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Dr. Gabe Mirkin's Fitness and Health e-Zine
January 6, 2013

How Endurance Exercise in Later Life May Prolong Lives

Competitive long distance skiers, ages 66 to 77, have
longer muscle telomeres and maximal ability to take in and use
oxygen (VO2max) than other active people of the same age (PLoS
One, Online December 26, 2012). Telomere length is a marker of
aging. The older you are, the shorter your telomeres. If your
telomeres are longer than those of your age group, you are
younger than your chronological age and therefore can expect
to live longer.
Many studies show that endurance exercise is associated with
* greater ability to take in and use oxygen
* living longer,
* less cancer,
* less diabetes,
* fewer heart attacks and strokes
The authors state: "Our results suggest that endurance
exercise training may . . . result in slowing of aging process by
maintaining telomere length. The positive association of VO2max
and telomere length underscores the importance of aerobic fitness
for healthy aging."
HOW TELOMERES PROTECT GENES: Genes govern your health,
physical characteristics, susceptibility to disease and how long
you live. They are located in chromosomes inside the cells in
your body. At the ends of chromosomes are small caps, called
telomeres, that protect chromosomes like the plastic tips on
shoelaces. They keep the ends of chromosomes from sticking
together and losing their ability to tell your cells what to do.
Each time a cell divides, parts of the telomeres break off.
Eventually the telomeres become so short that they cannot protect
chromosomes from sticking together. This causes aging, certain
diseases such as cancers, and eventually death.
exercise, the more oxygen you need to help convert food to fuel
your muscles. When you exercise so intensely that you have to
breathe hard and fast, you increase your needs for oxygen. It is
this markedly increased need for oxygen brought on by intense
exercise that helps to slow down the rate that telomeres shorten
with aging (Scand J Med Sci Sports. 2010;20: 39-48).
SIGNIFICANCE OF THIS STUDY: In this study and several
others, the level of fitness was associated with the length of
telomeres. Fitness is measured by VO2max, the maximal ability of
your muscles to take in and use oxygen. The higher the VO2max,
the greater the length of telomeres in the older competitive


Reports from

Chronic Vaginitis

Repairing Damaged Knee Cartilage

Hysterectomy: Leave the Ovaries


Why Obesity and Diabetes Have Become an Epidemic

The January 2, 2013 issue of the Journal of the American
Medical Association has an article with an answer for the obesity
and diabetes epidemic that has increased in North America over the
last thirty years, even while heart attack rates and deaths from
heart attacks have decreased. Dietary sugars, particularly
sugared drinks, appear to be responsible for this frightening and
life shortening epidemic.
Dietary sugar contains mostly two sugars, glucose and
fructose, either bound together as the double sugar sucrose, or
separately as individual glucose and fructose. The article shows
that glucose makes you feel full so you stop eating, but FRUCTOSE
and fatter.
THE STUDY: The authors used brain magnetic resonance
imaging to show that eating or drinking glucose, but not fructose,
reduced blood flow and activity to the hypothalamus (insula, and
striatum), the parts of the brain that tell you when you are full.
That means that glucose makes you feel full so you stop eating.
Fructose does not suppress appetite, so no matter how much
fructose you eat or drink, you can still be hungry.
MECHANISM: Eating glucose causes your pancreas to release
large amounts of insulin that suppresses hunger. On the other
hand, fructose does not cause your pancreas to release insulin, so
you lose the appetite suppressing effect of that hormone.
Before any sugar can be absorbed into your bloodstream,
it must first be reduced to a single sugar. Your body never
allows double sugars to be absorbed into your bloodstream. Table
sugar is a double sugar called sucrose that is made up of single
molecules of glucose and fructose bound together, so when you eat
table sugar, you get equal amounts of glucose and fructose.
Most sugared, soft drinks contain high fructose corn
syrup, a mixture of slightly more than fifty percent fructose and
slightly less than fifty percent glucose. This small difference
in concentration of glucose and fructose is probably irrelevant.
The reason that soft drinks are so fastening is that they are in
liquid form.
LESS FATTENING, while whole fruits (with their natural sugar) are
not very fattening at all. When food enters your stomach, the
pyloric valve at the end of your stomach closes and allows only
a liquid soup to pass into your intestines. Sugared drinks enter
your intestines almost immediately and are absorbed very rapidly,
causing a high rise in blood sugar.
Sugared foods must be broken down before they can pass into
your intestines to be absorbed. A sugary cookie, made with flour,
has tiny particles that are broken down relatively rapidly to
cause a high rise in blood sugar, but the rise is not as steep as
that from sugared drinks.
Fruits are full of fiber, so the particle sizes are
larger and take longer to slip through the pyloric sphincter.
Thus orange juice passes immediately into your intestines, while
an orange can sit in your stomach for more than five hours. That
is why sugared drinks are more fattening than cookies, and fruit
is far less fattening because of its delayed passage into your
that makes you fatter increases your risk for becoming diabetic.
Before insulin can do its job of driving sugar into cells, it must
first attach to insulin receptors, special hooks on the outer
walls of cells. Fat inside a cell prevents insulin from attaching
to its receptors and doing its job of driving sugar into cells, so
blood sugar levels rise higher and higher as you become fatter and
blood sugar causes sugar to stick permanently to the outer membranes
of cells. This destroys the cells to cause every known side effect
of diabetes: blindness, deafness, heart attacks, strokes, dementia,
impotence, infertility, nerve damage, lack of feeling, diffuse body
pain, and so forth.
WHEN IS IT SAFE TO TAKE SUGAR? I recommend that you take
sugared foods or drinks only when you are exercising or shortly
after you finish. Resting muscles draw no sugar from the
bloodstream to help prevent a high rise in blood sugar. On the
other hand, contracting muscles draw sugar rapidly from the
bloodstream to prevent a high rise in blood sugar. The more
vigorously you contract your muscles, the greater the effect of
muscles drawing sugar from your bloodstream. Contracting muscles
can draw sugar from your bloodstream without even needing insulin.
Seventeen hours after you finish exercising, muscles lose their
ability completely to take any sugar from the bloodstream without


Death of the President Zachary Taylor

"Ol' Rough n' Ready" Zachary Taylor was the twelfth
president of the United States. He was a brave and tough man who
fought many battles from the War of 1812 to the Mexican War.
On the Fourth of July, 1850, President Taylor was in good
health and attended a Sunday school program, where he ate a couple
of green apples. After that, he attended a groundbreaking
ceremony for construction of the Washington Monument. Then he went
back to the White House and ate a large bowl of cherries, and
drank cold water and milk.
SYMPTOMS: That night he started to feel sick, he vomited a
few times and his belly started to hurt. The next day he
developed bloody diarrhea, and when his temperature rose very
high, he called his doctor. The doctor told him he must have
cholera, gave him calomel, opium and quinine, and drew blood. He
did not send it off to a laboratory as we do nowadays. He drew
blood because doctors treated almost every disease with blood-
In spite of this treatment he continued vomiting, his
belly cramps worsened, and his bloody diarrhea become explosive.
He cried out when the doctors tried to touch his belly. His
temperature kept rising higher and higher and he died in his bed
on the evening of July 9th, the fifth day of his illness, at age
DIAGNOSES AT THAT TIME: The doctors diagnosed food poisoning
from eating too many cherries and drinking too much unpasteurized
milk and water. They had to be wrong because food poisoning
doesn't cause a fever that keeps on rising to very high levels.
Other people claimed that he died of malaria, because he
was very sick with malaria when he fought in Mexico, but malaria
is not characterized by vomiting and diarrhea.
Many people thought that he had been poisoned by
Southerners who were angered by Taylor's moderate stance on
slavery. The most common chemical used to poison people of that
period was arsenic. However, arsenic poisoning does not cause
high fever, diarrhea and vomiting.
To put the poisoning theory to rest almost 150 years later,
in 1991, Taylor's descendants had his body removed from its
Kentucky grave and sent samples of his hair and fingernails to Oak
Ridge National Laboratory in Tennessee. Arsenic levels were well
below levels that could have killed him. He couldn't possibly
have been killed by arsenic poisoning.
THE REAL DIAGNOSIS: The only tenable diagnosis has to be
based on the fact that he was well, on a hot day, ate a lot of
food that could have been contaminated with some germ, and then
developed diarrhea and vomiting and fever that had to be caused by
an infection. High fever is a hallmark for infection with
intestinal bacteria called salmonella typhosa.
The extremely painful belly that hurt so much when
doctors touched it was probably caused by a rupture of his
intestines that leaked intestinal contents into his belly.
He died from a food-borne infection that was common in
those days called typhoid fever. Today, he would be cured by
taking antibiotics.
president, James K. Polk, died of cholera and "debilitating
diarrhea". Thomas Jefferson probably died of amoebic dysentery.


Recipe of the Week:

Paella (Spanish Seafood Stew)

You'll find lots of recipes and helpful tips in
The Good Food Book


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Copyright 2012 The Sportsmedicine Institute, Inc.

Gabe Mirkin, M.D.
10901 Connecticut Avenue, Kensington MD 20895, USA

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