Home Posts tagged "Rick Cohen"

Weight Training for Baseball: Featured Articles

I really enjoy writing multi-part features here at EricCressey.com because it really affords me more time to dig deep into a topic of interest to both my readers and me.  In many ways, it's like writing a book.  Here were three noteworthy features I published in 2010: Understanding Elbow Pain - Whether you were a baseball pitcher trying to prevent a Tommy John surgery or recreational weightlifter with "tennis elbow," this series had something for you. Part 1: Functional Anatomy Part 2: Pathology Part 3: Throwing Injuries Part 4: Protecting Pitchers Part 5: The Truth About Tennis Elbow Part 6: Elbow Pain in Lifters

Strategies for Correcting Bad Posture - This series was published more recently, and was extremely well received.  It's a combination of both quick programming tips and long-term modifications you can use to eliminate poor posture. Strategies for Correcting Bad Posture: Part 1 Strategies for Correcting Bad Posture: Part 2 Strategies for Correcting Bad Posture: Part 3 Strategies for Correcting Bad Posture: Part 4

A New Paradigm for Performance Testing - This two-part feature was actually an interview with Bioletic founder, Dr. Rick Cohen.  In it, we discuss the importance of testing athletes for deficiencies and strategically correcting them.  We've begun to use Bioletics more and more with our athletes, and I highly recommend their thorough and forward thinking services. A New Paradigm for Performance Testing: Part 1 A New Paradigm for Performance Testing: Part 2 I already have a few series planned for 2011, so keep an eye out for them!  In the meantime, we have two more "Best of 2010" features in store before Friday at midnight. Sign-up Today for our FREE Newsletter:
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A New Paradigm for Performance Testing – Part 2

Yesterday, I featured Part 1 of this interview with Rick Cohen, MD, the president and founder of Bioletics.  Today, we pick up where we left off. EC: Please tell us about the tests you use to determine mineral levels.  For what specific minerals are you testing, and what are some of the common findings you're seeing that can make a big difference in how someone feels and performs? RC: Our daily diet must contain adequate amount of macro minerals, which are necessary for all biochemical processes in the human body.  These minerals include calcium, chloride, magnesium, phosphorus, potassium, sulfur and sodium.  Among these, the most important are calcium and magnesium. Calcium helps to neutralize acidity, clear toxins and build bones; it also increases alkalinity and muscular flexibility. And while calcium receives a lot of media attention, the true king of all minerals is magnesium. Magnesium is not only the single most important mineral in sports nutrition, but it is also one of the most critical elements in our body.  About 350 enzymatic functions depend on magnesium, including ATP, the key factor that creates energy for every cell.  Optimal magnesium levels enhance athletic endurance and strength by increasing metabolic efficiency.  Magnesium promotes muscular contractility, decreases oxygen consumption, and improves cardiovascular efficiency. Unfortunately, magnesium deficiency is very common.  Inadequate dietary intake, sweat loss, physical and psychological stress and acidic beverages-such as energy drinks and sodas-cause the body to extract both magnesium and calcium from the bones and tissues in an effort to maintain proper blood pH.  This combination of mineral loss and acidity in the body will decrease athletic performance and prolong recovery.  It will also increase bone turnover and the resulting risk of stress fractures.  This is exactly what we were seeing in younger female athletes with accelerated bone loss.

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Despite magnesium's pivotal role in energy production and muscular health, many athletes are completely unaware of its critical importance.  Part of the problem is that there is not an easy or inexpensive test available for intracellular magnesium levels. While it may seem easy enough to assess levels of minerals - especially of magnesium and calcium in the blood - it's not. We have overcome this problem by using a functional marker of mineral balance called NTx.  Bones are living tissues that are constantly breaking down and rebuilding.  When they break down faster than they can rebuild, the body excretes increased amounts of NTx.  While NTx is not specific indicator of low magnesium, it tells us when an athlete has an intracellular calcium/magnesium imbalance as well as poor amino acid and/or vitamin D status. EC: What's your take on the most effective way to combat a magnesium deficiency that's discovered? RC: That's where the other issue with magnesium comes into play: oral supplements work slowly; it can take more than a year to adequately restore your levels.  In the past, intravenous infusions were considered the most effective way to go.  But this was expensive and impractical for most athletes.  Based on our research at Bioletics, we have found that the use of a topical magnesium oil spray to be very effective at restoring low magnesium levels after only two to three months of use. EC: What about the hormonal panel you guys run?  What does it include? RC: As athletes, we want our body to have a positive anabolic to catabolic ratio.  In simple terms, anabolism is the process of growth and repair.  Your anabolic state is at its highest in your teens. Testosterone is the key anabolic hormone.  Catabolism is the process of breakdown and destruction. Your catabolic state is as its highest after injury and illness, and increases as we age.  Cortisol is the key catabolic hormone.  By measuring your saliva, it is possible to create a snapshot of both an athlete's testosterone and cortisol balance as well as their anabolic/catabolic status.  Unfortunately, we frequently find low T/C ratios in athletes.

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Testosterone is an important health and performance hormone-for both men and women.  It plays a key role in directing muscle growth and repair; it is what enables the body to generate optimal power and recover fully after such a hard effort.  Testosterone contributes to an athlete's ability to stay focused, motivated and positive.  A premature decline in testosterone levels can be attributed to a number of different factors: poor diet, lack of sleep, excess body fat, nutritional deficiencies, environmental estrogens, and/or the use of medications, alcohol, and drugs. Cortisol is a major steroid hormone produced in the adrenal glands.  It allows the body to cope during times of stress. Without proper cortisol response, you will not be able to effectively meet the daily challenges of life.  Cortisol levels exhibit a natural rise in the morning and fall at night.  If this rhythm is disrupted, the body's mineral balance, immune response, blood sugar and stress responses will all be negatively affected.

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While it is very difficult to reverse the natural age-related decline in testosterone, the effects of stress and training on testosterone can be minimized. Since even "positive" stress can deplete testosterone, those who participate in endurance-related sports are especially at risk for having lower than optimal levels. Research shows that testosterone levels are temporarily decreased as a result of overtraining, while serum cortisol levels increase.  These changes in testosterone to cortisol balance are sometimes disastrous for an athlete, as they lead to elevated resting heart rate, poor performance, slow recovery, sore muscles, poor appetite, lethargy, muscle loss, irritability and a low sex drive. Periodic assessments of both testosterone and cortisol are important when it comes to uncovering a potential hormonal deficiency or to simply fine tuning your training program. EC: I'm curious about the essential amino acid test.  In particular, I'm wondering if you're seeing issues in this regard not only in people who don't consume enough protein, but also in folks who DO eat a lot of protein and for whatever reason don't utilize it properly. RC:  Of all the Bioletics assessments, the widespread deficiency in essential amino acids was the one that surprised me the most.  Almost every athlete knows that they need to eat protein and most athletes supplement their diets with additional protein powders. Yet, 90% of the athletes whose plasma amino acids we've tested were essential amino acid deficient.

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Essential amino acids are the building blocks of protein.  They allow the body to build and maintain muscle, neurotransmitters, hormones and key digestive and metabolic enzymes.  Research shows that the lack of just one essential amino acid can significantly interfere with these processes. What I've come to realize is that athletes don't have a protein need; they have an essential amino acid need.  And it's not how much protein we eat that is critical; it's the biological value of the protein we eat that counts. It's a common belief that one protein is just as effective as another when it comes to rebuilding tissue.  But dietary proteins all contain a different mix of the eight essential amino acids we need.  Therefore their biological value-their ability to be utilized anabolically by the body-differs. Research indicates that approximately 40% of the protein in high biological foods such as whole eggs, meat, fish, poultry is used by the body for anabolic purposes.  Only about 20% of that found in low biological food such as whey, soy, egg whites, beans and nuts is used for growth and repair.  So, vegetarians and those who consume much of their daily protein as a bar or powder should know that these proteins are not well utilized by the body.

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And the problem gets even more complicated.  Even if you are careful to consume only high quality proteins, you still may not be utilizing them effectively.  Stress, age, the use of medications, and/or certain cooking methods can reduce your body's ability to fully digest the protein you're eating. Athletes need to be aware that competition, training, and injury all damage structural proteins.  As a result, the athlete's body naturally requires greater amounts of essential amino acids for repair, recovery, and growth.  An amino acid deficiency will prompt the body to break down body tissue-primarily muscle-in an attempt to access the missing essential amino acid(s) it needs. Because of all these issues, we strongly recommend that all athletes use an essential amino acid supplement formula.  These formulas do not require digestion and are almost 100% utilized for anabolic purposes.  While many of us have come to rely or believe protein powders will cover our protein needs-and I was one of them-we now understand that protein supplements are just not as effective as we once thought. EC: Lastly, you've just added an essential fatty acid (EFA) panel.  What are you looking for on this? RC: Yes, I'm very excited about this new assessment, as the benefits of optimal essential fatty acid status are numerous and it brings us closer to our goal of being able to conveniently and inexpensively assess EVERY key, biological process in the athletic body. Essential fatty acids perform many physical functions. No cell, tissue, gland, or organ can function normally without them.  Optimal EFA levels are critical to reducing overall inflammation in the body.  They help you work harder and recover faster; they protect your joints, improve your mood and promote deeper sleep. Our EFA status becomes stronger when we eat foods that are similar to those eaten by our primitive ancestors - lean meats, antioxidant-rich fruits and vegetables, and fats with a high omega-3 to omega-6 EFA ratio.

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Over the past 50 years, we've developed an unfounded fear of healthful fats.  And we've started over-consuming processed fats.  Most Americans consume very little natural omega-3 fats, which can be found in fish, grass-fed meats, seeds and nuts.  Instead, we eat  processed omega-6 fats: corn, soy, canola, and safflower oil.  As a result, we've created a very unhealthy omega-3 to omega-6 fat ratio in our bodies.  Recent research has shown that this low omega-3 to omega-6 ratio (Omega-3 index) is not only the most powerful marker of inflammation, but the strongest predictor of sudden, cardiac death. Last year, when Bend suffered the loss of a 39 year-old world class athlete and the cause of his death was attributed to unknown cardiac cause, I became very motivated to find an affordable, at-home EFA assessment for athletes.  I am excited to say that we now offer athletes the opportunity to assess inflammatory status and their critical Omega 3 index with just a single drop of blood. EC: Very cool.   Nothing like some cutting-edge stuff to wrap this great interview up!  Thanks for taking the time today, Dr. Cohen. For more information on Dr. Rick Cohen and Bioletics, head over to their website.  And, don't forget that they've arranged a sweet discount for all EricCressey.com readers.  Enter the coupon code ECCPP25 at checkout, and you'll receive $25 off the cost of your initial basic or complete panel. Please enter your email below to sign up for our FREE newsletter.
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A New Paradigm for Performance Testing – Part 1

Last September, I was put in touch with Dr. Rick Cohen, and we hit it off right away.  In addition to being a knowledgeable and super-qualified physician, Rick is also a baseball fan and performance geek just like me (I knew he was legit when I met him for the first time and he was rocking some Vibram Five Fingers shoes!).  Rick's enthusiasm and forward-thinking mindset is absolutely contagious and has gotten his company, Bioletics, off to a great start. Just to get a feel for what he does (and while remaining unbiased), I had my fiancee go through a series of performance testing they do (outlined below) and the entire process was fantastic.  One of the glaring issues discovered was low vitamin D, which has since been addressed.  Just two months prior to our work with Rick, I'd encouraged her to ask her primary care physician to check her vitamin D levels at a routine physical.  The physician's response was "No.  You're not post-menopausal." The take-home message from this quick story is that not all physicians have all the information (or even a small fraction of the information, as Vitamin D plays countless roles in the body other than bone metabolism). Since forward-thinking physicians are few and far between, it's sometimes a challenge to find someone good in your area - and that's where a guy like Rick and his company can come in to help out. I highly recommend Bioletics - to the point that I wanted to get Rick on-board for an interview to share some of his great information.  So, without further ado, Dr. Rick Cohen. EC: Thanks for taking the time for an interview, Dr. Cohen.  Please fill us in a bit about your background, what you're doing at Bioletics, and where the idea for the business really emerged. RC: My pleasure. It actually all started in your neck of the woods in Massachusetts. I had a medical practice with a focus on nutrition, athletic performance and aging there for over ten years. At the time, I was very dissatisfied with the assessment options available in the medical field. So, I developed a few of my own that could be done at-home with either a saliva or urine sample or a finger stick blood spot.

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After moving to Bend, Oregon last year, I became involved in screening some of the girls on my daughter's track team for iron deficiency and bone health. We also looked at vitamin D, which is a critical nutrient for both bone health and overall athletic performance. When the results came in, it turned out that 95% of the runners low in iron. Additionally, 80% of the team was vitamin D deficient and more than 50% were mineral imbalanced.  After adding amino acid and recovery hormone panels to the screen, I repeated it with several local elite athletes.  Again, the results were shocking: not a single athlete was healthy from a biological standpoint.

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At this point, it was pretty obvious that there was a need to turn the entire concept of human performance testing inside-out.  For years we've been obsessed with peripheral performance measurements-heart rates, VO2 levels and power output.  But the idea of looking inside an athlete's body has been completely overlooked. Giving athletes the ability to assess their unique, physiological needs represents a paradigm shift in athletic performance.  Despite all the marketing hype in the sports supplement industry, there's no such thing as a one-size-fits-all formula for improving your athletic performance. As athletes, our basic, biological needs are all very different.  We would never think of buying a bike, a baseball bat, or a pair of running shoes without trying them on or out for size.  Why do we use nutritional supplements-protein powders, recovery drinks and vitamins-without knowing if they are a good fit for us? EC: Now, let's talk about some of the specific things you guys can test.  I've been a big vitamin D guy for years now, and I know that's one of your core tests.  What are you seeing thus far? RC:  Optimizing your level of vitamin D3 is the single most important thing you can do for your health and well-being-and quite possibly your performance.  Interestingly enough, vitamin D isn't really a vitamin at all.  It's a hormone manufactured by your skin during critical periods of sun exposure. Vitamin D is both a key building block and a cellular activator of almost every physical process.  It regulates more than 2,000 of the 30,000 human genes.  It's an essential part of the endocrine system, as it controls several of the adrenal hormones, growth of cells, and production of enzymes.  It's a powerful immune booster that provides a front-line defense against colds and flu as well as cancer and autoimmune disease. Vitamin D is essential for optimum athletic performance, as it contributes to muscular strength and recovery while controlling physical reaction time, balance and coordination.

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So far, almost every athlete we have tested has had sub-optimal levels of vitamin D (less than 50 ng/ml) except for one professional triathlete who trains in the sun in Australia all year.  Many athletes have been extremely low-under 25ng/ml. Unless you can train outside year-round and/or make a conscious effort to get mid-day sun exposure; it is almost impossible to restore vitamin D to an optimal level-between  60 and 80 ng/ml-without supplementation.  When supplementing, the best results have come from the use of a sublingual vitamin D3 spray.  Gel caps, tablets and liquids are less effective. The most important thing to remember is that your vitamin D level needs to be assessed and monitored. You can't just take a random dose of vitamin D3 and expect to get results. Bioletics offers an at-home finger stick assessment that is virtually pain-free; it takes only two minutes and two drops of blood to complete. EC: Now, how about iron?  It's traditionally been a huge issue for female endurance athletes, but are you seeing it as much in females who aren't on that level of training volume? RC: Yes.  We learned this is a huge issue, especially among teenage girls.  In general, low iron is a problem among menstruating women because they lose blood every month.  With teenage girls, the issue is compounded by the fact that their diets tend to be lower in calories, red meat and protein-all of which are critical for obtaining adequate iron.

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Iron is critical for athletic performance, as it carries oxygen in the red blood cells from the lungs to the muscles.  Severe iron loss results in a reduction of red blood cells (a condition known as anemia).  What most athletes are not aware of is that you do not have to be anemic to be suffering from low iron.  The most common signs of iron deficiency are fatigue, irritability, poor performance and slow recovery. Another important point to stress is that while the assessment of red blood cell count, hemoglobin, hematocrit and serum iron are needed to diagnose anemia, these are not sensitive indicators when it comes to assessing deficiencies in iron stores-the supply of iron that's actually available for the body to use.  The iron-binding protein, ferritin, is a much more reliable marker of functional iron stores.  We like to see levels of ferritin in females between 40 and 70 ng/ml. EC: How about men?  Is too much iron a common finding? RC: Good question. In men, we are much more concerned with excessive iron than with low iron. This is because men do not bleed regularly and also tend to eat more red meat and calories than women. The problem with too much iron is that it can create free radical damage in the body.  Just as iron in metal rusts, it has a similar action in your body.  Fortunately, your body has natural antioxidants to protect against the free radicals created by iron.  But when levels get too high, it can become a problem.  As we get older, excessive iron levels can play a role in the development of heart disease, cancer and immune disorders. Excessive iron is linked to a genetic variation in iron absorption rates.  Hemochromatosis is a genetic disorder where the body absorbs iron too readily and iron stores can get tens or even hundreds of times higher than normal and cause severe organ damage. While the full blown disorder is relatively rare, many people have lesser variants which cause gradual accumulation of iron over time.  The second cause is dietary-we take in too much iron by eating iron-fortified foods like breakfast cereals and breads.

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Just as with vitamin D, it is necessary to know your iron levels before you begin to take any kind of iron supplement.  The restorative dose of iron is generally 36mg daily while the maintenance dose for those with a history of low iron is 18mg daily. Taking a restorative dose without knowing a benchmark can push iron levels too high.  Playing it safe and taking a maintenance dose may not be enough. Ideal levels of ferritin in men are between 70 and 100 ng/ml.  If your levels are higher than that, it is important NOT to take any iron supplements or eat iron-fortified foods. We have seen iron levels in the upper 100s and low 200s in younger male athletes.  For these men, we recommended they monitor the levels every few years and to consider donating blood twice a year.  This will not only keep their iron levels from climbing, but will greatly help those in need. Part 2 of this interview with Rick will run tomorrow, but in the meantime, I've asked with Rick to arrange for a special discount for EricCressey.com readers only.  If you head over to www.Bioletics.com and enter the coupon code ECCPP25 at checkout, you'll receive $25 off the cost of your initial basic or complete panel. Please enter your email below to sign up for our FREE newsletter.
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