Does Sleep Play a Role in Weight Gain and Weight Control?

Weight Gain and Sleep Patterns - Photo by Ed Yourdon at Wikimedia Commons

Can sleep play a role in patterns of gradual, long-term weight gain? According to several studies, getting an appropriate amount of sleep tends to be associated with less weight gain over time. Both long-term lack of sleep and sleeping more than a normal amount of time seem to have an association with long-term weight gain.

Sleeping Too Little or Too Much Associated With Weight Gain

According to a 2011 New England Journal of Medicine study on long-term, gradual weight trends, people may be less likely to gain weight if they average sleeping six to eight hours in a 24-hour period. Those who tended to sleep less than six hours and those who averaged sleeping more than eight hours tended to gain more weight over time.

An article in the Journal of Sleep Research found that women (ages 40 to 60) who gained 5 kg or more in a five to seven year period tended to either have short or long sleep durations, but men studied did not have the same correlation. A study published in the International Journal of Obesity & Related Metabolic Disorders found that only previously obese women tended to have weight gain associated with eating at night.

Sleep Cycle and Circadian Rhythms and Weight Gain - Photo by ceridwen at Wikimedia Commons

Less Sleep May Lead to Long-Term Weight Gain

One might think that less sleep would indicate that people are more active and have a higher metabolism; however, the Journal of Medicine study cited the following possible contributing factors for weight gain in those who tended to sleep less than six hours:

• Less sleep is associated with altered leptin and ghrelin.
• Those who stay up may feel subjectively hungry.
• Late-night snacks often include high-calorie and/or refined-carbohydrate foods.

Additional studies have linked sleep deprivation with obesity. Exposure to light may seem to reset the body's natural circadian rhythm. Appetite regulation seems to become more difficult for those who get inadequate sleep, and people may find it more difficult to lose fat when experiencing long-term sleep deprivation.

Too Much Sleep May Lead to Weight Gain

Sleeping more than eight hours was associated with weight gain in the New England Journal of Medicine study. Obesity may be accompanied by obstructive sleep apnea, which is often associated with poor quality sleep, daytime sleepiness and/or narcolepsy. Sleep disturbances are sometimes associated with stress, which is another factor that seems to play a role in weight gain in some populations.

Some people tend to gain weight during winter months, which may be related to a number of factors such as holiday eating and fewer options for exercising outside, but longer nights and shorter days may also mean changes in sleep patterns and circadian rhythms.  Symptoms of seasonal affective disorder (SAD), also called winter depression, may appear when days are shorter. Although the average long-term weight gain during winter months tends to be approximately one pound per year, people who are already overweight were more likely to gain five pounds, according to an NIH article.

Sleep and Obesity - Is There a Connection? - Photo by Bill Branson (NCI) at Wikimedia Commons

Connecting Weight Gain and Altered Sleep Cycles

Weight gain is a complex issue with many contributing factors, one of which may be sleep cycles. Several studies have shown that people who get too little sleep and those who tend to sleep more than normal may be more likely to gain weight. Those who have sleep disturbances such as insomnia and hypersomnia may benefit from an assessment by a healthcare professional who may be able to discover a variety of reasons for sleep disturbances and help one achieve a more normal sleep cycle. Perhaps getting good quality sleep for six to eight hours on a regular basis may help one to lose or avoid unwanted pounds.

Readers may also wish to read Yawning During Exercise? The Possible Causes Might Surprise You. Find more of my articles at the Fit Tips 4 Life site map.

Sources:

• Environmental Health Perspectives January 2010 (vol. 118, issue 1) article by Angela Spivey "Lose Sleep, Gain Weight"
•  International Journal of Obesity & Related Metabolic Disorders (October 2004, vol. 28) article by G.S. Anderson et. al. "Night eating and weight change in middle-aged men and women"
• Journal of Sleep Research June 2011 (vol. 20, issue 2) article by Peppi Lyytikäinen "Association of sleep duration with weight and weight-gain: a prospective follow-up study."
• National Institutes of Health March 22, 2000 article "Holiday Weight Gain Slight, But May Last A Lifetime" 
• National Sleep Foundation online article "Depression and Sleep" accessed May 6, 2012
• The New England Journal of Medicine June 23, 2011 article by Dr. Dariush Mozaffarian et. al. "Changes in Diet and Lifestyle and Long-Term Weight Gain in Women and Men"

Water and Sodium Levels During Exercise – Can You Drink Too Much Water?

People who are exercising vigorously and/or in hot environmental conditions may lose as much as three liters of water and 3.5 grams of sodium per hour. Many people now drink large amounts of water to avoid dehydration and an increase in core body temperature while exercising, but sometimes this approach may do more harm than good.

Can a person drink too much water while exercising vigorously? What are the risks for developing and symptoms of exercise-associated hyponatremia (EAH)? How can people treat this potentially serious imbalance? Learn more about how to stay safe during rigorous and extended exercise.

Vigorous Exercise Can Lead to Sodium Loss - Photo by Dontworry at Wikimedia Commons

How Much Water Should You Drink During Exercise?

Recommendations for re-hydration during exercise have changed many times over the years. Early recommendations ranged from discouraging any intake of fluids during exercise to drinking as much as possible. Much of the current research is leaning toward a common sense approach in which people who are exercising should drink when thirsty to prevent dehydration, adjusting fluid intake for variables such as environmental temperatures, clothing, and the intensity of the workout.

Water has been hailed as a great choice of beverage, particularly for those who are attempting to decrease calories and lose or maintain weight. Many people are turning to water as a beverage of choice – bottled water sales tallies second only to soft drinks in the United States. WebMD offers an informative quiz on water that people may find very helpful.

Some studies have indicated that athletes may be more likely to drink an increased amount of fluids if they have added flavorings. The FDA now requires manufacturers of flavored water, water beverages with added electrolytes and/or nutrients, and similar water-containing beverages to list ingredients on the labels and to produce these beverages under sanitary conditions with quality control processes in place. Some sources indicate that people who are exercising may benefit from drinking some fluids with electrolytes added, but more research is needed in this area.

Over the years, previous endurance limits have been pushed, with many athletes going greater distances and attempting harder forms of exercise than ever before. Some folks are pushing their own limits by making fitness commitments to increase their activity drastically, and some careers place people in hot areas while exerting much energy over extended periods of time.

Although a more active lifestyle has the potential to improve one's overall fitness level, extremes in exercise combined with large amounts of water intake can be dangerous and even deadly if a person's sodium level drops to unsafe levels.

Causes of Hyponatremia Related to Exercise - Photo by Kencf0618 at Wikimedia Commons

What Causes Low Sodium Levels During Exercise?

Many folks know that exercise can cause blood sugar levels to drop, particularly in someone who has diabetes; however, exercise, particularly if the exercise is rigorous, can also change electrolyte levels. Electrolytes are minerals in the blood that carry an electrical charge. Examples of electrolytes in the body include sodium, potassium, magnesium, and calcium. Electrolytes in the blood can affect acid/base balance, fluid status, muscle functions, and many other vital body processes.

Serum sodium, the level of sodium in the blood, is an electrolyte that can be affected by exercise, water replacement, potassium levels, and several other factors. Normal ranges for serum sodium is 135 to 145 milliequivalents per liter (mEq/L). Table salt is sodium chloride, and many people are trying to lower dietary sodium with good reason. According to the CDC, many Americans eat a diet much higher than the upper limits of  2,300 mg/day; the recommended limit for sodium is 1,500 mg/day for those with hypertension or high risk for complications related to a diet high in salt.

Although too much salt can cause many long-term health problems such as high blood pressure, a sudden drop in serum sodium, called hyponatremia, can quickly become a medical emergency in the short term. Sodium levels can decrease via sweating when a person exercises vigorously or continuously over a long time, but the drop in levels appears to be more related to drinking large amounts of water, the body's inability to excrete the excess water by urinating, or a combination of those factors.

Exercise-associated hyponatremia (EAH) may also be called:

• Fluid overload
• Water intoxication
• Exertional hyponatremia
• Exercise-induced hyponatremia

Risks for Exercise-Associated Hyponatremia - Photo by U.S. Army at Wikimedia Commons

Who is at Risk for Exercise-Associated Hyponatremia?

Most people who drink water or sports drinks while exercising do not experience unusually low sodium levels, but others may experience moderate or even severe drops in serum sodium. Several people tend to be more likely to develop a dangerous drop in sodium levels associated with exercise, including:

• Women (perhaps due to size, an increased likelihood to heed recommendations to drink more fluids, or genetic factors)
• People who have smaller bodies and lower body weight
• Folks participating in continuous exercise over an extended period of time
• Those exercising in warm environments, particularly if the person is not acclimated to the warmer temperatures (although some athletes may experience hyponatremia while exercising in cooler environments as well)
• Those who drink large amounts of water before and/or during exercise (some have experienced hyponatremia when hydrating with fluids with added electrolytes)
• Slower athletes (probably due to added time exercising in order to finish the course and perhaps the intake of additional fluids during that time)
• Those with certain pre-existing health conditions such as people who are not able to excrete fluids efficiently or those who excrete higher than normal amounts of sodium in sweat, such as someone who is a carrier of the cystic fibrosis gene
• People taking certain medications that decrease sodium levels

Symptoms of Water Intoxication - Photo by Ceccomaster at Wikimedia Commons

What are the Symptoms of Exercise-induced Water Intoxication?

Many of the symptoms of exercise-associated hyponatremia result from fluid overload in the brain as brain cells tend to swell in an effort to compensate for the electrolyte imbalance. Unfortunately, many symptoms are non-specific and could be related to other exercise-related changes, such as a drop in blood sugar or dehydration.

Hallmark signs that the symptoms are more likely to be related to hyponatremia instead of other factors include:

1. The person has been drinking large amounts of fluids.
2. The person will typically experience weight gain during and/or at the conclusion of the athletic activity.
3. The person may become bloated or puffy around the ankles, fingers, and/or face. If the fluid settles in the lungs, pulmonary edema may result in which the person may experience coughing and shortness of breath that is worse if the person lies down.

Signs and symptoms of EAH are often related to swelling in the brain and may include:

• Fatigue and/or lethargy
• Stumbling or lack or coordination
• Muscle cramps, spasms, or weakness
• Nausea and/or vomiting
• Slurred speech
• Headache
• Changes in mental status
• Confusion or strange behavior
• Seizures
• Coma

Sodium levels do not necessarily correlate with the severity of symptoms with hyponatremia, but levels higher than 128 and below 135 mEq/L are less likely to result in swelling of the brain than levels below 128 mEq/L with resulting serious signs and symptoms. According to a 7/15/2005 Sports Medicine article, an athlete with a serum sodium level of 87 mEq/L survived while others with levels of 117 and 122 mEq/L died, indicating that the sodium level may not necessarily predict the outcome of this medical emergency. Symptoms also seem to be related to how quickly the sodium levels drop and tend to be more pronounced in those who are overhydrated rather than dehydrated.

Few people would have access to laboratory equipment used to measure serum sodium levels while exercising, so recognizing early signs and symptoms and seeking proper emergency care could be a life-saving measure for an athlete with dangerously low sodium levels. Symptoms of hyponatremia can progress quickly and have the potential to lead to serious symptoms, including death.

Treatment for Low Sodium - Photo by Danny Hayes U.S. Navy at Wikimedia Commons

How is Low Sodium Caused by Exercise Treated?

Prevention of hyponatremia can be quite complex. Most people participating in exercise do not exercise with such intensity or duration to necessitate preventive steps. Those who are at risk for EAH or who have experienced EAH in the past should speak with a qualified healthcare professional regarding an individualized preventive plan, which might include a variety of suggestions, such as:

• Exercising at a less intense level
• Exercising for shorter periods of time
• Decreasing the amount of fluids ingested before, during, and after exercise while being careful to avoid dehydration
• Drinking or eating electrolyte replacements specific to that person's needs

Because the symptoms of hyponatremia are often non-specific, many people mistakenly encourage an athlete with hyponatremia to drink more water. This only adds to the problem by adding to the fluid overload and dropping the serum sodium levels further.

Someone experiencing symptomatic exercise-associated hyponatremia should seek emergency medical care and avoid drinking additional fluids. Cases of symptomatic hyponatremia typically require in-hospital intervention with treatment focused on increasing the person's urine output in order to lower the serum sodium levels and decrease edema in the brain. Treatment usually includes administering intravenous fluids that have high high levels of sodium. One study mentioned the possibility of administering certain types of diuretics to correct EAH, but more research is needed to determine if this treatment would be ideal.

Drinking sports drinks and/or administering intravenous normal saline does not seem to adequately treat hyponatremia in athletes that are experiencing symptomatic fluid overload and may lead to continued hyponatremia and swelling in the brain. Some studies have demonstrated that fluids with added carbohydrates and electrolytes are associated with higher plasma levels of sodium when compared to distilled water, green tea, or flavored water during and after exercise.

Some studies have looked at having athletes participating in long-endurance exercise to drink or eat sodium replacement fluids that are higher than typical sports drinks, including pickle juice, dissolved bullion cubes, chicken noodle soup, or soup broth, but I could not find clear guidelines for administration of oral fluids with high volumes of salt. Oral replacement with a high sodium content might discourage some athletes to drink due to an unpleasant salty taste and could in turn lead to dehydration.

Water and Salt Levels During Exercise - Photo by Gabriel Martin U.S. Navy at Wikimedia Commons

Exercise and Low Salt Levels

I was prompted to research the topic of exercise-induced hyponatremia after a friend of mine experienced significant symptoms after exercising. She survived, thanks to the quick response of her husband and the great EMTs in the area, but a sudden drop in sodium levels can lead to serious health concerns and even death.

Exercising regularly has many benefits for one's body and well-being. Many people assume that if drinking a little bit of water is good that drinking lots of water will be even more beneficial; however, that is not always true when replacing fluids lost during vigorous exercise. Most people who exercise will not experience hyponatremia, but those who are at risk or who have experienced EAH previously would benefit from consulting a healthcare professional for an individualized exercise and re-hydration plan to meet their special needs.

Find more of my articles at the Fit Tips 4 Life site map.

Sources (accessed on April 23, 2012 unless otherwise noted):

• Center for Disease Control and Prevention 02/23/2011 article "Water: Meeting Your Daily Fluid Needs"
• Journal of Athletic Training March/April 2009 article by Costas A. Anastasiou et. al. "Sodium Replacement and Plasma Sodium Drop During Exercise in the Heat When Fluid Intake Matches Fluid Loss" (accessed 04/24/2012)
• Journal of the American College of Nutrition 01/09/2006 article by Rick L. Sharp "Role of Sodium in Fluid Homeostatis with Exercise"
• MayoClinic July 14, 2011 article "Hyponatremia: Symptoms"
• National Institutes of Health 05/26/2010 article by David Zieve et. al. "Sodium in Diet"
• National Institutes of Health 09/20/2011 article by David C. Dugdale et. al. "Electrolytes"
• National Wildfire Coordinating Group 08/12/2005 safety bulletin "Appropriate Fluid Intake"
• Sports Medicine 07/15/2005 article by Louise B. Weschler "Exercise-Associated Hyponatremia: A Mathematical Review"
• U.S. Food and Drug Administration 04/13/2012 article "FDA Regulates the Safety of Bottled Water Beverages Including Flavored Water and Nutrient-Added Water Beverages"
• Wilderness Medical Society Spring 2001 article by Ian R. Rogers, MD, FACEM "Fluid and Electrolyte Balance and Endurance Exercise: What can we learn from recent research?"

Can a Group Exercise Class Cause Permanent Hearing Loss?

Hearing Loss and Exercise Classes - Photo by Heather Warick at Wikimedia Commons

Many people who might not have tried a group exercise, or aerobics, class in the past are now much more interested in working out in a group. Quite a few facilities have begun to offer aerobics classes that offer a sort of club feel or party atmosphere featuring fun and toning moves set to the beat of cultural or popular music. Other classes may have turned up the heat with workouts that promise to take people to the edge of their physical abilities, all to the tune of a hard-driving beat. Yet, all too often, the music levels in many group exercise classes are far above what is considered safe and is typically only exceeded by an instructor shouting in the microphone.

Although many of these classes are packed, some participants are steering clear. Health club members may look wistfully at the class but keep walking down the hall. They might be able to try the moves and enjoy the workout but aren't willing to put their hearing on the line. One lady made an insightful observation by saying, "A gym should care about my total physical health...and that includes my ears!"

How Loud is Too Loud in Aerobics Class? © Katrena

Sound Standards for Group Exercise Classes

According to the Environmental Protection Agency (EPA), hearing may be affected when a person is exposed to sounds greater than 85 decibels (dB) for more than 45 minutes, with an increased likelihood of hearing loss with habitual exposure. Sound levels at 91 db for any length of time are considered unsafe by many sources. Although certified group exercise instructors may be aware of sound standards, they may not realize that the noise level is unsafe in their classes. Other instructors may know that the music volume is too high but assume that participants want the louder volume.

Most gyms do not have audiometers for checking dB levels, so the assessment of whether or not the music volume is at a safe level often lies with group exercise instructors. Although some facilities might mark a certain setting for music levels on the sound system, individual instructors might ignore that safety directive. In addition, devices such as mp3 players have individual volume controls that can override the volume set on the sound system.

What are warning signs or red flags that the noise level is too high in an aerobics class? As a general rule of thumb, if you must shout to be heard by someone three feet away during class, the noise level is likely too high. The music volume is probably too high if one's ears hurt or ring (tinnitus) immediately after a class is over.

These loud volumes may also affect the instructor's hearing and the hearing of others who are in nearby areas of the facility. OSHA addresses noise levels for employees in which permissible noise exposure is 100 dB if exposed to the noise for two hours/workday. That maximum number decreases if the person is exposed to loud noises for longer periods of time.

Hearing loss due to prolonged exposure to loud noises is usually permanent. Prevention is a much better strategy than treating the problem after the fact, however options for adaptive devices such as various types of hearing aids are much more plentiful than in the past.

Protect Hearing in Group Exercise Class - Photo by photographer at Wikimedia Commons

Hearing Loss Prevalence and Symptoms

Although many assume that hearing loss only affects seniors, approximately six million people aged 18 to 44 have a hearing deficit in the United States. One million school-aged children also have hearing loss. The percentage of younger people with hearing deficits is rising, but many physicians may not routinely check for hearing loss at a regular physical. Hearing loss may not be readily apparent to the healthcare provider in a quiet setting in which only two people are carrying on a conversation. Hearing loss tends to be more apparent in group settings with background noise.

Unfortunately, sensorineural hearing loss due to sustained loud noises such as rock concerts and some group exercise classes tends to occur gradually and the person might not realize that he or she is experiencing permanent damage. People with this type of hearing deficit might notice a ringing in the ears, that they need to turn the television volume higher, feel that everyone (especially women and children) seem to be mumbling, or they might misunderstand statements that others are making, particularly in group settings.

The Better Hearing Institute offers several resources for people who think they may already have a hearing deficit, such as a:

• hearing loss simulator
• free online hearing check

Earplugs or a Plug for Lower Volume? - Photo by Light Current at Wikimedia Commons

Options for Creating a Healthier Environment for Exercise

As folks prepare to take an exercise class, they might ensure that they have well fitting athletic shoes, clothing that will not restrict, a full water bottle, an empty bladder. Some people now use earplugs when taking group exercise classes. Is that really necessary? Some might say yes while others would like to see a healthier environment for all students and the instructor(s).

Many gyms assume that people will not take a group exercise class unless the music is booming. Some participants will stop coming to classes, cancel a membership, and go elsewhere if they do not have music volumes at high levels in exercise classes. This group, which typically includes younger generations, may be quite vocal about their wishes and might be more likely to have somewhat of a herd mentality in which an entire group might join or cancel a membership to a health club.

However, a silent majority may prefer lower volumes in classes. Many in this group, which typically includes older adults, may be internally motivated and will often seek out other opportunities within the facility that meet their exercise needs while protecting their hearing. They may remain silent because they were taught not to complain or may assume that the facility will turn a deaf ear to their concerns. Perhaps they are simply choosing their battles.

Options for advocating for a hearing-friendly group exercise class include:

• Requesting that the instructor decrease the music and microphone volumes.
• Speaking with the group exercise coordinator about the issue.
• Voicing concerns with the director of the facility.

Documenting these concerns with specific details may carry more weight with the appeal for a change. Sometimes classes may be louder when the group exercise coordinator is not in the building. If some instructors are offering classes with safe music volumes, consider regularly attending those classes. Many instructors are only allowed to maintain a schedule if their class numbers meet a minimum expectation.

Unfortunately, many facilities and/or instructors ignore requests for quieter music in group exercise classes. Instructor enthusiasm and variety can more than make up for a lower volume of music, but facilities and/or instructors may simply look the other way and continue to crank up the volume for the sake of keeping as many members as possible. They may assume that the seniors, who are often the consistent members that may stay for many years, will simply adapt to alternate schedules rather than make the move to another facility.

If one facility refuses to accommodate a safety issue such as providing safe noise levels in group exercise classes, other facilities in the area might be able to provide a more suitable workout environment. When looking for a gym with the intention of taking group exercise classes, it is wise to visit the facility a few times and see for oneself whether or not music volume is controlled adequately before investing in a membership.

Noise Levels in Aerobics Classes

The bad news is that many gyms offer group exercise classes with dangerously high music levels that could contribute to permanent hearing loss in the future. Although instructor training and facility policy often includes limits on noise level, that safety issue is often overlooked in order to attract more members. However, an informed consumer might be able to encourage a healthier environment. Most people attend exercise classes in order to achieve better health and should not have to sacrifice their hearing in order to do so.

Find more articles at Fit Tips 4 Life site map.

Sources:

• Environmental Protection Agency article "Listen Up! Play it Safe With Your Ears. Play it Safe With Your Health" accessed on April 5 2012. (also includes puzzles and games related to ear health)
• IDEA Health and Fitness Association July 2001 article "Recommendations for Music Volume in Fitness Classes" accessed on April 5, 2012.
• George Mason University Physics and Astronomy article "Is Your Aerobics Class Making You Deaf?" accessed on April 5, 2012.
• United States Department of Labor Occupational Safety and Health Administration (OSHA) December 12, 2008 statement "Occupational Noise Exposure" accessed on April 5, 2012.

Yawning During Exercise? The Possible Causes Might Surprise You

Why do people yawn while exercising?

I had an interesting question from a participant in one of my group exercise classes the other day. She said that she tends to yawn uncontrollably during exercise class, quickly assuring me that my classes really aren't boring! The others in the class seemed sure that it was due to either fatigue or a lack of oxygen, but I decided to do a bit of research on the subject to satisfy my own curiosity.

Why do people yawn?

Yawning is a phenomenon that people experience before they are born, beginning at around eleven weeks after conception, yet scientists have not sorted out the complexities of this normal human action. Many theories have been tested with some interesting and sometimes mixed results. Here are a few...

Yawning and Oxygen Requirements

Although one common theory linked yawning with either low levels of oxygen or high levels of carbon dioxide, a study found that neither triggered yawning. They put the theory to the test by administering either 100% oxygen or gas mixtures containing 3% or 5% carbon dioxide, which is higher than normal CO2, and compared yawning rates with a control group. Although breathing rates were affected, yawning rates did not change. Studies that looked at exercise that doubled participant's breathing rates did not seem to change yawn rates either.



Yawning and Fatigue

Yawning is a common response to sleepiness, as detailed in the April 2007 Behavioral Brain Research article entitled The functional relationship between yawning and vigilance by Adrian G. Guggisburg et al. Sleepiness or exhaustion might be obvious in the person who suffers from insomnia or who knowingly does not get enough sleep, but those who seem to have an adequate amount of sleep could also be suffering from sleep disturbances of which they are unaware.

Many people suffer from sleep apnea, a condition in which the person stops breathing and then starts again while asleep. Another common condition that can disrupt sleep is periodic leg movement disorder (PLMD), a condition in which the person's legs twitch or move while the person sleeps. Those with sleep apnea or PLMD may wake up exhausted and tend to fall asleep during the day despite sleeping a normal amount of time due to repeated disturbances in the sleep cycle. Fatigue has quite a few other potential sources, such as an infection, food allergies, thyroid problems, and a diet lacking in necessary nutrients.

Yawning and Core Temperature Regulation 

According to a September 2008 Psychology & Behavior article by Andrew C. Gallup and Gordon G. Gallup entitled Yawning and Thermoregulation, yawning may be a way for the body to cool itself when other measures fail. Excessive or unusual yawning tends to occur with conditions that are commonly associated with a higher core temperature, such as multiple sclerosis, migraine headaches, stress, anxiety, sleep deprivation, and certain medications that may slightly elevate the body's temperature.

The core temperature typically rises during exercise, so yawning during an exercise class might indicate that the person's core temperature is rising and therefore the body is trying to cool itself. However, more studies specifically looking at thermoregulation and yawning would be helpful.

Medications That May Cause People to Yawn - Photo from Wikimedia Commons

Yawning and Medications

Several medications may be associated with yawning. According to the January 2007 Acta Psychiatrica Scandinavica article entitled Do your patients suffer from excessive yawning? by A. M Gutiérrez-Álvarez, the following medications tend to be associated with excessive yawning:

• selective serotonin reuptake inhibitors
• levodopa
• dopamine agonists
• MAO B inhibitors
• morphine
• methadone
• buprenorphine
• dextromethorphan
• benzodiazepine
• lidocaine
• flecaine 

It is interesting to note that in the above article, excessive yawning was shown to disappear with a decrease in dosage of the medication, so drug-induced yawning may be related to dosage.

Why Do People Yawn When Someone Else Yawns? - Photo by Scobull at Wikimedia Commons

Contagious Yawning

When seeing another person yawn, it is very common to yawn in response, but this does not happen every time a person sees someone else yawn. Why?

Humans as well as some mammals yawn, and this behavior may serve as a type of communication. According to the July 2010 Neuroscience & Biobehavioral Reviews article entitled Why do we yawn? by Adrian G. Guggisberg et al, yawning may serve to tell others that one is sleepy, bored, or perhaps experiencing mild psychological stress.

An article published in the 2011 PLoS ONE publication entitled Ingroup-Outgroup Bias in Contagious Yawning by Chimpanzees Supports Link to Empathy by Matthew W. Campbell and Frans B. M. de Waal found that chimps tended to yawn more when seeing someone familiar yawn than they did when seeing someone unfamiliar yawn. Perhaps folks who have common ground may be more likely to yawn when seeing someone familiar yawn, such as might be the case with an exercise class in which participants know one another.

The May 2011 Journal of Ethology article entitled The daily time course of contagious and spontaneous yawning among humans by Fiorenza Giganti and Iole Zilli found that test subjects were more likely to experience contagious yawning in early morning and late evening. Exercising at these times might mean that one is more likely to spontaneously yawn or to "catch" a yawn from another participant.

Yawning as a Symptom of Other Health Conditions

According to the NIH article Yawning – Excessive last updated 1/31/2011, excessive yawning could be the result of a vasovagal response, indicating a heart problem. Excessive yawning such as this may be more likely to persist throughout the day and not just during exercise. Yawning due to a medical condition in particular would warrant an evaluation by a healthcare professional.

Yawning During Exercise

I won't take the frequent yawning in my exercise classes personally, but I decided to publish my resulting research in order to help others out there who might be yawning while working out. The answer might not be simple or easily found, but knowing possible causes can help to focus efforts for someone who is trying to stop yawning excessively.

As with all of my articles, this information is not medical advice and anyone experiencing health issues should discuss those issues with his or her healthcare provider.

Related articles:

• Does Sleep Play a Role in Weight Gain and Weight Control?
• Exercise May Improve Cholesterol Ratio and Lower Triglycerides
• Walking – a Simple, Effective, Inexpensive Exercise

Visit the Fit Tips 4 Life site map to see other fitness articles by Katrena.

Coconut Oil and Its Affect on Cholesterol, Blood Sugar, BP, and Alzheimer's

Can Coconut Naturally Treat Diabetes? Photo by Robert Wetzlmayr at Wikimedia Commons

Several studies on coconut oil have produced some interesting results as researchers have looked at its effect on cholesterol, blood sugar, blood pressure, and dementia such as Alzheimer's disease. Most people automatically assume that all cholesterol has a negative effect on the body; however, one type of cholesterol, high density lipoprotein (HDL), has beneficial effects on the body by helping to prevent heart disease and stroke. Raising the HDL number can actually be a healthy move.

A higher "good" cholesterol (HDL) number can improve one's ratio when compared to the "bad" cholesterol. The CDC recommends an HDL level of at least 40mg/DL. Lifestyle changes, such as smoking cessation, increased exercise and weight reduction, and a healthy diet, can make a positive impact on cholesterol levels. A few foods and oils, such as certain whole grains, nuts like almonds, plant sterols, and omega-3 fatty acids may help to improve cholesterol ratios as well. But can coconut be added to that list?

Coconuts and Heart Health - Photo by Ranjithsiji at Wikimedia Commons

Coconut Oil's and Cholesterol/Triglycerides

According to several studies, coconut oil may show promise in improving one's cholesterol ratio as well. One such study comes from the Asia Pacific Journal of Clinical Nutrition, volume 20, issue 2 published in 2011. This report, entitled "Coconut oil is associated with a beneficial lipid profile in premenopausal women in the Philippines," by Alan B. Feranil et. al looked at how coconut oil affected lipid levels on 1,839 Philipino women and found that coconut oil in the diet was associated with higher HDL, or "good" cholesterol, numbers.

Lipids and triglycerides are closely tied to cholesterol as another type of fat in the blood. Lowering triglyceride levels can help lead to a healthier lifestyle and lower the risk for heart disease. According to an April 2010 article entitled "Beneficial Effects of Tender Coconut Water on Blood Pressure and Lipid Levels in Experimental Hypertension" in Journal of Cell & Tissue Research by D. Bhagya et. al, tender coconut water was associated with lowered blood pressure levels and lower triglyceride levels. Coconut water was also associated with higher total cholesterol levels, but the abstract did not indicate which type of cholesterol (HDL or LDL) was raised.

Coconut Oil to Treat Diabetes? - Photo by Drmarathe at Wikimedia Commons

Blood Sugar and Coconut Oil

Those with diabetes may find that coconut oil may help improve blood glucose levels. According to Sagar Naskar et. al in a December 2011 Journal of Ethnopharmacology article entitled "Evaluation of antihyperglycemic activity of Cocos nucifera Linn. on streptozotocin induced type 2 diabetic rats," coconut oil may have the potential to lower blood sugar levels with a low risk for side effects as demonstrated in an animal study.

Coconut Oil and Dementia

An interesting video shows how a neonatal doctor, Dr. Mary T. Newport, found that coconut oil seemed to significantly help her husband who was diagnosed with Alzheimers and was reaching the more severe stages of the disease. This video shows examples of impressive improvement in the clock test that this man experienced in a few weeks. Dr. Newport, who wrote Alzheimer's Disease: What if There was a Cure? described Alzheimer's as a sort of diabetes of the brain. Coconut oil might provide the brain with essential nutrients in which receptors for other sorts of "food" seem to be blocked in someone with Alzheimer's disease and other forms of dementia.

Which Type of Coconut Oil Works Best?

Not all coconut oils have the same effect on the body, according to some sources. One study by K. Gjovindan and Thankappan Rajamohan in the August 2009 Canadian Journal of Physiology & Pharmacology entitled "Wet and dry extraction of coconut oil: impact on lipid metabolic and antioxidant status in cholesterol coadministered rats" found that virgin coconut oil (VCO), or coconut oil extracted by wet process, produced superior results in lipid metabolism and antioxidant status when compared to coconut oil extracted by dry process, also known as copra oil.

The above video mentions to avoid hydrogenated coconut oil and to choose pure coconut oil.

Coconut Oil as a Natural Remedy - Photo by Ramon FVelasquez at Wikimedia Commons

Can Coconut Oil Lead to Healthier Living?

As scientists observe various cultures, they often look at key lifestyle differences that may help explain why some areas may have a lower incidence of health problems such as diabetes, heart disease, and Alzheimer's disease. Virgin coconut oil may have the potential to help people with poor cholesterol ratios, hypertension, diabetes, and Alzheimer's, but further studies are needed to help determine optimal daily levels and to determine what, if any, side effects the oil may produce.

Readers may also wish to read:

• Low Vitamin B12 Symptoms May Mimic MS or Alzheimer's Dementia
• UTI May Cause Sudden Confusion
• Exercise May Improve Cholesterol Ratio and Lower Triglycerides

Visit Fit Tips 4 Life site map for more articles on fitness and health!

How to Get Motivated to Exercise: Internal and External Personality Types

How to Get Motivated to Exercise for Life - Photo from NIH

Many people have lost hundreds of pounds only to discover that they have lost the same ones over and over. Or perhaps the numbers on the scale simply continue to rise higher and higher while others have maintained the same weight within a few pounds for decades. Although numerous sources speak of the great benefits of regular exercise and a healthy diet, many folks discover that getting motivated to start and maintain a regular exercise and healthy eating program may be very difficult.

One key issue to consider is one's personality, whether one is internally motivated or externally motivated. Both personality types have their strengths but both groups can also experience roadblocks to optimal individual fitness.

Pros and Cons of Being Internally Motivated - Photo by Dcoetzee at Wikimedia Commons

Advantages of Being Internally Motivated

When it comes to exercise and diet, those who are internally motivated may be able to embark on a quite successful solo exercise and healthy eating program. They may awaken at 5:00 a.m. and hit the treadmill, sidewalk, pool, or mall. They may have held a gym membership for twenty or more years. You could probably set your clock by these people who find motivation within themselves to stick with a routine, sometimes for years or even decades. They may not savor change, but these folks usually roll with the punches and adjust their routine to meet their needs.

Many of the people in this group are seniors. They may have grown up in a home where everyone was encouraged to pull themselves up by their bootstraps and keep on keeping on. These folks typically learned early in life how to rise above obstacles. They worked hard in younger years because they wanted food on the table and a warm place on which to lie their head at night. They are often loyal and seek to encourage others if asked. No, they do not always feel great, but they often realize that exercise enables them to achieve functional fitness and to enjoy life to a much fuller degree.

Diet choices in this group may be very healthy, or this group may simply exercise to the point where they balance the calories coming in. Many people in this group find that they maintain their weight or experience smaller weight gains over the long term than those who are externally motivated.

Disadvantages of Being Internally Motivated

Some who are internally motivated may participate in exercise classes that do not challenge them outside of their comfort zone either out of habit, in order to encourage someone else who may not be as fit, or perhaps to encourage the instructor. They may take care of others before taking care of themselves.

These folks with gym memberships may discover that a particular routine that has worked for them for years is suddenly replaced with a class that may or may not be safe for them. This could be the factor that serves as a huge roadblock to his or her health if another routine does not work well.

Internally motivated people may keep exercising despite injuries, with or without a doctor's blessing. Their stoicism might lead to denial of symptoms or signs that could indicate serious health problems. Sometimes they may miss making friendships as they focus on their fitness goals. Relaxation may be hard work for this group.

Don't put these people on a pedestal or assume that they always feel great – they are human and usually have to force themselves to work out during certain stages of their lives...but they typically do keep going and often quietly inspire many others along the way.

Pros and Cons of Being Externally Motivated © Katrena

Advantages of Being Externally Motivated

People who are externally motivated may be willing to try new things, as long as there is a tangible reward at the end. Perhaps a class reunion, upcoming wedding, gym challenge, or upcoming physical and/or bloodwork may do the trick. A gym that offers the latest workout equipment, newest group exercise classes, and largest pools may particularly attract those who are externally motivated. These folks tend to be willing to try all sorts of new fitness ideas, from techniques to music. They are usually game for going outside of their comfort zone, provided the goal is tangible.

Once committed, people who are externally motivated may achieve huge results in a short period of time. They may lose large amounts of weight and build muscle quickly. Sometimes the rewards do not even have to be huge or expensive. Gaining points, going for a t-shirt, receiving words of encouragement, or trying to get to the top of the list may be a great motivating force for the short term. Many people who are internally motivated benefit from gyms and programs that cater to this crowd, but prices for these facilities tend to rise as they keep purchasing new equipment to satisfy the ones who are seeking the "best" workout.

Disadvantages of Being Externally Motivated

New songs and equipment get old. New routines and instructors do too. Not everyone can win the challenge. A healthy diet is not often the easy road. Don't even mention weather, injuries, or full schedules.

Once the wedding, reunion, challenge, or blood test is over, those who are externally motivated may breathe a sigh of relief, pat themselves on the back and decide that they have finally achieved their goal. Now it is back to life as usual, which usually leads to weight gain, loss of muscle tone, and perhaps lowered bone density with higher blood sugar levels.

People who are externally motivated may spend large amounts of money on programs that offer flat abs and toned thighs in the twinkling of an eye. The fine print in those programs usually involves commitment to a strict diet that may or may not be healthy. Even the cheapest piece of equipment won't work if it is not used on a regular basis. Treadmills and other exercise equipment may become a clothes hanger and horizontal file for paperwork and other items. That great exercise DVD can quickly gather great amounts of dust. The one who is externally motivated may suddenly realize she is paying for a membership to a gym that she visits rarely.

Those who are externally motivated may miss out on ongoing fitness opportunities. The "boring" classes that are not branded may offer similar or even superior benefits over time, some with less potential for injury. Although this group may be willing to try all sorts of new classes, they may avoid even considering taking one that has been offered for years.

What Motivates You to Get Fit and Stay Fit?

Perhaps you are seeing a bit of yourself in some of these descriptions. That is a good thing! With knowledge comes an added ability to analyze and adjust. Both groups have advantages and disadvantages, and each group has something valuable to offer to the fitness world and to one's individual health. The key is to capitalize on those benefits and to tackle the challenges for a healthier life for years to come.

Check out the Fit Tips 4 Life site map for more great articles!

Energy Drinks and Alcohol: a Dangerous Combo

Dangers of Combining Energy Drinks and Alcohol

Many people, particularly adolescent and young adult students and athletes, are looking for ways to keep pushing, stay awake, and fit more into each hour. In the past, many looked to soft drinks for an extra boost, but energy drinks, which typically contain about three times the caffeine of a cola at around 70 to 80 mg, are now gaining popularity. An energy "shot" may contain about five times the caffeine found in an 8-ounce cola. The upper limit for caffeine in soft drinks is 200 parts per million, but energy drinks have bypassed this limit because they are typically labeled as "natural dietary supplements."

Caffeine Fast Facts

Caffeine constricts blood vessels, including those in the heart and head. It also makes the body's insulin less sensitive. In addition, the added calories of energy drinks may contribute to obesity and the consumption of "empty" calories. Many people become accustomed to consuming caffeine and need higher amounts to stay awake or alert.

Caffeine can cause side effects such as being jittery and anxious while headache and fatigue can result from withdrawing the substance if the person regularly consumes it. Caffeine intoxication or overdose may include symptoms such as tremor, fast heart rate, insomnia, abdominal pain and vomiting, low potassium levels, hallucinations, seizures, and even death. Those with heart conditions, eating disorders, or who are taking stimulants for conditions such as ADHD are particularly at risk for adverse effects from caffeine.

According to an American Academy of Pediatric article entitled "Kids Should Not Consume Energy Drinks, and Rarely Need Sports Drinks, Says AAP"energy drinks pose potential health risks because of the stimulants that they contain and should never be consumed by children or adolescents." According to a February 16, 2011 Medscape article "Energy Drinks Pose Serious Health Risk for Young People," children and adolescents should not consume more than 100mg total daily or 2.5mg/kg of caffeine in a day.

The Dangers of Combining Alcohol and Caffeine

Teens and young adults who consume caffeine combined with alcohol tend to have lower impulse control. Although the caffeine is a stimulant, it does not decrease impairment from alcohol or make a person more sober. On the contrary, drinking the two substances together makes the person less aware of the impairment and therefore more likely to drink and drive or take other potentially serious risks.

According to a November 13, 2009 press announcement by the FDA, several manufacturers pulled their alcoholic beverages that were mixed with caffeine. In order for a substance like caffeine to be legally added to a food or drink, the FDA must determine that it is generally recognized as safe (GRAS) to do so. The FDA banned the addition of caffeine to alcoholic beverages in November 2010.

According to the Medscape article cited above, about one-third to one-half of teens and young adults consume energy drinks. Mixing alcohol and caffeine is not a new concept; however, energy drinks and energy shots have significantly increased the caffeine content above and beyond that of colas and soft drinks of the past. Over half of college students who drink energy drinks also drink alcohol, a combination that can have grave consequences.

Alcohol and Caffeine Can be Deadly Combination - Photo by Nathanael from Wikimedia Commons

 Additional Sources:

• Healthday News for Healthier Living April 15, 2011 article "Alcohol-Energy Drink Combo Riskier Than Booze Alone, Study Says"
• The Partnership@DrugFree.org April 8, 2011 article "Combining Energy Drinks With Alcohol More Dangerous Than Drinking Alcohol Alone"

Visit the Fit Tips 4 Life site map for more of my articles!