A Runner’s Guide to Interpreting
Blood Work

by Cathy Fieseler, MD

Regular distance running can cause changes to some commonly measured blood values, both in the short term and long term.
(go to article)

How to Avoid Computer Vision Syndrome

The combination of ignoring eye health and staring at screens all day has led to a common affliction.
(go to article)

Carcinogen Report: Weed Killer and Hot Beverages

Roundup, coffee and the difference between hazardous and risky.
(go to article)

Underwater Rugby: Yes, It Exists

Underwater rugby is gaining in popularity in the U.S. It offers a fun, strenuous workout perfect for summer.
(go to article)

Editorial Advisor and Legendary “Groundpounder” Melvin Williams
Has Died

A former paratrooper and ergogenics expert who characterized himself as blessed with good biomechanics, Mel had completed 112 marathons.
(go to article)

Editorial: Is Body Dissatisfaction Always Bad?

by Jeff Venables

Is it always inappropriate to comment on your child’s weight?
(go to article)

The Clinic

Understanding Post-marathon Heart Rate
(go to article)

Is Alkaline Water a Sham?
(go to article)

Electrolyte Loss is Often the Cause of Cramps
(go to article)

A Clicking in the Calf
(go to article)

The Back Page

A Summer Break
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Tai Chi Offers Additional Option
for OA Sufferers

Osteoarthritis develops when cartilage deteriorates and the space between bones at the joints narrows, eventually causing pain as the bones change shape.

The first symptom is often pain in a joint after strenuous activity. The joint may be stiff in the morning, but loosen up after a few minutes of movement. Sometimes moving the joint may cause a grating sensation.

When osteoarthritis affects the knee, pain, swelling and stiffness develop. Discomfort can progress to difficulty walking, bathing and even getting in and out of bed. When osteoarthritis affects the hip, pain may be felt in the groin, down the inside thigh or as far away as the knee. When it affects the lower spine, pain can spread to the buttocks or legs.

The knee is the most commonly affected joint. In fact, almost half the population will have knee pain due to osteoarthritis by age 85. There is no cure; the only permanent treatment is a total knee replacement. According to Harvard Health Publications, more than 700,000 of these operations are performed in the U.S. each year, and the rate of knee replacement surgery has nearly doubled between 2000 and 2010.

Short of surgery, traditionally clinicians have relied heavily on NSAIDs to treat OA. But the cardiovascular, gastrointestinal and renal toxicities of NSAIDs have limited their use.

Acetaminophen (an analgesic, such as Tylenol or Anacin, without anti-inflammatory properties) is still widely recommended as an initial therapy due to its relative safety. In a recent meta-analysis reviewing drug efficacy published in The Lancet, however, acetaminophen was found to be no better than placebo. The NSAIDs diclofenac, etoricoxib and rofecoxib were associated with the greatest pain reduction for patients with knee or hip osteoarthritis. But etoricoxib is not available in the U.S., while rofecoxib was withdrawn worldwide in 2004.

In another study published in BMJ, acetaminophen—though recommended as a first-line analgesic for lower back pain and pain related to hip and knee OA—was again found to be no more effective than placebo for lower back pain and disability in the immediate term (less than or equal to two weeks) or for pain, disability and quality of life for up to three months. In addition, acetaminophen users were more likely to have abnormal results on liver function tests.

There is the potential for adverse events with NSAIDS as well, including exacerbation of heart failure, heart attack risk, GI upset, and bad interactions with the anticoagulant warfarin, which treats and helps prevent blood clots. All of this severely limits drug options for OA-related pain management.

Non-pharmacologic approaches are therefore often sought after, and they also help avoid the side effects from simultaneously using multiple drugs, a situation known as poly-pharmacy that is common among the elderly.

As is so often the case, the treatment with the least side effects and the most promise for OA sufferers, if not quite a magic bullet, appears to be physical activity. (continued)

FDA Announces New Food
Labeling Requirements

The FDA recently finalized new requirements for nutrition information on foods. The changes include:

  • “Calories from Fat” will be eliminated. Information on total, saturated and trans fat will still be included.
  • Information on “added sugars” must now be included.
  • New daily values for sodium, dietary fiber and vitamin D will be included.
  • The percentage of daily value for vitamins A and C will be removed since these vitamin deficiencies are rare.
  • Both "per serving" and "per package" calorie and nutrition information will be listed.
  • The "calories" and "servings" section will be more prominent.
  • Listed serving sizes will be closer to the amount people actually consume in a sitting.

The new labels will be required by July 2018.

Cane by Another Name
It has become less common for food manufacturers to simply state “sugar” as an ingredient in their foods. Many manufacturers rely on different words for products that are nutritionally similar, with perhaps the most widely-used example being “high-fructose corn syrup.” But as Margot Sanger-Katz, writing in The New York Times, points out, “there are also things like the ‘evaporated cane juice’ in the yogurt, and ‘rice syrup’ and ‘flo-malt,’ which are less obvious and amount to the same thing.” (continued)

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

Running & FitNews is published by the American Running Association. Address inquiries to ARA, Attention: FitNews Editor, 4405 East-West Highway., Suite 405, Bethesda, MD 20814 or send e-mail to run@americanrunning.com

The American Running Association is a nonprofit educational organization, designated 501(c)3 by the IRS. Running & FitNews provides sports medicine and nutrition information. For personal medical advice, consult your physician.

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