Category Archives for "Nutrition & Food"

Grilling meat and cancer. [Infographic] Tips to enjoy your barbecue without the risks.

By John Berardi, Ph.D.

grilling-meat-and-cancer

Everyone is worried about grilling meat and cancer…but should they be? Follow these surprising tips to enjoy your backyard barbecue while reducing the health risks.

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Ever heard that grilled meat is harmful to your health?

Carcinogens. Cancer. Scary stuff.

But don’t put away your grill just yet. There are steps you can take to minimize your risk and still enjoy the thrill of the grill.

Here’s what you need to know.

(Hint: drinking a beer with your burger can help.)

Click here for a fully printable version of this infographic. Hang it on your fridge or keep it with your cookbooks, and try the tips next time you’re grilling.

Want to know more about the science behind grilling, and its risks and benefits? Check out the accompanying article: It won’t kill you to grill. Grilling the safest, most delicious food (without the health risks).

Eat, move, and live… better.

The health and fitness world can sometimes be a confusing place. But it doesn’t have to be.

Let us help you make sense of it all with this free special report.

In it you’ll learn the best eating, exercise, and lifestyle strategies — unique and personal — for you.

Click here to download the special report, for free.

The post Grilling meat and cancer. [Infographic] Tips to enjoy your barbecue without the risks. appeared first on Precision Nutrition.

…read more

Read more here: Precision Nutrition

  

Nutrition for Injury Recovery - Part 4

Nutrition for Injury Recovery: Part 4

By John Berardi, Ph.D.

The right food and supplements can speed injury recovery. This is important — but often ignored.

Most trainers, coaches, nutritionists, therapists understand that nutrition can play a role in injury recovery.  However, in lecturing around the world, I’ve found that very few of them really know how to use food and supplements in this way.

Aside from recommending more water, topical homeopathic creams and gels, and glucosamine/chondroitin combinations, there’s really not much else on the menu when a client or athlete goes down with an acute injury.

That’s why we’re sharing this 5-part video series, filmed live at the 2012 Fit Pro Convention in Loughborough, England.

In this video series, we’ll teach you how the body repairs itself after an injury.

Then we’ll share the food and supplement protocols we use to get injured clients back in the game more quickly and completely.

To learn more, click the play button below to get started with Part 4 of Nutrition for Injury Recovery. (Click here for part 1, part 2, part 3, and part 5). The video is about 7 minutes long.

To download an audio or a video version of this file, click here.
Please be patient as downloads may take a few minutes.

Micronutrient needs during recovery

Vitamins and minerals are nutrients required in small amounts for metabolic reactions in the body. They can act as:

  • catalysts that bind to enzymes to facilitate enzyme action in the body;
  • coenzymes that work with other enzymes; or
  • substrates that are directly metabolized themselves.

Vitamins A, B, C, and D as well as calcium, copper, iron, magnesium, manganese, and zinc are all important for injury recovery. (Interestingly, vitamin E may slow healing so avoid vitamin E supplements during injury.)

However, the role that each vitamin and mineral plays is not well understood.

Until further research confirms these roles, we don’t know whether we should simply prevent a vitamin/mineral deficiency or add supplemental vitamins/minerals for extra healing.

Rather than discussing each vitamin and mineral that may affect injury recovery, let’s discuss only those that may require additional supplementation.

Vitamin A

Vitamin A enhances and supports early inflammation during injury, reverses post-injury immune suppression, and assists in collagen formation via collagenase modulation. Studies have shown that collagen cross-linkage is stronger with vitamin A supplementation and repair is quicker.

Typically 25,000 IU daily is recommended for short periods of time surrounding serious trauma and surgery. However, we do worry about toxicity. Supplementing with 10,000 IU daily for the first 1-2 weeks post-injury is probably safer.

Vitamin C

Vitamin C enhances neutrophil and lymphocyte activity during phase 1 of acute injury. It also plays an important role in collagen synthesis, as it helps form bonds between strands of collagen fiber. With vitamin C deficiencies, collagen fibers are formed abnormally and fibrous tissue is weak with poor adhesion.

Vitamin C is also a powerful antioxidant and immune system modulator, and research suggests that vitamin C can help people recovering from surgery, injury, and ulcers. Supplement with 1g- 2 g/day during periods of injury repair.

Copper

Copper is a mineral that assists in the formation of red blood cells and works with vitamin C to form elastin and to strengthen connective tissue. 2-4 mg/day is recommended during the first few weeks of injury repair.

Zinc

Zinc is required for over 300 enzymes in the body and plays roles in DNA synthesis, cell division, and protein synthesis — all necessary for tissue regeneration and repair.

Zinc deficiency has been associated with poor wound healing and, as zinc deficiency is one of the most common micronutrient deficiencies, we recommend supplementing 15-30 mg per day, especially during the initial stages of healing. (Note: Make sure to balance copper and zinc if you supplement, as an excess of one can create deficiencies of the other.)

Note: Calcium and iron deficiencies are, like zinc deficiencies, quite common. Because they’re important for bone health, athletes who are deficient in calcium and iron are more likely to suffer stress fractures.

Thus, while these two minerals may not play direct roles in injury healing, they play a large role in prevention. Get enough calcium and iron, preferably from whole foods rather than supplements.

Here’s a brief list of the vitamin and mineral supplements that help with acute injury recovery:

  • Vitamin A – 10,000 IU/day for 2-4 weeks post-injury
  • Vitamin C – 1000-2000 mg/day for 2-4 weeks post-injury
  • Copper – 2-4 mg/day for 2-4 weeks post-injury
  • Zinc – 15-30 mg/day for 2-4 weeks post-injury

Additional nutrients that may affect injury recovery

Supplemental amino acids powerfully affect injury healing. When the body is under stress, arginine and glutamine become conditionally essential amino acids.  These two amino acids and others speed up healing.

Arginine

This amino acid works several ways. First, it may stimulate insulin release and IGF action. These powerful anabolic hormones can stimulate protein synthesis and collagen deposition.

Via increased nitric oxide production, arginine may increase blood flow to the injured area and activate macrophages for tissue clean-up. These macrophages also produce and activate growth factors, cytokines, bioactive lipids, and proteolytic enzymes necessary for healing.

Finally, arginine may promote the conversion of ornithine to proline.

Studies using arginine in rodents and humans have demonstrated that high dose arginine supplementation can increase collagen accumulation, reduce lean body mass loss, reduce nitrogen excretion, and accelerate wound healing. Human doses have been in the range of 15-30 g per day; higher doses having the largest effect.

Ornithine

As supplemental arginine has shown benefit in wound healing and ornithine is the main metabolite of arginine, researchers have speculated that ornithine might also show similar benefits.

The mechanisms of action for ornithine in wound healing somewhat overlap those of arginine. Ornithine can be converted to the amino acid proline, which is essential in collagen deposition. Ornithine supplementation can improve protein metabolism in burn/trauma patients.

Studies using ornithine in trauma/injury situations have shown that ornithine can shorten healing time, increase healing strength, and increase nitrogen retention. Human doses in these studies have been in the 20-30 g/day range (10 g 2-3x per day) with larger doses having the greatest effect.

Glutamine

This amino acid is essential for the metabolism of rapidly turning-over cells such as lymphocytes and enterocytes.

During starvation, trauma, …read more

Read more here: Precision Nutrition

  

All About Phytates (Phytic Acid)

By Ryan Andrews

phytic acid whole grains All About Phytates (Phytic Acid)

Phytic acid – the storage form of phosphorus – is one of those pesky “anti-nutrients” the Paleo community keeps telling you to avoid.

It’s often considered an anti-nutrient because it binds minerals in the digestive tract, making them less available to our bodies.

Yet these same anti-nutrient properties can also help in the prevention of chronic disease.

What is phytic acid?

Seeds — such as nuts, edible seeds, beans/legumes, and grains — store phosphorus as phytic acid. When phytic acid is bound to a mineral in the seed, it’s known as phytate.

The tables below compare various seed types according to their phytic acid/phytate content.

Whole grains

Source: Schlemmer U, et al. Phytate in foods and significance for humans: Food sources, intake, processing, bioavailability, protective role and analysis. Mol Nutr Food res 2009;53:S330-S375.

Legumes

phytic acid beans All About Phytates (Phytic Acid)

Source: Schlemmer U, et al. Phytate in foods and significance for humans: Food sources, intake, processing, bioavailability, protective role and analysis. Mol Nutr Food res 2009;53:S330-S375.

Nuts

phytic acid nuts 1024x361 All About Phytates (Phytic Acid)

Source: Schlemmer U, et al. Phytate in foods and significance for humans: Food sources, intake, processing, bioavailability, protective role and analysis. Mol Nutr Food res 2009;53:S330-S375.

Oil seeds

phytic acid oils 1024x326 All About Phytates (Phytic Acid)

Source: Schlemmer U, et al. Phytate in foods and significance for humans: Food sources, intake, processing, bioavailability, protective role and analysis. Mol Nutr Food res 2009;53:S330-S375

As you can see, phytic acid content varies greatly among plants.  This is due to the type of seed, environmental condition, climate, soil quality, how phytate is measured in the lab, and so forth.

Roots, tubers, and other vegetables may also contain phytic acid, but usually in lower amounts.

The most concentrated sources tend to be whole grains and beans. Phytic acid is isolated in the aleurone layer in most grains, making it more concentrated in the bran.  In legumes, it’s found in the cotyledon layer (where the protein is).

Phytate = phytic acid bound to a mineral
Phytates perform an essential role in plants, as they are an energy source for the sprouting seed. When a seed sprouts, phytase enzymes break down the stored phytates.

When we eat the plant, phytates are hydrolyzed during digestion to myo-inositol-1,2,3,4,5,6-hexkisphosphate (IP6) and lower inositol polyphosphates including IP1 through IP5 (these are phytate degradation products).

Who’s eating phytic acid?

Everyone who eats plants consumes some phytic acid. It’s all a question of degree.

As you can imagine, intake tends to be much higher among those who follow non-Westernized diets.  In developing countries, plants are staple foods, which means people eat more of them, and therefore get more phytic acid.

In developed countries, plant-based or vegetarian eaters tend to consume more phytic acid than omnivores.  Further, males usually consume more phytic acid than females, simply because they eat more food.

Phytate digestion

Most phytate (37-66%) is degraded in the stomach and small intestines.

Ordinarily, our bodies regulate phytate levels pretty well, adjusting uptake in the gut and excretion until body levels come into balance.

Vitamin D status in the body seems to influence how much phytate is actually retained.  The more vitamin D, the more phytate retained; the less vitamin D, the less phytate retained.

Potential problems with phytic acid

Phytic acid can bind minerals in the gut before they are absorbed and influence digestive enzymes.  Phytates also reduce the digestibility of starches, proteins, and fats.

Here’s an example.

Vegan eaters often consume more iron than omnivores.  Yet, they also consume more anti-nutrients, including phytates, and these reduce the amount of iron available to their bodies. Consuming 5-10 mg of phytic acid can reduce iron absorption by 50%.

This is why vegetarian eaters should eat more iron than omnivores (33 mg for veg eaters vs. 18 mg for omnivores).

Daily iron loss for men & women
  • Adult men lose ~1 mg of iron per day
  • Adult menstruating women lose ~1.4 mg/day
  • Postmenopausal women lose ~0.8 mg/day
  • Lactating women lose ~1.1 mg/day

While in the intestines, phytic acid can bind the minerals iron, zinc, and manganese. Once bound, they are then excreted in waste.

This can be a good or bad thing, depending on the condition.  It’s a bad thing if you’re having trouble building up iron stores in the body and have developed iron-deficiency anemia.

When is it a good thing?  Keep reading – you’ll find potential benefits of phytic acid below.

Potential benefits of phytic acid

Despite its potential drawbacks, phytic acid is similar in some ways to a vitamin, and metabolites of phytic acid may have secondary messenger roles in cells.

Some experts even suggest that it’s the phytic acid in whole grains and beans that lends them their apparent protective properties against cardiovascular disease, cancer, and diabetes.

(Remember, the grains with little to no phytic acid are the refined ones.)

The supplement industry has caught on to this.  Have you even seen a bottle of inositol hexaphosphate, or IP6?  …read more

Read more here: Precision Nutrition

  

Nutrition for Injury Recovery - Part 3

Nutrition for Injury Recovery: Part 3

By John Berardi, Ph.D.

The right food and supplements can speed injury recovery. This is important — but often ignored.

Most trainers, coaches, nutritionists, therapists understand that nutrition can play a role in injury recovery.  However, in lecturing around the world, I’ve found that very few of them really know how to use food and supplements in this way.

Aside from recommending more water, topical homeopathic creams and gels, and glucosamine/chondroitin combinations, there’s really not much else on the menu when a client or athlete goes down with an acute injury.

That’s why we’re sharing this 5-part video series, filmed live at the 2012 Fit Pro Convention in Loughborough, England.

In this video series, we’ll teach you how the body repairs itself after an injury.

Then we’ll share the food and supplement protocols we use to get injured clients back in the game more quickly and completely.

To learn more, click the play button below to get started with Part 3 of Nutrition for Injury Recovery.  (Click here for part 1, part 2, part 4, and part 5). The video is about 8 minutes long.

To download an audio or a video version of this file, click here.
Please be patient as downloads may take a few minutes.

Calorie needs during recovery

In the previous video, we looked mostly at managing Stage 1 of injury recovery. Today, we’ll look at two important factors that affect Stage 2 and 3 injury recovery: adequate calorie and micronutrient intake.

Activity costs energy. Thus, we need more energy when training for sports, or following an exercise program.

Yet some athletes, especially female athletes, intentionally (to lose body weight) or unintentionally (due to improper nutrition education) under-eat.

This can lead to more repetitive stress injuries such as stress fractures or ligamentous injury. Thus, too few calories when healthy can lead to injury; too few calories during recovery can prevent an athlete from getting healthy.

Energy needs increase during acute injury repair. In fact, basal metabolic rate (BMR) may increase by 15 to 50% based on the severity of the trauma.  For example, sports injury and minor surgery may increase BMR by 15-20% ,while major surgery and burn injury may lead to a 50% increase in BMR.

Of course, comparatively speaking, an athlete or exerciser will have to eat less during injury recovery than during training and competition. Yet if they return to baseline intake, they may be under-eating.

Thus, nutrition coaches must balance the increased energy and nutrient needs of injured and recovering clients with the reality of less activity.

One example of calorie needs

Let’s take the example of a young male athlete. He’s 14 years old, 5’6? and 140 lb.

  • Basal Metabolic Rate – 1611 kcal/day (mean of 3 predictive equations)
  • Energy needs when sedentary – 1933 kcal/day (activity factor of 1.2)
  • Energy needs with daily training/competition – 2739 kcal/day (activity factor of 1.7)
  • Energy needs during recovery – 2319 kcal/day (activity factor of 1.2 and a 20% increase in metabolism due to injury)

As you can see, during injury repair, energy intake should decrease (2319 kcal) relative to training and competition (2739 kcal).  However, returning to sedentary baseline (1933 kcal) will lead to underfeeding.

This is important both clinically and practically.

Less physical activity means lower appetite. If an athlete is eating based on hunger cues, s/he may under-eat during recovery. S/he might lose lean mass, heal poorly, and progress slowly.

Thus while injured athletes should eat less during periods of injury, remember: They’re still athletes, and should eat as such. This includes things like eating every few hours, getting enough protein, balancing macronutrients, and getting enough important micronutrients.

Macronutrient needs during recovery

Protein

Injury repair requires more protein. Injured athletes should aim for 1.5-2.0 g/kg, up from the usual 0.8 g/kg. Many already do this.

To ensure a quick recovery, make sure to get this higher protein intake consistently. At minimum, injured athletes should be taking in 1 g of protein per pound of body weight.

Fat

We covered dietary fat in a previous video — you’ll recall that we recommended balancing dietary fat by getting about 1/3 of total fat intake from each of the three types of fat. Most importantly, aim for more omega-3s and cut down omega-6s, to get an omega-6 to -3 ratio that’s at least 1:1 and preferably closer to 3:1.

Carbohydrate

While athletes need glucose for athletic injury healing, no specific carbohydrate recommendations have been established for injury periods. However, you should probably include enough dietary carbohydrate to ensure adequate micronutrient intake and stable insulin concentrations (which, as an anabolic hormone, may affect wound healing). In some athletes accustomed to a higher intake of carbs, not getting enough will be an additional — and unwanted — stressor.

Macronutrient needs summary

Here’s how to implement these recommendations in treating injuries nutritionally:

Meal frequency

Eat every 3-4 hours.

Protein

Each meal/snack should contain complete protein including lean meats, lean dairy, eggs, or protein supplements (if whole food is unavailable).

Vegetables and fruit

Each meal/snack should contain 1-2 servings of veggies and/or fruit (1/2 – 1 1/2 cups or 1-2 pieces) with a greater focus on veggies.

Starches

Get additional carbohydrates from whole grain, minimally processed, high-fiber sources like whole oats, yams/sweet potatoes, beans and legumes, whole grain rice, quinoa, etc. Eat fewer starches when not training (such as during injury recovery), but don’t cut them too low, especially if an athlete is not already well adapted to using fat for fuel.

Fats

Eat each of the following good fats each day — avocados, olive oil, mixed nuts, fatty fish (such as salmon), flax seeds, and flax oil. Add 3-9 grams of fish oil daily, taken in divided doses if necessary.

Wrap-up and today’s takeaways

That’s it for part 3 of Nutrition for Injury.

For now, here are some key points.

  • Athletes and exercisers need to eat enough — when training and when recovering.
  • When you’re injured and recovering, you should eat less than you did when you were training hard… but more than you would if you were completely sedentary.
  • Eat at least 1 g of protein per pound of body weight; balance dietary fats (and get more omega-3s than -6s); get some (but not a lot of) starchy, high-fiber carbohydrates; and eat a lot of vegetables (with …read moreRead more here: Precision Nutrition

      

Nutrition for Injury Recovery - Part 2

Nutrition for Injury Recovery: Part 2

By John Berardi, Ph.D.

The right food and supplements can speed injury recovery. This is important — but often ignored.

Most trainers, coaches, nutritionists, therapists understand that nutrition can play a role in injury recovery.  However, in lecturing around the world, I’ve found that very few of them really know how to use food and supplements in this way.

Aside from recommending more water, topical homeopathic creams and gels, and glucosamine/chondroitin combinations, there’s really not much else on the menu when a client or athlete goes down with an acute injury.

That’s why we’re sharing this 5-part video series, filmed live at the 2012 Fit Pro Convention in Loughborough, England.

In this video series, we’ll teach you how the body repairs itself after an injury.

Then we’ll share the food and supplement protocols we use to get injured clients back in the game more quickly and completely.

To learn more, click the play button below to get started with Part 2 of Nutrition for Injury Recovery.  (Click here for part 1, part 3, part 4, and part 5). The video is about 11 minutes long.

To download an audio or a video version of this file, click here.
Please be patient as downloads may take a few minutes.

Three physiological targets

Once we understand how healing works, we can look for different therapies to help the process along, using a three-pronged approach:

  • Inflammation support (and management) through nutrition
  • Immune system support through nutrition
  • Regeneration and anabolic support through nutrition

Let’s start by talking about inflammation.

Inflammation

Treating acute injuries requires a tricky balance of managing inflammation while allowing it to do its important job.

Don’t try to avoid the inflammatory process in the acute phases of an injury. It’s critical for Stage 1 recovery.

But don’t make inflammation worse, either. Excessive inflammation could increase total tissue damage, slowing down the repair process.

While managing inflammation in the early stages, we want to reduce pain, as this can cause biomechanical compensations and changes that may lead to secondary injury.

However, again, strategies that eliminate pain often target inflammation. Rushing to eliminate inflammation (and pain) too soon may also reduce healing. Again, it’s a tight balancing act.

Dietary fat for inflammation control

A diet high in trans-fats, omega-6 rich vegetable oils, and saturated fat will be pro-inflammatory (in other words, it’ll worsen inflammation).  A diet high in monounsaturated fats and omega-3 fats will be anti-inflammatory.

The ratio of omega-6 to omega-3 in the diet is important for overall inflammation in the body — especially during normal periods of healthy living when we definitely want to keep inflammation under control.

In these circumstances, the omega-6 to 3 ratio should be anywhere from 3:1 to 1:1, which should lead to a balanced inflammatory profile.

Of course, overall fat balance is important here. With a good balance of saturated, monounsaturated, and polyunsaturated fats (about 1/3 of total fat intake each), the body’s inflammatory profile will look pretty good.

However, purposely decrease omega-6 fats and increase omega-3s (specifically fish oil).  High omega 6:3 ratios reduce collagen production while a low 3:6 ratio supports healing.

Even though relatively higher omega-3s create an anti-inflammatory response in the body, this response doesn’t interfere with repair; rather, it only helps with injury healing and collagen deposition.

Unfortunately, we haven’t yet determined the exact omega 6:3 ratio, nor the amount of fish oil supplementation required to manage inflammation during injury.

Studies with low dose fish oil (~450 mg to 1 g/day) have shown no effect on inflammatory or immune markers while other studies have shown that high dose fish oil (12-15 g/day) may reduce immune cell function in certain populations.

As a result, some authors have recommended anywhere from 3-9 grams of fish oil (salmon oil, sardine oil, menhaden oil, krill oil, etc.) per day.

In addition to the omega 6:3 ratio, research has shown that increased nut and seed consumption, as well as olive oil consumption, can mildly reduce inflammatory biomarkers.

Nuts, seeds, and olive oil likely share a common mechanism.  The monounsaturated fats found in all three contain compounds that can mildly reduce COX enzyme activity (something these foods share with ibuprofen). But again, be careful.  Too high a dose of any anti-inflammatory may reduce acute healing.

Thus: Improve omega 6:3 ratio while adding in healthy monounsaturated fats and balancing saturated, polyunsaturated, and monounsaturated intake. Here are some simple strategies to do this:

To balance your fats:

Increase intake of olive oil, mixed nuts, avocados, flax oil, ground flax and other seeds, etc. Get some of each fat source each day. These foods will balance out the saturated fats naturally present in your protein sources, leading to a healthy profile without needing a calculator. (Bear in mind that you may need to reduce overall portion sizes if you are inactive because of the injury.)

To balance your 6:3 ratio:

Add 3-9 grams of fish oil each day while reducing omega-6 fats like vegetable oils such as corn oil, sunflower oil, safflower oil, cottonseed oil, and soybean oil, etc. This strategy should take care of your omega 6:3 ratio.

Dietary herbs and phytochemicals for inflammation

Beyond healthy fat balance, certain dietary herbs can help manage inflammation.

Turmeric

A flowering plant in the ginger family, turmeric has long been used as an anti-inflammatory agent and in wound healing. Current research shows that the active ingredient, curcumin, is responsible for some of the benefits of turmeric. While adding turmeric to food every day is a good strategy, using 400-600 mg of supplemental turmeric extract 3x per day (or as described on the product label) is probably more manageable for most people.

Garlic

Garlic has been shown to inhibit the activity of the inflammatory enzymes cyclooxygenase and lipoxygenase and affect macrophage function. Again, though, while eating additional garlic is likely a good strategy, garlic extracts may be required for more measurable anti-inflammatory effects. Typically recommended dosing is 2-4 g of whole garlic clove each day (each clove is 1 g) or 600-1200 mg of supplemental aged garlic extract.

Bromelain

Bromelain is another anti-inflammatory plant extract from pineapple. While best known for its digestive properties, bromelain is an excellent anti-inflammatory and analgesic compound although its mechanism of action is poorly understood. …read more

Read more here: Precision Nutrition

  

Nutrition for Injury Recovery - Part 1

Nutrition for Injury Recovery: Part 1

By John Berardi, Ph.D.

The right food and supplements can speed injury recovery. This is important — but often ignored.

Most trainers, coaches, nutritionists, therapists understand that nutrition can play a role in injury recovery.  However, in lecturing around the world, I’ve found that very few of them really know how to use food and supplements in this way.

Aside from recommending more water, topical homeopathic creams and gels, and glucosamine/chondroitin combinations, there’s really not much else on the menu when a client or athlete goes down with an acute injury.

That’s why we’re sharing this 5-part video series, filmed live at the 2012 Fit Pro Convention in Loughborough, England.

In this video series, we’ll teach you how the body repairs itself after an injury.

Then we’ll share the food and supplement protocols we use to get injured clients back in the game more quickly and completely.

To learn more, click the play button below to get started with Part 1 of Nutrition for Injury Recovery.  (Click here for part 2, part 3, part 4, and part 5). The video is about 8 minutes long.

To download an audio or a video version of this file, click here.
Please be patient as downloads may take a few minutes.

All about soft tissue repair

With all the pain, swelling, redness, and dysfunction, injury can seem like a chaotic process. Yet at the physiological level, injury recovery is highly organized and consistent.

That allows researchers and clinicians to classify three distinct stages of repair:

Stage 1: Inflammation

Regardless of the type of injury, there’s usually damage to muscle, bone, and vascular tissue.  When these tissues are injured, they’re deprived of their normal flow of oxygen and nutrient-rich blood. Reduced blood flow, as well as the actual physical damage, leads to cell death.

The body then initiates the inflammatory process to clear out the damaged/dead cells and lay down new ones.

Inflammation itself is stimulated by the increased movement of inflammatory/immune chemicals (leukocytes, neutrophils, macrophages, phagocytes, etc.) into the injured areas. These chemicals take care of the cellular debris and attract plasma (fluid from the blood) and blood proteins to the site of injury.

This biochemical process removes injured tissues and starts the repair process.

Inflammation is characterized by three elements:

1. Pain.  This is a function of two things: First, certain chemicals involved in injury repair (substance P, calcitonin, histamines, cytokines) may interact with local pain receptors to cause the pain associated with inflammation. As inflammation proceeds, pain may also result from the swelling/pressure placed on nerve endings.

2. Swelling.  This is a result of fluid seeping through damaged — and now hyper-permeable — blood vessels into the damaged tissues. These vessels are typically damaged by the initial trauma. In addition, they’re often altered chemically during the inflammatory process.

3. Redness and heat. Vasodilation up-stream of the injury and constriction downstream shunts additional blood to the injured area, producing heat and redness. The upstream vasodilation is thought to be related to nitric oxide activity.

Although painful and irritating, we need the inflammatory process for repair. Without inflammation, injuries wouldn’t heal. So any attempt to eliminate inflammation is a mistake in the initial stages of an acute injury. 

Chronic injury is different.

Excessive inflammation, especially if it’s prolonged, can lead to other problems, such as continued macrophage activity at the site of inflammation and ongoing tissue destruction. This is why inflammation management is an important concept in injury recovery.  It’s also why anti-inflammatory drugs are often prescribed by physicians during chronic pain.

Stage 2: Proliferation

Once the inflammation of stage 1 begins to subside, most of the damaged tissues will have been removed from the site of injury, and new vasculature will have developed.

This restoration of oxygen and nutrient flow to the damaged area allows fibroblast proliferation/multiplication. Once this occurs, collagen and fibronectin are laid down. This forms what is commonly called “scar tissue.”

Importantly, scar tissue will lay down in alignment with the forces being placed on the area. (That’s why rehab and therapy is so important.)  Further, this scar tissue will contract and shorten as it matures.  This is due to fibroblast differentiation into myoblasts, which are similar to smooth muscle cells.  This reduces the size of the injury.

Stage 3: Remodeling

Eventually, the scar tissue (typically made up of type II collagen) will be degraded and type I collagen (much stronger) will be laid down in its place. Although this new tissue will never likely be 100% normal, it can become about 80% as strong as uninjured tissue.

Since this tissue is created along tension lines, functional activity (rehab and therapy) is critical throughout the recovery process, as it helps to maintain the length of the scar tissue. It’ll also help arrange the tissue in an organized pattern, in line with adjacent soft tissue fibers.

This predictable pattern of soft tissue healing can give us clues about how to manage injuries through the use of physical therapy, manual therapy, nutritional strategies, and drug interventions.

All about bone repair

Bone healing undergoes a similar, yet unique, process when compared to soft tissure repair.

Stage 1: Reactive phase inflammation

Bleeding from the fractured bone and surrounding tissue causes the fractured area to swell. This is similar to the inflammation phase experienced in soft tissue injury.

Stage 2: Soft callus formation

At this point, the pain and swelling will decrease. The site of the fracture will stiffen, with new bone forming. New bone is weaker than uninjured bone. It’s also incomplete and, therefore, cannot be seen on x-rays.

Stage 3: Hard callus formation

During this phase, new bone begins to bridge the fracture, covering the incomplete soft callus. This bony bridge can be seen on x-rays.

Stage 4: Bone remodeling

The fracture site remodels itself, correcting any deformities that may remain as a result of the injury. This final stage of fracture healing can last up to several years.

Like soft tissue injuries, bone injuries go through an early inflammation phase. This attracts plasma and inflammatory cells to the site of injury. These cells help to clear out the damaged tissue and revascularize the area.

After this occurs, other …read more

Read more here: Precision Nutrition

  

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