06/06

ask-the-doctorPlantar fasciitis is a common cause of foot and heel pain. Typically this pain is located on the bottom of the foot just in front of the heel pad on the inner or middle side of the foot. The plantar fascia is a thick tendon that connects the heel bones to the toes. This tendon serves as a shock absorber for the foot and helps in supporting the arch of the foot. Overuse or excessive stress on this tendon can cause small tears that lead to inflammation and significant pain.
 
Some common risk factors for plantar fasciitis include:
-Obesity
-Poor foot mechanics
-Improper shoe wear
-Long distance running
-Jumping exercises
-Prolonged standing
 
In MAX we have a fair amount of jumping or plyometric exercises that are very good for cardiac conditioning and development of muscle power. Generally speaking the heart muscle gets conditioned faster then skeletal muscle. Therefore, your skeletal muscles will fatigue more quickly and your form will break down before you get “exhausted” due to deconditioning from the heart.
 
There are muscles on both sides of the foot and leg that help to support the foot and ankle. The peroneus longus and peroneus brevis insert on the outermost or 5th metatarsal (mid bones of the foot) and the tibialis anterior inserts on the inner or 1st metatarsal bone. When these muscles are strong and conditioned, they help with stabilizing lateral (side-to-side) foot motion and control the rate of movement in the foot during jumping exercises. If however, these muscles fatigue quickly or are not yet strong, the foot and ankle has more mobility and collapse in the arch, which in turn can put more strain on the plantar fascia.
 
This is one of the reasons that plantar fasciitis typically develops in an exerciser after several weeks or months of exercise. It generally occurs when the aerobic or cardiac conditioning out paces the skeletal muscle conditioning. In other words, your heart endurance allows you to jump or run for longer periods of time, but your leg muscles are not conditioned enough to control your ankle motion. If in addition to decreased muscle strength, you are carrying around extra weight, are wearing improper shoes, have poor foot mechanics or are increasing the amount of time or the intensity of your jumping, you are a set up for plantar fasciitis.
 
So what should you do?
 
It is important to know what type of foot you have and have the proper shoe wear before embarking on exercise and lifestyle changes. There are several very good running stores and even some online stores which will question you about your feet and recommend proper shoe wear. Podiatrist or Sports Medicine/Rehabilitation Medicine physicians are also useful for providing recommendations and treatment plans. It is important to note that not one type of sneaker is good for everyone. Sometimes due to foot or even hip and knee mechanics you will need an orthotic insert to place in your shoe.
 
In general, a helpful guideline for shoe wear and orthotic use is to fix what is too flexible (i.e put in arch support in a very flat foot or over-pronating foot) and to accommodate foot deformities that are fixed (i.e. relief or padding around bony deformities such as bunions). A common mistake is to over correct too much (using too rigid or too high an arch support). This can lead to other issues higher up the kinetic chain such as knee, hip or back issues.
 
Plantar Fasciitis is typically worst in the morning just after getting out of bed. Pain is usually severe with initial weight bearing and then subsides throughout the day with walking and weight-bearing. Pain can also be severe after prolonged sitting or immobility. It is often helpful to wear nighttime splints to keep the foot/Achilles tendon stretched out overnight. This will decrease the initial severe morning pain because the fascia will have more mobility and will not be able to “scar down” overnight.
 
Aside from using proper shoe wear and night time splints, occasional use of anti-inflammatory medications such as Motrin will be helpful. Adding anti-inflammatory foods such as turmeric, (curcumin), boswellia, and Omega-3 fatty acids in addition to decreasing intake of Omega-6 fatty acids may also be helpful. Icing can be helpful as well. Sometimes, despite the above interventions, you will might need a cortisone injection into the plantar fascia to decrease inflammation and pain.
 
During the acute inflammatory phase of plantar fasciitis, it is important to limit the activities such as high impact jumping and running that can aggravate the condition. Modify your exercise to limit jumping until pain resolves during activity and upon wakening. As pain decreases is it imperative to resume jumping/high-impact exercises slowly over a period of weeks to even months to prevent recurrence. As with all my recommendations, if you have persistent heel pain that is refractory it is important to seek the advice of a medical professional to make sure other modifications or treatments are indicated.
 
Disclaimer. The information provided here is not intended to substitute for medical care and should not be used for treatment or diagnosis. If you have, or suspect you have a problem concerning your health please consult with a licensed healthcare professional.
Article written by Dr. Jessica Miller

05/31

ask-the-doctor

Fatty acids have many important uses in our bodies. Fatty acids come in different shapes and sizes, and are named based on their size and chemical structure. Omega-3 fatty acids are a specific class of fatty acids that are utilized by our bodies and are used as the precursors for anti-inflammatory compounds.

Essential Fatty Acids are those that cannot be made by our bodies and must be consumed as part of our diet. The name Omega -3 Fatty acid describes a class of different length fatty acids which all contain a similar chemical structure.

The most well-known Omega 3 fatty acids are ALA (alpha linolenic acid), EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid).

ALA is found in
Flaxseed
English walnuts
Brussel sprouts
Salmon
Sardines
Chia
Hemp
Tofu
Spinach
Other plant foods

The body in theory has the ability to convert ALA into DHA and EPA. However, this pathway is influenced by dietary intake and does not work optimally in all people. Therefore, it is often helpful to consume foods with DHA and EPA in case the body is unable to make these compounds in the needed amounts. There are multiple studies that have shown the health benefits of DHA and EPA and I will describe these in more detail later in this article.

EPA and DHA are more difficult to obtain with a strict vegetarian diet. Sea plants and certain fermented foods do contain small amounts of DHA, but DHA is not found in land based plants. DHA makes up about 20% of the brain by weight, and is found in most fish, eggs, and milk and cheeses obtained from grass fed animals. EPA is found in most fish, especially salmon and sardines. The amount of EPA and DHA in fish is dependent on their diet. Farmed fish are sometimes supplemented with processed Omega-3 fatty acids to increase the concentration found in these fish.

Multiple studies have demonstrated the beneficial effects of Omega-3 fatty acids, specifically EPA and DHA, for our general health and well-being. Below is a summary of my review of the literature, and the findings in various studies:

– Fish oils lower blood sugar and decrease liver fat stores
– Increasing DHA and EPA decreases the incidence of metabolic syndrome by 20%
– EPA and DHA supplementation helps to lower blood pressure (at approx. 1gm/day)
– In obese patients, insulin sensitivity is improved with supplementation of EPA and DHA (at approx. 1 gm/day)
– Higher levels of EPA consumption lower risk of CHF (congestive heart failure) and increase survival in patients with heart failure by 35% – thought to be because of the effect on the heart muscle pumping ability
– Omega-3 fatty acids improve exercise-induced asthma and increase pulmonary function 5-fold based on pulmonary function tests
– Fish oils help to slow neuro-inflammation and may slow progression of neuro-degenerative disorders (eg. Alzheimers, Parkinson’s)
– Mild cognitive dementia improves with supplementation of 900mg of DHA
– Omega-3 Fatty acids may slow or reverse nerve damage from diabetes

So what should you do? All fish oils are not created equally. Fish oil in its natural state obtained directly from the diet is probably best, but it is difficult to eat the amount needed by our bodies. The next best option is supplementing our diet with at least 2.5 grams/day of EPA and DHA in the form of a pharmaceutical grade, highly refined Omega-3 fatty acid supplement (if ok with your doctor). Unrefined fish oils can have many contaminants such as PCBs and Mercury. Most fish oils sold over the counter have a very low concentration of EPA and DHA and contain “other Omega-3 fatty acids” which require our bodies to convert them into an active form. As was stated earlier, ALA intake is important, but this needs to be converted into DHA and EPA in order to be effectively utilized in the anti-inflammatory pathway.

One final note is that while Omega-3 fatty acids such as ALA, EPA, and DHA are the precursors of anti-inflammatory mediators in our body, Omega-6 fatty acids such as AA (arachidonic acid) are the precursors of the pro-inflammatory mediators in our body. Omega-6 fatty acids are found in many cooking oils such as corn, palm, sunflower, safflower and soybean oil. The western diet is very high in omega-6 fatty acids and relatively low in omega-3 fatty acids. By increasing the amount of omega-3 fatty acid consumption and decreasing omega-6 fatty acid consumption, the inflammatory state of the body is improved. This is thought to have a beneficial effect of chronic inflammatory disease states such as arthritis.

Disclaimer. The information provided here is not intended to substitute for medical care and should not be used for treatment or diagnosis. If you have, or suspect you have a problem concerning your health please consult with a licensed healthcare professional.

05/23

 

ask-the-doctor

Now that you are eating a cleaner more nutritious diet, you should be feeling the beneficial effects of your efforts. In theory, if you are eating a variety of fresh fruits, vegetables and meats, you should be able to get the majority of your nutrients from your diet. The problem is that many fruits and vegetables are grown in over-farmed soil devoid of vital nutrients.

In addition, the way food is cooked can denature or destroy nutrients found in food. For example a study published in 2009 in the Journal of Zhehiang University Science, was done which examined the effects of steaming, microwaving, boiling, stir-frying and stir-frying follow by boiling on broccoli in China. The study found that all types of cooking except steaming resulted in “significant losses of chlorophyll and vitamin C and significant decreases in total soluble proteins and soluble sugars”. The study goes on to say that “indole glucosinolate were significantly modified by all cooking treatments but not steaming”. Indole glucosinolates are sulfur-containing compounds that have been associated with a possible decrease in lung cancer and colorectal cancers.

Lilli Link and John Potter from the Mailman School of Public Health in Columbia University reviewed 9 years of medical studies and published an article in 2004. They found that consumption of vegetables (raw or cooked) was associated with a lower cancer risk, however 9 of the 11 studies reviewed showed an even lower risk with raw vegetables as opposed to cooked vegetables. They suggested that “cooking changes the availability of nutrients, destroying digestive enzymes and changes the structure and digestibility of food“. So it appears that consumption of vegetables in general is beneficial but consumption of raw vegetables may be even more beneficial to your overall health. That being said, make sure that you carefully wash and clean vegetables, because raw vegetables often contain bacteria which can be harmful. Furthermore, it is important to do your best to remove as much pesticides as possible from the surface of the vegetables.

Amino acids provide the building blocks for protein production in your body. Amino acids are divided up into three groups, Dispensable (our bodies can make these under almost all circumstances), Indispensible or Essential (can never be made by our body and must be consumed through diet or supplements) and Conditionally Indispensible (can be made by our body under many circumstances but not always).

Consuming foods such as fish, eggs, sea vegetables, salmon, brussel sprouts, broccoli, garilic onion, chicken legumes, dairy (occasionally) and soy will help to provide you indispensable amino acids. It appears that you do not need to eat these foods at every meal, but it is important to eat them over a period of several days to help maintain your body’s amino acid stores.

There are many nutrients which are helpful to add into your diet, possibly via supplements, such as Vitamin D3, Calcium, Magnesium, Omega-3 Fatty Acids and Glutamine. In the following weeks articles, I will be addressing the importance of each of these supplements as valuable additions to our diet.

To summarize the above information, adding well cleaned, raw vegetables and fruits to your diet, and adding high quality proteins such as eggs, chicken, legumes and fish will increase the nutritional density in your diet and provide your body with important building blocks to function optimally.

Disclaimer. The information provided here is not intended to substitute for medical care and should not be used for treatment or diagnosis. If you have, or suspect you have a problem concerning your health please consult with a licensed healthcare professional.

05/20

Maryanne B:A

 

 

 

 

 

 

 

 

“THE MAX changed my life!!! 3 kids and I never thought I would get my old self back…..however I’m back and better than ever!!!”

THE MAX Challenge combines the best in fitness classes, nutrition counseling and motivation to help you make a fast and lasting change to your health, appearance and fitness level in just 10 weeks. Enrolling in THE MAX is like having a personal trainer, nutritionist and a personal coach. For franchise information contact Rubin Mendelson Rubin@THEMAXFranchising.com

Protein Pops

 

 

 

 

 

 

 

 

 

PREP TIME

5 mins

These make-ahead protein pops are an easy, filling, tasty post-workout snack.

Yield: 6

Serving Size: 1

Protein in 1:  1/6

Fruit in 1:  1/6 (if not using additional freeze dried fruit)

 INGREDIENTS

  • Protein Pops
  • 1 banana
  • 2 cups coconut milk (I like cashew)
  • 3 scoop of MAX Chocolate Protein powder
  • ⅓ cup cocoa powder
  • Toppings
  • Unsweetened chocolate
  • Freeze-dried fruit

Directions

Purée the pops ingredients in a blender for a minute or so until smooth. Pour into popsicle molds and freeze for a minimum of two hours.

Extract the pops and garnish with the suggested toppings, invent your own combos, or enjoy as is.

05/19

THE MAX Challenge of Toms River opened its doors on April 14th 2014 and never looked back! James and Jeanine Frederick along with Charlie and Janice Kehr fell in love with the program as members in 2012 and decided to become franchisees.

When asked what they love most about being Franchise owners, they replied, “Seeing the members’ excitement and emotions at the end of every MAX Challenge after they’ve transformed mind, body and spirit, is the most rewarding part.”

Franchisee Jeanine Frederick said… “We have an amazing team, all sharing the same characteristics which defines THE MAX culture: passion for what we do, compassion for others, and dedication to working as a team to help our members succeed.Toms River Staff Pic copy

05/18

PB Banana Rasberry Crepes

 

 

 

 

 

 

 

 

 

 

Ingredients

* 1 1/2 scoops of MAX Vanilla Protein Powder

* 1/3 c egg whites

* Dash of all natural vanilla

* 2 Tbsp. organic peanut butter

* 1 banana sliced

* 1/4 c berries heated

* 1 packet Stevia

Directions

Place a nonstick skillet over medium high heat. In a bowl combine egg whites and MAX protein powder and whisk until protein powder is dissolved. Scoop about 1/2 of the mixture (if using an 8-inch pan) or 1/3 of the mix if using a smaller pan, into the pan and rotate pan around so the batter spreads thin. Cook until the bottom is lightly browned and flip it over to cook through.   In a saucepan over medium heat, stir together raspberries, stevia and water until the stevia is dissolved. Heat the mixture to boiling, stirring often. Reduce heat and add the vanilla.  Spread with peanut butter, sliced bananas, pour heated raspberries and juice from raspberries over top. You can also use MAX Chocolate Protein Powder

05/16

Working out with a partner is really the best thing one can ask for. It works wonders when your partner has same health and fitness goals, weight achieving target and similar aims.

Your partner knows you best so he’d help you make your workout session go safer and efficient.  Your motivation elevates on a different level altogether when you see pal working harder with complete devotion.

Partner by your side means a friend who is going to help you out with the hard training and make things easier for you. It also makes you train your body harder. It ensures commitment to unlimited fun and fitness. Most importantly it doubles your chances of achieving your goal.

What are you waiting for? Find your most like-minded partner and achieve the body you have always desired.  Join refer a friend today

ask-the-doctor
To answer this question, I have been reviewing the literature on this topic and it appears that there is not a general consensus on this subject. The answers, which are still up for debate seem to depend on the goals you are trying to achieve. It appears that not only the timing of meals, but the type of meals, and the timing of exercise plays a role on the metabolic effects.
 
In an animal study by Sasaki published in Nov 2014, his findings suggest that eating in the morning and exercising later in the afternoon or evening has a more beneficial effect with regard to body fat and weight gain. In the group that ate early and exercised later, the was less body and fat weight gained. In addition, there was an increase in skeletal muscle weight gain. So according to his findings, eat earlier in the day and exercise later for increased fat loss and increased skeletal muscle weight gain.
 
S. Bo published a study in Dec 2015 in the International Journal of Obesity that found that the same meal consumed in the evening resulted in a decreased resting metabolic rate and increased insulin response. In English, this means that you will essentially burn more Calories by eating a meal in the morning then you would by eating the same meal in the afternoon or later evening. Furthermore, multiple studies have observed that skipping breakfast is correlated with obesity, elevated BMI (body mass index) and increased waist circumference.
 
According to KJ Hackney in a study published in the journal of Medicine and Science in Sports and Exercise, consuming protein before heavy resistance training (weight training) results in an increase in resting energy expenditure (increased metabolism) as compared to consuming carbohydrates prior to heavy resistance training. Other research suggest that whey protein is beneficial because it is fast absorbing and contains branched chain amino acids, specifically leucine, which has anti-catabolic (muscle breakdown) and increased anabolic (muscle building) signaling.
 
For trained athletes who are competing in endurance (long time or long distance) exercises, the recommendation at this time is to consume low glycemic carbohydrates or complex carbohydrates such as oatmeal, heavy mixed grain breads, or most vegetables. Exercising in a fasted state compromises fuel stores and results in less than optimal performance. There is also some research to suggest that high fat or even protein intake before exercise can be beneficial as well. Therefore, again there is no definitive consensus on the type of food to consume prior to exercise.
 
In another study, published by Sasaki in 2014 in the Journal of Nutritional Science and Vitaminology, eating between 1 and 4 hours before exercise resulted in no difference in the metabolism of trained subjects. The metabolism of both carbohydrates and fat oxidation remained the same despite the timing of intake. Thus, as long as you eat between 1 and 4 hours before exercise there is no difference in the body’s ability to metabolism fat and carbohydrates afterwards.
 
Obviously, eating a very heavy meal immediately before exercise is not recommended because your body will shunt blood to your stomach and GI tract to help with digestion and this blood flow will be at the expense of your muscles. Small meals with moderate complex carbohydrates and protein, such as an almond milk smoothie, with protein powder and a little fruit, eaten at least 30 before exercise may be ideal. This allows for some digestion to occur prior to exercise and allows for fuel stores to replenish.
 
With regard to eating after exercising, the British Journal of Nutrition published a study in 2013 by NM Farah, that contradicts the above studies, and demonstrated that there may be an advantage for body fat regulation exercising before breakfast instead of after breakfast.
 
Further research suggests that eating a meal right after resistance exercise (weigh training) may increase muscle mass and decrease adipose (fat) tissues as opposed to eating a meal several hours after weight training. After your workout, your body needs to repair itself and restore the energy you just burned. For the first 2 hours after your workout, your body uses your food intake to refill your muscle energy stores. Two-hours post exercise, this ability to store energy decreases by about 50%, and then those Calories are more likely to be stored as fat.
 
As was discussed in prior articles, insulin sensitivity is very important. The more resistant you are to insulin, the more likely you will have issues such as abdominal obesity, heart disease, high blood pressure, diabetes, etc. By eating within 2 hours after exercise, there is a beneficial effect on your body’s insulin sensitivity for the next 24 hours.
 
A small meal at least 30 minutes to 1 hour prior to exercise appears to refuel your energy stores and enable more optimal performances during exercise. Eating within 2 hours of completing exercise helps to refuel your muscle glycogen stores and appears to enhance metabolism and increase insulin sensitivity for the following 24 hours. Our bodies are remarkably complex and depending on genetics, environment, and baseline level of fitness, our needs are different. As always, it is important to listen to your body and eat accordingly.
 
Disclaimer. The information provided here is not intended to substitute for medical care and should not be used for treatment or diagnosis. If you have, or suspect you have a problem concerning your health please consult with a licensed healthcare professional.

05/13

 

Coffee Protein

 

 

 

 

 

 

Yield: 1 Filled MAX Shaker cup

Serving Size: 1

Protein: 1/2

Fruit: 1

Fat: 1/2

Ingredients

* Banana

* 1 ½ scoop of MAX Chocolate Protein powder

*1/2 cup of unsweetened almond milk

*1/2 cup of brewed coffee

*1 Tbsp of Natural Peanut Butter

* 7 ice cubes

Directions

Add all ingredients to blender and blend to desired consistency.