Shannon Clinic – Melbourne Chiropractic and Sports Care Blog
When people talk about the keys to living a healthy life and performing at your best, exercise and diet are always front and centre. Rightly so, as exercising at least 150 mins per week at moderate to vigorous intensity and eating a well-balanced diet rich in green leafy vegetables, fruits, grains and seafood and low in red meats and saturated fats are essential for longevity and a healthy life. But there is a third pillar that is regularly overlooked that is just as important as diet and exercise and that is sleep. In this blog Melbourne city chiropractor Dr. Shannon discusses the importance of sleep on athletic performance.
Sleep Deprivation
Sleep deprivation can be due to sleep disorders like insomnia and sleep apnoea. These disorders are often associated with symptoms such as difficulty falling asleep or maintaining sleep and require further clinical investigation. However, most sleep deprivation occurs due to poor sleep quality and duration. The average adult requires 7-9h of sleep per night yet those with sleep deprivation will get less than 5-6h of sleep per night. Some people pride themselves on their ability to work with very little sleep yet sleep deprivation has been shown to affect human (and athletic) performance in a myriad of ways including:
Impaired cognition effecting decision-making, judgment, mood, and reaction times
Metabolic disruption including diabetes and obesity
Weight gain to due craving more unhealthy and high carbohydrate foods and in larger portions
Immunological resulting in increased proinflammatory cytokines which impair immune function and impede muscle recovery and repair from damage
Cardiovascular dysfunction
An increased risk of injury
There is also a dose-dependent relationship between sleep and performance; the greater the sleep loss the greater the performance loss, with performance loss occurring with as little as 2-4h of sleep loss. And for those who believe they are able to recoup the sleep they lose during the week on the weekends, the evidence says the contrary.
Improving Sleep Quality and Duration
The two sleep interventions that have received most research are sleep extension and sleep hygiene. Sleep extension and napping involves extra sleeping time to make sure the 7-9h daily limit is being met; this is especially useful when one knows they have a day of potential sleep deficit ahead. Sleep extension might involve going to sleep earlier or utilization day time naps that are more than 20 mins but less than 60 minutes and occur before 3pm. Sleep hygiene helps to improve sleep quality and duration and essentially involves a healthy sleep routine such as:
Don’t go to bed if you aren’t sleepy
Rise at the same time every morning, including on the weekends
The bed is for sleeping only, don’t watch TV or use electronic devices in bed
Avoid caffeine after lunch
Avoid alcohol, especially before bed
Avoid high intensity interval training before bed
Try to create a dark, quiet and cool space to sleep (ambient temperature is 19+/-2 degrees)
Improvements in sleep extension can lead to improved skill specific execution in sports, improved cognition including reaction times. mood, alertness and vigor. While improved sleep hygiene results in less fatigue and sleepiness.
Final Thoughts on Sleep and Performance
Whether the goal is optimizing performance at work, in sport or about doing all you can to live a healthy life, sleep needs to be given as much attention as diet and exercise. By improving the quality and duration of sleep through better sleep hygiene and sleep extension one will yield benefits such as, reducing the risks of preventable disease like diabetes, obesity, cardiovascular disease, improved judgment and decision-making and optimized athletic performance and recovery.
If you are looking for other blogs on ways to improve performance check out Melbourne city chiropractor Dr. Shannon’s blog on how to improve your athletic performance in just 15 minutes with mental imagery or on the promising results seen with NMN supplementation in middle and older aged adults. To make an appointment with Melbourne city sports chiropractor Dr. Shannon or remedials massage therapist Paula Pena you can book below. Our Melbourne CBD chiropractic clinic is located on Collins Street, opposite the Melbourne Town Hall.
Shannon Clinic – Melbourne Chiropractic and Sports Care Blog
The Game Changers, a movie promoting the benefits of a plant-based diet on athlete performance has been gaining a lot of traction. With big sports stars involved like Lewis Hamilton, Novak Djokovic, Arnold Schwarzenegger, Jackie Chan and backed by Hollywood heavy weight director and producer James Cameron one can see why. However, for the uninitiated majority of those involved with this production including the chief science advisor are supporters of plant-based diets, leading to a somewhat biased slant. Therefore, the question needs to be asked “what does the research really say about plant-based diets and athletic performance”.
“love to put Viagra out of business, just by spreading the word on plant-based eating.”
James Cameron – The Independent 25/04/2018
Diets for athletic performance are extremely individualised and are geared towards the specific demands of the athlete and sport the individual competes in. In a very simplistic manner, it requires a balance of protein, carbohydrates and fats to aid with the development of lean muscle mass, energy production and recovery matched against energy expenditure or calories burned throughout the day.
Gluten Free Diets
Athletes are always looking to find that extra edge over their competitors and diet is one area that can be utilized to good effect however, all that glitters may not actually be gold. A few years ago with the explosion of gluten and wheat intolerances and celiac disease a few athletes decided to go gluten free and claimed it was responsible for improving their athletic performance, even though they hadn’t been diagnosed as celiac.
Interestingly though these claims aren’t currently supported by the research, with a study in 2015 that took 13 competitive endurance cyclists with no history of celiac disease and compared their time trial performance while on a short term gluten containing diet and on a gluten free diet. The study showed athletic performance didn’t improve for the athletes on a gluten free diet with no history of celiac disease. Given, this study had a small sample size of 13 athletes and was conducted over a short time period (7-day diets) it is however currently the only study comparing gluten free and gluten containing diets on athletic performance in non-celiacs.
Ketogenic Diets
Ketogenic diets have been another diet trend amongst athletes, especially in the world of sports like CrossFit. Ketogenic diets are low in carbohydrates and high in fats, which at first glance seems counterproductive to athletic performance when carbohydrates are an athlete’s main source of energy. In the non athletic population Ketogenic diets or low carbohydrate diets have been shown to be beneficial with weight-loss and reductions in the risk of diabetes.
As it is becoming quickly evident the current literature investigating diet and athletic performance is sparse and generally low in quality. This trend continues when comparing plant-based diets versus omnivore (animal and plant) diets and athletic performance, especially in the elite athletic population which is the premise of The Game Changers documentary.
A search of PubMed found only one review paper which systematically reviewed the current literature comparing vegetarian and omnivore diets with physical performance. The paper included 8 studies, 7 randomised controlled trials and 1 cross-sectional study and found there were no differences in athletic performance between a vegetarian-based diet and omnivore diet.
“As someone who follows a plant-based diet, I believe we need a healthier high street option that tastes amazing but also offers something exciting to those who want to be meat-free every now and again.”
Lewis Hamilton on his Neat Burger company – The Sun 29/08/2019
With such limited and low-quality evidence currently available comparing diets and athletic performance, it is extremely important in this commercial and marketing driven age that we step back and ask questions to understand where the truth lies, rather than letting a documentary “inform” us. Plant-based diets and reducing animal meat intake has been associated with health benefits, with a large section of the research on plant-based diets focusing on its potential risk reduction in chronic preventable diseases such as cardiovascular disease.
At present there is limited research available analysing its effects on athletic performance with no known larger scale multi-arm studies comparing a variety of diets on athletic performance. Currently the evidence does not show a positive association between a plant-based diet and athletic performance compared to other animal meat with plant based diets.
Final Thoughts on Plant-Based Diets
Diets for athletes, especially elite athletes are extremely individualised and what works for one athlete might not necessarily work for another. Whatever diet is chosen, plant-based or omnivore it should be driven by a nutritionist, dietitian or health professional with sports nutrition training and be grounded in the best evidence available.
If you are looking for some guidance on sports nutrition or are wanting to optimize your bodies performance, Melbourne city chiropractor Dr. Shannon is well placed to help. For an appointment with sports chiropractor Dr. Shannon or our sports massage therapists, Paula Pena at our Melbourne CBD chiropractic clinic you can book below. Our chiropractic clinic is located in the Melbourne CBD on Collins Street, oppposite the Melbourne Town Hall.
Shannon Clinic – Melbourne Chiropractic and Sports Care Blog
Sedentary behaviour and your health
It might seem strange to hear the average working week in Australia has reduced by 2 hours per week however, that doesn’t mean people are working less, it purely represents a shift from productivity to outcome based performance measurements. Tied together with the development of new technologies and the introduction of flexible working options including working from home, it means workers days are stretched longer, they are available more of the time and are working more hours they don’t register.
Ultimately this leads to more sedentary behaviour at work. Anecdotally, Melbourne city chiropractor Dr. Shannon says this trend has become more pronounced since the pandemic, which is also coupled with a significant reduction in physical activity levels to well below the recommended guidelines of 150mins per week of moderate to vigorous activity.
Interestingly, the first occupational study looking at health outcomes in those who were physical active at work versus those who weren’t was published way back in 1951. The Morris paper looked at the rates of coronary heart disease (CHD) in bus drivers compared to ticket conductors and it was no surprise to see bus drivers had a higher incident of CHD compared to ticket conductors. To confirm these findings Morris and Crawford then compared the risk of heart attacks between postmen and government clerks and found a similar result; government clerks more often suffered heart attacks than postmen.
Fast-foward to 2019 where we now know that sedentary behaviour is associated with higher blood pressure, total cholesterol and poor cognition and academic performance. It is also strongly associated with all cause mortality, fatal and non-fatal cardiovascular disease, type 2 diabetes, metabolic syndrome along with being moderately associated with ovarian, colon and endometrial cancer.
Time to get moving!
As Morris showed in his studies, workers who were more active had lower incidents of cardiovascular disease (CVD) and this rings true today. In 2018 the Physical Activity Guidelines Advisory Committee Scientific Report highlighted the importance of physical activity which is linked to improved sleep, cognition, immune function, minimizing weight gain, reduced risks of depression, anxiety, dementia, colon, breast, bladder, endometrial, oesophagus, stomach, kidney and lung cancer as well as reduced risks of chronic preventable diseases like high blood pressure, type 2 diabetes and cardiovascular disease. There is also low grade evidence indicating sit to stand desk (ie. being more active) reduces low back pain in office workers.
Breaking up sedentary behaviour doesn’t need to be difficult, it might involve introducing a sit to stand desk to help modulate posture throughout the day, getting up from the desk and walking around the office at regular intervals, it could include exercising during the lunch break and for the extremely busy people think about replacing your car commute to work with a ride or run. Whatever it is you chose to break up your sedentary behaviour with, it is important that you are reaching the minimum guidelines for physical activity – 150 minutes of moderate to vigorous activity per week.
As a Melbourne city sports chiropractor Dr. Shannon advocates strongly the importance of physical activity, and utilizes exercise therapy with all his patient. If you would like to make an appointment to see chiropractor Dr. Shannon, or remedial massage therapist Paula Pena at our Melbourne CBD chiropractic clinic book below. Our Melbourne city chiropractic clinic is located on Collins Street, opposite the Melbourne Town Hall.
Shannon Clinic – Melbourne Chiropractic and Sports Care Blog
In November 2017, Melbourne city chiropractor Dr. Shannnon wrote an article for The Australian Chiropractor outlining the importance of exercise as medicine and the role chiropractors can play in prescribing exercise therapy to their patients. This is a copy of text published in the magazine article.
Exercise Medicine – A Chiropractors Domain
When people think of sports and exercise medicine they conjure up images of locker rooms, being pitch side, working and traveling with teams and athletes, and to some extent this would be right. However, sports and exercise medicine is also about the promotion and advocation of exercise medicine. That is, prescribing exercise and dietary advice for the treatment and prevention of chronic diseases.
Today’s society is driven by technology, phones, tablets, laptops, watches, automated machines and cars, all there to make our lives easier. Yet the more we rely on technology the more sedentary we have become. People can spend as much as half of their waking day sitting, with relatively idle muscles, and as little as 4-5% of their day spent in moderate to vigorous exercise 1,2.
Sedentary Lifestyle and Physically Inactivity
This sedentary lifestyle is in part responsible for the rapid escalation in chronic preventable diseases, where global type II diabetes rates have risen from 4.7% in 1980 to 8.5% in 2016, and worldwide obesity rates have jumped significantly between 1980 and 2013, with a 9% increase in the male population and a 10% increase in the female population3,4. With developed countries such as the US, UK, Australia and New Zealand driving these alarming trends 5.
Physical inactivity is responsible for approximately 9% of premature deaths worldwide and is the 4th ranked leading risk factor for mortality 6,7. Where those who spend 10 or more hours in a car per week, have an 82% greater risk of cardiovascular disease mortality compared to those who spend 4 hours or less8. This sedentary behaviour is leading to weight gain, even when food intake is accounted for, and there is a growing body of evidence linking sedentary behaviour to an increased risk of mortality from cardiovascular disease, type II diabetes and obesity 9.
This link is not hard to appreciate when the risk factors for cardiovascular disease, type II diabetes and obesity are examined, as all include physical inactivity 10,11,12. However, it is not only these three chronic preventable diseases that are important. Overweight and obese people have a greater risk of developing prostate and colon cancer, and weight gain is also associated with hypertension, asthma, arthritis and fair to poor health 13,14.
It is for this very reason the American College of Sports Medicine established the Exercise is Medicine® initiative to encourage primary care professionals to include exercise when designing treatment plans for patients. As primary care practitioners, it is vitally important that Chiropractors take up the mantra “exercise is medicine” and incorporate dietary advice and exercise into patient treatment plans to improve patient outcomes.
The Importance of Physical Activity
Why is exercise medicine so important? Physical activity reduces the risk of developing cardiovascular disease by 30% 15. It reduces the risk for death and disability due to diabetes, chronic kidney disease and lower respiratory disease 16. It has also been shown to reduce the risk of breast and colon cancer, with growing evidence showing it may be beneficial in reducing the risk of pancreatic and lung cancer 15. The benefits of physical activity aren’t confined to chronic diseases, it results in lower blood pressure, enhanced insulin sensitivity, increased high density lipoproteins, lower triglycerides and it helps with weight management 17,18.
In the elderly it preserves bone mass and reduces the risk of falling19. It helps to prevent and improve mild to moderate depressive disorders and anxiety, and is associated with a lower risk of cognitive decline and dementia19. It is also beneficial in the treatment of back pain by reducing pain levels and improving physical and psychological function 20,21.
Considering the benefits of physical activity for back pain, in addition to the high-quality evidence showing that NSAID’s and paracetamol are ineffective in the treatment of back pain 22,23. Chiropractors are in a strong position to use this evidence to advocate and prescribe physical activity as a part of their patient’s treatment plan, to enhance their clinical outcomes.
They should also be advocating physical activity and dietary changes to reduce their patient’s chronic disease mortality and morbidity rates. As a result, those ‘at-risk’ patients will reduce their risk factors and aid in lowering their Metformin, anti-hypertensive and statin medications. There is growing strong evidence supporting the benefits of diet such as, the Mediterranean diet and low carbohydrate diets and physical activity, in the treatment of type II diabetes, hypertension and high cholesterol 24,25,26,27,28,29.
Physical Activity Guidelines
So, what and how much physical activity should we be doing? Well, according to the American College of Sports Medicine position paper on exercise, they recommend a comprehensive exercise program consisting of cardiovascular exercise, resistance, flexibility and neuromuscular exercises 19. This should involve at least 150 minutes per week of moderate intensity physical activity 19. With several studies showing a dose response between chronic physical activity and health outcomes, meaning the more one is physical activity the greater the benefits are 30.
For those patients who are at risk of cardiovascular disease, they should undertake at least 120 minutes per week of moderate to high intensity aerobic exercise 18,31. For those looking to lose weight and prevent weight gain, they should be engaging in 150-250 minutes of moderate intensity exercise along with resistance training 31,32.
Chiropractors Should Be Advocating Exercise Medicine
Assessing patients risk factors for chronic preventable diseases is not outside the scope of a Chiropractors practice and can be easily assessed using measurements such as BMI, blood pressure, waist circumference, and if available blood lipids. There is a wealth of heart health diet questionnaires available online and The Heart Foundation provides charts and calculators for establishing a patient’s 5-year cardiovascular disease risk. Whether you are involved with sports and exercise medicine or not, advocating exercise and dietary advice to improve patient outcomes, mortality and morbidity rates should be a part of all Chiropractors treatment plans.
As a Melbourne sports chiropractor Dr. Shannon utilizes exercise therapy and advocates for reductions in sedentary behaviour and increases in moderate to vigorous physical activity. If you are interested in reading more about the benefits of exercise read you blog on why exercise is beneficial for immune function. To book an appointment with Melbourne city chiropractor Dr. Shannon or remedial massage therapist Paula Pena you can book below. Our Melbourne CBD chiropractic clinic is ideally located on Collins Street in the CBD of Melbourne opposite the Melbourne Town Hall and City Square.
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