Fructose Tolerance is a Concept Gaining Diagnostic Ground

A hormone may serve as a powerful biomarker of weight gain-related illnesses.
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Herbal Supplements Often Don’t Supplement

In many cases, unlisted contaminants were found to be the only plant material found in the product samples.
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Burn After Running

The difference between participating in a single exercise session and remaining sedentary has more resonant consequences than you might have considered.
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Two Winter Sport Honorable Mentions

Here are two additions to the list of winter sports that match running in METs from the last issue.
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Unleashing Innovators to Launch Precision Medicine

Medicine designed for the individual, rather than the average, patient is an idea whose time has finally come.
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To Avoid Processed Foods Process Your Own

One of the delights of home processing is exercising utter control over added fat, sugar and salt without compromising flavor.
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The Clinic

Slow Down and Skip the Surgery?
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Slumped Form Can Overload the Calves
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Battling Chronic Tendon Injury
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Try Glucose Testing Over Months, Not Just Days
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The Back Page

Announcing… The 2015

our inspiration

Indoor Track Facilities: Build them and athletes will come

Taking Some Heat – Time in a sauna

Seen and Heard while Running
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Is High Intensity Running Bad for You?

Exercise does not have to be vigorous to be beneficial. Trading intensity for duration is a well-known strategy for still ensuring positive outcomes like reduced fat content in the blood after eating. However, the debate about the efficacy of intense exercise has become distorted recently with the publication of a study in the Journal of the American College of Cardiology that found running intensely will not improve your lifespan over remaining sedentary.

What the study found unsettled many people but it is really its misrepresentation in the media that is causing most of the confusion. For starters, it's worth reviewing what the study is actually saying.

The researchers, mostly from the University of Copenhagen, used the database of 1,100 men and women from the Copenhagen City Heart Study to draw their conclusions. They found that slow joggers tended to live longer than those who ran faster. They also found that people who ran the most often and at the fastest pace had lifespans similar to those who did not exercise at all. So to be clear, the researchers report first and foremost what many other studies have found: some running is better for you than being sedentary. What should we make of the other part?

An Effect Without a Cause
Today we have vastly more tools than at any other epoch in human history to look at sweeping patterns over long periods and unearth statistically significant causal relationships. It's important to remember that the problem with Big Data isn't the data. There is much to learn by careful analysis of huge data sets, looking for patterns—always keeping in mind that correlation does not imply causation.

The problem usually lies in the reportage of the day's hot finding. The media's natural inclination to distort the results when delivering the news is as deeply unfortunate as it is understandable. The widely reported conclusion that a high level of running has the same effect as no running at all is problematic for several reasons. (continued)


Work-Desk Treadmilling Has a Long Way to Go

A new 12-week study looking at the real-world efficacy of treadmill desks in the workplace has found that challenges remain in truly making a good idea great. Conducted by the Oregon State University College of Public Health and Human Sciences with co-authors from East Carolina University and researchers from Pennington Biomedical Research Center in Baton Rouge, the findings were published in the Journal of Occupational and Environmental Medicine.

The group set out to evaluate the effectiveness of a three-month “treadmill desk intervention” in changing fitness behavior among overweight and obese office workers. The group’s mean age was 40 years. Twenty subjects were assigned their usual working conditions, and 21 received a shared treadmill desk intervention. Physical activity level was determined using accelerometers, and measured along with sedentarism both before and after the intervention.

Compared with the control group, the intervention group increased daily steps and light physical activity, as well as decreased sedentary time, but only modestly. For example, the treadmillers only sat less by 3.6 minutes per hour during working hours.

The increase in physical activity did not help workers meet public health guidelines for daily exercise, and the machines posed logistical challenges that might lead companies to conclude they are not worthwhile enough to offset their expense. For example, the researchers found that work considerations often kept employees from using the desks, even though the company had approved and encouraged employees to participate in the program. And employees were required to share the treadmill desks, which meant scheduling the time they would be using them.

Ultimately, even though workers who used the desks increased their average number of daily steps by more than 1,000, they benefited little by way of weight loss or change in BMI.

Treadmill desks have been gaining popularity as a solution for helping sedentary workers out of their desk chairs during the work day. This study was concerned specifically with whether the availability of these desks helped change employee behavior. It turns out the employees only used the treadmills about half the time they were asked to, averaging one session of 45 minutes a day on the machines.

Another issue is that the subjects who used the desks tended, on average, to walk at about 1.8 miles an hour, a speed considered only light physical activity, and a far cry from a brisk 3.5 (or more) mph walk many people comfortably achieve when the focus is entirely on the exercise session. One of the challenges with the treadmill desk is surely that it needs to be used at a low enough intensity for employees to still perform their work duties.

Public health guidelines suggest adults need at least 30 minutes of moderate to vigorous physical activity several days a week, with some recommendations flatly stating 60 minutes at this level, and on most days. Yet there is value even in standing at your desk. The ACSM’s 2011 physical activities tracking guide gives up to three times the energy expenditure of sitting (i.e., 3.0 METs) to “standing and talking at work” (“up to” because the older, 2000 compendium value was just 2.3 METs).

There may be cardiovascular or other benefits when people begin increasing their steps, even in small amounts at low intensity, but reversing the effects of a sedentary lifestyle requires more activity.

Though this is a separate, more challenging issue from simply whether the prospect of at-work treadmilling could possibly improve lifestyle fitness behavior, this latter issue of just altering habits presents ample challenges, as noted above by the fact that participants underperformed by half. Even more disconcertingly, initially more than 700 employees of the company were targeted for recruitment, with just 10 percent of them in the end even expressing interest in participating.

JOEM, 2014, Vol. 56, No. 12, pp. 1266-1276,

ACSM Compendium of Physical Activities, 2011,


editorial board

Kenneth Cooper, MD
Kevin Beck
Jack Daniels, PhD
Randy Eichner, MD
Mary Jo Feeney, MS, RD
Mitchell Goldflies, MD
Paul Kiell, MD
Sarah Harding Laidlaw, MS, RD
Paul Langer, DPM
Douglas Lentz, CSCS
Todd Miller, MD
Gabe Mirkin, MD
Col Francis O’Connor, MD
Stephen Perle, DC, CCSP
Pete Pfitzinger, MS
Charles L. Schulman, MD
Bruce Wilk, PT, OCS
Mel Williams, PhD
Michael Yessis, PhD
Jeff Venables, Editor

board of directors

Jeff Harbison, President
Bill Young, Secretary-Treasurer
Immediate Past-President
(Vacant) Vice President
Robert Corliss
Charles L. Schulman, MD, AMAA Pres.
AMAA President
Terry Adirim, MD, MPH
Gayle Barron
Sue Golden
Senator Bill Frist, MD
Jeff Galloway
Jeff Harbison
Ronald M. Lawrence, MD, PhD
Jeff Moore
Noel D. Nequin, MD
David Pattillo

Association Staff

Executive Director: Dave Watt
Project Consultant: Barbara Baldwin, MPH

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