By the looks of my snow-laden backyard, I suppose it would be fair to say it is a bit early for me to be Spring cleaning, but cleaning I am. You see, as embarrassed as I am to admit, I have clutter--clutter that is invading both my physical and mental space and it's impeding my efforts for a healthier me. So, I have decided that it is time to clean house and my mind.

Rarely do we make the connection that clutter can affect our health and fitness, but it can.

Impact of Physical Clutter

• Increased Stress: Staring at piles of  unread magazines on the kitchen counter, searching through the overflow of old notes pinned on the cork board and rifling through a closet full of clothes that no longer fit can cause anxiety and stress. Experiencing these annoyances on a daily basis can result in chronically elevated levels of cortisol--the stress hormone. Chronically high cortisol levels have been linked to "emotional" eating and weight gain, as well as to heart disease.
• Accidental Injuries: Book bags, clothes, toys, etc., that have been left on the floor can lead to accidental falls and potentially serious injuries.
• Fire Hazard: Stacks of papers and other items can potentially serve as fuel to spread a fire that has been accidentally started.
• Health Hazard: Cluttered areas can serve as a breeding ground for bacteria, mold and mildew--especially when items are stored in dark, damp places such as the basement.
• Impedes Efforts to Exercise: It is hard to use your treadmill when it has become a storage space for last season's clothes. Likewise, a bike ride is unlikely if you have to wade through an accumulation of yard tools to reach your bike.
• Trigger for Mental Clutter: Holding onto mementos of yesteryear has the potential to hold you back by creating emotional clutter. Often, we use these possessions to define who we are -- which can be okay unless these items set self-identity in "stone." This can keep us from reaching our full potential. Life is a series of moments that define who we are. Past moments should be used as footholds to take us through present moments and into the future, not lock us into yesteryear.

Remove the physical clutter from your home and clear the emotional clutter in your mind for an easier travel down the road to better health and fitness.

While many American children are not getting enough exercise, there is an emerging subset at risk for getting too much--the young athlete. In recent years, there has been an increase in the number of children participating on organized sports teams year-round. Many of these athletes are members of travel teams and specialized sports associations and are subject to intense training as a result. Furthermore, some of these children and adolescents are playing on multiple teams, often during the same season, which can also lead to excessive training. This degree of training puts the young athlete at risk for overuse injuries, overtraining syndrome and eventually burnout--all of which have the potential to undermine attempts to instill a lifelong habit of exercise that is necessary for well-being later in adulthood.

Overuse Injuries
Approximately 50 percent of sports-related injuries treated at pediatric sports medicine facilities are the result of overuse. The bones of children and adolescents are not yet fully developed, making them more susceptible to microtrauma caused by the repetitive stress of sports training that lacks sufficient periods of rest and recovery. Overuse injuries in the young athlete can interfere with the proper growth and development of the musculoskeletal system, causing problems later in life.


Overtraining Syndrome and Burnout Symptoms

• Impaired sports performance despite regular training
• Chronic muscle or joint discomfort
• Lack of motivation to practice or compete
• Overuse injuries, such as stress fractures and tendinitis
• Chronic fatigue
• Increased resting heart rate
• Changes in mood or personality, such as increased irritability

Tips to Avoid Overtraining Children and Adolescents

• Incorporate at least 1 to 2 days off per week from training and competition.
• Balance high-intensity workouts with low-intensity workouts that are designed to facilitate recovery.
• Encourage participation on only one sports team per season.
• Cross-train/vary sporting activities.
• Emphasize the development of fundamental fitness skills, such as agility, balance, strength, endurance, power and coordination rather than on acquiring sport-specific skills.
• Provide a hiatus of 2 to 3 months per year from sport-specific training to allow time for mental and physical recovery.

The American Academy of Pediatrics states that the goal of fitness and sports programs for children and adolescents should be to instill a lifelong interest in physical activity. Skill development in all areas of fitness should be paramount, as should the development of social skills and the understanding of the importance of team work and healthy competition. If the child athlete shows any signs of overtraining or burnout, adjustments should be made to the training program.


References
Pediatrics: Official Journal of the American Academy of Pediatrics; "Overuse Injuries, Overtraining and Burnout in Child and Adolescent Athletes"; Joel S. Brenner and the Council on Sports Medicine and Fitness; 2007

ACSM's Health & Fitness Journal; "Overtraining in Young Athletes: How Much is Too Much?"; Avery D. Faigenbaum; 2009

A little over a year ago I had pneumonia, which put a terrible dent into my training regimen. My lungs had never hurt so badly or had been so congested as they were then. Each breath felt like I was drowning. Interestingly, during my bout with pneumonia I had a terrible craving for pineapple. I eat plenty of fruit during the day, but prior to my illness I rarely ate pineapple. I decided to read about pineapple in my copy of The Encyclopedia of Healing Foods. I was floored when I read that pineapple contains bromelain, a protein-digesting enzyme which aids in the break down of thick mucus associated with pneumonia and bronchitis; in addition, bromelain exhibits anti-inflammatory and antibiotic effects. Wow--a perfect example of how some foods contain medicinal properties and can help you to recover from illness or injury.

If you are recovering from an illness or injury that has sidelined you from your favorite exercise, your best bet for nutritional healing is to meet with a sports nutritionist or registered dietitian. A nutritional expert can determine the best course of action based on your individual needs.

The American Dietetic Association highlights the following nutrients as having roles in the healing process:

• Zinc: Zinc is an essential mineral that boosts your immune system. It helps to inhibit the activity of certain viruses. It also plays a role in protein synthesis and cell development; therefore, it aids in the healing process of wounds. Daily requirements for zinc are dependent upon age and gender. In general adult women and men should consume approximately 8 mg and 11 mg per day, respectively. Pregnant or lactating women need intakes around 11 to 12 mg daily. Intake levels should not exceed 40 mg per day. Red meat, oysters, sunflower seeds, pumpkin seeds, almonds, pecans and ginger root are some food sources of zinc.
• Vitamin A: Vitamin A is a fat-soluble vitamin. It promotes the development of healthy skin and tissues that form the linings of the eyes and the respiratory, intestinal and urinary tracts.  When these tissues are weakened, infection is more likely because bacteria can enter the body through the broken down areas. It is recommended that adult women consume 2,310 IU (International Units) and men consume 3,000 IU of Vitamin A. Some food sources of vitamin A include liver, fortified milk, carrots, sweet potatoes and spinach.
• Vitamin C: Vitamin C is also known as ascorbic acid and is an antioxidant. It aids in fighting against infection. According to the American Dietetic Association, vitamin C may have an antihistamine effect which can alleviate symptoms associated with a cold and decrease the number of days the illness lasts. Vitamin C also helps to form collagen, which helps to heal wounds and injuries to the ligaments and tendons. Adult women and men should consume approximately 75 mg and 90 mg of vitamin C per day, respectively. In addition to oranges, vitamin C can be found in red bell peppers, tomatoes, broccoli, strawberries and cabbage.
• Vitamin E: Vitamin E is an antioxidant. It enhances the immune system and has anti-inflammatory properties. Both adult men and women need to consume approximately 22.4 IU of vitamin E. Excessive intake of vitamin E can interfere with certain medications and can increase the risk for bleeding. Vitamin E can be found in almonds, hazelnuts, peanuts, and wheat germ oil. Other food sources include tomatoes, spinach and broccoli.

References:
The Encyclopedia of Healing Foods; Michael Murray, R.D.; 2005

The American Dietetic Association complete Food and Nutrition Guide; Roberta Larson Duyff; 2006

The American Dietetic Association

NIH Office of Dietary Supplements

Eating the right foods will not only promote your health, but it can give you that extra boost you need to perform at your best during workouts and competitions. Striking a nutritional balance is key in delaying the onset of fatigue and facilitating recovery from exercise. Active individuals need a rich supply of carbohydrates to fuel their exercise. Ample amounts of protein are required to help with muscle repair; and, some fat is necessary to absorb the fat soluble vitamins A, D, E, and K.  In addition, fat helps to fuel prolonged bouts of exercise. Maintaining an electrolyte balance, particularly levels of sodium and potassium, is essential for optimal performance as well.

General Diet Composition for Active Individuals

• Carbohydrates should be the base macronutrient in an athlete's diet. The goal is to consume 3 to 5 grams of carbohydrate per pound of body weight. If you train hard, you will want your consumption to be near the high end of this range. The low end of this range will suffice for noncompetitive athletes engaging in moderate-intensity exercise to promote health.
• Protein needs of active individuals are greater than the general population; however, the typical American diet provides more than enough protein to meet this need. The goal should be to consume approximately 0.54 to 0.9 grams of protein per pound of body weight. Body builders will want to consume quantities near the top end of this range.
• Fat should make up 20 to 35 percent of total daily caloric intake. Greater amounts than this increase the risk for heart disease. Restricting fat intake to values less than 20 percent increases the likelihood of developing a nutritional deficiency.
• Fluids need to be consumed regularly throughout the day and during physical activity to prevent dehydration. Water losses as low as 2 percent of body weight can impair exercise performance. During post-exercise recovery, approximately 16 to 24 ounces of fluid should be ingested for every pound of body weight lost from the activity.
• The electrolytes sodium and potassium may need to be consumed in greater amounts compared to intakes of the general population, especially for individuals involved in strenuous, prolonged physical activities or those who train or compete multiple times throughout the day.  Approximately 400 to 700 milligrams of sodium and 80 to 100 milligrams of potassium are lost in one pound of sweat. Supplements are not necessary, however, if the right foods are eaten post-exercise.

Foods for the Active Individuals Pantry and Refrigerator

• Nuts and nut butters provide protein and healthy fats. Depending on the type of nut, these can be a source of sodium and potassium (e.g., 2 TBS. of peanut butter provides 149 mg of sodium and 214 mg of potassium).
• Whole-grain breads, pastas and cereals provide carbohydrates, some protein and may be sources of electrolytes. (e.g., 1 cup of Cheerios provides 20 g of carbohydrate, 3 g of protein, 160 mg of sodium and 170 mg of potassium).
• Legumes and beans offer protein and carbohydrates and can be good sources of potassium.
• Sweet or baking potatoes offer carbohydrates and potassium and some protein and sodium.
• Canned tuna provides protein and healthy fats, as well as sodium and potassium.
• Eggs and low-fat dairy products, such as cheese and greek-style yogurt are good sources of protein. Low-fat milk products also provide carbohydrates. Furthermore, eggs and dairy products contain sodium and potassium. 
• Dried, frozen and fresh fruit and vegetables offer carbohydrates. Depending on the type of fruit or vegetable, it can be a good source of potassium (e.g., one medium banana provides 450 mg of potassium).

References
Medicine & Science in Sports & Exercise; March 2009; "Nutrition and Athletic Performance"; Nancy Rodriguez, PhD, et al.

American Dietetic Association

Nancy Clark's Sports Nutrition Guidebook, Fourth Edition.

When I was a kid, my friends and I didn't need adults to schedule physical activity for us. Exercise was already a natural component of our daily interactions with one another. Whether we were playing "cops and robbers" on our bikes in the neighborhood or wading in the creek nearby, we were moving and didn't think twice about it. Unfortunately, now-a-days, most children are not meeting the minimum requirement of an hour of exercise a day, despite the plethora of community-based family fitness and sports programs designed to get kids active.

In response to this discrepancy, researchers from the University of Bristol in Bristol, United Kingdom set out to determine the effect that a best friend has on a child's activity level. Investigators studied 472 boys and girls ages 10 to 11 years. Here is what they found:

• Activity level is positively correlated to the best friend's activity level for both boys and girls; however, the predicting factors of the best friend's influence on activity level differ between genders. For boys, activity level is directly related to the best friend's activity level. For girls, those who engage in active play with their best friend obtain higher levels of physical activity than those girls who do not.
• Activity level was greater for both boys and girls when they actively played with their best friend in the home or neighborhood setting compared to those children who just engaged in active play with their best friend at school.
• Participating on a sports team with a best friend was not associated with an increase in the amount of time spent being physically active.
• Boys and girls who engaged in greater amounts of active play had lower Body Mass Index scores.
• Boys spent more time in active play than girls.

The investigators concluded that efforts made to improve children's physical activity levels should focus on encouraging active play with best friends, particularly outside of the school setting.

Reference
Medicine & Science in Sports & Exercise; "Better with a Buddy: Influence of Best Friends on Children's Physical Activity"; Russel Jago, et al.; February 2011.

About twenty years ago, I was enrolled in an undergrad course led by a professor who had a theory that children could safely and effectively engage in strength training. A requirement of the class was to help him collect data for a study he was conducting to test this hypothesis. At the time, his thinking was a bit progressive. The school of thought then was that lifting weights could injure the growth plates and stunt growth in the developing child. Today, evidence indicates the contrary--strength training in youth can be safe and beneficial for overall health.

Benefits of a Youth Resistance Training Program

• Increased muscular strength
• Improved motor skills
• Enhanced sports performance
• Increased bone mineral density
• Improved body composition/maintenance of a healthy body weight
• Reduced risk for sports injuries
• Increased self-esteem, confidence and body image
• Improved social skills

At What Age Can Strength Training Begin?

• Strength training for youth can begin around the ages of 7 to 8 years--when a child is able to listen to, understand, and follow directions. In general, if the child is able to participate in other athletic activities, such as Little League baseball or soccer, then he is ready to engage in strength training.

Getting Children Started

• Constant and competent supervision is required while the child is resistance training because of the potential for serious injury. The instructor/coach should have knowledge regarding the physical and emotional development of children and an understanding of the principles of strength training. Safety guidelines, such as proper spotting and correct equipment size, also need to be followed. 
• The initial emphasis should be on helping the child to understand the concepts of basic strength training and developing proper form.
• When choosing resistance level, it is best to underestimate the child's strength. This serves three purposes: first, it reduces the risk for acute and overuse injury; second, it ensures that the correct lifting technique will be learned; and, third, it allows progression to be readily perceptible to the child. In other words, the child will be able to see a quicker advancement through workload levels during the initial stages of the program.  This will help to maintain motivation and create a sense of self-efficacy.
• The American College of Sports Medicine contends that the resistance training guidelines recommended for adults can be implemented in a program for children. The child should perform 1 to 3 sets of 8 to 15 repetitions at a workload that elicits moderate muscular fatigue without compromising proper mechanical form (in general, an intensity that is equal to 60-80% of the child's 1RM). Strength training should be performed 2-3 days per week on nonconsecutive days.

Points to Consider

• The resistance training session should begin with a warm-up and end with a cool down of about 5-10 minutes each.
• Progression should occur gradually.
• Strength training exercises should be varied to develop full-body benefits.
• Prepubescent children increase strength through neuromuscular adaptations. As a result, muscular hypertrophy in this group is unlikely; however, postpubescent youth can expect to see increases in muscle size due to adequate levels of anabolic hormones.
• Strength training activities do not have to be limited to the use of weight  machines and free weights, but can also include medicine balls, resistance bands, and even the child's own body weight (e.g., pull-ups, push-ups, etc.,).

References
ACSM's Resource Manual for Guidelines for Exercise Testing and Prescription; Sixth Edition.

American Council on Exercise