Severe obesity

Severe Obesity: Evidence for a deranged Metabolic Program in Skeletal Muscle?

Journal of Exercise and Sport Sciences, Volume 40 (4), October 2012, p 204-210.

A Review and Summary

            There are many health complications associated with being obese and, I believe, that as an understanding of how damaging obesity is to the body, medical science is just beginning to scratch the surface.  To this point most of the research has focused on understanding and managing health risk factors such as the levels of blood pressure, cholesterol, blood glucose, and triglycerides to name a few.  To my knowledge, few research studies have been conducted to understand the efficiency with which obese people metabolize or ‘breakdown’ stored body fat to be used as a source of energy.  This study had a very broad scope and not all of the information included in this particular study will be discussed here.  Specifically, this review will be focused on the findings regarding fatty acid oxidation, which is one of the energy systems used to break down body fat.

            Before getting into the specifics of this study’s findings a basic understanding of how the body provides itself with energy during exercise.  This process is far more complex than described here, but for the sake of simplicity only the very basics of the process will be discussed.  Inside of every individual muscle cell is a naturally occurring biochemical compound call ATP-Cr.  The energy released from this compound causes muscular contraction during exercise.  This compound is a stored form of energy that the body keeps supplied within the muscles ready to be used at a moment’s notice.  However, the body is only capable of storing enough of this compound to fuel about 15 seconds of intense physical activity.  It takes a rest period of 45 seconds to one minute for the muscles to restore the levels to be driven through this primary energy system.  If physical activity is to continue longer than 15 seconds energy for this ATP-Cr compound must be restored from another source.  This is accomplished through what it called the glycolytic system which manufactures the ATP-Cr compound by breaking down the glycogen within the muscle cell.  Glycogen is the name given to the amount of glucose stored within muscle cells.  This process is a little slower than the initial ATP-Cr system.  Exercise supported by this energy system cannot be maintained at as high of intensity as the first system. Furthermore, the muscle cells can only store enough glycogen to support about 2 minutes of exercise.  This lead into the third and final energy system; fatty acid oxidation.  Again, this energy system is about replenishing the ATP-Cr levels within the cell, and yes, as the name suggests, it does this through the breakdown of stored body fat, converting it into fatty acids which are transfer to the liver.  At the liver, the fatty acids are converted into glucose, which travels to the muscle cells and becomes muscle glycogen.  This glycogen is then used to make more ATP-Cr.  As you have probably guessed from the description this process is even slower.  In fact, it is the slowest method of providing the muscles with energy and it only comes into play when the first two systems have run their course.  Again, because this is slower the intensity of exercise that can be maintained is lower than that which can be achieved through the two previous energy systems.  This oxidation system really only comes into play during slow pace, endurance events.  Energy from this system will support the body for up to two hours, depending upon intensity, before the body must consume calories to continue having adequate energy levels.

            It is time to focus on the research findings of the study.  The purpose of this study was to identify whether or not there is a difference in the efficiency of the use of the fatty acid oxidation system between obese people and those of healthy body weight.  This was accomplished through using three groups of people: healthy weight, BMI averaged 23.8; obese BMI average 30.2, and severely obese BMI average of 53.8.  The method used for this was to measure the amount of carbon dioxide released from the muscle cells of the rectus abdominus during exercise.  Carbon dioxide is a chemical by-product of muscular contraction.  The rate at which it is produced can be used as an indicator for the efficiency of energy production within the muscle cells.

            One of the most interesting findings from this study is that there was no difference in the efficiency of fatty acid oxidation between the groups of healthy 23.8 BMI and obese people of the 30.2 BMI group.  So, it would seem that the bodies of those who are obese, but only just heavy enough to be considered obese, can metabolize body fat for energy just as well as those that are of healthy BMI, provided that the obese group exercises.  However, the severely obese, 53.8 BMI group, on average, used this fatty acid oxidation at a rate approximately 60% less efficient than the other groups.  Or, it can be considered that the severely obese group metabolized body fat with only 40% of the efficiency that the healthy and obese groups.  It should be noted that after these initial findings the study conducted intervention assistance using nutritional counseling, exercise counseling, or a combination of both.  The group that underwent both the exercise and nutrition counseling saw the greatest improvement through weight loss and improved fitness.

            So how does the affect structuring an exercise program for the severely obese to maximize weight loss?  Start by understanding that any exercise is better than no exercise. Slow duration, low intensity, endurance exercise is not the most efficient way to lose weight but for those who are severely obese it is generally the safest and easiest way to begin.  Start by focusing on building up the endurance until you are able to 30 minutes of continuous cardiovascular exercise without needing to stop to rest.  After reaching the 30 minute mark start strength training.  Perform this on any cardio piece; treadmill, bike, or elliptical.  For strength training, perform one set of an exercise for the back chest, shoulders, arms, and legs.  Focus on learning the fundamentals of the motion.  After two weeks complete two sets of each exercise and add a third set after one month.  Workout Twice a week with weights for the first month and perform cardio four days per week.  Starting in the second month add a third weight training session each week.  This is a basic plan meant to lay a foundation to build upon.  Gradually increase the cardio by 5 minutes a week until you a performing a full hour of cardio.  The weight loss will be slow with this program, especially without strict control of the diet.  Remember, at the beginning of the program the purpose of exercise is to improve physical endurance and the ability to move so that the body is prepared for more intense exercise later.

WOW CHALLENGE Sept 18-20

Weekly Challenge Week of September 10-14

Trainer standard: 5 rounds

As many rounds as possible in 20 minutes of:

Burpees 10 reps

Squat Jumps 10 reps

Jump Rope 1 minute

Plank 1 minute

Mogul Jumps 10 reps

Skater Jumps 10 reps

Exercise Instructions:

Burpees

Start with the feet shoulder-width apart. Drop into a squat placing the hands on the ground and shoot both feet backwards so that the body is in the position of the top of a push up.  Bring the feet up to the chest, lift hands off the ground and stand up.

Squat Jumps

Start with feet shoulder-width apart and drop down into a squat.  Explode upwards and jump into the air.

Plank

Get into a push up position and drop the elbows to the floor so that the forearms are flat on the ground.  Stay up on the toes and hold the position with weight distributed over the shoulders.

Mogul Jumps

Start in the push up position.  Rotating only at the hips, and with the knees slightly bent rotate both feet out to the right side.  Touch and immediately rotate to the left.

Skater Jumps

Stand on just the right foot and jumps sideways to the left.  Land on the left foot only, pause and jump back to the right landing on the right foot.

Ten things to improve your exercise program

Ten things to Improve Your Exercise Program

1.      Have a goal.  It amazing how many people come to me, and when I ask, “what is your goal?” answer with some variation of, “to be healthy,” or, “to lose weight.”  Congratulations on achieving a generic, mundane, and vague goal.  This goal will get you nowhere quick.  A proper goal is a specific and measurable objective that can be obtained in a realistic time frame.   Don’t say your goal is ‘to lose weight.’  How much weight and in what time frame?  An example of a solid goal would be to lose thirty pounds in six months.  That is specific, measurable, and realistic.  That is a goal that lends itself to development of a solid, organized plan. This leads into point number two.

2.      Have a plan. Would a person set out to build a house without a well-designed blueprint?  You could but it would not last long or stand up to the storms.  Fitness programs are the same way.   Develop a plan that is not only structured to achieve the goals in the gym but can also account for the chaos of life.  Vacations, holiday seasons, sick kids, overtime, bad weather and many other obstacles happen almost every day.  Some come up unexpectedly while other happen at the same time every year or are scheduled months in advance.  Thanksgiving through New Year’s does not jump out of the wood work.  Plan ahead to deal with these obstacles then work the plan when the time comes.  Maybe November through January means cutting back from four workouts a week to three.  Life can be accommodated with a little forethought and planning.

3.      Action.   Work the plan.  It won’t work if you don’t do it.

It is the goal that sets the plan; it is the plan that sets the action; it the action that achieves the result; and it is the results that bring success.  And it all begins with the simple word goal. - Shad Helmstetter

4.      Nutrition.  It is impossible to out exercise poor nutrition.  It does not matter what the goal of the program is.  If the eating does not match the goal of the exercise the results will never happen.  Start by correctly identifying the amount of calories needed to achieve the goal.  There are several online resources that will help you do this.  I suggest starting with the calorie tracker at www.livestrong.com, ultimately, it is important to have a healthy understanding of what amounts of macronutrients; the protein, carbs, and fat your body will need to achieve the goals.  But, before that simply focus on learning to eat and live with the right amount of calories.

5.      Evaluate and adapt.  Another word for this is variety.  Do something different every time.  Einstein said, “Doing the same thing over and over while expecting different results is insanity.”  Change the weight or change the reps, move faster or move slower.  Workout at a different time of day or different days of the week.  Exercise for a longer period of time or cut down on the amount of time.  The human body adapts quickly, if nothing changes then within six to eight weeks the body has adapted and the exercise is no longer as effective.  This is called a plateau.  Avoid it by evaluating and adapting.  Change it up.

6.      Focus on improving the ability to move.  Exercise is often associated with achieving and maintaining a healthy body weight. While it will help burn extra calories and make it easier to stay at a healthy weight that is not it’s most important function.  Whether for everyday living or sport performance exercise is specific movement done to improve the ability to move.  Everything that the human body does in the gym should be aimed at improving everything that it does outside of the gym.  Ask this question when considering including any exercise in your program, “do I repeat this movement in real life?”  Bicep curls will help to give a person big arms but how often in real life do you use just your arms to lift 100lbs?  Think about the movements outside of the gym that your body does consistently.  In the gym find exercise movements that mimic real life and train to be strong in those movements.

7.      Coordination is key.  This is directly tied into point number six.  Exercise should not simply mimic real life movements and make a person stronger in those movements.  It should also improve the efficiency with which the body performs the movement.  Translation:  the maximum result desired with the least amount of effort.  For the reason it is important that during training form is never compromised.  When you begin to sacrifice form for more repetitions or heavier weight you immediately begin training against improving coordination and efficiency.

8.      Focus on proper posture.  Probably the most common problem I see with people is ignoring proper posture when lifting.  This will only make poor posture worse.  Standing with proper posture will help strengthen the core muscles and improve posture over time.  Stand with the feet shoulder-width apart and the torso erect.  The head should be up and looking straight ahead.  The shoulders should be back so that the chest looks open and the shoulder blades feel ‘tucked in.’ Maintain this position throughout the exercise.  Any parts of the body that have difficulty moving into this position may be signs of muscle tightness or weakness that needs to be addressed. If you are going to move into a squat from this position the hips should move backward as they come down.  This will ensure that the back stays braced with the shoulders back and open.  If you lean forward so that the shoulders pass in front of the knees the back has become rounded.  This is a dangerous position and is a sign that the lower back and core muscles are too weak for the amount of weight being lifted.  Lighten the weight and maintain proper form.

9.      Train to improve balance.   It is probably one of the least trained aspects of physical fitness and like muscular strength, if you do not use it you will lose it.  Most exercises are performed with both feet firmly planted on the ground.  Again, how often is the body actually like this?  Walking, jogging, running, going up stairs and just about every other routine movement the body goes through over the course of the day is done with only one foot in contact with the ground.  Master the fundamentals of exercise following the posture guidelines in point eight.  Every exercise becomes more challenging when performed on one foot or on an unstable surface like a BOSU ball or balance board.

10.  Sit as little as possible.  The human body is designed to move.  A long period of sitting is one of the worst things for it.   It slows metabolism more than lying to sleep at night.  Proper posture is harder to maintain when seated than standing.  Immobility will wreck the body very quickly.  Excessive weight gain is just one of the ways that happens.  Spend all day at a desk.  Get up and move every hour for five minutes.  Stand up while you talk on the phone.  Any movement, even for short periods of time will improve blood circulation and make you feel more energetic.

Good Morning Salad

Good Morning Salad	Makes 1 serving
Ingredient	Quantity	Calories	Fat Grams	Protein Grams	Carb Grams
Flax Seed	1tbsp	35	1.5	2	4
Egg, whole	2	140	10	13	0
Egg white	2	35	0	7	0
Turkey Bacon	3 slices	75	4.5	6	0
Fresh Raspberries	1/2 cup	32	0.4	1	7
Fresh Spinach	1 cup	20	0	2	3
Avocado	1/5 of avocado	50	4.5	1	3
TOTAL		387	21	32	17

Instructions

Cook turkey bacon in microwave for 2 minutes.  In a skillet cook the eggs as an omelet.  Stir in the flax seed with the eggs and season with 1 tsp each black pepper, garlic powder, and crushed red pepper.  On a plate make a small salad with the spinach, raspberries, avocado, and turkey bacon.  Once done, lay the omelet on top of the salad and eat.  Takes 10 minutes to make.

Weekly challenge Workout September 17, 2012

Trainer Time: 27 minutes  48 seconds

Equipement Needed:

70lb, 40lb, and 20lb Kettle balls for men (m)

40 lb, 20lb, and 10lb Kettle balls for women (w)

1 set of TRX Bands

1 Jump Rope

10 agility hurdle- 6”

1 Swiss Ball

Set up:

Find an open space.  Attach the TRX band high and adjust handles to chest height.   Set out the agility hurdles in a straight line 18 inches apart.  Place the swiss ball, jump rope and kettle balls off to the side and out of the way.

Instructions:

Complete all rounds of each group of exercises as quickly as possible.  Move from exercise to exercise without resting.  Try not to rest until  completing all exercises in the group for the total number of specified rounds.  After completing all rounds of the group rest exactly one minute before starting the next group of exercises.  Use this one minute rest to set up equipment for the next round.

The Workout:

Round one: Complete three rounds

Kettleball Deadlift-70lbs (m) or 40lbs (w)-12 reps

TRX Pullups-12 reps

Agility Hurdles (there &back)

Side Plank-30 seconds each side

Rest one minute after completing all three rounds

Round two: Complete three rounds

Kettleball snatch-40lbs (m) or 20lbs (w)-6 reps each arm

Jump Rope 1 minute

Swiss Ball rollouts- 12 reps

Rest one Minute after completing all three rounds

Rounds Three: Complete three rounds-lower TRX handles to 12 inches above the floor

Kettleball One-leg squat-20lbs (m) or 10lbs (w)-6 reps each leg

Hip Thrusts-12 reps

TRX pushups-12 reps

Exercise Instructions:

Kettleball Deadlift

This is performed by starting in a squat, with feet shoulder-width apart, stand over top of the kettleball.  Keep the shoulders squared and behind the knees.  Grasp the handle of the KB with both hands.  Brace the core muscles and stand straight up, exhale through the movement.  Reverse the motion returning to the bottom of the squat, inhaling at the same time.

TRX Pullups

Make sure that the handles have been adjusted to chest height.  Grasp a handle in each hand and walk forward so that the body becomes parallel to the floor with the chest directly below the handles.  Keep your feet together and core braced.  Using the muscles of the back and arms pull chest up until it touches the hands.  Pause for one second and reverse the motion.  Remember to stay tight all the way through the movement.

Agility Hurdles

Lead with the right foot and step over the first hurdle, follow with the left.  Do not step over the next hurdle until both feet have crossed the previous hurdle.  Follow this pattern to the end of the line.  Then turn around and return leading with the left foot.  Focus on going a little faster each time.

Side Plank

Start by lying on the side of the body in a straight line. Place the forearm flat along the ground so that the elbow is directly beneath the shoulder and the hand is straight in front.  Keep the feet together with one on top of the other.  Lift the hips off the ground and hold high enough that the body is in a straight line.  Hold this position for 30 seconds than switch sides and repeat.

Kettleball Snatch

Start in the same position as the KB deadlift but grasp the kettleball with only one hand.  Explode upward, bringing the arm up past the shoulder and extending it straight overhead.  The arm should be fully extend by the time the body is standing straight.

Swiss Ball rollouts

Starting on the knees place the ball in front of the body with both hands on top.  Lean forward on the knees and extend the arms forward, pushing the ball.  Continue until the arms are fully extended and the body is straight from fingers to knees with the core braced.  Hold this position for two seconds, then contract the abs and reverse the motion back to the starting position.

Kettleball one-legged squat

Hold the KB with one hand at the shoulder.  Point the elbow out.  Pick up the opposite foot and point out in front of the body.  Drop into a squat.  Reverse the motion and remain standing on one leg.  Complete all reps on one side then switch.

Hip Thursts

Lie flat on the floor on the back.  Place hands out to the sides of the body.  Keeping the legs straight lift the feet until directly above the hips.  Point toes at the ceiling and lift the hips off the floor.  Lower, keep feet up, and repeat.

Maximizing Muscle Growth-radio show 09/14/2012

I read an interesting part of a book online entitled The Max Muscle Plan by Brad Schoenfeld.  He has a great viewpoint on the muscles' response to exercise.  I am going to share some of that information with you because understanding muscular response to exercise is key to increasing muscle mass and strength if that is the goal of the program.  Specifically, I will be quoting his book in the numbered points because the explanations given are thorough and well-written.

It is important to understand that for muscular development and mass gains that no nutritional element is more important than protein.  Without adequate protein intake the body cannot properly recover for exercise and respond with growth.  Shoot for 1 gram of protein per pound of body weight when gaining muscle mass.  The other most important nutrient is water.  Water comprises approximately 70% of a muscle while another 25% or so is made from the various proteins, cells, and tissues that form the muscle.  Drink about a gallon of water per day to support proper muscle function and growth.

Muscle tissue is always in one of two different states.  It is always either anabolic, muscle-growing, or catabolic, muscle-breakdown.  Which of the two states exists comes down to a combination of exercise and nutrition.  Protein synthesis is the process by which the body creates new muscle tissue resulting in an anabolic period.  Despite the potential for new muscle to be formed as a result of exercise the body is never in a state of protein synthesis (anabolic) during exercise.  Exercise always causes a state of protein breakdown (catabolic) as the fibers of the muscles are broken down from the resistance of the weights.  Following the end of the exercise session the muscle tissue begins the process o rebuilding.  The body's response to exercise is to accelerate protein synthesis, and with proper nutrition, a prolonged state of anabolism can occur and the result is that the muscles will become bigger.  This state can potentially last up to 48 hours.

There are three primary factors other than nutrition that have an affect on the muscle's response to exercise: muscle tension, muscle damage, and metabolic stress.

From The Max Muscle Plan by Brad Schoenfeld

1. Muscle tension. Tension exerted on muscles during resistance exercise is generally considered the most important factor in muscle development. The tension from lifting weights disturbs the integrity of working muscles, thus bringing about a phenomenon called mechanotransduction. Simply stated, mechanotransduction is the process by which mechanical signals are converted into chemical activity; in this case, the signals turn on anabolic pathways. Up to a certain point, greater muscle tension leads to a greater anabolic stimulus—a classic case of adaptation. However, it seems that an upper limit exists, beyond which high tension levels have a diminishing effect on muscle growth. Once this threshold is reached, other factors become increasingly more important in the growth process. This is why bodybuilders generally display superior muscle growth compared with powerlifters even though bodybuilders routinely train with lighter weights.

2. Muscle damage. Anyone who lifts weights has undoubtedly felt achy and sore after an intense exercise session. This phenomenon, called delayed-onset muscle soreness (DOMS), generally manifests approximately 24 hours after an intense workout, and the peak effects are seen about two to three days postexercise. DOMS is caused by localized damage to muscle tissue in the form of microtears in both the contractile proteins and surface membrane (i.e., sarcolemma) of the working muscles. What many people fail to grasp, however, is that a certain amount of soreness may indirectly benefit muscle development. Here’s why: The response to muscle damage can be likened to the acute inflammatory response to infection. Once the body perceives damage, immune cells (neutrophils, macrophages, and so on) migrate to the damaged tissue in order to remove cellular debris to help maintain the fiber’s ultrastructure. In the process, the body produces signaling molecules called cytokines that activate the release of growth factors involved in muscle development. In this roundabout way, localized inflammation—a source of DOMS—leads to a growth response that, in effect, strengthens the ability of muscle tissue to withstand future muscle damage. Adaptation!

3.  Metabolic stress. Perhaps the most intriguing factor associated with muscle development is exercise-induced metabolic stress. Research on patients confined to bed rest show that metabolic stress induced by the application of a pressure cuff can help attenuate muscle wasting, even in the absence of exercise. Other studies have found that pressure-cuff exercise performed with very light weights—far less than what is normally considered sufficient for promoting muscular adaptations—can promote significant muscle growth as a result of generating a substantial amount of metabolic stress.

Anyone who has been on a strength training or mass building program can tell you that DOMS gradually becomes easier to deal with and the body recovers more efficiently as a person becomes more fit.  Soreness after a workout is not necessary for the body to increase in protein synthesis and result in a gain of muscle.  In fact, for people that have been regularly training for six months or more, excessive soreness can be a problem.  It is a symptom over training and inadequate nutrition.  The body's ability has been impeded and it remains in a catabolic state after the exercise is completed.  Ever have trouble walking after a leg workout? Or does the back tighten up at the slightest movement.  Over training is most likely the cause, make the workout easier.

Getting the proper nutrition into the body as quickly as possible optimizes the recovery process and begins the anabolic phase resulting into muscle growth.  Ideally a person should eat within 45 minutes of completing exercise.  If that is not possible, do not sweat it.  However, it is absolutely necessary to eat within two hours of exercise in order to maximize anabolic potential.  I advocate eating real food whenever possible but if that is not practical for you have a protein shake consisting of 300-400 calories, 10-15g fat, 30-40g protein, and 20-40g carbs.

Here is a couple of sample recovery meals for maximizing the anabolic recovery.  One meal is for every morning exercisers the other is for those who workout in the afternoon or evening.

Anabolic Breakfast
1 cup or two packets of sugar free oatmeal
2-4 eggs
1-2 tbsp of Peanut Butter
1 tbsp of flax seed

Anabolic Lunch or Dinner
1 baked sweet potato or 2 cups of spinach
1 chicken breast of salmon fillet
1/2 avocado

Childhood activity may Prevent Osteoporosis as an Adult

Childhood activity may Prevent Osteoporosis as an Adult

Regardless of age physical activity and exercise is commonly accepted as an excellent method for both preventing and reversing obesity.  The American College of Sports Medicine, the organization through which I am certified as a personal trainer, has declared the month of September to be childhood obesity awareness month.  The purpose behind this is to help the general public understand that increased levels of physical activity in children can lead to a lifelong benefit of increased health.  In support of this, this post contains information about another preventable health problem, osteoporosis, which is being shown by recent research to be largely preventable during the childhood years.  The evidence is strong enough that researchers believe as many as 60% of current adult osteoporosis cases could have been prevented by increased physical activity as a child.

The years between the ages of five and about fifteen appear to be the most influential for a child to develop strong bones that will serve the child throughout the adult years and into old age.  The strengthening of the bones is proposed to happen in primarily two ways.  The first is that there is an increase in bone mineral accrual.  Various minerals are present throughout the bones of the human body.  Simply put, the more minerals that are made into the bones as they grow the stronger the various tissues within the bone become as they knit together to form the solid structure of the bone.  This helps to improve the overall mass of the bone, which is the second indicator of the health of the bone structure.  The more mass (weight) a bone has in relation to its length the denser the bone becomes.  This increase in density means that throughout the life of the person the bone will be less susceptible to osteoporosis developing and weakening the bones.  Bones weakened by osteoporosis are more likely to fracture than bones without it. 

So what physical activity, as a child, is best for improving bone growth?  Several different studies have looked into this question.  The answer seems to be any form of exercise that increased mechanical load on the bone.  In the context of exercise mechanical load is often weight-training.  But, that is not necessarily appropriate for children, especially before the onset of puberty.  In prepuberty aged children, the child’s own body weight is sufficient resistance with typical childhood activity.  Anything that involves walking or running is adequate.  However, jumping appears to be the best form of physical activity for children to improve the quality of bone structure.  One study in particular, found that by having children stand on platforms, varying from 12 inches to 24 inches in height, and the jumping off the platforms to the ground, the children improved bone mass and mineral quality by almost 7% more than a control group that did not perform the jumps but participated in the same running activities as the research group.

Maintaining physical activity over the entire lifetime is important for maintaining healthy bones and preventing osteoporosis.  Just like muscular strength, healthy strong bones follow the “use it or lose it” principle.  Physical inactivity does more than increased the possibility of gaining body fat.  It may make a person more prone to osteoporosis.

Stay Hydrated to Exercise Safely in the Heat

The summer heat can take a toll on the body during outdoor exercise.  Excessive heat warnings may be common May through September but do not wait until the weather man issues the heat warning to be cautious about overexertion while outdoors during this time of year.  Anytime that the day time heat exceeds 90 degrees Fahrenheit it is time to use caution when exercising or working outdoors.  This is especially true anytime that a person lives in a place of high humidity like Arkansas.  The increased heat index associated with humidity puts people that live in hot, humid environments at a greater risk than those who live in dry heat.

For the person exercising outside this time of year the excessive heat is not the primary concern. Given enough time, the body can adapt to a hot humid environment provided that it can stay adequately hydrated. This may be done over a period of three to four weeks with gradual increases in both length of time training and intensity of exercise in the heat. It is the increased risk for dehydration as the body loses water through excessive sweating that may lead to a potential exercise-induced heat-related medical emergency.  Staying hydrated is a key component for staying safe in the heat. Proper hydration begins long before the workout or practices does.

Most people wake up dehydrated in the morning. The several hours of sleep that a person should be

getting are also several hours during which the body is not being hydrated. That first trip to the toilet is more about eliminating certain biochemical waste products than it is about eliminating excess fluids. However, it is the first opportunity to assess hydration status. At all times of the day, urine should be the color of clear lemonade, just a shade darker than water. If it is bright yellow the body is dehydrated. If the urine is both yellow and has a strong odor the body is severely dehydrated and is dire need of fluids before any physical activity. Working outdoors or exercising in the heat and being dehydrated from the get go is asking for trouble. But trouble may be avoided if the body is properly hydrated for the activity ahead.

Sweating is a natural method for the body to cool itself during physical exertion.  In addition to some of the chemical waste products that the body produces during exercise, sweat also helps to release the excess body heat generated by the exercise, thus cooling the body. The problem comes when the body has sweated off too much excess water causing a state of dehydration.  When this happens the body is unable to release enough excess heat through sweating because it lacks enough water to produce sweat.  As the sweating mechanisms stop working the the resulting rise in body temperature may become too high. This has the potential to cause severe damage both to the brain and the body, up to the point of death.  This can happen when the body loss of as little as 1% of body weight will result in a rise in body temperature.  For a person that weighs 150 lbs this is a water weight loss of 1.5 lbs. Fluid loss in the range of 3-5%, 4.5 to 7.5 lbs, will place a great strain on the cardiovascular system; a dangerous decrease in blood pressure combined with an excessively increased heart rate. As blood pressure begins to drop the heart must beat faster in order to circulate the blood to keep the body going. Staying hydrated replaces fluids, preventing this dangerous drop in BP. Go for an hour run during the day time high and this can be done quite easily. At a 7% loss, 10.5 lbs for a 150 lb person, complete collapse of the body is likely. This is exercise-induced heat stroke and a medical emergency. When it sweats, the body also loses electrolytes, primarily sodium and potassium. This is why sports drinks like Gatorade may be necessary of exercise will last longer than one hour.

Here are some safety tips to reduce the risk of putting yourself in danger.

·         Avoid exercising in the heat of the day.  Exercise early in the morning or late at night.  Exertion during the coolest temperatures of the day will minimize the risk of a heat-related problem.
·         Stay hydrated all day.  Do not drink simply because you feel thirsty.  Remember, the most accurate assessment of proper hydration is the color of urine. If you plan on exercising in the heat drink at least one ounce of water per pound of body weight per day to ensure proper hydration.
·         Weigh yourself before and after exercising outdoors. For every pound of water lost from exercise drink 12 oz of water and 8 oz of an electrolyte sports drink. Water alone is inadequate because it does not contain the electrolytes that help regulate blood pressure to safe and healthy levels. Try to be completely re-hydrated within 2-3 hours after finishing exercise. 
·         Do not go to sleep at night dehydrated from a long run in the heat. This will severely impair the recovery process. It is better to wake up to use the bathroom at night than to sleep all night dehydrated. A decrease in the frequency of urination combined with prolonged heat exposure is a symptom of dehydration. 
·         Exercise with a partner and carry a cell phone; if one of you has a problem the other person can call an ambulance.
·         After finishing the exercise focus on rehydrating and cooling off before taking a shower. The temperature change shock of going from exercising in the heat to cool indoors with a/c to a hot shower may make a person feel worse if they have not rehydrated. Wait 20-30 minutes and start rehydrating before cleaning up.