabolize ibuprofen. (13)

Ibuprofen damages the kidneys and interferes with immune function. The drug reduces glomerular filtration, the process by which the kidneys filter excess fluid and waste products into the urine, thereby straining the kidneys. Ibuprofen also impairs the immune response, suppressing the body’s ability to target and eradicate viral infection. (14)

It Carries Prenatal Risks, Too

In recent years, an alarming body of evidence has accumulated indicating that prenatal use of ibuprofen increases the risk of fetal and infant health problems. Using ibuprofen during pregnancy is associated with decreased birth weight, an increased risk of cerebral palsy, and altered fetal testis development. (15, 16, 17) Ibuprofen may induce these effects in a developing fetus by interacting with maternal hormones, inducing brain oxidative stress, stimulating endocannabinoid receptors in the nervous system, and inhibiting sulfation, a crucial biochemical pathway involved in detoxification.

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Why Aspirin Isn’t as Beneficial as You May Think

Public health authorities have long recommended low-dose aspirin therapy (taking a daily “baby aspirin” dose of 81 mg) for the prevention of cardiovascular disease. (18) However, recent research has cast serious doubt on the validity of this practice. A large NIH-funded study published in 2018 found that aspirin use has no beneficial effects on “healthy lifespan,” classified as life free of dementia or persistent physical disability, in older adults. (19)

Furthermore, the supposed benefits of aspirin in at-risk individuals must be weighed against the established health risks of the drug, including an increased risk of GI bleeding, hemorrhagic stroke, and brain bleeding. (20, 21)

The problematic effects of aspirin aren’t limited to adults; prenatal aspirin use is associated with an increased risk of fetal testicular dysfunction and cerebral palsy. (22, 23) The mechanisms by which aspirin induces these effects are similar to those noted with ibuprofen; aspirin alters maternal hormone production, causes oxidative stress, and inappropriately stimulates the endocannabinoid system, a biological system that plays a pivotal role in the development and function of the brain.

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Acetaminophen: Dangerous for Children—And Adults

Acetaminophen is an OTC analgesic consumed in the United States in massive quantities. Each week, approximately 23 percent of American adults pop an acetaminophen-containing medicine. (24) Unfortunately, few understand how harmful this common pain-relief drug may be.

• When women take acetaminophen before becoming pregnant or during pregnancy, they may significantly increase their baby’s risk of developing childhood asthma, ADHD, autism, a reduced IQ, behavioral problems, language delay, impaired executive function, and cerebral palsy. (25, 26, 27, 28, 29) (In animal studies, female mice exposed to acetaminophen/paracetamol gave birth to female offspring with dysfunctional reproductive systems.) (30)
• Paternal preconception acetaminophen use for eight or more days is also associated with ADHD in children. (31) Acetaminophen increases the risk of these conditions by decreasing glutathione, the body’s master antioxidant, thus leaving the fetal respiratory system and brain vulnerable to oxidative stress.
• Acetaminophen use during early childhood may also be harmful. The use of acetaminophen in babies between the ages of 12 and 18 months increases the risk of autism spectrum disorder eight-fold. (32) In adults, acetaminophen may blunt emotions and empathy, indicating that it has adverse neurobehavioral effects well beyond pregnancy and childhood. (33, 34)

Acetaminophen is also toxic to the liver and kidneys. Over half of all acute liver failure cases are caused by acetaminophen overdose. (35, 36) Acetaminophen causes liver damage by increasing the permeability of the gut, allowing inflammatory bacteria to move from the gut into the liver. (37) The current recommended maximum dose for acetaminophen of 4,000 mg per day is capable of inducing liver damage, as indicated by elevations in the liver enzyme ALT, after just four days. (38) Last but not least, acetaminophen increases the risk of kidney and blood cancers. (39, 40) While the mechanism is not well understood, a potential explanation is that acetaminophen is a metabolite of phenacetin, a known (and now banned) carcinogen.

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Decongestants Can Have Serious Cardiovascular Side Effects

The active ingredient in most decongestants is pseudoephedrine. Pseudoephedrine stimulates alpha-adrenergic receptors, which activate the sympathetic nervous system, increase heart rate, and raise blood pressure. When taken by individuals with undiagnosed hypertension, decongestants can cause hypertensive emergencies. (41, 42) To put this in perspective, 75 million Americans have hypertension, and over half of those do not have the condition under control or are undiagnosed. While decongestants list potential risks on the label, few people read the label or heed the advice. Decongestants pose a significant threat to these individuals, despite their OTC availability.

Decongestants have also been found to induce urinary problems in males over 50 years of age and can cause insomnia, nervousness, rapid heart rate, heart attack, and heart palpitations. (43) To make matters worse, taking decongestant nasal sprays for longer than just three days can induce a vicious cycle of rebound congestion—essentially, congestion gets worse after you stop taking the decongestant because your nasal passages have become dependent on the drug. This leads many people to continue decongestants indefinitely.

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The Many Dangers of Proton Pump Inhibitors

Proton pump inhibitors (PPIs) are among the most widely used OTC drugs for stomach upset, yet they come with a lengthy list of adverse effects. Proton pumps are well known for their role in the stomach, where they facilitate gastric acid production. The intention of taking a PPI is to reduce the activity of gastric proton pumps, thus lowering gastric acid production and alleviating reflux, peptic ulcers, and indigestion. However, few people realize that proton pumps are present in nearly every cell of the body and are essential for cellular energy production.

They Can Hurt Your Gut Health

Gastric acid is a component of chyme, the mixture of gastric juices and partially digested food that passes from the stomach to the small intestine. In a person with normal gastric acid production, chyme regulates the acidity of the upper small intestine, preventing bacteria from overreaching their bounds. By inhibiting gastric acid production, PPIs reduce the acidity of chyme and allow the number of microbes in the small intestine to rise, causing small intestinal bacterial overgrowth (SIBO). (44, 45) PPIs also change the composition of the gut microbiota, increasing levels of opportunistic pathogens and the risk of serious infections including Clostridium difficile, Campylobacter, and pneumonia. (46, 47, 48) Changes to the gut microbiota induced by PPIs may also raise the risk of chronic liver disease by increasing Enterococcus bacteria, which travel from the gut to the liver and exacerbate alcohol-induced liver disease, nonalcoholic fatty liver disease, and nonalcoholic steatohepatitis. (49)

PPIs Can Lead to Nutrient Deficiencies

In addition to controlling bacterial populations in the small intestine, gastric acid is also required for the absorption of nutrients. Low gastric acid impairs digestion. Accordingly, deficiencies of vitamin B12, magnesium, iron, calcium, and vitamin C are common in users of PPIs. (50) In fact, poor magnesium and calcium absorption is one reason why PPIs may increase the risk of osteoporosis. (51)

They Have Neurological Effects

PPIs have been linked to an increased risk of dementia and Alzheimer’s disease. Use of one PPI, omeprazole, is associated with declines in visual memory, episodic memory, motor and mental response speed, new learning, short-term and long-term attention, information retention, and strategy development. (52) Regular users of PPIs have a 44 percent increased risk of dementia compared to those who don’t use the drugs. (53)

There are several ways PPIs may contribute to neurodegeneration:

• PPIs increase deposits of amyloid-beta plaques. Accumulations of these malformed proteins have been found in the brains of Alzheimer’s patients. PPIs cause this condition by upregulating enzymes that produce amyloid-beta and reducing the activity of protein-degrading lysosomes.
• PPIs interact with tau protein, a component of neurofibrillary tangles. Neurofibrillary tangles accumulate inside neurons and impair neurological function in Alzheimer’s disease.
• PPIs decrease magnesium and vitamin B12 levels. B12 deficiency negatively affects cognition and promotes neurological damage by interfering with DNA synthesis and methylation and promoting homocysteine neurotoxicity.  Magnesium deficiency harms cognition by lowering the brain’s defenses against oxidative stress.
• PPIs inhibit proton pump function in neurons. Neuronal proton pumps regulate the release of neurotransmitters; impaired proton pump function alters neurotransmitter release and reuptake. (54)

They Can Hurt Your Heart Health

PPIs are harmful to the cardiovascular system. The use of PPIs after a heart attack is associated with a 30 percent increased risk of cardiovascular death, a subsequent heart attack, or stroke. (55) Use of PPIs is also associated with an increased risk of stroke and heart failure. (56, 57) PPIs induce cardiovascular dysfunction by reducing nitric oxide, which promotes the dilation of blood vessels and improves blood flow, and by increasing ADMA, a metabolic byproduct of arginine metabolism that damages the function of endothelial cells, which line the heart and blood vessels. By reducing levels of vitamin B12 and vitamin C, PPIs also weaken the body’s ability to lower homocysteine and oxidative stress, which are underlying causes of cardiovascular disease.

They Can Lead to an Increased Risk for Serious Illnesses—And Even Death

PPIs increase the risk of chronic kidney disease, gastric cancer, and colon cancer. A shocking 20 to 50 percent increase in risk for chronic kidney disease has been observed with regular use of PPIs. (58) PPIs promote gastric and colon cancer by raising the pH of the stomach, which causes the release of excessive amounts of gastrin, the hormone that causes the stomach to release gastric acid. Hypergastrinemia promotes gastric and colorectal cell hyperplasia, fundic gland polyps, and gastric carcinoids. (59, 60)

Long-term use of PPIs carries an increased risk of death, according to a recent study published in BMJ Open. In the study, the researchers examined the medical records of 275,000 users of PPIs and nearly 75,000 people who took another type of acid-suppressing drug, H2 blockers. They ultimately found that those who took PPIs for one to two years had a 50 percent increased risk of dying over the next five years compared to those on H2 blockers! (61) The increased risk of death is likely due to the neurological, cardiovascular, renal, and carcinogenic effects of prolonged PPI use.

The Issues PPIs Cause Are Long Term

As if the numerous harmful effects of PPIs weren’t enough, these drugs can also cause problems once they’ve been stopped. PPIs elevate the pH of the stomach, stimulating cells (known as parietal cells) to make more of the hormone gastrin. Elevated gastrin causes the stomach to produce more proton pumps and larger amounts of stomach acid. When PPIs are removed, the increased quantity of proton pumps and gastric acid can result in worse reflux than before the PPI, a condition referred to as “rebound reflux.” Rebound reflux promotes a hard-to-break cycle in which removal of the PPI worsens reflux, causing the affected individual to reach for PPIs again and again. However, the good news is that parietal cells are continually undergoing renewal, as healthy cells replace old ones, so former PPI users are not necessarily destined for rebound reflux forever.

Finally, there is evidence that the adverse effects of PPIs can pass from mothers to children. Use of PPIs during pregnancy may increase the risk of asthma in children by interfering with maternal digestion of proteins. Impaired maternal protein digestion may increase the number of allergens to which a fetus is exposed. Ultimately, this can cause changes in a developing baby’s immune system that may bring about an increased risk of allergies after birth. (62)

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Antihistamines May Impact Your Brain

In 2016, total sales of antihistamines in the United States amounted to a staggering $6.89 billion dollars, making them some of the most popular OTC medications. (63) Unfortunately, antihistamines are not exactly harmless. A recent study found that the use of anticholinergic drugs, a class of drugs under which antihistamines are included, is associated with an increased risk of dementia. (64) Benadryl, one of the most popular antihistamines, has been found in animal studies to impair memory consolidation, the process by which memories are stabilized after their initial acquisition. (65)

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Here Are Your Alternatives to OTC Drugs

Clearly, over-the-counter drugs are not as harmless as we’ve been led to believe. Fortunately, there are many safe, natural alternatives to OTC drugs that you can use to relieve pain, protect your heart, reduce congestion and allergies, and alleviate acid reflux and indigestion.

Five Alternatives to Ibuprofen and Acetaminophen

If you’re looking for pain relief, try one of these remedies in place of an OTC pain killer.

1. Boswellia

Boswellia is a resin extracted from the Boswellia serrata tree native to India, the Middle East, and North Africa. In ayurveda, an ancient Indian system of medicine, boswellia is used to treat arthritic pain, reduce inflammation, and quell fevers. Modern science has confirmed the anti-inflammatory, antiarthritic, and analgesic properties of this plant, which mediates these conditions through the inhibition of inflammatory leukotrienes. (66) Boswellia that has been standardized to contain 30 percent AKBA (3-acetyl-11-keto-beta-boswellic acid) is most useful for relieving pain and inflammation and improving joint mobility.

If supplementing with Boswellia serrata resin itself, the therapeutic dosage is typically between 800 and 1,200 mg taken three times per day. Encapsulated boswellia supplements that have been standardized for AKBA content, on the other hand, are taken at much lower doses of around 100 to 250 mg per day. Pregnant women must avoid boswellia because it can promote abortion.

2. Tart Cherry Juice

Tart cherry juice contains high levels of antioxidant and anti-inflammatory compounds that reduce inflammation in the musculoskeletal system. Tart cherry juice has demonstrated benefits in the treatment of arthritis, exercise-induced muscle pain, and fibromyalgia. (67) Seek out a version that doesn’t contain added sugars to reap maximum anti-inflammatory benefits.

Tart cherry juice is most frequently consumed as a juice. In clinical trials, doses of tart cherry juice ranging from two to 12 ounces per day have been used; I recommend starting at the lower end of this range (two ounces) and working your way up from there, if necessary, until you notice a reduction in inflammation and pain. I recommend choosing an organic, no-sugar-added tart cherry juice such as Pomona Organic Tart Cherry Juice. Tart cherry juice can be safely consumed by pregnant women.

3. Turmeric

Turmeric, which contains the compound curcumin, is useful for alleviating arthritis pain. (68) Curcumin by itself has low bioavailability, requiring high doses to achieve therapeutic results. Piperine, a compound in black pepper, enhances curcumin absorption, so look for supplements that contain both compounds. Curcumin/piperine supplements should ideally contain 500 mg curcumin and 20 mg piperine per dose. Up to three doses can be taken per day. (69)

More recently, two more curcumin products with enhanced bioavailability were introduced to the market: BCM-95, a product that combines natural cofactors from turmeric root with curcumin to enhance bioavailability, and Meriva, a patented combination of curcumin and soy lecithin. The recommended dose of BCM-95 is 500 mg twice a day and that for Meriva is 200 to 500 mg twice a day.

While it is safe for pregnant women to consume turmeric in low doses with food, it should not be taken in high doses, such as those found in supplements, during pregnancy.

4. CBD Oil

CBD comes from the Cannabis sativa plant. It is extracted from the resin of cannabis buds and flowers and does not contain psychoactive THC. CBD exerts pain-relieving effects, alleviating neuropathic, rheumatoid arthritis, and cancer pain by acting on the body’s endocannabinoid system. (70) I recommend thoroughly researching the brand of CBD oil you intend to use because inadequate regulation of the CBD industry has led to a lack of standardization and a high rate of mislabeling. (71)

5. Collagen

Collagen is a protein found in the connective tissue, skin, and bones of both our own bodies and the animals we eat. Supplementation with collagen has been found to significantly improve range of motion and alleviate joint pain in individuals with exercise-induced joint discomfort. (72) You can obtain collagen in your diet by consuming bone broth, chicken skin, or bone-in sardines, or by supplementing with a hydrolyzed collagen powder such as Vital Proteins’ Collagen Peptides.

In addition to these supplements, consuming an anti-inflammatory diet, getting adequate sleep and sun exposure, acupuncture, and keeping stress at a minimum can also alleviate pain with zero side effects.

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Four Options to Try Instead of Aspirin

Instead of aspirin, protect your cardiovascular health with these natural alternatives.

1. An Unprocessed, Nutrient-Dense Diet

A processed diet high in refined carbohydrates and lacking in crucial nutrients increases your risk of heart disease. Conversely, a nutrient-dense diet composed of organic, grass-fed animal products, seafood, plentiful non-starchy vegetables, moderate amounts of starchy plants, fruits, nuts and seeds, and healthy fats creates a foundation for a healthy heart.

2. Sunshine

Our bodies evolved under conditions of plentiful sun exposure. Sun exposure is required for the production of vitamin D and nitric oxide, both of which boost heart health. Aim for approximately 15 minutes of sun exposure per day, with face and limbs exposed as much as possible, during the peak hours of the day.

3. Exercise

This may seem like a no-brainer, but exercise is crucial for your heart health and is a much safer way to protect your heart than taking aspirin! Aim for regular exercise—30 or more minutes per day four days a week. Also, if you work a sedentary job, make sure to take frequent standing and walking breaks throughout the day or invest in a standing desk. Prolonged sitting is a major but modifiable risk factor for cardiovascular disease that we can easily reverse by getting out of our desk chairs! (73)

4. Improve Your Gut Health

A growing body of evidence indicates that the gut microbiota influences the development of cardiovascular disease. (74) Protect your heart by optimizing your gut health with an anti-inflammatory diet rich in fiber, eating fermented foods, and by addressing gut dysbiosis and possible infections. (75)

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Three Natural Decongestants

Instead of decongestants, try these home remedies.

1. A Warm Compress

Try applying a warm pack over your sinuses. Wet a washcloth with warm water and hold it over your sinuses to relieve sinus pressure.

2. A Hot Shower with Essential Oils

The steam from the shower will vaporize the oils, which you can then inhale into your sinuses. Eucalyptus and peppermint are two excellent options for opening the sinuses. (76)

3. Warm Tea and Soup

Drinking warm liquids can help loosen up congestion.

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Instead of Taking PPIs, Follow These Three Steps to Fix the Underlying Problem

Reflux is typically not caused by high stomach acid but rather by increased intra-abdominal pressure resulting from SIBO, which in turn may have been caused by low stomach acid. Instead of PPIs, you can cure reflux without medication by focusing on eradicating SIBO and restoring adequate stomach acid production. Here’s how to correct reflux without PPIs.

1. Eat a Low-Carb Diet

You can address SIBO with a low-carbohydrate diet or a low-FODMAP diet. The low-FODMAP diet should not be followed long term because it may starve beneficial gut bacteria of the fermentable fiber they require for fuel.

2. Improve Your Stomach Acid Production

Boost stomach acid production with hydrochloric acid capsules and supplement with enzymes and nutrients that aid digestion. Note that individuals on aspirin, corticosteroids, ibuprofen, or other NSAIDs should not take hydrochloric acid due to the risk of exacerbating GI bleeding and ulcers. Bitter herbs such as dandelion, gentian, and yellow dock and apple cider vinegar or lemon juice can also promote gastric acid production.

3. Feed Your Good Bacteria

Restore beneficial bacteria and a healthy mucosal lining in the gut with fermented foods, probiotics, bone broth, and gelatin.

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Instead of Antihistamines, Try These Five Options

There are many natural ways to alleviate allergies without resorting to antihistamines.

1. Quercetin

Quercetin, a flavonoid found in kale, onions, apples, and a variety of other fruits and vegetables, is a potent natural antihistamine that is free of side effects. (77)

2. Vitamin C

Vitamin C also lowers histamine by physically breaking apart the structure of the histamine molecule. (78)

3. Raw Honey

Local raw honey can benefit those with seasonal allergies by suppressing IgE-mediated hypersensitivity reactions and histamine release by mast cells. (79)

4. Improving Your Gut Health

Improving the health of your gut may also alleviate allergies. Research indicates that children with allergies tend to have increased levels of opportunistic and pathogenic bacteria, such as Staphylococcus, Clostridium, and Escherichia coli, and reduced levels of healthy bacteria such as Lactobacillus and Bifidobacteria. (80, 81)

5. Alleviating SIBO

SIBO may also contribute to allergies by triggering excess histamine production. Restoring balance to the gut microbiota with probiotics, particularly ones that degrade histamine, such as Bifidobacterium infantis and Lactobacillus plantarum, and treating SIBO may relieve allergic symptoms. Consuming fermentable fiber, which gut bacteria metabolize to produce butyrate, reduces intestinal permeability and increases T regulatory cells, which suppress certain immune responses such as those involved in allergies.

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Now I want to hear from you. Do you regularly take over-the-counter medications? Would you consider trying any of the alternatives I’ve suggested? Let me know in the comments below.

The post How Safe Is Your Over-the-Counter Medicine? appeared first on Chris Kresser.

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What do you do if your new client is not only pregnant, but has never really been an “exerciser?”

This can be a challenging situation for a fitness professional, especially if you are new to training pregnant women. You will likely find conflicting information on what your client should and should not be doing, and it can be hard to know where to start, so let’s start with with basics.

First of all, we think it is brilliant that your new client has come to you for advice during this special time. Pregnancy can be an incredible opportunity for many women to start on a journey towards healthy living (that may extend well beyond the pregnant period).

The fact that your client has reached out to you for coaching is important, as we know that statistically very few women (around 15 percent) actually meet the recommended guidelines for exercise in pregnancy. There can be many barriers to exercise in pregnancy including factors like fatigue, family and work demands, musculoskeletal pain or lack of motivation.¹ If she has made the effort to reach out to you, you will want to do your best to support her through this special time.

In years past, women were given advice from health professionals such as “don’t start any new form of exercise during pregnancy”, which eventually got watered down to “don’t start anything new in the first trimester.” Women were often scared to exercise and health professionals were very conservative in their recommendations.

Here’s the thing: for women with no contraindications, the benefits of exercise in pregnancy are so substantial that they far outweigh the risks.

Doctors now agree that in an uncomplicated pregnancy, all women should be encouraged to exercise regularly — even if they haven’t done much exercise before. Some of the benefits of exercise in pregnancy to mother and baby include:^1-7

• Improved (or maintained) cardiovascular fitness.
• Improved maternal glucose tolerance.
• Reduced risk of excessive weight gain.
• Improved quality of life scores.
• Potentially improved sleep quality and reduced insomnia.
• Reduced lower limb edema and low back pain (exercise in water).
• Improved psychological well-being (reduced rates of anxiety and depression).
• Better self-esteem and body image satisfaction.
• Decreased resting heart rate of the fetus and improvement of viability of the placenta.
• Potential reduction in risk of preeclampsia.
• Lower birth weight of baby, increased gestational age and potentially improved neurodevelopment.
• Leaner body mass at age 5 for the infant.

So now that you know just how amazing exercise is for pregnant women, the next step is to find out if your client is safe to exercise. This requires screening by a medical practitioner (typically the obstetrician or GP), who will check to make sure your client does not have any medical or obstetric reasons why exercise might be problematic for her or the baby.

You can find a list of contraindications and relative contraindications in the recent Canadian guidelines for physical activity in pregnancy.¹⁰ Your client’s medical practitioner can also advise her on any precautions that she should undertake when exercising through her pregnancy.

What About Miscarriage?

It is important to understand that miscarriage rates have been reported to be as high as 12–15 percent, with most occurring in the first trimester.^8,9 However, research has shown that exercise in the first trimester does not increase the risk of miscarriage.¹⁰

Although there is no link between exercise and miscarriage, it is worth finding out if your client has any fears around miscarriage, has experienced a previous miscarriage or has been undergoing IVF. In some of these circumstances, your client may prefer to commence her program in the second trimester — especially if she is new to exercise.

Once you have determined that your client is safe to begin exercise, it is important to find out:

1. What are her goals?
2. What has her previous experience with exercise been like?
3. What is her current level of fitness and skill?
4. What does she enjoy?

Let’s go through each of these questions individually.

1. What Are Her Goals?

Given that this client is not a regular exercise-goer, it seems prudent to find out why she is starting now. Is she concerned about her pelvic floor muscles? Does she want to have a healthy pregnancy so that she can offer her baby the best start in life? Is she concerned about putting on weight?

Your initial screening process will help you ascertain your client’s goals so that you can help her work towards them.

Your client’s goals for exercising in pregnancy may surprise you. If she states that her sister or mother had pelvic floor dysfunction and she is scared that she might have the same issues, it would be worthwhile referring her to a pelvic health physiotherapist for screening and advice. In the meantime you can use your sessions to help her gain better awareness of her breathing, posture and pelvic floor muscles.

If your client is scared about putting on too much weight during pregnancy, you can use your coaching skills to learn a little more about this mindset (we cover this in a lot more detail in the Coaching & Training Women Academy Pre- and Postnatal Coaching Certification).

Understanding your client’s motivation to begin exercising will give you a common ground in your work together.

2. What Has Her Previous Experience With Exercise Been Like?

This new client has does not have a regular habit of exercise — why is this the case? Is it because of she has lacked the motivation or time in the past? Does she hate the sensation of sweating? Do loud gyms give her the heebie-jeebies? Has she had bad experiences with fitness professionals in the past?

Finding out what her previous experience has been like and why she doesn’t participate regularly in exercise may help you avoid some of the same mistakes and get your client to develop a long-term love of exercise — or at least remove her distaste for it!

3. What Is Her Current Level of Fitness and Skill?

Where you start with this client will of course be very different if she a total beginner to strength training compared to if she was a college athlete but has taken a few months off more recently.

For women who are completely new to exercise (or have not done anything significant in recent years), it is recommended that you start with a reduced level of intensity and volume.

For example, the current guidelines for exercise in pregnancy are for women to do 150 minutes of moderate-intensity exercise (or 75 minutes of higher intensity exercise), plus two sessions of strength training per week. If your client has done nothing more than walking for 10 minutes per day, then you may start with walking 15 minutes per day over five sessions and then build up from there. You would start with a level of intensity where she can maintain a conversation (she should be able to talk, but not sing).

In terms of strength training, if your client has never lifted weights before, then you would use this opportunity to teach her the fundamental lifts with light weights and a focus on form. You should avoid more complex or high-skill exercises, where the risk of injury would be high.

For example, while low-skill exercises such as squats, deadlifts and bent-over rows might be a great place to start, high-skill exercises such as snatches and cleans should be avoided.

In terms of load, given her low starting point, you may well find that she increases the weight lifted over the course of the pregnancy, as compared to more experienced lifters who will usually reduce the weights as the pregnancy progresses. As always, this is going to be dependent on your client and her response to exercise. If your client has poor coordination and balance, start with exercises that use a wide base of support and fewer elements for her  to control.

4. What Does She Enjoy?

Does your client like a structured exercise program, that is familiar and repetitive? Does she prefer variety and crave new exercises each week? Does she love that sensation of a burn in her thighs, or does she really love the “lengthening” sensation from yoga?

When it comes to exercise in pregnancy, there is no “perfect exercise” that suits everyone.

We have spoken to hundreds (if not thousands) of pregnant women and found that that many different forms of exercise have been enjoyed by pregnant women around the globe,  including weight training, swimming, yoga, pilates, dancing, walking and so much more.

Find out what your client enjoys and what makes her feel good. Often, incorporating some mobility exercises into a program can not only be fun, but can help relieve aches and pains during pregnancy.

The Bottom Line

As you can see, the guidelines for exercising for “newbies” is very similar to what we would use for those who have exercised on a more regular basis. The main differences are that the starting point will usually be lower in intensity and volume and that the rate of progress through the exercises might be slower.

Be sure to monitor your client’s response to exercise to progress and regress appropriately, and be aware of the symptoms that will warrant ceasing exercise (such as bleeding, leaking amniotic fluid or chest pain) for any pregnant client.

As always, there are no recipes or strict rules, and as a good coach it is up to you to develop a good relationship with your client and monitor her through the pregnancy, adapting the exercises wherever required. Keep in mind that when working with pregnant or postnatal clients, exercises may need to be modified or changed frequently due to your client’s changing needs.

References

1. Prather H, Spitznagle T, Hunt D, Benefits of exercise during pregnancy, PM R. 2012 Nov;4(11):845-50; quiz 850. doi: 10.1016/j.pmrj.2012.07.012. https://www.ncbi.nlm.nih.gov/pubmed/23174548
2. Kramer MS, MacDonald SW, Aerobic exercise for women during pregnancy, Cochrane Database Syst Rev. 2006 Jul 19;(3):CD000180. https://www.ncbi.nlm.nih.gov/pubmed/16855953
3. Barakat R, Cordero Y, Coteron J, Luaces M, Montejo R, Exercise during pregnancy improves maternal glucose screen at 24-28 weeks: a randomised controlled trial, Br J Sports Med. 2012 Jul;46(9):656-61. doi: 10.1136/bjsports-2011-090009. Epub 2011 Sep 26. https://www.ncbi.nlm.nih.gov/pubmed/21948120
4. Montoya Arizabaleta AV, Orozco Buitrago L, Aguilar de Plata AC, Mosquera Escudero M, Ramirez-Velez R, Aerobic exercise during pregnancy improves health-related quality of life: a randomised trial, J Physiother. 2010;56(4):253-8 https://www.ncbi.nlm.nih.gov/pubmed/21091415
5. Nascimento SL, Surita FG, Cecatti JG, Physical exercise during pregnancy: a systematic review, Curr Opin Obstet Gynecol. 2012 Dec;24(6):387-94. doi: 10.1097/GCO.0b013e328359f131. https://www.ncbi.nlm.nih.gov/pubmed/23014142
6. Kasawara KT, do Nascimento SL, Costa ML, Surita FG, e Silva JL, Exercise and physical activity in the prevention of pre-eclampsia: systematic review, Acta Obstet Gynecol Scand. 2012 Oct;91(10):1147-57. doi: 10.1111/j.1600-0412.2012.01483.x. Epub 2012 Jul 24. https://www.ncbi.nlm.nih.gov/pubmed/22708966
7. Hollenbach D, Broker R, Herlehy S, Stuber K, Non-pharmacological interventions for sleep quality and insomnia during pregnancy: A systematic review, J Can Chiropr Assoc. 2013 Sep;57(3):260-70. https://www.ncbi.nlm.nih.gov/pubmed/23997252
8. Maconochie N, Doyle P, Prior S, Simmons R, Risk factors for first trimester miscarriage-results from a UK-population-based case-control study, BJOG, https://doi.org/10.1111/j.1471-0528.2006.01193.x
9. Lashen H, Fear K, Sturdee DW, Obesity is associated with increased risk of first trimester and recurrent miscarriage: matched case–control study, Human Reproduction, Volume 19, Issue 7, 1 July 2004, Pages 1644–1646, https://doi.org/10.1093/humrep/deh277
10. Mottola MF, et al., 2019 Canadian guideline for physical activity throughout pregnancy, Br J Sports Med. 2018 Nov;52(21):1339-1346. doi: 10.1136/bjsports-2018-100056. https://www.ncbi.nlm.nih.gov/pubmed/30337460

The post How to Train a Pregnant Client Who’s New to Exercise appeared first on Girls Gone Strong.

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I’ll start with the bad news: There are no vegetarian collagen sources. Every collagen supplement you see on the shelf came from a living organism. Though somewhere down the line someone will probably grow legitimate collagen in a lab setting, it’s not available today or for the foreseeable future.

Now, some good news: Vegans and vegetarians probably need less dietary collagen than the average meat eater or Primal eater because a major reason omnivores need collagen is to balance out all the muscle meat we eat. When we metabolize methionine, an amino acid found abundantly in muscle meat, we burn through glycine, an amino acid found abundantly in collagen. If you’re not eating muscle meat, you don’t need as much glycine to balance out your diet, but it’s still a dietary necessity.

Collagen isn’t just about “balancing out meat intake.” It’s the best source of a conditionally essential amino acid known as glycine. We only make about 3 grams of glycine a day. That’s not nearly enough. The human body requires at least 10 grams per day for basic metabolic processes, so we’re looking at an average daily deficit of 7 grams that we need to make up for through diet. And in disease states that disrupt glycine synthesis, like rheumatoid arthritis, we need even more.

What About Marine Collagen?

Okay, but eating a product made from a cuddly cow or an intelligent pig is off limits for most vegetarians. What about marine collagen—collagen derived from fish bones, scales, and skin?

Back about twenty years ago, “vegetarians” often ate fish. A number of them still exist out in the wild, people who for one reason or another avoid eating land animals (including birds) but do regularly consume marine animals. If it jibes with your ethics, marine collagen is a legitimate source of collagen for vegetarians. The constituent amino acids are nearly identical to the amino acids of mammalian collagen with very similar proportions and properties.

It’s highly bioavailable, with the collagen peptides often showing up intact in the body and ready to work their magic—just like bovine or porcine collagen. In fact, if you ask many marine collagen purveyors, it’s even more bioavailable than mammalian collagen owing to its lower molecular weight.

I’m not sure that’s actually accurate, though.

According to some sources, marine collagen comes in smaller particles and is thus more bioavailable than mammalian collagen, but I haven’t seen solid evidence.

There’s this paper, which mentions increased bioavailability in a bullet point off-hand, almost as an assumption or common knowledge.

This analysis found low molecular weights in collagen derived from fish waste. Mammalian collagen generally has higher molecular weights, so that appears to be correct.

However, a very recent pro-marine collagen paper that makes a strong case for the use of marine collagen in wound repair, oral supplementation, and other medical applications does not mention increased bioavailability. It may be slightly more bioavailable—the lower the molecular weight, the more true that is—but I don’t think the effect is very meaningful. Mammalian collagen is plenty bioavailable (most efficacious studies use collagen from cows or pigs), even if it’s a few dozen kilodaltons heavier.

But even if marine collagen isn’t particularly superior to mammal collagen, it is equally beneficial.

For skin health: Fish collagen improves hydration, elasticity, and wrinkling in humans who eat it. And again.

For metabolism: Fish collagen improves glucose and lipid metabolism in type 2 diabetics. HDL and insulin sensitivity go up, triglycerides and LDL go down.

And although fish collagen hasn’t been studied in the treatment of joint pain, if it’s anything like other types of collagen, it will help there too.

What Are Strict Vegetarian Options?

What if you absolutely won’t eat collagen from marine sources? Is there anything you can do as a vegetarian to make up for it?

Make Your Own

You could cobble together your own facsimile of collagen by making an amino acid mixture. Glycine, proline, and arginine don’t cover all the amino acids present in collagen, but they’re widely available and hit the major ones.

Still, eating the amino acids that make up collagen separately doesn’t have the same effect on those collagenous tissues as eating them together in a collagenous matrix. One reason is that the collagen matrix can survive digestion more or less intact, giving it different biological properties and effects.

In one study, rats with osteoporosis ate collagen hydrolysate that scientists had marked with a radioactive signature to allow them to track its course through the body. It survived the digestive tract intact, made it into the blood, and accumulate in the kidneys. By day 14, the rats’ thigh bones had gotten stronger and denser with more organic matter and less water content.

Another study found similar results, this time for cartilage of the knee. Mice who ate radioactive collagen hydrolysate showed increased radioactivity in the knee joint.

In both cases, the collagen remained more or less intact. A blend of the isolated amino acids would not. The fact is that collagen is more than glycine. When you feed people collagen derived from pork skin, chicken feet, and cartilage, many different collagenous peptides appear in the blood. You don’t get any of those from isolated glycine.

That’s not to say it’s pointless. Pure glycine can be a helpful supplement, used in several studies to improve multiple markers of sleep quality. Just don’t expect it to have the same effect as full-blown collagen.

Get Adequate Vitamin C

Acute scurvy, caused by absolute vitamin C deficiency, triggers the dissolution of your connective tissue throughout the body. Teeth fall out, no longer held in by gums. Wounds don’t heal, your body unable to lay down new collagen.

Vegetarians usually don’t have any issues getting adequate vitamin C.

Get Adequate Copper

Copper is a necessary cofactor in the production of collagen. Studies show that you can control the production of collagen simply by providing or withholding copper.

The best vegetarian source of copper is probably dark chocolate, the darker and more bitter the better.

Get Adequate Lysine

Lysine is another amino acid that’s necessary for the production of collagen.

The best sources of lysine are in meat of all kinds, but vegetarian options include hard cheeses like parmesan and pecorino romano, as well as eggs.

True vegetarian collagen doesn’t exist. Strict vegetarians will balk. But if you can bend the rules a bit, realize that making marine collagen out of fins and scales and bones is far less wasteful than just throwing it away, and look at the benefits with an objective eye, you’ll be pleasantly surprised. Even if you don’t end up using marine collagen, at least you have a few tools for getting many of the benefits with quick shortcuts and optimizing your own production of collagen.

Have you ever tried marine collagen? If you’re a vegetarian, would you consider it?

Thanks for reading, everyone. Take care and be well.

The post Does Vegetarian Collagen Exist? appeared first on Mark’s Daily Apple.

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High blood pressure is often dubbed the “silent killer.” It affects 1 in 3 Americans, and according to the CDC (Centers for Disease Control and Prevention) “About 11 million U.S. adults with high blood pressure aren’t even aware they have it and are not receiving treatment to control their blood pressure.” High blood pressure is […]

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In history books, nutritional deficiencies have usually been found in the wake of wars, droughts, and the wide-spread famine that results. These days though, most of us have the time and the resources to enjoy a balanced, nutrient-rich diet so why has it become normal to need extra helpings in the form of bottled pills and powdered scoops?

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Soothing soups are a staple during the winter months because of their warm comforting qualities. This broccoli blue cheese soup is a nutritious addition to your soup repertoire. Bone broth is used as the liquid base for an added boost of amino acids, collagen, and minerals to enhance your immune system during cold and flu season.

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“Our most private thoughts and emotions are not actually our own. For we think in terms of languages and images which we did not invent, but which were given to us by society.”

Alan Watts

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Last week’s post on iron levels got a big response and garnered a ton of questions from you guys. Today, I’m going to clarify a few things and answer as many questions as I can. First, do iron and ferritin levels mean different things for men and women? If so, how do those differences manifest? What about premenopausal women vs postmenopausal women? Second, what do we make of the fact that ferritin is also increased in times of inflammation? Is there a way to distinguish between elevated ferritin caused by inflammation and elevated ferritin caused by high iron? Third, is desiccated liver a good option for liver haters? And finally, I share some exciting plague news.

Let’s go:

Emma wrote:

I’d love to see more info on iron levels as they relate to men and women differently. I recently had an iron infusion for low ferretin, not thinking much would change I actually experienced so many positive effects I didn’t even know were coming my way. I’m less cold, no more afternoon fatigue, less hair falling out, no more random palpitations, improved restless leg syndrome and the number one big change is it improved anxiety levels – in fact my anxiety is now gone. The last two are due to a connection between iron and dopamine. I learnt that children with mental health issues are often treated for low ferretin where possible, elevating levels to around 100 showing positive results (would love to see literature on this), for me my ferretin went from 20 to 130 and its changed my life, at 31 I haven’t felt this good in years. Yay iron!

That’s awesome to hear. Yes, it’s important to stress the very basic essentiality of iron. Without it, we truly cannot produce energy. And since energy is the currency for everything that happens in the body, an iron deficiency makes everything start to fall apart.

As for gender and iron, there’s a lot to discuss.

A good portion of women with hemochromatosis never actually express it phenotypically, meaning their lab tests don’t show evidence of dysregulated iron metabolism or storage. According to one study of hemochromatosis homozygotes (people who inherited the mutation from both of their parents), being a woman makes it 16x more likely that your hereditary hemochromatosis won’t actually present as iron overload.

Another study found that among mostly-age-matched men (42 years) and women (39 years) with hemochromatosis, 78% of the men had iron overload while just 36% of the women had it. Iron overload was defined as transferrin saturation over 52% combined with ferritin levels of 300 ng/mL for men and 200 ng/mL for women.

High iron levels are more of an issue for postmenopausal women than premenopausal women. The latter group regularly sheds blood through menstruation, and if anything, they’re at a higher risk of low iron. Plus, estrogen is a key regulator of iron metabolism. As menopause sets in and estrogen diminishes, that regulation suffers.

For instance:

In postmenopausal Korean women, high ferritin levels predict metabolic syndrome and subclinical atherosclerosis.

High ferritin predicts metabolic syndrome in postmenopausal but not premenopausal women.

In premenopausal Korean women, higher ferritin levels predict better bone mineral density; menopause nullifies this relationship.

Remember that ferritin is actually a measurable protein bound to iron, so testing a ferritin level is technically an indirect way to measure iron. Why is this important? Another characteristic of ferritin (the protein) is that it is an ACUTE PHASE REACTANT. This means that ferritin levels can fluctuate with illnesses and other inflammatory states in the body that drive up a ferritin value that is not related to an actual iron level fluctuation. Don’t get ferritin checked when you are sick with a cold or other illness.

This is a great point.

Ferritin is marker of long term iron storage, but it’s also an acute phase reactant that up regulates in response to inflammation or oxidative stress.

If you want to be really careful, you should get a HS-CRP test—that measures your overall inflammatory status. If CRP is elevated, ferritin can be elevated without saying anything about your iron status.

Come to think of it, if elevated ferritin can be a marker of inflammation and oxidative stress, the inflammation could be responsible for some of the negative health effects linked to high ferritin. Or, if having too much iron in the body can increase oxidative damage, it may be that high iron levels are increasing inflammation which in turn increases ferritin even further. Biology gets messy. Lots of feedback loops. However, the fact that many studies cited in the previous iron post that use blood donation to treat high ferritin have positive results indicates that for most people, ferritin can be, in most situations, an accurate estimation of your iron status.

To make sure it’s an iron problem, get a transferrin saturation test as well. That indicates the amount of iron you’re absorbing, with below 20% being low and over 45% being high. People with high ferritin and high transferrin saturation do have high iron levels. People whose ferritin is artificially enhanced by inflammation will have normal transferrin saturation levels.

I have one last question on this. You say “Don’t stop eating liver every week.” If you can’t stand the taste of liver, what do you think about taking liver capsules made from grass-fed New Zealand beef every day instead?

That’s a great option. Go for it.

People should generally aim for 4-8 ounces of fresh liver a week. Note the amount of desiccated liver in your capsules and multiply by 3 to get the fresh liver equivalent, then take enough each day (or all at once) to hit 4-8 ounces over the week. I hear good things about this one.

Mark,
Thank you for your article on HH. I carry the gene but have been managing my iron levels through phlebotomies. I am full Keto, meat and all and have found my iron levels have not been effected by going Keto. Early detection is the key and ongoing monitoring. Bring on the plague!!!

You joke about that now, but there’s a startup that’s breeding heritage rat fleas that produce a mild strain of the plague that evades the attention of the immune system and proliferates throughout the body to keep iron levels in check without killing you. I’m an early investor, have a couple swarms installed in my condo, and (knock on wood) so far have avoided anything worse than a sore throat and maybe a mild open sore or two. There’s actually a big rift forming between the techs who want to keep the fleas heritage and those who want to go ahead with CRISPR and engineer them. One variant has had a deer tick gene inserted that adds an anesthetic compound to the flea’s saliva. That way you can have a personal swarm on you and never feel any bites or itches.

I’m not sure about CRISPR just yet, but I gotta say it’s pretty nice to be covered in fleas and not feel the bites. Time will tell.

Ok, I’m joking.

That’s it for today, folks. I hope I’ve answered some of your concerns, and if not, let me know down below. Thanks for reading!

References:

Lainé F, Jouannolle AM, Morcet J, et al. Phenotypic expression in detected C282Y homozygous women depends on body mass index. J Hepatol. 2005;43(6):1055-9.

Qian Y, Yin C, Chen Y, et al. Estrogen contributes to regulating iron metabolism through governing ferroportin signaling via an estrogen response element. Cell Signal. 2015;27(5):934-42.

Seo SK, Yun BH, Chon SJ, et al. Association of serum ferritin levels with metabolic syndrome and subclinical coronary atherosclerosis in postmenopausal Korean women. Clin Chim Acta. 2015;438:62-6.

Cho GJ, Shin JH, Yi KW, et al. Serum ferritin levels are associated with metabolic syndrome in postmenopausal women but not in premenopausal women. Menopause. 2011;18(10):1120-4.

Chon SJ, Choi YR, Roh YH, et al. Association between levels of serum ferritin and bone mineral density in Korean premenopausal and postmenopausal women: KNHANES 2008-2010. PLoS ONE. 2014;9(12):e114972.

The post Dear Mark: Iron Followup appeared first on Mark’s Daily Apple.

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Imagine this: your client is training consistently five to six times a week; they meet with you as their coach, diligently note their workouts in their training log, and send your their weekly updates. They never (OK, almost never) skip their warm-up — even the breathing drills! And yet, week after week, they are lifting less weight, moving slower, and feeling more out of breath. This is the training reality for many physically active pregnant women as they progress from first to second to third trimester.

Historically, the guidelines for physical activity during pregnancy have focused on demonstrating safety. However, in recent years, the cumulative body of evidence suggests that exercise is not only safe during pregnancy, but is recommended as a way to reduce pregnancy complications and optimize health. For example, the Society of Obstetricians and Gynaecologists of Canada prescribes at least 150 minutes of low to moderate intensity physical activity over a minimum of three days each week.

For those who have been physically active before getting pregnant, meeting these guidelines may not be difficult. However, this group of women — from avid exercisers to recreational and competitive athletes — may struggle with setting appropriate fitness goals during this period, as the focus shifts away from specific athletic benchmarks to preparing and supporting the body through pregnancy.

Athletic identity takes a back seat during the nine months of gestation. While some women cruise through the pregnancy, others find themselves struggling with the newly-imposed limitations on the type and intensity level of the physical activity, compared to their regular baseline.

How much a pregnant woman’s day-to-day life will change will depend on the type of activities she usually enjoys, as well as how well she is feeling throughout the pregnancy.

Compare a woman who loves hiking to a woman who loves soccer. The first will be able to continue hiking well into her pregnancy — while the distance and the intensity of her hikes may decrease, she can continue engaging in the activity she most enjoys.

Meanwhile, pregnant soccer players will often be advised to cease playing, due to risk of being hit in the abdomen. Similar guidelines will apply to any high-impact sports, or sports with higher risk of falling — think water skiing, mountain biking and others.

What can be difficult is finding the middle ground between the regular levels of activity and intensity that your client is used to, and being completely sedentary. The all-or-nothing mindset is all too familiar to the human species, so as the energy levels, the body shape, and physical fitness in general of your client start to change, and she is no longer able to be active in a way that she is used to, it is can be tempting for her to throw in the towel, and simply “wait it out.”

To help your client set appropriate training goals as she is growing a human, you can adopt the following strategies:

Keep the Frequency

How often can a pregnant woman exercise? The good news is that this is one of the things that can stay the same up until the very end of the pregnancy, barring any complications.

For healthy low-risk pregnancies, women can exercise as frequently as they have before getting pregnant (few exceptions may apply to competitive athletes who are used to training multiple times a day).

While older guidelines used to prescribe specific heart rate ranges for pregnant women, most medical professionals no longer use those. Perceived rate of exertion may be a better indicator of effort here. Keep in mind that what might have been a “light” physical activity in the past, may now rate as “moderate” or even “hard.”

Your pregnant client can use her energy levels, and take into account possible symptoms, like nausea, to guide her workout frequency and intensity throughout the nine months.

Adjust the Timeline

In pregnancy, energy and general well-being can fluctuate significantly from week to week, so longer training cycles (four to six weeks) are less meaningful. For example, walking uphill may have been possible at eighteen weeks, but is uncomfortable at twenty weeks, because of increased pelvic discomfort, so shifting to a stationary bicycle may be in order.

Consider shifting the setting of fitness goals to a daily or a weekly cycle, and use the following questions to guide you:

• Has your client engaged in any intentional physical activity today?
• Has your client done any strength training this week?
• Has your client gone out for a walk this week?
• How many days has your client been able to exercise this week?

Maintaining regular schedule for physical activity — and aiming for consistency, rather than specific exercises — will be helpful.

Reframe the Mindset

Higher level of physical fitness before pregnancy can be a blessing and a curse. On one hand, a healthy low-risk pregnancy is more likely, and the likelihood of negative health outcomes is diminished.

On the other hand, putting on shoes or getting out of bed have likely never been a struggle for your client. Whereas before, she would fall asleep quickly, and could sleep through a tornado, now she might toss and turn, struggle to get comfortable, wake up multiple times to pee, inexplicably wake up at 3 a.m. and stare at the ceiling for an hour before giving up and crawling out of bed for snack, only to fall asleep again on the couch for another hour or two.

Athletic women are used to their bodies functioning a certain way. Pregnancy, with its ever-changing aches, pains and symptoms, presents a significant challenge to how these women view themselves.

At the same time, while it is customary to train for months for an upcoming athletic event, we do not usually approach pregnancy the same way. This is not surprising, as athletics and motherhood are often portrayed as being at odds with each other.

If childbirth was an endurance event — which it is! — how might you approach pregnancy differently?

• How would you train?
• How would you taper?
• What nutrition strategies might you employ?
• What about stress management and self-care? How will you use your support network in your preparations for the big day?
• What will your recovery look like?

For a pregnant athlete, reframing labor and childbirth as a type of athletic event can be crucial not just for setting appropriate fitness goals during pregnancy, but also for reconciling both identities.

Women who engage in competitive athletics before pregnancy may struggle with setting appropriate fitness goals during pregnancy. As a health and fitness professional, you can assist your clients to remain active by keeping the frequency of their workouts, adjusting the timeline of training goals, as well as helping her reframe her mindset to view labor and childbirth as a form of athletic event.

References

1. Canadian Guideline for Physical Activity throughout Pregnancy. Available at: https://els-jbs-prod-cdn.literatumonline.com/pb/assets/raw/Health%20Advance/journals/jogc/JOGC908_LR-1539864964137.pdf
2. McGannon K, Gonsalves C, Schinke R, Busanich R: Negotiating motherhood and athletic identity: a qualitative analysis of Olympic athlete mother representations in media narratives. Psychol. Sport Exerc. 2015, 20:51-59 http://dx.doi.org/10.1016/j.psychsport.2015.04.010.

The post How to Help Your Active Client Set Training Goals During Pregnancy appeared first on Girls Gone Strong.

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Good morning, folks. After a awesome week (and weekend) taking over the Whole30® Recipes Instagram (you can still check out all the great videos, tips and recipes I shared here), my team and I are taking a breather. Look for a success story later in the week. In the meantime, we have some practical ideas for your Monday morning. We’re shaking things up with a movement guide you can put into action at work today. Thanks to Jessica Gouthro of PaleoHacks for these awesome suggestions, and let us know which you’ll be adding to your routine. 

Working at your desk all day doesn’t have to mean poor posture and an achy body. Whether you sit or stand at work, remaining sedentary for hours takes its toll on the body. After just a few hours, your body will begin to stiffen, your lower back will ache, and you’ll grow sluggish.

But you can free yourself from common aches and pains associated with desk work in just a few minutes with these easy stretches to release the lower back and hips. You don’t have to do all 13 of these stretches at once. Instead, use this list as a guide and choose two or three stretches you think your body needs. Perhaps you’re looking for a nice stretch through your shoulders, or maybe you could really benefit from moves that help open up your hips. Every little bit of movement adds up when you’re sitting for long periods of time, and doing just one of these stretches every day will help you look and feel better, and avoid pain.

Try each of these 13 functional workspace stretches to relieve aches and pains and instantly improve your posture.

1) Standing Overhead Reach | 5 Breaths, 3x

Stand up from your chair with your feet about hip-width apart and toes pointed forward.

Clasp your fingers together and turn your palms facing up toward the ceiling.

Reach your clasped hands overhead, and press your palms upward while keeping your shoulders and core engaged.

Hold for five deep breaths and enjoy the stretch. Release. Repeat three times.

2) Butterfly Elbows | 4 Reps

Sit tall in your chair and place your fingertips gently behind your ears. Do not interlock fingers or apply any pressure to your neck.

Lift your chest and ribs up as you stretch your elbows back to feel a lengthening across your chest. Breathe in deep to fill your lungs. On the exhale, round your back, drop your chin and bring your elbows to meet in front of you. Gently press your elbows forward to feel a stretch across your upper back and shoulder blades.

Inhale to return to the starting position. Continue alternating one movement per breath until you have completed four reps.

3) Chair Chest Opener | 5 Breaths, 2x

Scoot towards the front of your chair, and sit on the very edge. Reach your hands back with thumbs pointing down and grasp onto the sides of your chair.

Lift your chest and roll your shoulders back and down. Elongate your neck by imagining you can press into the ceiling with the top of your head.

Lean deeper into the stretch to feel the opening across your chest.

Take five deep breaths, then rest. Repeat a second time.

4) Standing Chair Lat Stretch | 5 Breaths, 2x

Stand facing your chair, about three feet away.

Keep a slight bend in your knees, then hinge at your hips and reach your arms long to grasp onto the back of the chair. Make sure your arms are straight.

Lengthen your shoulders and flatten your lower back, forming a straight line from hands to hips. Align your head in between your arms and take five deep breaths.

Release, then repeat a second set.

5) Standing Chair Lat Twist | 3 Reps Per Side

In the same position as the stretch above, reach your right hand down to your left foot to create a twist in your upper body.

Hold for two breaths, then return to the starting position with both hands on the chair and switch to twist in the other direction. Maintain a flat lower back and slightly bent knees the whole time.

Repeat three times per side.

6) Mirrored Chair Pose | 3 Reps

Stand facing your chair with your feet together.

Hinge at the hips to squat down, aiming to mimic the height of the chair with the top of your thighs.

Keep your spine straight. Reach your arms up overhead with palms facing each other.

Hold for five full breaths, then release.

Repeat three times.

7) Seated Figure 4 Hip Stretch | 3 Breaths, 2x Per Side

Sit on your chair with both feet flat on the ground.

Lift your right leg and place your ankle across your left knee. Keep your right foot flexed.

Sit up nice and tall, then lean slightly forward as you gently press down on your right knee—just enough to feel a stretch in the hips.

Hold for three breaths, then release and switch sides.

Repeat two times per side.

8) Seated Spinal Twist | 2 Breaths, 3x Per Side

Sit on your chair with both feet flat on the ground.

Reach your left hand to your right knee and your right hand to the back edge of the chair.

Press gently with both hands as you look over your shoulder and rotate your torso. Lean slightly forward to allow more space for the twist.

Take two deep breaths, then switch to the other side.

Repeat three times per side.

9) Bound Neck Stretch | 2 Breaths, 3x Per Side

Sit up tall in your chair and reach your right arm straight down by your side.

Reach your left hand behind your back to clasp your right wrist, then tilt your neck to the right.

To increase the stretch, gently press your arm away from your torso.

Hold for two deep breaths, then release and switch to do the other side.

Repeat three times per side.

10) Alternating Fingers Wrist Stretch | 2 Breaths, 3x Per Side

Sit up tall in your chair. Reach your right arm straight out in front of you with fingers pointing down towards the ground.

Use your left hand to gently pull on the back of your right hand to stretch the top of your wrist. Hold for two breaths.

Flip your right hand up so that your palm is facing out, and pull back with your left hand to stretch the bottom of your wrist. Hold for two breaths.

Alternate between stretching the top and bottom of your right wrist three times, then switch to the other side.

11) Hamstring Stretch | 3 Breaths, 2x Per Side

Stand up and face your chair. Step back about two feet.

Raise your right foot and place the heel on the middle of the chair with your foot flexed.

Place your hands on your hips and hinge forward, until you feel a stretch through your hamstring. Keep a slight bend in both knees to maintain muscular engagement.

Take three deep breaths, then switch to the left leg.

Repeat two times per side.

12) Chair Pigeon Pose | 3 Breaths, 2x Per Side

Stand facing your chair.

Place your right shin across the front of the chair, with your knee on the chair and foot off the edge. Keep your foot flexed.

Grasp onto the edges of the chair with both hands and step your other leg back to straighten out the knee and hip. You can control the depth of this hip stretch by bending or straightening your elbows.

Take three deep breaths, then switch to the other leg.

Repeat two times per side.

13) Single Leg Toe Pull | 2 Breaths, 3x Per Side

Stand facing your chair. Hinge forward at the hips and place your hands on the chair.

Grab your right toes with your right hand. Keep your left hand on the chair and a microbend in your left leg.

Pull slightly upward on your right toes until you feel a stretch in your calf and hamstring. Make sure to keep your hips square and your lower back as flat as possible.

Hold for two breaths, then switch sides.

Complete three sets per side.

Thanks again to Jessica Guethro of Paleohacks. Questions or other ideas for staying relaxed and limber at work? Shoot me a line in the comments below. Have a great week, everyone. 

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