Legumes play an important role in traditional diets in many parts of the world. They are low in fat, are good sources of protein and fiber, and contain a variety of micronutrients and phytoestrogens (plant estrogens). Phytoestrogens have received a lot of attention for their ability to fight not only cancer, but also heart disease and osteoporosis. They help balance hormones in the body and thus are thought to be particularly valuable for the hormone-dependent cancers: breast cancer and prostate cancer. It is well known that male hormones play a role in prostate cancer development.

Despite their advantages, legumes play a minor role in most Western diets. The typical Western based diet (lower in vegetables and legumes and higher in animal-based foods) can cause an increase in both male and female hormones (androgens and estrogens), while a plant-based diet tends to lower these hormones. This is the basis for the role of diet in the development of hormone-dependent cancers.

Soy foods, such as tofu, soy milk, soy beans, and vegetarian burgers, seem to be particularly rich in cancer-fighting properties. This is at least partially due to a form of phytoestrogen, called isoflavones, that is found primarily in soy. It appears to help prevent prostate cancer by binding to male hormone receptors in the prostate, thus reducing the stimulating effect of male hormones on prostate cell growth.

Epidemiological studies have shown that high levels of isoflavones are often associated with low rates of breast, colon, and prostate cancer. This has been used to explain why countries such as Japan and China that typically consume large amounts of soy have lower risks of these diseases.

The difficulty with consuming soy for reducing risk of prostate cancer is the lack of clinical trial evidence to support its use. As with any dietary component, it is difficult to isolate the effect of a particular food type to prove its effectiveness. One prospective study, including over 12,000 men, did evaluate consumption of soy milk. It found that those who drank soy milk regularly had a reduced risk of prostate cancer. The relationship held up after other factors were controlled for. Other studies need to be done to further establish the benefits of soy. In the meantime, getting more soy foods into your diet can be healthy for many reasons, and lowering your risk of prostate cancer may be one of these.

The prostate gland depends on testosterone for growth and development. Prostate cells, both noncancer and cancer, do too. This is why prostate cancer is sometimes referred to as a hormone-dependent cancer. Higher levels of circulating testosterone lead to higher concentrations in the prostate, and this appears to increase the risk of clinically significant prostate cancer. However, higher testosterone levels are not consistently found in prostate cancer patients, so there is more to the relationship.

A possible protective role of exercise has been proposed based on its ability to lower testosterone levels and to boost the immune system. Exercise causes a temporary reduction in testosterone, so regular exercise can reduce long-term exposure to testosterone. And chronic exercise has been shown to increase the number and activity of natural killer cells, which are part of the immune system that attack cancer cells.

Based on these effects, it seems that exercise should be beneficial, but the evidence concerning the impact of exercise on prostate cancer risk is inconclusive. In a review of 17 epidemiological studies of varying quality, 9 showed a beneficial effect, 5 no effect, and the other 3 actually showed an increased risk related to exercise or physical activity. None of the studies, however, provided conclusive proof, but taken together, they seem to support a weak beneficial effect of regular exercise on prostate cancer risk.

The challenge is proving that men who exercise regularly develop less prostate cancer when all other factors are the same. This requires a prospective long-term randomized study, and this probably will never be done. The best long-term prospective studies that looked at habitual physical activity in adulthood are encouraging, however.

A study of nearly 18,000 alumni of Harvard University showed that those who maintained a high level of physical activity were about half as likely to develop prostate cancer after the age of 70 as those who were least active. Another prospective study evaluated the level of physical fitness, as well as physical activity, on the risk of prostate cancer. Higher fitness levels were associated with lower risk in men under 60, but not in older men. And men who expended more than 1,000 kcal per week in exercise had lower risk than those who did not get this much exercise. The best long-term study of men's health is the Health Professionals Follow-up Study. It began in 1986 and has followed over 47,000 men in various health occupations since then. Data was collected in the beginning, and periodically through the study, on many factors including physical activity. The only positive result through 1994 was that at least 3 hours per week of vigorous physical activity was associated with a reduced risk of metastatic prostate cancer. But no relationship was observed between physical activity and the incidence of total or advanced prostate cancer. The same study, however, found an inverse relation between physical activity and BPH, more activity meant a lower likelihood of urinary symptoms or surgery for BPH. Walking 2–3 hours per week was enough to lower the risk of BPH.

The bottom line is that questions remain about the relation between exercise and prostate cancer, but there is no question that regular exercise is good for general health. So, it is wise to get some moderate exercise on most days of the week, and you may be protecting yourself from prostate problems, too.

Vitamin D Deficiency: A Global Concern

If you live north of the line connecting San Francisco to Philadelphia and Athens to Beijing, odds are that you don’t get enough vitamin D. The same holds true if you don’t get outside for at least a 15-minute daily walk in the sun. African-Americans and others with dark skin, as well as older individuals, tend to have much lower levels of vitamin D, as do people who are overweight or obese.

Worldwide, an estimated 1 billion people have inadequate levels of vitamin D in their blood, and deficiencies can be found in all ethnicities and age groups. (1-3)  Indeed, in industrialized countries, doctors are even seeing the resurgence of rickets, the bone-weakening disease that had been largely eradicated through vitamin D fortification. (4-6)

Why are these widespread vitamin D deficiencies of such great concern? Because research conducted over the past decade suggests that vitamin D plays a much broader disease-fighting role than once thought.

Being “D-ficient” may increase the risk of a host of chronic diseases, such as osteoporosis, heart disease, some cancers, and multiple sclerosis, as well as infectious diseases, such as tuberculosis and even the seasonal flu.

Currently, there’s scientific debate about how much vitamin D people need each day. The Institute of Medicine, in a long-awaited report released on November 30, 2010 recommends tripling the daily vitamin D intake for children and adults in the U.S. and Canada, to 600 IU per day. (7) The report also recognized the safety of vitamin D by increasing the upper limit from 2,000 to 4,000 IU per day, and acknowledged that even at 4,000 IU per day, there was no good evidence of harm. The new guidelines, however, are overly conservative about the recommended intake, and they do not give enough weight to some of the latest science on vitamin D and health. For bone health and chronic disease prevention, many people are likely to need more vitamin D than even these new government guidelines recommend.

Vitamin D Sources and Function

Vitamin D is both a nutrient we eat and a hormone our bodies make. Few foods are naturally rich in vitamin D, so the biggest dietary sources of vitamin D are fortified foods and vitamin supplements. Good sources include dairy products and breakfast cereals (both of which are fortified with vitamin D), and fatty fish such as salmon and tuna.

The body also manufactures vitamin D from cholesterol, through a process triggered by the action of sunlight on skin, hence its nickname, “the sunshine vitamin.”  Yet some people do not make enough vitamin D from the sun, among them, people who have a darker skin tone, who are overweight, who are older, and who cover up when they are in the sun. (1)

Correctly applied sunscreen reduces our ability to absorb vitamin D by more than 90 percent. (8) And not all sunlight is created equal: The sun’s ultraviolet B (UVB) rays—the so-called “tanning” rays, and the rays that trigger the skin to produce vitamin D—are stronger near the equator and weaker at higher latitudes. So in the fall and winter, people who live at higher latitudes (in the northern U.S. and Europe, for example) can’t make much if any vitamin D from the sun. (8)

Vitamin D helps ensure that the body absorbs and retains calcium and phosphorus, both critical for building bone. Laboratory studies show that vitamin D can reduce cancer cell growth and plays a critical role in controlling infections. Many of the body’s organs and tissues have receptors for vitamin D, and scientists are still teasing out its other possible functions.

New Vitamin D Research: Beyond Building Bones

Several promising areas of vitamin D research look far beyond vitamin D’s role in building bones. And, as you might expect, the news media release a flurry of reports every time another study links vitamin D to some new ailment. These reports can be confusing, however, because some studies are stronger than others, and any report needs to be interpreted in the light of all other evidence. More answers may come from randomized trials, such as the VITamin D and OmegA-3 TriaL (VITAL), which will enroll 20,000 healthy men and women to see if taking 2,000 IU of vitamin D or 1,000 mg of fish oil daily lowers the risk of cancer, heart disease, and stroke.

Here, we provide an overview of some of the more promising areas of vitamin D research, highlighting the complex role of vitamin D in disease prevention—and the many unanswered questions that remain.

Vitamin D and Bone and Muscle Strength

Several studies link low vitamin D levels with an increased risk of fractures in older adults, and they suggest that vitamin D supplementation may prevent such fractures—as long as it is taken in a high enough dose. (9-13)

A summary of the evidence comes from a combined analysis of 12 fracture prevention trials that included more than 40,000 elderly people, most of them women. Researchers found that high intakes of vitamin D supplements—of about 800 IU per day—reduced hip and non-spine fractures by 20 percent, while lower intakes (400 IU or less) failed to offer any fracture prevention benefit. (13)

Vitamin D may also help increase muscle strength, which in turn helps to prevent falls, a common problem that leads to substantial disability and death in older people. (14-16)  Once again, vitamin D dose matters: A combined analysis of multiple studies found that taking 700 to 1,000 IU of vitamin D per day lowered the risk of falls by 19 percent, but taking 200 to 600 IU per day did not offer any such protection. (17)

A recent vitamin D trial drew headlines for its unexpected finding that a very high dose of vitamin D increased fracture and fall risk in older women. (18) The trial’s vitamin D dose—500,000 IU taken in a once-a-year pill—was much higher than previously tested in an annual regimen. After up to 5 years of treatment, women in the vitamin D group had a 15 percent higher fall risk and a 26 percent higher fracture risk than women who received the placebo.

It’s possible that giving the vitamin D in one large dose, rather than in several doses spread throughout the year, led to the increased risk. (18) The study authors note that only one other study—also a high-dose, once-a-year regimen—found vitamin D to increase fracture risk; no other studies have found vitamin D to increase the risk of falls. Furthermore, there’s strong evidence that more moderate doses of vitamin D taken daily or weekly protect against fractures and falls—and are safe.

So what is the significance of this study for people who want to take vitamin D supplements? A reasonable conclusion would be to continue taking moderate doses of vitamin D regularly, since these have a strong safety record, but to avoid extremely high single doses. This recent finding does present a challenge to scientists who will work to understand why the extreme single dose appears to have adverse effects.

Vitamin D and Heart Disease

The heart is basically a large muscle, and like skeletal muscle, it has receptors for vitamin D. (19) So perhaps it’s no surprise that studies are finding vitamin D deficiency may be linked to heart disease. The Health Professional Follow-Up Study checked the vitamin D blood levels in nearly 50,000 men who were healthy, and then followed them for 10 years. (20) They found that men who were deficient in vitamin D were twice as likely to have a heart attack as men who had adequate levels of vitamin D. Other studies have found that low vitamin D levels were associated with higher risk of heart failure, sudden cardiac death, stroke, overall cardiovascular disease, and cardiovascular death. (21-24) How exactly might vitamin D help prevent heart disease? There’s evidence that vitamin D plays a role in controlling blood pressure and preventing artery damage, and this may explain these findings. (25) Still, more research is needed before we can be confident of these benefits.

Vitamin D and Cancer

Nearly 30 years ago, researchers noticed an intriguing relationship between colon cancer deaths and geographic location: People who lived at higher latitudes, such as in the northern U.S., had higher rates of death from colon cancer than people who live closer to the equator. (26) Many scientific hypotheses about vitamin D and disease stem from studies that have compared solar radiation and disease rates in different countries. These can be a good starting point for other research but don’t provide the most definitive information. The sun’s UVB rays are weaker at higher latitudes, and in turn, people’s vitamin D levels in these high latitude locales tend to be lower. This led to the hypothesis that low vitamin D levels might somehow increase colon cancer risk. (2)

Since then, dozens of studies suggest an association between low vitamin D levels and increased risks of colon and other cancers. (1,27)  The evidence is strongest for colorectal cancer, with most (but not all) observational studies finding that the lower the vitamin D levels, the higher the risk of these diseases. (28-38) Vitamin D levels may also predict cancer survival, but evidence for this is still limited. (27) Yet finding such associations does not necessarily mean that taking vitamin D supplements will lower cancer risk.

The VITAL trial will look specifically at whether vitamin D supplements lower cancer risk. It will be years, though, before it releases any results. It could also fail to detect a real benefit of vitamin D, for several reasons: If people in the placebo group decide on their own to take vitamin D supplements, that could minimize any differences between the placebo group and the supplement group; the study may not follow participants for a long enough time to show a cancer prevention benefit; or study participants may be starting supplements too late in life to lower their cancer risk. In the meantime, based on the evidence to date, 16 scientists have circulated a “call for action” on vitamin D and cancer prevention: (27) Given the high rates of vitamin D deficiency in North America, the strong evidence for reduction of osteoporosis and fractures, the potential cancer-fighting benefits of vitamin D, and the low risk of vitamin D supplementation, they recommend widespread vitamin D supplementation of 2000 IU per day. (27)

Vitamin D and Immune Function

Vitamin D’s role in regulating the immune system has led scientists to explore two parallel research paths: Does vitamin D deficiency contribute to the development of multiple sclerosis, type 1 diabetes, and other so-called “autoimmune” diseases, where the body’s immune system attacks its own organs and tissues? And could vitamin D supplements help boost our body’s defenses to fight infectious disease, such as tuberculosis and seasonal flu? This is a hot research area and more findings will be emerging.

Vitamin D and Multiple Sclerosis: Multiple sclerosis (MS) rates are much higher far north (or far south) of the equator than in sunnier climes, and researchers suspect that chronic vitamin D deficiencies may be one reason why. One prospective study to look at this question found that among white men and women, those with the highest vitamin D blood levels had a 62 percent lower risk of developing MS than those with the lowest vitamin D levels. (39) The study didn’t find this effect among black men and women, most likely because there were fewer black study participants and most of them had low vitamin D levels, making it harder to find any link between vitamin D and MS if one exists.

Vitamin D and Type 1 Diabetes: Type 1 diabetes is another disease that varies with geography—a child in Finland is about 400 times more likely to develop it than a child in Venezuela. (40) Evidence that vitamin D may play a role in preventing type 1 diabetes comes from a 30-year study that followed more than 10,000 Finnish children from birth: Children who regularly received vitamin D supplements during infancy had a nearly 90 percent lower risk of developing type 1 diabetes than those who did not receive supplements. (41)  Other European case-control studies, when analyzed together, also suggest that vitamin D may help protect against type 1 diabetes. (42) No randomized controlled trials have tested this notion, and it is not clear that they would be possible to conduct.

Vitamin D, the Flu, and the Common Cold: The flu virus wreaks the most havoc in the winter, abating in the summer months. This seasonality led a British doctor to hypothesize that a sunlight-related “seasonal stimulus” triggered influenza outbreaks. (43) More than 20 years after this initial hypothesis, several scientists published a paper suggesting that vitamin D may be the seasonal stimulus. (44) Among the evidence they cite:

• Vitamin D levels are lowest in the winter months. (44) 
• The active form of vitamin D tempers the damaging inflammatory response of some white blood cells, while it also boosts immune cells’ production of microbe-fighting proteins. (44) 
• Children who have vitamin D-deficiency rickets are more likely to get respiratory infections, while children exposed to sunlight seem to have fewer respiratory infections. (44) 
• Adults who have low vitamin D levels are more likely to report having had a recent cough, cold, or upper respiratory tract infection. (45)

A recent randomized controlled trial in Japanese school children tested whether taking daily vitamin D supplements would prevent seasonal flu. (46) The trial followed nearly 340 children for four months during the height of the winter flu season. Half of the study participants received pills that contained 1,200 IU of vitamin D; the other half received placebo pills. Researchers found that type A influenza rates in the vitamin D group were about 40 percent lower than in the placebo group; there was no significant difference in type B influenza rates. This was a small but promising study, and more research is needed before we can definitively say that vitamin D protects against the flu. But don’t skip your flu shot, even if vitamin D has some benefit.

Vitamin D and Tuberculosis: Before the advent of antibiotics, sunlight and sun lamps were part of the standard treatment for tuberculosis (TB). (47) More recent research suggests that the “sunshine vitamin” may be linked to TB risk. Several case-control studies, when analyzed together, suggest that people diagnosed with tuberculosis have lower vitamin D levels than healthy people of similar age and other characteristics. (48)   Such studies do not follow individuals over time, so they cannot tell us whether vitamin D deficiency led to the increased TB risk or whether taking vitamin D supplements would prevent TB. There are also genetic differences in the receptor that binds vitamin D, and these differences may influence TB risk. (49) Again, more research is needed. (49)

Vitamin D and Risk of Premature Death

A promising report in the Archives of Internal Medicine suggests that taking vitamin D supplements may even reduce overall mortality rates: A combined analysis of multiple studies found that taking modest levels of vitamin D supplements was associated with a statistically significant 7 percent reduction in mortality from any cause. (50) The analysis looked at the findings from 18 randomized controlled trials that enrolled a total of nearly 60,000 study participants; most of the study participants took between 400 and 800 IU of vitamin D per day for an average of five years. Keep in mind that this analysis has several limitations, chief among them the fact that the studies it included were not designed to explore mortality in general, or explore specific causes of death. More research is needed before any broad claims can be made about vitamin D and mortality. (51)

Preparation Time: 10 minutes

Cooking Time: 3 minutes

Serves: 4

This recipe is to make really healthy protein pancakes. The ingredients provided will make about 4 pancakes but you can make them how big or small you want.

Ingredients

• 1/2 cup - Rolled Oats
• 1/2 cup - Cottage Cheese (full of calcium caseinate)
• 1/2 cup - Egg Whites
• 1/4 tsp - Baking Powder
• 1/4 tsp - Cinnamon
• 1/4 cup - frozen or fresh raspberries (or other fruit)
• 1/2 cup - Whey Protein

Steps

• Mix all the ingredients, except raspberries, in a food processor and blend until nice and smooth. Remove the blades and delicately fold in the raspberries. Coat a non-stick pan with a little cooking oil if you want and heat it over medium heat. When the pan is hot enough, cook your pancakes one at a time until set and golden, about 1-2 minutes per side. I like to divide my batter into 3 small pancakes, but you may choose to make one large, 2 medium or 3 small pancakes, whatever works for you.

The following tips may lower your chance of getting kidney stones:

• The most important thing you can do is drink more fluids, especially water if your doctor says it is okay. Try to drink 8 to 10 glasses of water a day. If you don't already drink that much, slowly increase how much you drink. For example, add one more glass of water each day until you are drinking 8 to 10 glasses a day. This slow increase will give your body time to adjust to the extra fluids. You are drinking enough water when your urine is clear or light yellow. If it is dark yellow, you are not drinking enough fluids.
• If you had a calcium kidney stone, it may help to:
  • Eat less salt and salty foods. One way to do this is to avoid processed foods and limit how often you eat at restaurants.
  • Talk to your doctor or dietitian about how much calcium you need every day. Try to get your calcium from food, rather than from supplements. Milk, cheese, and yogurt are all good sources of calcium.
• If you had an oxalate kidney stone, your doctor may ask you to limit certain foods that have a lot of oxalate, such as dark green vegetables, nuts, and chocolate. You don't have to give up these foods, just eat or drink less of them.

If you have had kidney stones in the past, it may also help to:

• Eat a balanced diet that is not too high in animal protein. This includes beef, chicken, pork, fish, and eggs. These foods contain a lot of protein, and too much protein may lead to kidney stones. You don't have to give up these foods. Talk to your doctor or dietitian about how much protein you need and the best way to get it.
• Increase how much fiber you eat. Fiber includes oat bran, beans, whole wheat breads, wheat cereals, cabbage, and carrots.
• Avoid grapefruit juice.
• Drink lemonade made from real lemons (not lemon flavoring). It is high in citrate, which may help prevent kidney stones.
• Talk to your doctor if you take vitamins or supplements. He or she may want you to limit how much fish liver oil or calcium supplements you take. Also, do not take more than the recommended daily dose of vitamins C and D.

More Heart-Healthy Advice

Boston, MA – Men who do weight training regularly—for example, for 30 minutes per day, five days per week—may be able to reduce their risk of type 2 diabetes by up to 34%, according to a new study by Harvard School of Public Health (HSPH) and University of Southern Denmark researchers. And if they combine weight training and aerobic exercise, such as brisk walking or running, they may be able to reduce their risk even further—up to 59%.

This is the first study to examine the role of weight training in the prevention of type 2 diabetes. The results suggest that, because weight training appears to confer significant benefits independent of aerobic exercise, it can be a valuable alternative for people who have difficulty with the latter.  

The study will be published online in Archives of Internal Medicine on August 6, 2012. 

“Until now, previous studies have reported that aerobic exercise is of major importance for type 2 diabetes prevention,” said lead author Anders Grøntved, visiting researcher in the Department of Nutrition at HSPH and a doctoral student in exercise epidemiology at the University of Southern Denmark. “But many people have difficulty engaging in or adhering to aerobic exercise. These new results suggest that weight training, to a large extent, can serve as an alternative to aerobic exercise for type 2 diabetes prevention.” 

Type 2 diabetes is a major public health concern and it’s on the rise. An estimated 346 million people worldwide have type 2 diabetes, and diabetes-related deaths are expected to double between 2005 and 2030, according to the World Health Organization. More than 80% of these deaths occur in low- and middle-income countries. 

The researchers, including senior author Frank Hu, professor of nutrition and epidemiology at HSPH, followed 32,002 men from the Health Professionals Follow-up Study from 1990 to 2008. Information on how much time the men spent each week on weight training and aerobic exercise came from questionnaires they filled out every two years. The researchers adjusted for other types of physical activity, television viewing, alcohol and coffee intake, smoking, ethnicity, family history of diabetes, and a number of dietary factors. During the study period, there were 2,278 new cases of diabetes among the men followed. 

The findings showed that even a modest amount of weight training may help reduce type 2 diabetes risk. The researchers categorized the men according to how much weight training they did per week—between 1 and 59 minutes, between 60 and 149 minutes, and at least 150 minutes—and found that the training reduced their type 2 diabetes risk by 12%, 25%, and 34%, respectively, compared with no weight training. Aerobic exercise is associated with significant benefits as well, the researchers found—it reduced the risk of type 2 diabetes by 7%, 31%, and 52%, respectively, for the three categories above. 

The researchers also found that the combination of weight training and aerobic exercise confers the greatest benefits: Men who did more than 150 minutes of aerobics as well as at least 150 minutes of weight training per week had a 59% reduced risk of type 2 diabetes. 

Grøntved said that further research is needed to confirm the results of the study as well as to analyze whether or not the findings can be generalized to women. 

“This study provides clear evidence that weight training has beneficial effects on diabetes risk over and above aerobic exercise, which are likely to be mediated through increased muscle mass and improved insulin sensitivity,” said Hu. “To achieve the best results for diabetes prevention, resistance training can be incorporated with aerobic exercise.” 

Other HSPH authors included Eric Rimm, associate professor in the Departments of Epidemiology and Nutrition, and Walter Willett, Frederick John Stare Professor of Epidemiology and Nutrition and chair of the Department of Nutrition. 

Support for the study was provided by the National Institutes of Health (DK58845 and CA55075). 

“A Prospective Study of Weight Training and Risk of Type 2 Diabetes Mellitus in Men,” Anders Grøntved, Eric B. Rimm, Walter C. Willett, Lars B. Andersen, Frank B. Hu, Archives of Internal Medicine, online August 6, 2012.

Sports massage is a form of massage therapy that is tailored to treat the needs of athletes. The use and application of specific techniques is the foundation of sports massage, yet what distinguishes it from other modalities is the intention behind the therapy. Many of us might think of massage as relaxing and holistic. Sports massage, in contrast, is designed to achieve specific goals, such as increasing performance or treating or preventing injury. The purpose of a sports massage session can vary, depending upon numerous factors that are unique to each athlete. For instance, sports massage can be used effectively to treat conditions such as tendonitis, strains, sprains, and adhesions. It can also be used in conjunction with training schedules and conditioning programs to enhance performance, aid in recovery and reduce the potential for injuries.

The major applications of sports massage are recovery, remedial (to improve a debilitating condition), maintenance, and event (pre, inter, and post). An athlete can enhance his or her performance by knowing when to incorporate sports massage into a training routine. Healthy, injury-free muscles perform better, longer, and with less chance of injury.

Sports massage can help to optimize the positive factors that affect performance, such as healthy muscle and connective tissues, normal range of motion, high energy and fluid and pain-free movement, as well as inducing mental calm and improving alertness, and concentration. It also can help minimize negative factors such as dysfunctional muscle and connective tissue, restricted range of motion, low energy, staleness, pain, and high anxiety^(1a).

Sports massage decreases injury potential by helping to prevent acute injuries (muscle tears) as well as chronic injuries stemming from wear and tear (tendonitis). Regular massage allows the muscles and soft tissue to stay supple and healthy, lengthened and flexible and free from adhesions, thereby reducing the potential for injury. By increasing circulation and assisting the body’s healing processes and breaking down scar tissue and adhesions, sports massage can help chronic injuries get better.

Important Primary and Secondary Effects of Sports Massage^(1b)

Primary effects refer to the physiological and psychological condition of the athlete and include:

• Improved fluid circulation (blood, lymph),
• Muscular relaxation,
• General relaxation,
• Functional separation of muscle and connective tissue (i.e., breaking up adhesions),
• Connective tissue normalization (releasing areas of tension, etc.),
• Increased mental alertness and clarity, and
• Deactivation of trigger points. (A trigger point is a nodule of tight muscle tissue that can refer pain locally or to other areas of the body.)

Secondary effects refer to performance-related outcomes and include:

• Greater energy,
• Greater flexibility and range of motion,
• More fluid movement (i.e., referring to the quality of the range of motion),
• Faster recovery, and
• Pain reduction.

If you decide that sports massage is the right treatment for you, it is important to find a well-trained therapist. Check out if a practitioner has had training in sports massage from an accredited school. Currently, there is no national credentialing that signifies a person who has passed a test demonstrating a solid understanding of the foundations and techniques of sports massage, so you will have to ask a few questions. How many hours of training (in general) did they have? Was their school accredited by the American Massage Therapy Association? How many hours of training in sports massage did they receive? What kind of athletes have they worked with? Were the athletes training or competing at the time? Is your therapist an athlete (on any level)?

Many sports massage practitioners participate in races or competitive events, which increases their understanding not only of the uses and benefits of sports massage, but of other factors that go into being an athlete. For example, the length of time between the massage session and the athletic event directly relates to the depth of pressure a therapist should use. A knowledgeable therapist will know that a pre-event massage, which is meant to encourage general looseness, calls for less deep work than a regular “maintenance” massage. It is important that your therapist always errs on the side of caution when using deep pressure, and that they have an understanding of the psychology of an athlete and the physical demands of training.

One of the benefits of working regularly with the same sports massage therapist is that he or she can learn to feel what is “normal” for your tissue and body type and can keep a watchful eye on any changes that may signal the need to head off potential trouble spots. If an injury does occur, the therapist can join the team of health care practitioners helping you to recover. Here, the focus is on healing the injury quickly and effectively, minimizing the side effects of the injury and decreasing the chance of re-occurrence.

The use of sports massage in training routines varies depending on the athlete, the sport being trained for and the level of competition. It is important to mention that every athlete and every situation is going to be different, and that each person should research and find a plan that is most suitable for them. With that in mind, let’s take a look at how two different athletes used sports massage in conjunction with their training.

When Uta was competing in 5K to 10K races, or preparing for a marathon, she received sports massage twice a week. Usually, she scheduled her massages the day after one of her harder training sessions for the week. If that wasn’t possible, she would allow herself a treatment session on the same day as her hard workout, but she would wait at least 3 to 4 hours to let her body recover some from the training before addressing soft tissue needs. Getting regular massage during her intense training periods also helped Uta psychologically, by allowing her to give back to her body and take some time for herself.

Training for my first triathlon, I used sports massage regularly. I noticed that I could identify potential problems and head them off before they became an impediment in my training. I also felt, during the most intense training periods, that taking the time to give back to my body really helped me to feel like I was rounding out my training program. Having time to recover, making the effort to work my muscles and being in tune with my body, all played integral roles in my ability to train as hard as I did, without hurting myself.

Getting regular massages during training is a great way to generate feedback for yourself about how you are doing. The more feedback you can gather about performance and training, and how your body is responding to it all, the better informed you will be about how you can compete and recover from competition. Sports massage, therefore, can be a great tool for athletes in their training. It provides myriad benefits, including increasing performance potential, speeding recovery time, and reducing the prevalence of injuries. And let’s not forget the wonderful relaxation, stress relief, and whole body integration that everyone—not just the athlete—can obtain from massage!

Every child needs to learn the ABC’s of life. When it comes to establishing healthy habits, you can teach them how to “ABCDE” (Act Boldly to Change Diet and Exercise).

Why is this important?

• Good nutrition and plenty of exercise are the building blocks for strong growth, healthy development, and lifelong wellbeing for children.

• These days, too many children are not receiving the proper nutrition or enough exercise:

  • - They are not eating enough - an estimated 16 to 17 million children live in homes where they are at risk of going hungry (approx. 1 in 6 households).

  • - They are not eating enough healthy food – an estimated 1 in 3 children are overweight and about 1 in 6 (ages 6-17) are obese.

  • - They are not getting enough exercise – only 30% of children (aged 6 to 17) participated in 20 minutes plus of vigorous physical activity on a daily basis. Children need to get 60 minutes of exercise on a daily basis.

What are the benefits of good nutrition and daily exercise for kids?

Mental and behavioral benefits

• Good nutrition is essential to healthy brain development in children which is, of course, critical to learning.

• Children who exercise regularly and eat healthily are likely to:

  • - perform better academically 

  • - feel better about themselves, their bodies, and their abilities

  • - cope with stress and regulate their emotions better

  • - avoid feelings of low self-esteem, anxiety, and depression.

• Establishing healthy eating and exercise habits early in life can lead to long term healthy behavior in adulthood.

Physical benefits

• Children need a wide variety of nutrients (e.g., protein, complex carbohydrates, healthy fats, minerals, vitamins) to assist in their daily growth and development and to protect them from childhood illnesses.

• Daily exercise also helps children to build stronger muscles and bones and limit excess body fat.

• Healthy eating also cuts down on risk for cavities, eating disorders and unhealthy weight control behaviors (i.e., fasting, skipping meals, eating very little food, vomiting, using diet pills, laxatives, or diuretics), malnutrition, and iron deficiency.

• Healthy eating and consistent physical activity help to prevent chronic illnesses that appear in adulthood associated with obesity, e.g., heart disease, diabetes, high blood pressure, and several forms of cancer.

What are the effects of different settings on the eating and exercise habits of kids?

In the home:

• Lack of access to healthy, wholesome foods and inadequate physical activity - contributes to kids becoming overweight and not getting adequate nutrition for their growth and development. Children need at least 60 minutes of daily physical activity in the form of physical play or sports.

• Hunger – kids who do not get enough to eat are at risk of developing chronic health conditions, behavioral problems, academic struggles, anxiety, depression, and even obesity especially if they only have access to poor quality processed food.

• Unhealthy weight control behaviors - have been found to co-occur with obesity. Many adolescents, particularly teenage girls, have body image concerns and engage in these behaviors threatening both their physical and mental health. 

• Media effects –

  • - Food advertising - targeted at children is dominated by commercials for unhealthy food (e.g., candy, sugary cereals, sugary beverages, processed snack foods, fast food restaurants). Food advertising is pervasive and can be found on multiple media platforms (TV, web, and even embedded in computer games).

  • - Advertising by other industries - often objectifies girls and women, contributing to body dissatisfaction, eating disorders, low self-esteem, and depression.

  • - TV watching – television viewing is linked to childhood obesity because it displaces physical activity, increases snacking behavior while watching, exposes kids to potentially harmful advertising, and reduces their resting metabolism.

At school:

• Risks to academic achievement - result from children not getting adequate nutrition and physical activity. Hunger can be particularly damaging to children’s progress in school and cognitive development overall.

• Overabundance of unhealthy foods - too many schools offer poor nutritional choices in the form of unhealthy school lunches or even vending machines filled with candy, processed snacks, and sugary beverages.

• Lack of opportunities for physical activity - many schools have scaled back requirements for a daily recess and do not prioritize physical education opportunities for children at every age.

• Peer behaviors – peers can serve as remarkably powerful role models for children and may share their unhealthy eating or exercise habits with them.

• Stigma of being overweight – can lead to social and psychological distress (e.g., depression, low self esteem). Bullying and teasing from peers can be particularly damaging and teachers and school staff may attribute less desirable personality characteristics to obese youth and their families.

In the neighborhood:

• Overabundance of unhealthy foods – there are a growing number of communities called “food deserts” where supermarkets and grocery stores are scarce or charge higher prices for healthy foods than processed foods. In addition, many underserved communities are populated with fast food restaurants that are often located near schools and playgrounds.

• The built environment – lack of adequate and safe parks, bike lanes, playgrounds, recreational facilities, or walkways can restrict opportunities for children and teens to get exercise.

Why are you critical to establishing healthy behaviors in your kids?

• You are role models

  • - Children are instinctively primed to imitate their parents and caregivers. They are incredibly sensitive to the messages that are sent about eating and exercise. You exert the most influence on your children’s behavior and can model healthy attitudes and habits toward food and physical activity that persist as they grow up.

• You are gatekeepers

  • - Parents and caregivers control the types of food children have access to in the home and can maximize access to healthy, wholesome foods (fruits, vegetables, lean proteins, whole grains, and low-fat dairy).

  • - You can also monitor children’s diet, exercise, and limit media consumption (TV/video watching, web surfing, and videogames).

•  You are taste-setters

  • - Parents and caregivers significantly influence the likes and dislikes that children attach to certain foods. These influences can last a lifetime. Each of us can probably remember a favorite home cooked meal from our childhood. There is even research that suggests that this begins in infancy; children who are breastfed may be exposed to different flavors in their mother’s breast milk than the sugars and fats in infant formula. Breastfeeding may provide protection from the development of obesity.

  • - Eating with your children at regular family mealtimes can help establish positive nutrition habits and healthy weights for children.
    

• You are advocates

  • - Parents and caregivers can push local leaders to introduce affordable transportation (e.g., bus or shuttle lines) to supermarkets or grocery stores if there are none in their communities.

  • - You can call for the construction of parks or playgrounds and restriction of fast food places in your neighborhood.

  • - You can push school administrators to introduce after-school programs that incorporate physical activity or nutrition education, healthier school lunches, and policies that eliminate the use of vending machines on school grounds.

  • - You along with members of your community can volunteer to coach afterschool sports.

This Indonesian dish packs a massive flavour punch and is quick and easy to make.

Ingredients

• For the spice paste

• 5 shallots, roughly chopped
• 3cm/1¼in galangal, roughly chopped
• 3 stalks lemongrass, roughly chopped
• 5 cloves garlic, roughly chopped
• 3cm/1¼in ginger, roughly chopped
• 5 dried chillies, soaked in warm water, seeds removed and roughly chopped
• For the salmon
• 5 tbsp vegetable oil
• 1kg/2lb 4oz salmon fillet, cut into cubes
• 2 cinnamon stick
• 3 cloves
• 3 star anise
• 3 cardamom pods
• 1 stalk lemongrass, roughly chopped
• 400ml/14fl oz coconut milk
• 2 tsp tamarind paste
• 6 kaffir lime leaves
• 6 tbsp desiccated coconut, toasted
• 2 tbsp soy sauce
• 2 tbsp fish sauce
• 2 limes, juice only
• sea salt and freshly ground black pepper
• For the mint salad
• 2 tbsp rice wine vinegar
• 3 tbsp toasted sesame oil
• 3 tbsp mint leaves
• 3 tbsp coriander leaves
• ½ cucumber, finely shredded
• 250g/9oz white cabbage, finely shredded
• 1 red chilli, finely shredded

Steps

• 1 For the spice paste, place all the ingredients into a food processor and pulse to form a paste. Transfer the paste to a small bowl and set aside.
• 2 For the salmon, heat a heavy-based pan over a medium heat, add half the oil then brown the salmon on all sides, remove from the pan and set aside.
• 3 Add the remaining oil to the pan and fry the spice paste for 2-3 minutes. Add the cinnamon, cloves, star anise, cardamom and lemongrass and cook for another couple of minutes.
• 4 Return the salmon to the pan, mix well then add the coconut milk, 200ml/7fl oz water, tamarind paste and lime leaves and bring to a simmer.
• 5 Add the toasted coconut, soy and fish sauces and return to the boil, stirring all the time to make sure it doesn’t stick.
• 6 Turn down to a gentle simmer and cook for 2-3 minutes. Add the lime juice and season with sea salt and freshly ground black pepper.
• 7 For the salad, whisk the rice wine vinegar and sesame oil together in a bowl then add the remaining ingredients and toss to combine.
• 8 To serve, spoon the curry onto the plate and pile the salad alongside.

• 4 servings