2009 Spring Fspn Cancer Exercise

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A M E R I C A N C O L L E G E O F S P O R T S M E D I C

ACSMFIT SOCIETYPAG

Letter from the Editorby Dixie Thompson, Ph.D., FACSM

Welcome to the Spring 2009 issue of the

ACSM Fit Society Page! In this special

issue, we focus our attention on a portion ofthe population that comprises millions:cancer sufferers and survivors. You will findinformation on exercise strategies specific tocancer patients. We also include exercise andnutritional tips targeting the prevention ofcancer.

Even if cancer has yet to affect your own life,we hope you use the information containedin this issue to help keep your risk low. Asalways, thank you for your readership!

Dixie L. Thompson, Ph.D., FACSM

Editor, ACSM Fit Society Page

E-mail: [email protected]

To subscribe to the ACSM Fit Society Page, please

send an e-mail to [email protected].

THEME: CANCER AND EXERCISE

Nutrition and

Cancer

Prevention

by Ruth MacDonald, R.D., Ph.D.

Cancer is a frightening disease that affects thelives of millions worldwide. Many of us knowsomeone personally who has struggled withcancer or has lost a loved one to this disease or have suffered from it ourselves.

The good news is that recent National CancerInstitute statistics show a reduction in theincidence of cancer in the United States. Thismay be due in part to earlier detection andbetter screening for cancers, or perhaps itreflects a reduction in the number of peoplewho smoke cigarettes. Cancer is a complexdisease that can occur in almost all types ofcells in our body, and there is no single causeof cancer. Some factors, such as cigarettesmoking, have clear links to cancer. Otherstrongly linked factors include exposure toradiation (including sunlight), andenvironmental chemicals and pollutants. Forcenturies, foods have been linked to cancer, inboth promotion and protective capacities.

More recently, we are learning that physicalactivity and maintaining a healthy weight are

also closely linked to reducing cancer risk.

All foods, from fruits and vegetables toprocessed cheese and cookies, are complex

mixtures of many chemicals. Foods containknown nutrients like carbohydrates, fats,proteins, vitamins and minerals; but alsothousands of other chemicals such aspolyphenols, tannins, catechins, sterols andflavonols. Hence, to understand the role offoods in cancer, we must understand thechemical composition of foods and the roles these specific chemicals in the cancer process

This is a daunting task and one that may nevbe fully completed because of the number ofchemicals and the multitude of possibleinteractions in a normal diet.

There are several ways to study theassociations between foods and cancer. Oneway is to compare cancer incidence in

populations with the foods they consume. Thtype of epidemiological study providescorrelations but cannot prove cause and effecbut it does allow scientists to identify whichdietary factors may be most important forfurther study. Over the past 50 years, manystudies have been conducted to clarify the roof foods and ingredients in cancer. Some ofthese have been popularized in the lay pressand have been promoted in the grocery storeFor example, higher intakes of dietary fiberwere correlated with lower risk of coloncancer. As a result of this finding, foodmanufacturers rushed to increase the fibercontent of foods and promoted high fiber dieto reduce colon cancer risk. Subsequent large

human clinical trials, however, have beenambiguous about the protective effects of fibein colon cancer.

Another dietary component thought to play significant role in cancer is dietary fat. Somestudies found a higher incidence of breast ancolon cancer in populations that consumedhigh amounts of fat. Many studies were doneto identify the specific types of fat and themechanisms through which these componenmay impact cancer risk, but as with fiber, larghuman studies of dietary fat related to cancerhave not shown a clear relationship. This isfrustrating to consumers, but reflects thecomplexity of the disease, the diet, and theinteractions between the two that occur in th

human body. As we develop better molecular

I N S I D E T H I S I S S U E :1 | Letter from the Editor

1 | Nutrition and Cancer Prevention

2 | Q&A with ACSM

3 | Exercise During Cancer Treatment4 | Cancer Prevention: Lifestyle Changes

5 | Protein and Athletes

6 | The Athletes Kitchen

Sprin


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tools, it is likely that we will be able to clarifywhich genetic factors influence the response todietary components in individuals. While wewait for science to reach this point, diets highin fiber and low in fat may have many positivehealth benefits and continue to berecommended to reduce cancer risk.

Food ingredients, including flavors, colors,preservatives and artificial sweeteners, have

been widely publicized as cancer-causing.These concerns are largely unfounded. TheFDA has stringent requirements todemonstrate safety before any component isadded to the nations food supply. While we

may never be fully sure that a chemical willnever cause cancer given the rightenvironment in a specific individual, the U.S.food supply is very safe. However, we may notassume that the food supply is free ofcarcinogens, because some edible plantscontain naturally occurring mutageniccompounds and environmental pollutants docontaminate plant and animal foods. In

general, these are in very low concentrations.

To reduce the risk of exposure to thesecompounds, one should consume a widevariety of foods from reputable sources.

The American Institute for Cancer Researchhas undertaken an extensive evaluation of thescientific research of the relationships amongfoods and cancer. They have identified thefollowing foods as being helpful in reducingthe risk of the main forms of cancer in the

United States, to include breast, prostate andcolon cancers. These foods should be part ofones everyday diet, because they are rich invitamins, minerals, fiber and many beneficialcompounds such as polyphenols, flavonoids

and catechins, which have a variety of positiveeffects on the body. Citrus fruits, grapes and berries Cruciferous vegetables (broccoli,

cauliflower) Dark green leafy vegetables (spinach, kale) Colorful vegetables (tomatoes, squash,

pumpkin) Beans

Whole grains

Fish and flaxseed Dairy foods (yogurt, skim milk) Nuts (walnuts, almonds) Green and black tea

While a healthy diet is critically important tolowering cancer risk, many other lifestylefeatures are also important. Here are ways toimprove overall health and protect yourselffrom cancer:

Avoid smoked, salted or burnt meats Seek a balanced diet, adequate in protein,

and carbohydrates Maintain a healthy weight Perform regular exercise Avoid sugary drinks and high-fat foods

Get routine screenings and checkups Dont smoke Get enough sleep Use household and farm chemicals proper Enjoy life and manage stress

Q&ABy Anthony Luke, M.D., MPH, FACSM

Q: Ive heard that exercise is helpful even though I am undergoing chemotherapy

treatment for cancer. Ive never exercised regularly and my doctor hasnt explicitly

recommended it. What kind of exercise should I do? Should I just get started?

A: Its always a good idea to let your physician know youre starting an exercise program if yourebeing actively treated for a medical condition. He or she can provide advice and monitor you durinyour treatment. There are clear benefits for exercise in general for cancer patients before, during anafter treatment. A recent survey of oncologists and cancer patients suggested that patients andphysicians both feel its important to exercise, with a trained professional supervising if possible.Exercise programs for cancer patients can be found at some hospitals, or an experienced physicaltherapist or an exercise physiologist certified to work with cancer patients may be helpful in puttina program together. You can take Yoga, tai chi, Pilates and dancing classes.

In terms of suggestions on exercises to select, it helps to take into account ones own interests andexperience with exercises. Aerobic activities are helpful to maintain good endurance. Approximatel70 percent of patients experience fatigue during chemotherapy and radiation. For beginners, startwith an exercise program that introduces activity for a few minutes a day. This can involve going foa brisk walk, doing chores around the house, playing with your kids or pets, or walking to work.Always begin with a light warm-up for two to three minutes before doing any exercise with morevigorous intensity. You can exercise briefly several times a day to start, to allow a chance to rest andrecover; for example, try exercising three times a day for 10 minutes at a time. If you tire easily,gradually work your way up. You can increase the amount you exercise weekly as yourcardiovascular endurance improves.

To keep the musculoskeletal system in shape, try to pick physical activity that uses the large musclegroups. Stretching exercises can be helpful to stay flexible. Resistance training, like weightlifting, isuseful in maintaining muscle mass and strengthening bones through weight loading. If you have acatheter, be careful not to do exercises using muscles near the catheter, which may cause it todislodge. Exercise can be a great way to feel better about your health, keep yourself energized, and

have fun.

ACSM Fit Society PageEditorial Board:

Dixie L.Thompson, Ph.D., FACSM, EditorUniversity of Tennessee

Thomas Altena, Ed.D.

Southwest Missouri State University

Katherine A. Beals, Ph.D., R.D., FACSMUniversity of Utah

Joanne Bieniasz, MSCBeaumont Hospital

Kate A. Heelan, Ph.D.

University of Nebraska-Kearney

Gerald Jerome, Ph.D.Towson University

Anthony Luke, M.D., M.P.H.

University of California, San FranciscoLynn Millar, Ph.D., FACSM

Andrews University

James Pivarnik, Ph.D., FACSM

Michigan State UniversityMartha Pyron, M.D.

University of Texas

Jan M. Schroeder, Ph.D.

California State University, Long Beach

ACSM is the worlds largest association devoted tosports medicine and exercise science.ACSM advances and

integrates scientific research to provide educational and

practical applications of exercise science and sportsmedicine.

Permission to reprint material from this publication is

granted by ACSM contingent upon manuscripts beingreprinted in total without alteration and on proper credit

given to ACSM by citing ACSM Fit Society Page, issue and

page number; e.g., Reprinted with permission of the

American College of Sports Medicine, ACSM Fit SocietyPage, Spring 2009, p. 3.

A M E R I C A N C O L L E G E O F S P O R T S M E D I C I N E

ACSMFIT SOCIETYPAGE

Cancer Prevention (continued from page 1)

(continued on page

ACSM Fit Society Page A Quarterly Publication of the American College of Sports Medicine www.acsm.org Spring 2009 Page 2


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ExerciseDuring CancerTreatment

By Kerry Courneya, Ph.D., and Margaret McNeely, Ph.D.

What is cancer?According to the American Cancer Society

(ACS), there are more than 100 differentdiseases that are classified as cancer. Thecommon thread among these different types ofcancers is that they all start as abnormal cellsthat grow out of control in some part of thebody. The ACS estimates that more than 1.4million Americans were newly diagnosed withcancer and more than a half million wereexpected to die of the disease in 2008. Thethree most common cancers occurring in menare prostate, lung and colorectal cancers; inwomen, breast, lung and colorectal cancers arethe three most common. Cancer may betreated by a number of methods, either aloneor in combination. These treatments includesurgery, radiation, chemotherapy, hormonal

therapy and biological therapy.

How exercise helpsAn increasing number of studies haveexamined the benefits of exercising duringcancer treatment. Although the majority ofstudies have examined women with early-stage breast cancer, research evidence suggeststhat exercise can have a positive impact onbody weight, overall fitness, muscle strength,flexibility and quality of life, as well as onsymptoms such as pain and fatigue. A recentstudy by Kerry Courneya, Ph.D., andcolleagues found benefits from exercise forchemotherapy completion. In the study,women with breast cancer participating in a

resistance training program during

chemotherapy had dose reductions and fewerdelays in their chemotherapy treatments.

Physical activityrecommendations

The optimal form of exercise training forcancer patients undergoing treatment stillremains unclear. Research studies havegenerally examined moderate-intensity aerobicexercise, resistance exercise, and/or combined

programs. Further research is needed todetermine the best type, timing and intensityof exercise for the different types and stages ofcancer. Despite these limitations, for the mostpart, exercise prescriptions have closely

followed the published guidelines of theAmerican College of Sports Medicine.

Special considerationsIndividuals are potentially different in theirresponses to cancer treatment. Exerciseprograms may need to be modified to allowfor down days in the treatment cycle. In thecase of chemotherapy or biological therapy,

this may mean avoiding or scaling backexercise on days when side effects fromtreatment are more pronounced. In the case ofradiation therapy, exercise may need to bereduced, or in some cases avoided, toward theend of treatment and/or in the early weeksfollowing treatment.

If an individual is not regularly active andwishes to start an exercise program duringcancer treatment, they may need to start withlow-intensity exercise, consisting of slowwalks, and gradually progress exercise overtime. If they will be receiving chemotherapy, itmay be wise to wait one chemotherapy cycleto see the response to treatment prior tostarting an exercise program.

Individuals undergoing cancer treatment

should:

Obtain approval from their oncologist(cancer doctor) before starting an exerciseprogram.

Have vital signs (temperature, pulse/ heartrate, blood pressure, respiration rate)monitored regularly. If participating inmoderate-to-vigorous exercise, have theirblood pressure and heart rate monitoredbefore, during and after exercise to ensurethat participation in exercise is appropriateand safe.

Exercise with a partner, caregiver or exerciseprofessional for safety reasons.

Avoid public fitness facilities and activities(e.g., swimming), where there may be anincreased risk of exposure to viral and/orbacterial infection.

Avoid swimming if undergoing radiationtherapy treatments or if they have anindwelling catheter (a tube that goes in the

body), such as a central venous catheter orperipherally inserted central catheter.

Stop exercise and contact their doctor if thhave any of the following symptoms durinexercise or after an exercise session: Disorientation, dizziness, blurred vision o

fainting Sudden onset of nausea, vomiting Unusual or sudden shortness of breath Irregular heart beat, palpitations, chest

pain Leg/calf pain, bone pain, unusual joint

pain or pain not caused by injury Muscle cramps or sudden onset of

muscular weakness or fatigue

Exercise precautionsAlthough exercise may be an effectiveintervention for cancer patients undergoingtreatment, it is important to recognize theremay be factors that make it unwise to exercisIn these cases, exercise may be still beneficialhowever, the risks may be higher, and closemedical supervision may be required.

According to the ACS, the following arespecific precautions to be aware of duringcancer treatment: Anemia (low red blood cell count): If the

red blood cell count is low, the bodys abilito carry oxygen to the tissues is reduced.

Exercise may need to be scaled back andpossibly avoided.

Neutropenia (low white blood cell count): the white blood cell count is low, the bodyability to fight infection is reduced. Exercisshould be avoided if there is a fever above100.4F (>38C).

Thrombocytopenia (low platelet count): Ifplatelet count is low, there is an increasedrisk of bruising and bleeding. Avoid contacsports or activities with high risk of injury falling. Report any unusual bruising orsymptoms, such as nose bleeds, to a doctor

Side effects such as vomiting and diarrhea,and symptoms such as swollen ankles,unexplained weight loss/gain, or shortness

of breath with low levels of exertion maymake exercise unsafe. Check with a doctobefore exercising.

ConclusionResearch evidence suggests that individualswith cancer who follow recommendedguidelines and observe specific precautionscan safely exercise during cancer treatment.


Did you know

The American College of Sports Medicine and theAmerican Cancer Society recently launched aspecialty certification for fitness professionals,enabling to work with patients suffering orrecovering from cancer. Visitwww.acsm.org/certification for more details.


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CancerPrevention:LifestyleChanges

By Rebecca M. Speck, M.P.H., and Kathryn H. Schmitz,Ph.D., M.P.H.

More than 500,000 cancer deaths occur in theUnited States each year. It is estimated that one-third of these deaths can be attributed to diet and

physical activity habits, including the roles ofoverweight and obesity. In the interest of avoidingcancer, behavior choices that focus on achievingand maintaining a healthy weight throughphysical activity and healthy diet can greatly

reduce a persons lifetime risk of developingcancer.

We know that being overweight or obese isclearly associated with an increased risk ofdeveloping certain cancers, including breast (inpost-menopausal women), colon, endometrium(uterus), esophagus and kidney. Obesity alsolikely raises the risk of other cancers, including

cervix, gallbladder, Hodgkins lymphoma,multiple myeloma, ovary, pancreas, thyroid, andcertain types of prostate cancer. There is also

ample evidence that regular physical activity isuseful for cancer prevention regardless of yourbody weight.

Achieving and maintaining a healthy weight canbe very challenging over a lifetime. We cope withdemanding schedules, hectic lifestyles, anabundance of choice, and conflicting information.This is why weight loss or maintenance cannot bebased solely on one approach. The best available

research indicates that weight loss is most likelyto occur by restricting calorie intake andincreasing physical activity. Physical activity isessential to weight maintenance and avoidingweight gain (before and after weight loss). Theamount of physical activity required formeaningful weight loss is 250 minutes or moreper week.

It is understood that weight gain is the result of acombination of eating too much and moving too

little. Therefore, weight loss and/or maintenanceof a healthy weight should be approached withthe goal of reversing both trends, through eatingless and moving more.

Eating a healthy diet means making choices thatpay attention to what type of calories you areeating and the amount of calories going into yourbody. A great way to start paying more attentionto what you eat is to write down everything youconsume for a week and review it. If you noticeservings of fried foods, sweets, and soft drinks ona daily basis, note that these have little to nonutritional benefit and are high in calories.

Alternative food options might be whole grainpretzels, yogurt, and 100-percent vegetable orfruit juice, which have higher nutritional value.For most adults, a reduction of just 50-100calories per day may prevent gradual weight gain,making daily food choices very important.

A healthy diet should focus on obtaining amajority of your calories from plant sources. Eatfive or more servings of a variety (different colorsand textures) of fruits and vegetables each day.Choose breads and cereals that are made withwhole grains, as opposed to processed or refinedgrains. Limit your consumption of processed red

meats by choosing poultry, fish or vegetarianoptions. Finally, if you drink alcohol, limit yourconsumption to no more than one drink per dayfor women and two for men.

In regard to physical activity, ACSM recommendsadults get 30 minutes of moderate to vigorousaerobic physical activity (brisk walking, cycling,water aerobics, doubles tennis, mowing the lawn)five times a week and muscle strengthening ontwo or more days a week. If you are trying to loseweight and keep weight off, build to 60 to 90minutes of moderate to vigorous activity fivetimes per week. Moderate-intensity aerobic

activity requires you to work hard enough to raiseyour heart rate and break a sweat. One good wayto judge if you are in this range is if you can talk,

but not sing sustained notes. During vigorous-intensity aerobic activity, your heart rate will bevery fast and you will not be able to hold aconversation.

When changing your lifestyle to adopt or increasephysical activity behaviors, it is important tothink about how active you are currently. If youare not physically active, a gradual increase to 30minutes a day of moderate-intensity aerobic

activity will be beneficial and more realistic. Agreat place to start would be to get a pedometerand write down how many steps you take per dfor a week before starting to increase your activilevel. Then, increase your daily step count by 10percent per week until you are doing 30 minuteof some type of aerobic activity on most days ofthe week. Remember, an initial increase to anyamount of physical activity from previously doin

none is an improvement! If, on the other hand,you are already achieving 30 minutes on most

days, consider elevating your goal to 60 to 90minutes of moderate or more intense aerobicactivity on most days. Just remember makethose increases gradual and realistic for yourlifestyle.

Whatever changes you feel ready to make, beassured that even small steps will eventually takyou a long way toward preventing cancer!

Q: My 16-year-old son is a volleyball

player and has been experiencing lower-

back pain for three weeks. Hes pretty so

and has to lie in bed after a long practice

Our friends son was diagnosed with a

back tumor when he was 14 and we do

have a family history of cancer. How do

know if my son has cancer?

A: Certainly, a diagnosis of cancer issomething you dont want to miss, especiallywith a young person. Though anything ispossible, the likelihood of this diagnosis isminimal. The most common cause of lower-back pain in a young athlete is a stressfracture, which usually hurts when the athletextends the back. Musculoskeletal issues areby far the most likely causes of the majority oback pain. One characteristic ofmusculoskeletal pain is that its usually relatedto physical activity. Maneuvers that stress theback typically hurt, and rest usually makes

things better. Concerning symptoms for morominous causes of back pain would be pain arest or at night. The description of the pain isoften deep, boring, throbbing pain. The painmay not be related to exercise. Cancer painassociated with a bone tumor may havepressure features, since it is expanding in thebone, similar to toothache-type pain. The pacan be worse when you are laying down, sinmore blood flow may be directed toward thetumor. If there are any other symptoms suchas fever, fatigue or weight loss, or if the pain persistent despite even a week of rest, its gooto let your physician know. Fortunately, mostcomplaints of back pain with young peoplewill be musculoskeletal, and are rarely due tocancer.

Q&A (continued from page 2)


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Protein andAthletes

By Nancy Clark, R.D., FACSM

Protein is a hot topic among athletes of all sports.

They want to know how much protein they need,when they should eat it, what the best kind ofprotein is, and if they should buy sports drinkswith protein. The purpose of this article to answersome of these questions and leave you with thismessage: While adequate protein is important inyour sports diet, protein should take its place as

the accompaniment to carbs (grains, fruits,vegetables) in each meal and snack.

Q: Ive been eating egg whites for breakfast.

Ive heard they are an excellent source of

high quality protein, right?

A:Yes, egg whites offer high-quality, muscle-building protein. But take note: egg whites aremostly water, and are not packed with protein.A three-egg white omelet has only about 10 gramsof protein. You could more easily swig 10 ouncesskim milk and skip the cooking and dishwashing.

A whole egg has about six grams of protein, andis rich in vitamins and minerals. The yolk ischolesterol-rich; the debate continues whether or

not the cholesterol you eat affects your bloodcholesterol and heart-health not likely.

Better than eggs or egg whites, choose to fuelyour muscles with carb-rich and health-protectiveoatmeal for breakfast. Cook it with skim milk(instead of water). If you want more protein, addalmonds, walnuts and/or 1/4 cup of powdered milk.

Q: Ive been lifting weights for several years.

Do I need a high-protein diet?

A: In the early stages of training, your proteinneeds are higher than when you have establisheda stable muscle mass. Once you have builtmuscle, your protein needs return to the standardrequirements. Yet, most strength-trained athleteshabitually eat a high-protein diet, and this

becomes a moot point. Research suggests

resistance exercise enhances the way your body usesthe protein you eat, and this actually results ingreater efficiencyand a reducedprotein requirement.

Q: How many protein bars per day are too

many?

A: To start, you need to determine how muchprotein your body needs and then assess howmuch protein you eat via your standard diet.Most athletes eat more than enough protein

without supplements! To estimate your dailyneeds, multiply your weight by 0.5-0.75 grams ofprotein per pound (1.0-1.5 g/kg). If you arerestricting calories or are a novice exerciser who isbuilding new muscles, your protein needs are alittle higher, but 1 gram of protein per pound of

body weight (2 g/kg) is more than enough!

Example: If you weigh ~120 lbs., the suggested intake is

~60-90 grams protein per day; 90-120 grams ifdieting or starting to lift weights seriously.

If you weigh ~160 lbs., the suggested intake is~80-120 grams protein per day; 120-180 if

dieting or starting to lift weights seriously.

To determine how much protein you eat at meals,use the information on food labels and/or analyzeyour diet through Web sites such aswww.fitday.com or www.sparkpeople.com.

Once you know how much protein you eat at

meals and snacks, you can then determine howmany protein bars you need (probably none!).That is, if your diet offers 100 grams protein andyou need only 90 grams, theres no need to buy aprotein bar other than for calories to curb hunger.The athletes most likely to benefit from proteinbars are dieters who restrict calories (includingdancers, runners, wrestlers, gymnasts),vegetarians, and picky eaters.

Q: Im a vegetarian and try to eat some plant

protein at each meal. I still wonder if I am

getting enough protein to support my

training for a half-Ironman event.

A: Many vegetarians who think they eat well aresurprised to learn how little protein plant foodsoffer. For example, a petite vegetarian athlete who

needs at least 55 grams protein per day might baseher meals on these plant-proteins for the day: Breakfast: a dollop of hummus (4 g protein) on

toast Lunch: a Boca burger (13 g) Dinner: a quarter-cake of tofu (9 g)

That totals only 26 of the recommended 55grams of protein! Yes, she gets a bit more proteinfrom the grain foods and veggies that round outher meals, but she would be wise to double thoseprotein portions.

Getting enough protein is particularly important ifyou are restricting your calories to lose weight.Protein needs to jump when calories are low,

because the protein is used for fuel rather than f

building or repairing muscle. If you areconcerned about your protein intake, meet withcertified specialist in sports dietetics forpersonalized advice. To find your local CSSD, usthe referral network at www.SCANdpg.org.

Q: Should I use a sports drink with protein

during my endurance runs that last longer

than an hour?

A: If your goal of taking a sports drink withprotein during an endurance event is to enhanceyour performance, dont bother. Endurance islargely affected by how many calories youconsume while you exercise. Studies that haveexamined protein + carbs during enduranceexercise indicate when the total calorie intake is

similar, the proposed endurance benefits are notthere.

A good tactic is to eat a tried-and-true, well-tolerated carb-protein snack or light meal withinthe hour or two before you embark on a long ruor other form of endurance exercise. That is,

enjoy some pre-exercise cereal with milk, a bagewith an egg, or a few swigs of low-fat chocolatemilk. This gets protein into your system, so itsready to be used. Then after the first hour ofendurance exercise, target ~200 to 300 calories carbs/hour. Choose the sports beverage that tastbest to you. Soon after youve finished training,have a wholesome protein + carb snack or mealto help reduce muscle soreness.

Q: I know I should eat a 3- or 4-to-1 ratio of

carbs to protein right after I exercise, but I

dont know what that looks like in terms of

food, so I buy a recovery drink to be sure I

get the right ratio. Are there other options?

A: Commercial recovery drinks are more aboutconvenience than necessity. You can enjoyablyrefuel with chocolate milk, yogurt, a sandwich opasta with meat sauce. The ratio need not beexact; you just dont want to consume a heavyamount of protein that sits in the stomach andslows digestion.

Also, whether or not a protein-carb sportsbeverage is superior to a carb-only beverageremains debated. In a recent study where athlete

drank either a carb or a carb-protein recoverydrink immediately after muscle-damagingdownhill running, both beverages offered asimilar recovery process over the course of threedays. The authors conclude the meals in thosepost-exercise days supplied the protein and carbneeded to recover. Yet, in a six-day study withcollege cross-county runners, those who took acarb + protein supplement reported less sorenesthan those who took only carbs.

You wont go wrong by refueling soon afterexercise with a carb-protein combination!



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The nations top public health physician wants you to

know: Exercise greatly reduces serious risks to

your health. Simply increasing your physical activity

a little can help you and your family prevent many

illnesses and improve your health, fitness and

well-being. So join Acting Surgeon General Steven K.

Galson, M.D., MPH today and become more physically

active and healthy.

For more information, and ways to get started, visit the

Exercise is Medicine Web site at www.exerciseismedicine.org .

Exercise is Medicine!

Exercise is Medicine is a program of the American College of Sports Medicine.This public service announcement is in collaboration with the Office of the Surgeon General.

Heres a tool to improve your health.IMPORTANT ADVICE FROM THE OFFICE OF THE SURGEON GENERAL

Documents

2009 Spring Fspn Cancer Exercise