Health and fitness is both the goal of many recreational rowers and the foundation for all successful competitors. Valuable new recommendations based on solid science are constantly emerging, along with questionable advice based on outdated information, or the misinterpretation of preliminary. Unless otherwise noted, the information included here has been drawn from Dr. Gabe Mirkin’s[i] authoritative Fitness and Health Newsletter,[ii] identified simply as [Mirkin, followed by the date].
APPLYING ICE
“Applying ice to sore muscles can ease the pain but it delays healing by decreasing the healing immune response (Knee Surg Sports Traumatol Arthrosc, Feb 23, 2014; American J of Sports Medicine, June 2013). Anything that reduces inflammation delays healing: cortisone-type drugs, most pain-relieving medicines, such as non-steroidal anti-inflammatory drugs like ibuprofen (Pharmaceuticals, 2010;3(5)), immune suppressants that are often used to treat arthritis, cancer or psoriasis, and anything else that blocks the immune response to an injury.” [Mirkin, October 21, 2018. https://www.drmirkin.com/fitness/why-ice-delays-recovery.html]
“You feel cold most in your fingers, ears and toes. During World War II, gunners on the bombers complained bitterly about frozen hands, ears and toes. The Army Air Force added special insulation to their gloves, hats and boots, and they stopped complaining even though they still suffered frostbite on the skin of their necks and front of their chests. They had unzipped their jackets because they didn’t feel cold… [ Mirkin, January 21, 2018. https://www.drmirkin.com/fitness/cold-weather-exercise-tips.html]
DIETS
High Protein Diets
“A recent study in mice showed that increasing dietary protein from 15 percent to 46 percent of calories caused the mice to develop 30 percent more arterial plaques than mice on their normal-protein diet, even though they did not gain more weight (Nature Metabolism, Jan 23, 2020;2:110-125). Furthermore, the mice on the high-protein diet were at very high risk for heart attacks because the plaques were unstable. This study could explain why high-protein diets are associated with increased risk for heart attacks in humans…
“High-protein diets can:
• raise blood TMAO levels that increase heart attack risk (European Journal of Nutrition, July 5, 2019:1-14)
• damage healthy kidneys (Nephrology Dialysis Transplantation, Nov 27, 2019; June 7, 2019)
• increase risk for diabetes (Am J Clin Nutr, Nov 2015;102(5):1266-78; Nov 2004;80(5):1246-53).” [Mirkin, February 9, 2020]
Keto Diets
“The various ketogenic diets that severely restrict all carbohydrates and replace them mostly with fats are associated with increased risk for non-alcoholic fatty liver disease or NAFLD (JAMA Intern Med, published online July 15, 2019). NAFLD can lead to diabetes, heart attacks, strokes, liver cancer and other cancers (Curr Opin Clin Nutr Metab Care, Jul 1, 2012;15(4):374-380). Ketogenic diets have also been associated with kidney stones, constipation, diarrhea, fatigue, headaches, bad breath, bone fractures, and an increase in LDL cholesterol that increases risk for heart disease. Ketogenic diets increase markers of cholesterol and inflammation, although they do lower triglycerides (Obesity, June 2019;27(6):971-981).
“Any diet that restricts vegetables, fruits, whole grains and beans is unhealthful because these plant foods are rich sources of soluble fiber that is converted in your intestines to short chain fatty acids (SCFAs), which lower high cholesterol, high blood pressure, and high blood sugar. A deficiency of soluble fiber markedly increases risk for an overactive immune system (inflammation) that can damage cells throughout your body.” [Mirkin, September 12, 2019]
Low-Carbohydrate Diets
“Several recent papers show that diets that restrict all carbohydrate-containing foods can cause diseases and shorten your life. People who eat the most vegetables, fruits, beans and whole grains, which are full of carbohydrates, have the lowest rates of heart attacks and heart disease (Nutrition Journal, July 10, 2018;17:67), partly because these foods are rich sources of soluble fiber (Nutr Rev. Apr, 2009;67(4):188-205).” [Mirkin, September 28, 2018]
“A study of elite race walkers shows that a low-carbohydrate, high-fat diet will slow their race times and training (J of Physiology, February 14, 2017).
Thirty world-class race walkers participated in an intense high speed training program and took in the same total calories. They were divided into three groups:
• High carbohydrate
• Alternating days of high and low-carbohydrate intake
• Low-carbohydrate, high fat (LCHF) diet
They trained intensely for three weeks. Results showed that:
• The high carbohydrate and the alternate-day high-carbohydrate groups improved their race times. The LCHF group did not improve.
• The LCHF group burned a greater percentage of fat during intense exercise.
• The LCHF group required more oxygen to exercise intensely at 80 percent of their maximum speed for two hours. The LCHF diet forced the athletes to burn more fat and less carbohydrates so they required more oxygen, and therefore had to slow down.” [Mirkin, April 30, 2017]
Meat and Eggs
“A recent news headline proclaimed, “An Egg a Day May Keep Heart Disease Away” (Time, May 21, 2018), based on a study of 512,891 adults in urban and rural areas of China. Those who ate one egg a day were reported to have an 18 percent reduced incidence of heart attacks and an incredible 26 percent reduction in bleeding strokes (BMJ Heart, May 21, 2018). Studies on benefits or harm from eating eggs are very conflicting, but this is the first large study I have seen that claims to associate eating eggs with a dramatically reduced risk for heart attacks and strokes.
“One egg yolk contains 200 mg of cholesterol, so eggs are one of the richest food sources of cholesterol. However, many studies show that cholesterol you eat in foods is a relatively minor cause of high blood cholesterol (Am J Clin Nutr, 2013;98:146-59). High blood cholesterol is associated with eating:
• refined carbohydrates such as sugar and foods made from flour
• excess calories
• not enough of the foods that contain soluble fiber
• possibly too much animal saturated fats (saturated fats in plants are OK)
A study from McMaster University reported that saturated fat may not be associated with increased risk for arteriosclerosis (BMJ, August 11, 2015).
“Sugar and other refined carbohydrates may put you at higher risk for heart attacks than any amount of eggs, so it makes no sense whatever to replace eggs with:
• pancakes or waffles covered with maple syrup
• dry breakfast cereals that are made by grinding grains into flour, removing most of the fiber and adding sugar
• bakery products such as bagels and muffins” [Mirkin, September 2, 2018]
“Nobody really knows whether or not eating eggs is safe. We have studies showing that people who eat more than five eggs a week have increased risk for diabetes and breast and colon cancer, but the studies show only that eating eggs is associated with these conditions. We have no studies that show that eggs cause disease in humans.” [Mirkin, March 6, 2016]
“A brilliant and very important breakthrough study shows that restricting mammal meat and eggs markedly lowers blood levels of TMAO (Eur Heart J, Feb 14, 2019;40(7):583-594). Mammal meat and eggs are rich sources of choline, carnitine and lecithin that are converted in your body to a chemical called TMAO that can damage arteries, which can cause plaques to form and later to break off to cause heart attacks and strokes. This is a very exciting article because it uses diets with the same total calories to show that mammal meat causes the highest rises in blood levels of TMAO in healthy adults and this very high rise in TMAO is completely independent of the amount of saturated fats in the diet.
“The authors showed that mammal meat increases blood and urine TMAO levels an average of three times higher than the equivalent in chicken or vegetarian meals. There was no difference in TMAO blood levels between high and low saturated fat diets that had red meat as their protein source. Removing as much fat as possible from the meat did not produce TMAO levels lower than meat that had a lot of fat. Participants lowered their blood levels of TMAO by going from a diet based on mammal meat to one based on chicken. The authors also showed that carnitine caused higher blood levels of TMAO than lecithin. See my earlier reports: Research on TMAO
Why I STILL Restrict Meat, Eggs and Milk “ [Mirkin, January 22, 2017]
Vegetarian Diets
“ Two of the studies compared dietary protein from plants and animals and the third one compared dietary fats from plant or animal sources.
“Researchers at Harvard monitored the records of more than 130,000 people for more than thirty years (JAMA Int Med, August 1, 2016), and found that:
• every three per cent increase in calories from plant protein, compared to animal protein, reduced risk of death during the study period by 10 per cent, and risk for death from heart disease by 12 percent
• eliminating unprocessed red meat dropped death risk by 12 per cent
• a 10 percent increase in animal protein was associated with a two per cent increased risk for death from all causes and an eight per cent increased risk for death from heart disease
• death rate rose markedly for those who smoked, drank excess alcohol, were obese or did not exercise
• regular eaters of red meat died earlier than those who regularly ate fish or chicken
“Researchers from the Mayo Clinic in Arizona reviewed six studies involving more than 1.5 million people (Journal of the American Osteopathic Association, May, 2016), and found that:
• people who restrict red meat, fish and chicken for at least 17 years lived an average of 3.6 years longer than those who ate meat regularly
• eating red meat and processed meats is associated with earlier death, particularly from heart disease.” [Mirkin, August 14, 2016]
DELAYED ONSET MUSCLE SORENESS (DOMS)
“To make muscles stronger, you need to exercise intensely enough to damage the muscles. You can tell that you are damaging muscles when you exercise vigorously enough to feel soreness in those muscles eight to 24 hours later, which is called Delayed Onset Muscle Soreness or DOMS (Strength & Conditioning Journal, October 2013;35(5):16–21)…
“You can stop exercising when you have DOMS if you want, but you will become stronger if you take easy recovery workouts while your muscles are still sore. Athletes do not usually plan to take off workouts during recovery, even though resting when the muscles feel sore will allow muscles to heal faster than exercising at a low intensity. If you exercise at low intensity during recovery, your muscles will become more fibrous and resistant to injury when you stress them in the next intense bout of exercise. If you are a runner, run faster two or three times a week and much more slowly when you feel soreness on the days after running fast. If you are a weightlifter, lift heavy weights once or twice a week and much lighter ones on the following day or days when your muscles feel sore. If you are a basketball player, scrimmage hard for several hours on one day, then run plays and practice shooting on the next days when your muscles feel sore. If you play golf, practice your long drives on one day and practice putting on the following days when your muscles feel sore.” [Mirkin, October 21, 2018 https://www.drmirkin.com/fitness/delayed-onset-muscle-soreness-doms.html ]
ENERGY DRINKS
“Energy drinks can raise blood pressure and may cause irregular heartbeats, according to a study conducted at Travis Air Force Base in California (Journal of the American Heart Association, April 26, 2017;6(5)). This extremely well-planned, performed and controlled study shows that two hours after drinking 32 ounces (four cups) of a popular energy drink, some of the healthy volunteers developed irregular heartbeats (corrected QT interval) and elevated systolic blood pressure. The QT interval on an electrocardiogram is the time it takes the lower heart (ventricles) to recover before the next heartbeat. If it is too short or too long, it can cause irregular heartbeats that can cause sudden death.
“The study’s control drink containing just sugar and caffeine did not cause irregular heartbeats and although it raised blood pressure a little bit, it was far lower than that caused by the name-brand energy drink and returned to normal much faster. Both types of drink contained the same 108 g of sugar and 320 mg of caffeine, but the energy drink contained various other ingredients that are listed as a “proprietary energy blend.” Those who took the caffeine-only drinks had their blood pressures return to normal after six hours, while those who took the energy drinks had much higher blood pressures at two hours and still had elevated blood pressures at six hours. Diastolic blood pressures and heart rates were the same for both groups.” [Mirkin, May 7, 2017. https://www.drmirkin.com/nutrition/energy-drinks.html]
HOT WEATHER TRAINING
“You don’t need special sports drinks or power bars. Even the most elite athletes can get the nutrients they need from ordinary foods, water and salt. Healthy and fit people usually don’t need to drink or eat when they exercise at a casual pace for less than two hours. However, they can prolong their endurance by taking:
• a source of sugar when they race or exercise very intensely for more than an hour
• a source of water when they exercise intensely for more than a half hour in very hot weather or several hours in cooler weather
• a source of salt when they exercise for more than three hours
[Mirkin, June 4, 2017. https://www.drmirkin.com/fitness/what-to-eat-and-drink-for-hot-weather-exercise.html]
INJURIES
The most common rowing injuries are generally overuse, stress-related injuries of the knees, spine, and ribs.[iii] and may result from rowing, ergometer training, running and strength training.”[iv] Other common injury sites include the wrist and hand, forearm, shoulder, and hips.[v] One study at Harvard University suggests these injuries are most common in the early spring preparation for racing season.[vi]
INTERVAL TRAINING
Definition of Intervals
“Interval training means that you move over a fixed distance at a very fast pace, then slow down for recovery and then repeat exercising at a fast pace followed by a slow recovery. You stop the workout when your muscles start to tighten or feel still. Interval training causes you temporarily to exceed your lactic acid threshold, so you can increase the rate that muscles can take in and use oxygen…” It has been used in endurance sports since the 1920’s, though the science was not fully understood until more recently. (American Journal of Physiology-Endocrinology and Metabolism, June 2006). [Mirkin, January 5, 2014]
Types of Intervals
“There are two types of intervals: short and long. A short interval takes no more than 30 seconds and does not build up significant amounts of lactic acid in the bloodstream, so you can do lots of repeat short intervals in a single workout. Long intervals are defined as taking two minutes or more and are very tiring, so you can do only a limited number in each workout.“ [Mirkin, February 17, 2019]
Effectiveness of Intervals
“The American College of Sports Medicine (ACSM) surveyed more than 4,000 fitness professionals and found that High Intensity Interval Training (HIIT) was the most popular trend in fitness for 2018 (ACSM Health & Fitness Journal, Dec 2017). The most efficient, time-saving and health-benefitting way to exercise is to use short intervals (Scandinavian Journal of Medicine & Science in Sports, Jan 2014). [Mirkin, February 17, 2019 https://www.drmirkin.com/fitness/how-to-do-interval-training.html]
Injuries from HIIT
“A recent study shows that people who use high-intensity interval training (HIIT) are far more likely to become injured than people who use less intense exercise and that the highest injury rate from interval training is in men at ages 20 to 39, the ages when they are at their highest potential to be at their best competitive level to become champion athletes (J Sports Medicine and Physical Fitness, Feb. 12, 2019). [Mirkin, April 21, 2016. https://www.drmirkin.com/fitness/highintensity-interval-training-can-increase-injuries.html]
Benefits of Intervals
“Almost all competitive athletes use some form of interval training because shorter bursts of very intense exercise are far more effective than more casual exercise to make you stronger and have greater endurance. Intense interval training has also been shown to be more effective in maintaining fitness and preventing diseases such as heart attacks than casual exercise, because intense interval training strengthens the heart more, widens blood vessels more and increases maximum circulation (Cell Metabolism, Mar 7, 2017;25:581-592). Interval training also takes far less time than continuous training for these exercise benefits (J of Physiology, March 2010).” [Mirkin, April 21, 2019 https://www.drmirkin.com/fitness/highintensity-interval-training-can-increase-injuries.html]
REST & RECOVERY“
“If you want to become stronger and faster and have greater endurance, you need to exercise on one day intensely enough to damage your muscle fibers and feel sore on the next day, and then train at reduced intensity for as many days as it takes for your muscles to heal and the soreness to lessen. Then you take your next intense workout. Knowledgeable athletes in most sports train by stressing and recovering because:
” • You can’t make a muscle stronger unless you damage muscle fibers. You can tell you are exercising intensely enough to damage them if your muscles feel sore the next day.
” • You can’t improve your maximal ability to take in and use oxygen unless you train intensely enough to become short of breath.
Even if you are not a competitive athlete, you can gain greater exercise health benefits by adapting to the same stress and recover program. It will make your heart and skeletal muscles stronger and increase blood flow to your heart.
“The faster your muscles recover from an intense workout, the greater your improvement. The key to training is to speed up your recovery so you can take your next intense workout as soon as possible. Anabolic steroids, the banned performance-enhancing drugs, improve athletic performance in part by helping muscles recover much faster from hard workouts, but they also increase your chances of suffering a heart attack in the future.” [Mirkin, September 15, 2019. https://www.drmirkin.com/fitness/recovery-the-key-to-improvement-in-your-sport.html
]
For a more complete discussion of this subject, science-based and written by an elite competitive athlete/science writer, see Good to Go, by Christie Ascwanden [W. W. Norton & Company, 2019]. It is excellent.
SLEEP
“Every athlete who trains for competition in sports that require endurance learns sooner or later that after exercising long and hard, you feel sleepy and need to go to sleep to recover. Older people may need even more sleep after intense exercise than younger people. If you don’t get lots of extra sleep when you do prolonged intense exercise, you don’t recover as quickly and are at increased risk for injuring yourself…
“The soreness and burning you feel during prolonged intense exercise is a sign that muscles are being damaged. A muscle is made up of thousands of muscle fibers like a rope is made of many strands. Each muscle fiber consists of a series of blocks called sarcomeres that fit up against each other end-to-end, at a junction called the Z-line. The soreness that you feel with prolonged endurance exercise is caused by damage directly to the Z-line. When this happens, the muscle can no longer contract with as much force. The muscle gets stronger when you cause damage at the Z-lines and then allow the damage to heal.
“Damaged muscles start healing by a process called inflammation that turns on your immunity, and muscles heal faster by resting. The best way to rest your muscles is to sleep. Damaged muscles release two cytokines, called interleukin 6 and tumor necrosis factor alpha, that make you feel sleepy and prolong the time that you normally sleep. During sleep, your brain produces large amounts of growth hormone that stimulates muscle and bone growth and repair…
“The average college athlete gets 6.5–7.2 hours of sleep each night (J. Sci. Med. Sport, 2014;18). Increasing their sleep duration to eight or more hours per night improves performance in many different sports (Sleep, 2011 Jul 1; 34(7): 943–950)…
“You cannot reach your full potential in endurance sports unless you are able to sleep long hours and do not have a job that requires you to move about much of the day. Endurance training requires spending lots of time sleeping and resting your muscles. Nobody really knows how or why prolonged exercise makes you tired, but it appears that the older you are, the more sleep you need to recover from the muscle damage of vigorous exercise.” [Mirkin, January 22, 2017. https://www.drmirkin.com/fitness/sleep-to-recover.html]
SPORTS DRINKS
“Many studies show that you can exercise longer and more intensely and recover faster when you take a source of sugar during vigorous exercise. Dozens of brands of sports drinks are promoted to fill this need, but a new study from Appalachian State University shows that a banana appears to offer superior results, specifically helping athletes to recover faster from intense exercise (PLoS One, March 22, 2018). The red blood cells of athletes eating bananas produced much lower blood levels of a genetic precursor of COX-2, which causes inflammation that delays recovery, than those of the group that took sports drinks.
“Fruits and their juices have lots of antioxidants and other nutrients that sports drinks do not contain. An earlier study by the same authors showed that fruit caused less inflammation than some sports drinks (PLoS One, May 17, 2012). Other studies have also shown that fruit juices can improve athletic performance better than sports drinks do (Am J of Physiol–Endo and Metab, December 2015).” [Mirkin, April 22, 2018. https://www.drmirkin.com/fitness/fruit-beats-sports-drinks-for-exercisers.html]
STRENGTH AND ENDURANCE TRAINING
“Researchers in Australia showed that adding a weight lifting program to cycling or running will help to improve performance only if you know that when your muscles are sore, you have to take the day off or go slow and easy (Sports Medicine, July 2017;1–14).
” • After running or cycling very intensely, you need to go slow and easy for more than 24 hours.
” • After lifting weights intensely, you should go easy on those muscle groups for several daysIf you want to train the same muscle groups for both endurance and strength, you need to use long recovery periods of less intense exercise after each intense workout, or you will be at high risk for injuries and an over-training syndrome of chronic fatigue and muscle damage. You should not exercise at a fast pace or lift heavy weights when your muscles are still sore from a previous workout. High-intensity interval cycling done after heavy-resistance exercise decreased strength gains because of the soreness it caused (Scand J Med Sci Sports, Sept 23, 2016).
“You can set up a schedule for lifting weights every second or third day and alternate running or cycling intensely on one day and easy on the next, but always listen to your body and back off if your muscles hurt. One study showed that in just six days of training the same muscles intensely, your muscles will be so sore that you won’t be able to exercise intensely and you will have a significant decrease in strength (Research Quarterly for Exercise and Sport, Aug 2015;86(4):387-396).” [Mirkin, June 30, 2019 https://www.drmirkin.com/fitness/benefits-of-combining-strength-and-endurance-training.html]
STRETCHING
“Whenever I see someone stretching before or after hard exercise, I worry that the person has gotten bad advice about training.
• You should not stretch before a competition because stretching weakens muscles.
• You should not stretch after hard exercise because stretching muscles that are already damaged by intense exercise delays recovery and increases risk for injury.
• You cannot lengthen muscles or tendons by stretching.
An extensive review of the scientific literature showed that the supposed benefits of stretching are highly controversial (Int J Sports Phys Ther, 2012 Feb; 7(1): 109-119).”[Mirkin, October 27, 2019. https://www.drmirkin.com/fitness/stretching-doesnt-deliver.html]
WEIGHT LIFTING
“You can become very strong and grow large muscles just by lifting a single set of 6 to 12 repetitions of a weight that is 75 percent of your maximum, three times a week (Sports Med, Apr 2020;50(4):751-765). You need to lift a weight heavy enough to damage muscle fibers to make a muscle bigger and stronger, but causing more damage than that increases your chances of injuring yourself.
“Basic Principles
• You will not become any stronger or grow larger muscles by lifting weights six times a week than you will by lifting three times a week, as long as you do the same volume of lifts (J Strength Cond Res, Jul 2019;33 Suppl 1:S122-S129; J Strength Cond Res, May 2018;32(5):1207-1213).
• You will not become stronger by lifting all muscle groups five days a week than by doing only one muscle group a day for five days as long as you do the same number of sets (10-15 sets), same number of exercises, same number of 6-12 repetitions maximum, at 70-80 percent of your one-repetition maximum (J Strength Cond Res, Jul 2019;33 Suppl 1:S130-S139).
• As long as you train to failure (which means you are lifting to the point of fatigue), you can gain about the same amount of strength and muscle size either by lifting heavy weights a few times or by lifting lighter weights many more times (J Strength Cond Res, Oct 2015;29(10):2954-63).
• Taking longer rest periods between sets will cause greater gains in strength and muscle size, because increased rest between sets allows you more time to recover for your next set (J Strength Cond Res, July 2016;30(7):1805-12).” [Mirkin, 28 March, 2020]
[i] Dr. Gabe Mirkin began running after completing his residency at Mass General Hospital at the age of 28, switched to cycling thirty years later to avoid injuries. At the age of 85 he continues to cycle 365 days a year, alternating 30 mile rides three days a week with recovery days and weight training. He is the author of The Sports Medicine Book, (with Marshall Hoffman, Little Brown, 1978), was board-certified in several medical specialties, authored a chapter in the Merck Manual, and has written extensively on sports medicine, health, and nutrition for more than forty years. (He is also a long-time personal friend.)
[ii] Dr. Mirkin’s e-newsletter is available free at DrMirkin.Com
[iii] Hosea, Timothy M., Hannafin, Jo A., “Rowing Injuries,” Sports Health, 2012 May; 4(3): 236–245.
[iv] Jo A. Hannafin, MD, PhD, “Common Rowing Injuries, Prevention and Treatment,” Team Physician, US Rowing
[v] ibid
[vi] Hosea, Timothy, Hanafin, Jo A., op cit