The Best Way To Eat Fruit

I have read many articles saying to eat fruit on an empty stomach because it can ferment when eaten with other foods. Then some articles say it does not matter when you eat fruit because it takes hours for your body to digest anyway. So when is the best time to eat fruit? 

-- Jacquelyn


Fruit is an incredibly healthy food group: packed with vitamins, nutrients, fiber and water. But there have been some nutritional claims circulating that suggest fruit can also be damaging if eaten in conjunction with other foods. The basic premise is that high-sugar fruits help to ferment the other digested foods in a "full" stomach, causing gas, indigestion and other problems. While it's true that fruit helps accelerate fermentation in things like bread starters, the idea that it could do so in a stomach is completely false.

"There is no need to eat any food or type of food on an empty stomach. This myth has been around for a long time. There is no science to support it even though proponents make scientific-sounding statements," Jill Weisenberger, MS, RD, CDE, author of Diabetes Weight Loss -- Week by Week, told HuffPost Healthy Living by email.

Fermentation is a process in which bacteria, fed by sugars, colonizes on food and changes their compositions. Fermented foods include things like wine, yogurt, bread and kombucha. To occur, a ferment requires bacteria. But stomachs, with their high concentrations of hydrochloric acid, are hostile environments that kill bacteria far before they are able to colonize and reproduce.

"One of the main purposes of the stomach is to sterilize food by mixing and churning it within the muscular, acid-containing stomach,” Dr. Mark Pochapin, director of the Monahan Center for Gastrointestinal Health at NewYork-Presbyterian Hospital/Weill Cornell Medical Center told the New York Times in an article on the topic.

Another claim, that the body has trouble digesting the carbohydrates in fruit in combination with other foods is also not supported by the science. "The body produces digestive enzymes for protein, fat and carbohydrates and releases them from the pancreas together," says Weisenberger. "If we could not digest mixed meals, we would not even be able to digest most foods since most foods are a combination of nutrients. For example, even vegetables like green beans and broccoli are a mix of carbohydrate and protein."

What's more, gas is produced by the colon -- not the stomach. So while fruit can cause gas in some people, the contents of their stomachs will have little relevance. But Jacquelyn is correct about one thing: according to Pochapin, food reaches the colon about six to 10 hours after we eat it. So while fruit isn't damaging to eat at any time, it is also true that we spend many hours digesting it anyway.

Ultimately, the better question is how much -- rather than when -- we eat healthful foods like fruit.

"The concern should not be empty stomach or with a meal. Rather the concern should be how can I eat more of this health-boosting food group," explains Weisenberger.

Should You Drink Water After A Massage?

Why do masseuses always tell you to drink lots of water after a massage?

Massage therapists often ask patients to drink water after a rubdown. In fact, it's recommended by the American Massage Therapy Association. But why?

Many practitioners believe that deep tissue massage releases toxins from the muscles and into the blood stream. They assert that the water helps the kidneys and pancreas to process those toxins. And while research shows that massage is useful for many conditions -- from anxiety to several types of cancers to childhood constipation -- the truth is that there's no research that clearly illustrates how massage affects toxicants in the body.

"To my knowledge, there is no solid base of research to support the notion that massage moves toxins out of the tissues. By solid, I mean more than a single study. Instead, to be given serious consideration, we need multiple studies, from multiple investigators, in peer-reviewed publications, reporting similar results on this point," wrote massage therapist Tracy Walton, LMT, MS in an editorial for Massage Today.

"There clearly is room for more dialogue and research in the profession of massage about the precise effects of our work."

In addition to the research on the benefits of massage for particular conditions, the National Center for Complementary and Alternative Medicine offers several theories, ranging from neurological to physiological, about how massage affects the body, but none particularly relate to toxicant release.

That said, drinking water isn't just essential to life -- though most properly nourished people drink enough water to live. Drinking enough water is also essential to good health, and that is often related to our body's ability to detoxify. Water supports the kidneys as they process toxicants and nutrients. And a well-hydrated body transports oxygen throughout all cells.

So while the reason many massage therapists recommend drinking water directly after massage isn't firmly established in the research literature, there are many good reasons to drink it anyway.

Neck Cracking, Dangerous? Spinal Manipulation May Increase Risk Of Stroke

I crack my neck all the time. Is it really dangerous?
-- Laura 

If you crack your neck to relieve pain, you aren't alone. By one estimate, chiropractors perform between 18 and 38 million cervical spine manipulation treatments each year. That involves quick motions to loosen the joint and ligaments, which often makes a "pop" sound -- and that helps explain the colloquial term we often use: "cracking."

Cracking isn't just reserved for necks -- people commonly crack their knuckles, lower backs, hips, ankles and toes. Any joint can be "cracked," either by a professional or at home. Here at Healthy Living, several members of our team, along with readers who have written in, want to know if their own cracking is safe.

So what exactly is going on when a neck -- or really any joint area -- pops? Our joints contain fluid and gasses like nitrogen and carbon dioxide. When you put the liquid under pressure, as happens when force is applied to the joint, the gas exits, creating a pop sound, explained Dr. Stephen Perle, a chiropractor and Professor of Clinical Sciences at the University of Bridgeport. Interestingly, though we associate the pop with the dissipation of tension in the ligaments, they just coincide as a result of the movement -- they are unrelated.

Neck cracking was a subject of great interest when the British Medical Journal released commentaries from two sides of a debate: is neck manipulation worth the (admittedly) small risk of grave injury?
Although the practice, which is most popular among chiropractors (the commentary dealt specifically with professional manipulations) is not high risk, rare side effects include stroke brought on by a tear to the lining of the vertebral artery, which supplies blood to the brain. Does the risk outweigh the benefits? As might be expected, divisions within the medical community run along specialist lines. While many chiropractors think the manipulation is useful and safe, orthopedic surgeons are apt to disagree. Because the rate of injury is so low, the treatment looks safe from a public health perspective.
Arguing against neck manipulations in the BMJ, three clinical therapy professors pointed to studies that suggested neck manipulation was no more effective than other treatments, like exercising the muscles that support the spine, that are meant to alleviate the same pain. Given the association between neck cracking and stroke, however inconclusive, why risk it?

In contrast, arguing in favor of the treatment, epidemiologist Dr. David Cassidy of the University of Toronto and colleagues points to the tremendously low risk of stroke, and additional research that shows how neck manipulation can alleviate pain in ways that other treatments cannot. Perle, who is currently researching the relationship between cervical manipulation and stroke, agrees with Team Cassidy.

"We know that spinal manipulation causes stimulation of areas of the brain that block pain, changes the function of the muscles that help support the spine and changes the flexibility of motion segments in the spine," says Perle. "Exercises can help loosen the muscles and other treatments can help with pain, but the flexibility of the joint -- that's uniquely aided by manipulation."

But Dr. Michael R. Marks, an orthopedic surgeon who is a spokesperson for the American Association of Orthopedic Surgery, remains cautious. "When we talk about medical complications, they can be really small, say one percent," says Marks. "But if it happens to you, it's 100 percent."

He suggests that age may be a factor. "If you're a relatively young person, a spinal maniupation is relatively safe because you've got muscle strength, strength in the ligaments, bone strength. But as you age and your blood vessels get a little bit hard, you have some atherosclerosis -- because of the chiropractic manipulation -- you run the risk of artery eruption."

That's not the only age-related concern when it comes to a cervical spine manipulation, according to Marks. Older adults have more porous bones that are more prone to fracture. A quick, forceful motion is more likely to cause fracture in old bones than younger ones.

Luckily, one area where older adults do not need to worry when it comes to manipulations is arthritis. While it's a common myth that joint cracking can lead to arthritis later in life, research consistently shows that there is simply no association.

The bottom line is this: the odds of getting a debilitating injury -- either a vascular injury that results in stroke or a fracture or, a third rare option, nerve damage -- is very low, particularly if you have healthy, strong bones, ligaments and muscles. But do you want to take the chance? Maybe not. Just don't worry about arthritis -- there's no relationship at all.

Paleo Diet: Healthy Or A Hoax?

My health practitioner advised me to adopt this Paleo diet to reduce cholesterol and blood sugar. Also said it's an ideal way to lose weight. It recommends avoiding dairy, sugar, grains and legumes. Is this the answer to most of our health problems?
-- Rita

If you're unfamiliar with this popular diet, the Paleo Diet (also known as the "Caveman Diet") prescribes a pattern of eating that mirrors the way your ancestors ate back (way back!) in the day. The assertion is simple: diseases like obesity, diabetes and heart disease are illnesses "of civilization" and so, to combat the ill effects of the modern diet, we should return to a pre-civilization, hunter-gatherer diet of meat, fish, fruits and vegetables. That means all gains from the agrarian revolution -- grains, dairy, legumes, salt and sugars -- are off the menu.
"Although in theory this may seem like a sensible diet, particularly when removing sugar and salt, it has eliminated several food groups like dairy and grains, which provide essential nutrients, such as calcium, vitamin D, magnesium and phosphorus in dairy and B vitamins, fiber and antioxidants in grains," says Joy Dubost, a registered dietitian and a spokesperson for the Academy of Nutrition and Dietetics. "Legumes also provide a great protein source with little fat and lower in calories while providing essential nutrients and fiber."
Lisa Sassoon, a registered dietitian and assistant clinical professor of nutrition at NYU, agrees. "There's no real research behind it either. And it eliminates things that do have research behind them: grains, beans and low-fat dairy."

That research shows that nutrients in legumes, whole grains and dairy help to lower one's risk of osteoporosis and cardiovascular disease, reduce blood pressure, and maintain a healthy weight, according to Dubost.
And while the diet's restrictive nature might result in initial weight loss, it can be problematic as a long-term weight loss solution, according to the researchers we spoke with. When you eliminate whole food groups, you are bound to pay more attention to what you eat. And the ban on refined grains, salt and sugars means that processed foods are out. For those with a relatively processed diet, that will likely result in weight loss. And excess weight is one of the major associated conditions to high cholesterol, high blood pressure and pre-diabetes.
"If you lose weight, your cholesterol comes down. Weight loss will help all of those other things, with the exception of certain cases, where there’s a genetic predisposition," says Sassoon. In this way, Rita's doctor may be correct: if she currently eats a diet high in refined carbs, processed meals and sugar-laden treats, the Paleo Diet is certainly a step in the right direction.
But if she already has a diet full of fresh produce, lean proteins and whole foods, Paleo eating may not result in weight loss and may prevent healthy eating behaviors that come naturally. "If someone eats low-fat plain yogurt with berries for breakfast, that's not allowed on the diet," says Sassoon.
"The biggest issue to be addressed is not eliminating these food groups but ensuring that portion size is appropriate," explains Dubost.
There's also problematically little stated about saturated fat. As part of the Paleo diet, it would be easy to choose cuts of meat that are sky-high in artery-clogging LDL cholesterol and saturated fat. Especially for someone used to eating low-fat dairy protein, this switch would be harmful to cholesterol levels. And while the Paleo diet is high in fiber (thanks to all the fresh produce), forbidden foods like whole grain oats, beans and other grain and legume sources of fiber have been found to help moderate cholesterol levels.
There's another, wholly unrelated problem: pleasure. "It eliminates quinoa, ice cream, pasta -- these things we love to eat, that make us social creatures," says Sassoon. "And that means we're less likely to stick with it, more likely to binge. It's not just about losing weight, it’s also about learning how to enjoy food in a healthy way."
So does the Paleo Diet really lower cholesterol and help with many of the conditions that lead to metabolic syndrome? Only insofar as they cut out sugary, fatty and processed foods. Buy you can do that without eliminating whole food groups or imitating the eating patterns -- most likely dictated by food scarcity -- of pre-agrarian ancestors.

Why Do My Eyelids Twitch?

Why does your eyelid go through twitching phases?
-- Anya

Myokymia, or involuntary eye twitching, is a condition that many of us are familiar with. And it seems everyone has an opinion on what triggers it: Is it fatigue? Eye-strain? Stress?

"Most of the time, myokymia is idiopathic, which is a fancy way of saying we have no idea why it happens," says Dr. Andrea Thau, an associate clinical professor at SUNY Optometry and a spokesperson for the American Optometric Association. "It’s such a benign condition, and tends to resolve on its own, so there's little incentive to research it."

Essentially, myokymia is a twitch -- an involuntary muscle spasm in the upper eyelid muscle that causes a fluttery sensation. The trick to stopping it, according to Thau, is to "break the twitch." She recommends trying alternating hot and cold compresses, which can soothe the overactive nerve that's causing the spasm. If that doesn't work, "try drinking a glass of tonic water," she recommends. "The quinine helps nerve impulses."

Some doctors will prescribe antihistamines for particularly stubborn or enduring eye twitches. If eyes are a bit swollen -- due to low-grade allergic reaction -- that can cause the nervous system to overreact and trigger a twitch.

Huffpost Wellness Editor Patricia Fitzgerald has observed clinically -- which is to say, in an observational, rather than a scientifically rigorous research setting -- that patients of hers have mentioned fatigue and stress in connection to eyelid twitching. Fitzgerald finds that many of her patients' twitches are resolved by acupuncture.

In very rare instances, eyelid twitching can indicate a more serious condition, like the beginning stages of multiple sclerosis or a lesion on the brain stem. Those conditions typically begin with a host of symptoms, and in this circumstance the eyelid twitch soon moves to the facial muscles, as well. It's so rare, in fact, that Thau says she's never seen it in clinic herself.

There is another condition that affects the eyelid muscles, a rare disorder called blepharospasm, in which the eyelids involuntarily close. This can take the form of brief, excessive blinking or squinting and can progress to full eye closure, according to Mary Smith of the Benign Essential Blepharospasm Research Foundation. Blepharospasm affects about 60,000 Americans, and is more likely to affect women and those over 40, Smith says. "It can be problematic, if you don’t know when your eyes are going to shut, you may walk into things or fall," she says. "It’s definitely debilitating."

There's a genetic component to blepharospasm and also a trigger -- sometimes trauma, a secondary condition like dry eye or even external factors like bright or rapidly changing lights. It is most commonly treated with regular Botox injections and, interestingly, blepharospasm was among the conditions listed during Botox's first FDA approval in 1988, according to Smith.

If you experience occasional eye twitches, chances are it's a benign. But it's important to get your eyes checked each year by an ophthalmologist or doctor of optometry to rule out any other problems. Even if it's simply eye strain or stress causing the twitch, it could indicate a need for glasses.

Adult Acne: Why Does It Happen?

I'm a 61-year-old woman who has hardly had a pimple my whole life, til now. Lately, I've been getting these huge, what I call, under-grounders. They hurt like the dickens but never come to a head. They appear around my mouth, near my nose or on my forehead. What is going on?
-- Jane 

A pimple occurs when sebum -- the lubricant that naturally moisturizes our skin and hair -- is trapped under dead skin cells and debris in a hair follicle, according to the Mayo Clinic. Typically, sebum rises to the surface, where it is able to condition the skin. If it gets trapped, it creates an ideal circumstance for bacteria to grow. What Jane calls "under-grounders" are actually pockets of sebum and bacteria that are trapped further down along the hair shaft, deep within the follicle.

Adult acne is common -- about 30 percent of women and 20 percent of men between the ages of 20 and 60 have breakouts, according to WebMD. So why would a person develop acne later in life? Very often, it's related to hormones.

"When adult women experience acne outbreaks, hormones are usually the primary culprit," dermatologist Dr. Diane S. Berson said in an interview with Medical News Daily. "Hormonal acne can be particularly frustrating because it may not respond to the same over-the-counter treatments that worked for some women during their teenage years."

At 61, menopause, hormonal treatments or a growing ratio of androgen (male) hormones like testosterone may be contributing to the sudden emergence of acne, according to an explainer by the American Academy of Dermatology. Research shows that testosterone, for example, causes increased production of sebum by the sebaceous gland.

Other causes of adult acne can be medication related -- some psychotropic medications, like lithium, or steroids or hormonal medications can contribute to acne breakouts, according to the Mayo Clinic.
The best course of action may be to talk to a doctor about having your hormone levels checked and to speak with a dermatologist about proper skincare. Since many acne medications and special soaps are geared towards teenage skin, which is thicker and less dry, picking the right skin care regimen for an adult requires greater care.

Losing The Last 10 Pounds: Why Does Weight Loss Get Harder?

"Why is it so hard to lose the last 10 pounds? And why is it harder to lose weight the smaller I get?"
-- Tamara

Anyone who has tried to lose weight knows about those frustratingly immobile final five or 10 pounds. And while there are a lot of suggestions (just Google "last 10 pounds" and you'll enter an echo-chamber of weight loss advice, scientific half-truths and can-do enthusiasm), the truth is that several pretty straight-forward reasons can explain that unshakeable weight.
The first is easy to fix, but also the most psychologically daunting: it could be something called "diet fatigue," in which the repetitive behaviors dieting requires -- keeping a food journal, weighing portion sizes, skipping that glass of wine -- become arduous, hard to manage and, frankly, boring.
"Dieters become less careful, they are not taking the precautions they did in terms of knowing what they ate, how much," says Carla Wolper, Ed.D., R,D., research faculty at the Obesity Research Center at St. Luke’s and assistant professor in the Department of Psychiatry at Columbia Medical Center. "They may not realize they’re not as careful anymore."

That's not an invitation for blame -- it can happen insidiously and there's an easy solution. If the scale needle slows its descent, simply write what you eat down in a food journal. "Keeping food records is always recommended," says Wolper. "Studies show that people will lose weight, even if they don’t do anything different to their diet but simply start writing it down."
There is also the possibility that it's time to recalculate. When a person begins to lose weight, their metabolic rate drops. In other words, they need fewer calories to meet basic functioning and requirements. While a 150-pound woman might have a certain basic metabolic rate, that rate may drop when she becomes a 130-pound woman. That's why it's a good idea to reevaluate caloric needs after more than 10 pounds of weight loss, according to Wolper.
"People who are normal weight tend to eat fewer calories than people who are overweight, every day, forever," agrees Rebecca E. Lee, director of the Texas Obesity Research Center and a professor of nutrition in the Department of Health and Human Performance at the University of Houston. "It takes fewer calories to maintain a lower body weight. This doesn't necessarily mean that they eat less volume -- they might, but they also might eat more nutrient dense foods that have fewer calories, like vegetables, fruits, lean meats, etc."
There's an additional consideration regarding metabolism: something called "metabolic adaptation."
"When dieting, your body is forced to work on a reduced number of calories per day. Eventually your body adapts and trains itself to live on whatever calories it gets -- without losing weight. This built-in survival mechanism is your body’s way to protect you against starvation," says Dr. Caroline J. Cederquist, a metabolic expert and board-certified medical weight management specialists. "Once you have hit this point, you may manage to lose a few bonus pounds, but they will come off much more slowly and, before you know it, the weight you lost may start to come back on!"
So what can you do? Interestingly, the answer is not exercise. (Which is not to say you shouldn't exercise. Please exercise!) Very often we're told that building muscle mass will help rev up our metabolisms because muscle tissue burns more calories per hour than fat tissue does. But, as Wolper explains, the difference in caloric burn rate is minor. Fat tissue burns about two calories per pound per day, while muscle tissue of the same weight burns seven calories per day. If someone made a significant change -- transformed two pounds of fat into two pounds of muscle, that would amount to a difference of 10 more calories burned per day.
"The truth is that skeletal muscle doesn’t burn that much more than fat. Our brains burn the most calories. In fact, the lean tissue that burns a lot of calories is our heart, lungs, liver and brain. About 60 percent of the calories that are burned come from those four sources," says Wolper.
Exercise may help create a greater calorie deficit and that will help further along weight loss or help maintain sustained weight loss -- but it won't make a big metabolic difference.
Instead, in addition to redoubling food journal efforts and recalculating caloric intake for one's new size, Cederquist recommends something she calls a "metabolic adjustment phase." Instead of reducing calories, she suggests a two-week period of increased meal sizes. "During this phase, the goal is not to lose weight, but to readjust your body’s ability to metabolize an increasing number of calories, by increasing portion sizes and bumping up caloric intake."
Most of all, it's important to evaluate one's goals. Have you reached a healthy weight? If so and if continued weight loss is a huge struggle, it may be time to consider entering a maintenance phase. "Focus on the benefits of maintaining your weight loss," says Cederquist. "And remember that maintaining is as important as losing."

Cardio Or Weights First? Exercise Order Sometimes Matters

"Is there an order to working out? In other words, should I do weights first and then cardio?"
-- Karen 

Working out is always good for you. The good news is that, whether you do it before or after weight training, cardiovascular exercise like running, swimming, biking or machine-work will improve everything from your heart health to your mood to your chance of avoiding many cancers. And lifting weights helps with everything from bone density to metabolism.
But according to exercise physiologists and personal trainers we spoke with, the order of operation can change depending on a person's goal.
"This question is one of the biggest questions on people's minds when they go to the gym," says personal trainer and HuffPost blogger Jeff Halevy. For those who are seeking weight loss, cardio should come first, but if gaining muscle mass is the goal, it's time to hit the weight room first. But why?

Let's start with the muscle-building scenario. "Doing cardio first will induce fatigue that may compromise technique and possibly increase risk of injury," explains Fabio Comana, director of Continuing Education for the National Academy of Sports Medicine. Exhausting oneself with a big run right before weights and resistance training doesn't just up the risk of injury, it also means you'll have less energy to throw into a really good weight training session.
On the other hand, if you're looking to lose fat, Halevy recommends doing interval cardio training before getting started on weights. As he explains, the cardio will deplete your body's supply of glycogen -- the stored form of glucose in muscle cells and a primary material in our energy storage. Once glycogen is depleted, the body turns to more long-term storage sources, like fat.
"If your goal is strictly a lean body -- not to be strongest, or most powerful, but achieve maximal leanness -- I always recommend implementing high-intensity interval training at the beginning of each workout," says Halevy.
But that doesn't mean weights aren't important for fat loss. In fact, when it comes to analyzing the percentage weight loss that's comprised of fat versus lean tissue like muscle, weights have cardio beat overall.
"Resistance training should always be a consideration," explains Comana in an email. "Mother nature will help us lose lean tissue naturally (23 percent in women between ages 30 and 70), that we need to preserve. Diet and cardio also results in lean tissue losses (68 percent fat, 22 percent muscle / lean tissue). Whereas diet and resistance leads to 97 percent fat loss, and only 3 percent lean tissue loss."
There may be other reasons for doing cardio first. As Comana points out, many more people are familiar with cardiovascular exercise, so it will seem less intimidating and is thus more likely to happen. If the weight room is daunting enough to prevent a workout session, it's worth getting started on cardio and working your way up. And if another health goal -- say Type 2 diabetes or hypertension prevention or treatment -- is the priority, Comana recommends cardio over resistance. "Some diseases are better managed with cardio first, then introducing resistance training later," he told Healthy Living.
It's important to get the opinion of a doctor and certified personal trainer or exercise professional before proceeding, but the takeaway is simple: if you're exercising, no matter the order, you aren't doing anything wrong. Depending on your goal, you may want to choose one type of exercise over the other. Of course, you could alternate days and avoid the question entirely.

What Is Metabolism: How Long After I Eat Is Weight Added To My Body?

"How long does it take for the food I ate to add weight to my body?" -- Bunter122 

Today's question comes from a reader who would prefer to stay anonymous, but it is certainly a thought that many people have had. Given that we all have different metabolic speeds, what is the average amount of time it takes food to be digested and then shunted off to its various purposes?
"We have a pretty good indication about the timeline from the sequence of ingestion, digestion, and egestion. The whole thing plays out over a span of roughly 12 hours on average," says Dr. David Katz, a HuffPost Healthy Living contributor and director of the Yale University Prevention Research Center. "By the time the residual waste of food is passing out of us, the useable parts have all been put to use -- for energy expenditure, as heat generation, or placed into storage, as either glycogen [from carbohydrate], or fat."
After you eat, the food passes through your stomach and small intestine in about six to eight hours, according to the Mayo Clinic. Then, it enters the large intestine where it is further digested. Putting it as delicately as possible, Mayo Clinic gastroenterologist Dr. Michael F. Picco writes: "Elimination of undigested food residue through the large intestine usually begins after a total of 24 hours. Complete elimination from the body may take several days."
For a complete understanding of what the body does to digest food, the National Institutes of Health has a great explainer. For our purposes, it is essential to understand that as food is digested, enzymes and hormones are secreted by the stomach and small intestines (as well as fat cells) and work to break down the carbohydrates, protein and fat we've eaten into usable material for our cells.

A growing number of endocrinologists -- those who study our hormone system -- are beginning to see the hormone response as far more complicated than previously thought, as well as far more individualized: there is a wider variance in how people respond to food, they suspect.
"While the question posed seems extraordinarily simple, I don't think that there can be a simple answer to it," says Dr. Kaveh Ashrafi, an associate professor of physiology at the University of California, San Francisco School of Medicine who studies fat metabolism. "The prevailing view essentially considers feeding behavior/exercise as the sole determinants of body weight. For this to be true, one has to assume that the body itself is simply an inert vessel; if you put more food in it, it must get fat, if you move it, it must lose weight."

What Is Excessive Sweating?

Why do I sweat so bad when I exercise?
-- Denise, 56, Mokena, IL

We've gotten some variation of this question from several readers: why do some people sweat more than others? Why do some people sweat from their faces, while others mostly sweat from their hands? When is sweating considered excessive and why am I sweating anyway?
So we spoke with Dr. Lyall Gorenstein, surgical director at the Columbia University Hyperhidrosis Center in New York and Dr. Noel Perin, director of minimally invasive spinal surgery, Department of Neurosurgery at NYU Langone Medical Center and an expert in treating complex hyperhidrosis.
Let's start with the basics: the primary purpose of sweating is to cool your body down. "Sweating is the body’s natural, neurological response to cool the body by stimulating the sweat glands to produce moisture that cools the body by drawing heat from the body during evaporation," Perin tells HuffPost Healthy Living. "Because everyone’s body is different, the response differs from one individual to another, producing varying levels of perspiration."

When your body temperature rises, whether because of sweltering external temperatures, exercise or hormonal changes (often associated with menopause), it stimulates the two to five million sweat glands that are distributed under your skin. These glands exist throughout the body, though they have higher concentrations in certain areas like the palms of the hands and the soles of the feet.
Perspiration works because it carries the heat generated by your body to the skin's surface, where it evaporates into the atmosphere, lowering overall internal temperature. Think of a bead of sweat as a vehicle for heat conducted by your body: it transports body heat to the surface, where it can diffuse into the external world. And that protects the integrity of your cells and organs from the dangers of overheating.
A secondary, less pronounced purpose to sweating is to help shed the body of waste that occurs as a natural byproduct of cell metabolism, according to Gorenstein.
But why do some people sweat more than others? Among the range of sweating that is considered normal -- that is, functional, predictable and not associated with a medical condition -- there is no known reason for the variation in sweating. "If we're talking about otherwise healthy individuals, which is to say not people who are obese or have another condition that could contribute, it's simply a physiological variation," Gorenstein tells HuffPost Healthy Living. "Just like how the average resting body temperature is 98.6, but many people exist on a bell curve around that."
Since sweating is a normal, physiological response to exercise, chances are that sweating during exercise -- even if you are sweating more profusely than your neighbors on the treadmill -- is not an indication of a problem. When in doubt, it's always better to have that confirmed by a doctor.
However, if the sweating occurs not just during exercise, but at random -- as a stress response or when you are at rest or in a controlled temperature environment -- it could indicate a condition known as hyperhidrosis. One telltale sign of hyperhidrosis is that you'll often sweat profusely from one specific area of the body, most often the palms of your hands or soles of your feet, but also sometimes the armpits.
"It can reach a point of socially uncomfortable results," says Perin. "Everything from minor annoyances such as smudged writing paper to much greater issues like difficulty holding a pen or the social discomfort caused by soaked clothing and wet handshakes."
Sometimes excessive sweating can be caused by another condition in what is called secondary hyperhidrosis. Infectious disease, hyperthyroidism, menopause and some cancers can cause hyperhidrosis, according to the Mayo Clinic, though Gorenstein has found that obesity is the most common cause of secondary hyperhidrosis.
But people with primary hyperhidrosis very often begin to experience it in early childhood or even infancy, according to Gorenstein. "Patients will tell me stories about leaving tracks on the floor as toddlers," he says. Primary hyperhidrosis is to some extent hereditary. In fact, WebMD reported that about 50 percent of hyperhidrosis cases can be traced to family history.
No one is sure what the mechanism for primary hyperhidrosis is, beyond the understanding that it is a neurological response. Gorenstein has conducted a series of clinical studies comparing hyperhidrosis patients to a control group of normal sweaters: monitoring the brains of study participants using an fMRI machine, he and his colleagues showed the group visually disturbing images to cause anxiety and stress response. They demonstrated that when patients with primary hyperhidrosis looked at the pictures, their hands began to sweat. The control group did not sweat, though they did have other measures of sympathetic response, such as quickened pulse.
For hyperhidrosis patients, treatment options vary: while some mild forms respond to prescription-strength topical antiperspirants, other options include water iontoforesis, botox injections in the armpits (an FDA-approved use) or, in extreme cases, surgical intervention.
While hyperhidrosis can be debilitating, especially socially, it is not dangerous on its own. It can, in some rare instances, be associated with a dangerous condition and should be diagnosed properly for that reason. Likewise, exercise-induced sweat, even at above average volume, isn't anything to worry about.

Muscle Soreness, Explained

I've been working out fairly consistently for about 1.5 years. I do strength training about twice per week and cardio 5 times per week. I've noticed that my thighs, particularly my quads, burn all the time with a small amount of exertion, such as ascending a flight stairs.
Why do my thighs burn so much with minimal exertion?
-- Kim, 29 Texas

Let's talk about muscle soreness. Delayed-onset muscle soreness, or DOMS as it is often called, is the common -- one could even say requisite -- result of a workout. If you do an activity you're not used to, such as taking a new type of fitness class, attacking a hill on your bike when you're used to riding on flat ground, or running a far longer distance than you are accustomed to -- the difference in muscle use can cause micro-tears in muscle fibers and connective tissue. As your body works to repair itself, you may feel some low-grade pain in the area.
But this is where the phrase "no pain, no gain" comes in: those tears and the subsequent repair help make the muscle stronger -- and that improves overall fitness. But it comes with some ache along the way.

In particular, movements that include "eccentric muscle contractions," which occur when the muscle must contract even as it is being elongated (running downhill or walking downstairs, for example) might cause some delayed onset pain. But why?
"Think of it like the weakest link," says Allan Goldfarb, Ph.D., a professor in the Department of Kinesiology at the University of North Carolina, Greensboro and a fellow of the American College of Sports Medicine. "Muscle proteins hold that weaker bit together and if there is too much force or tension [from exercise] on those muscle fibers or proteins, they are vulnerable to getting slightly damaged."
In an effort to repair the damage, the body can actually over repair explains Goldfarb, and that can activate pain receptors. What's more, the muscles can suffer from some low-level inflammation that can add to the pain.
DOMS can be mitigated by slow, steady stretching exercises, says Goldfarb. And recent studies have suggested that ice baths can also help improve soreness.
But that doesn't necessarily sound like what's going on in the case of this question. For starters, it seems as if you're experiencing muscle pain concurrent with the activity, rather than hours after. We asked Dr. Lynn Snyder-Macker, PT, ATC, SCS, ScD, a professor in the Department of Physical Therapy and the Center for Biomedical Engineering Research's Interdisciplinary Graduate Program in Biomechanics and Movement Sciences at the University of Delaware for her opinion.
"It doesn't sound muscular to me (one flight of stairs!)," she wrote in an email to HuffPost Healthy Living, pointing to the burning sensation, which is different than a sore muscle's ache. "It sounds more like nerve or patellofemoral pain or referred pain from the hips." That combined with your young age make her believe that this isn't exercise-related after all.
Many illnesses could cause this type of pain: fibromyalgia is one diagnosis that fits in with unexplained muscle soreness, according to Goldfarb. That's not to say that unexplained muscle burning or soreness is a sign of serious illness, but it may be worth further evaluation by a medical specialist, like a sports medicine doctor.

How To Stretch Safely For Flexibility After 50

 I am looking to get back into martial arts at 58. How do I get my agile flexibility back without tearing my muscles while stretching? -- David 

  It's true that as we age, flexibility becomes an even bigger concern. All of the experts we interviewed agreed that older bodies come with an ultimatum: Use it or lose it. If you aren't maintaining an active lifestyle, you can expect accelerated muscle loss, decreased stamina, strength, range of motion, balance and flexibility.

 So getting into a new fitness routine or revisiting or ramping up an old one, like Martial Arts, is a really great idea. But David is right to be concerned about flexibility in middle age. "There are normal things that happen with aging -- naturally occuring phenomena," says Patrice Winter, a clinical physical therapist and spokesperson for the American Physical Therapy Association. "One of those is flexibility -- if you don’t stretch and move, your joints start to get less flexible. It's really important to keep joints moving."

 And some parts of our bodies suffer more than others. "The older we get, sitting more, our hamstrings tend to get tight. The muscles in the back of the calf, around our Achilles' tendons," says A. Lynn Millar, Ph.D., a physical therapist and professor of physical therapy at Winston-Salem State University in North Carolina. "The other area that people might not notice as much is the chest muscles. If we’re working at a desk, we bring our head forward and round our shoulders, so the muslces in the front of our chest -- our pectoral muscles -- get shortened and tight while our back muscles loosen."

There are so many kinds of stretching that it can be a bit confusing. The key is to warm up the muscle and then push its limits in terms of pliability and range of motion. John McCarthy, a physical therapist and an associate professor of physical therapy at the University of Alabama, Birmingham, recommends doing either static or dynamic stretching exercises. Static stretching, or taking a position that elongates the muscle and holding it, is beneficial because it's extremely low risk for injury, he says, while still improving range of motion and flexibility. Because static stretching doesn't involve warming up the muscles first, it's best to do the stretches during or following a cardio or strength-training workout.

 Dynamic stretching, by contrast, involves taking a position at the end range of motion, applying slow, steady pressure to push that boundary and then returning. Because it is a series of exercises, it does double duty -- warming up the muscle and then working to enhance flexibility and range of motion.

Regardless of your chosen type of stretching, McCarthy recommends consulting a physical therapist or well-regarded book for specific moves. Millar suggests this routine: choose stretches based on where you feel tightness. For static stretches, the typical recommendation is 30 seconds per stretch, performed in three reps. "You'll see an improvement in the range of motion even if you do each exercise once for 15 seconds," she says, but the benefit is greater with increased duration and repetition. Although most official guidelines recommend stretching three times a week, Millar says that daily stretching is more effective and not dangerous.

 For dynamic stretching, think about your activity and how you will use your body. For example, if you'll take on a martial arts class, you might know you'll be throwing punches and high kicks. Before you get started, do some slow motions to simulate the positions you'll take during the course of the class.

 But how do you know if you've taken a stretch too far? You should still be able to breathe and talk, says Winter. If you have to hold your breath, you're going too far. Millar says that you shouldn't feel your muscles trembling -- a sign that you're stretching too deeply. Dial it back until you're feeling a gentle pull, but no burning or pain, she says.

 One caveat: many older patients experience tightness around the hips and other joints. While this is often muscular, it can occasionally be a sign of arthritis-associated tightness in the joint. To differentiate, Millar, who is also a fellow of the American College of Sports Medicine, recommends checking your hamstrings: if you can lie flat on the ground and lift your leg to a 90-degree angle, the problem is unlikely to be inflexibility and is instead arthritic stiffness in the knee or hip, she says. If you suspect the latter, see a physician for a medical evaluation.