Is Chocolate Milk Really That Bad?

I read that schools are taking chocolate milk off of their available drink lists for lunch. Is this true? Is chocolate milk that bad? I know you think it is a great recovery drink! - Jonathan R., Omaha, Nebraska

Thank you, Jonathan, for the question. You're right that I'm a big believer in chocolate milk as a recovery drink for runners. And I am seriously irked that schools are abandoning it. Fried mozzarella sticks remain on many school menus, whereas chocolate milk (with as much sugar as a glass of apple juice) is taken off! It may not be perfect, but drinking flavored milk is healthier for our kids than drinking no milk.

My friend Dr. Felicia Stoler -- an exercise physiologist, registered dietitian, and mother -- is leading the charge to get chocolate milk back in the schools. [Full disclosure: She is also a paid spokeswoman for the National Dairy Council.] Felicia makes the following points:

• Chocolate milk has nine essential nutrients, including calcium, potassium, and vitamin D.

• No other single beverage replaces the nutrient-rich package found in milk.

• Low-fat or skim chocolate milk has a valuable role in the diet as a way of increasing consumption by palatability and taste.

• Six leading health organizations – including the American Academy of Pediatrics and American Heart Association recognize the value of milk (including flavored milk) in a healthy diet.

• Kids who drink chocolate milk are not any heavier than kids who don't, and their diets do not contain more sugar; actually they have better quality diets than those who don’t drink milk.

• When chocolate milk is removed from the cafeteria, overall milk consumption decreases by up to 70%.

• As kids transition from adolescence to teens, their calcium intake as a group decreases.

• Chocolate milk is great for recovery. (Yeah!)

• New research implies there are antioxidant properties of cocoa and chocolate milk. (It may be good for your heart.)

I encourage you to join me in fighting to save chocolate milk in schools. You can get more information at www.raiseyourhand4milk.com.
 
Drink up!

Enjoy the ride.

Have a question for the Running Doc? E-mail him. NOTE: Due to the volume of mail, we regret that the Doc cannot answer every e-mail.

PLEASE Do the Baby Aspirin

Hello Readers,

I just returned from the San Antonio Rock ‘n’ Roll Marathon and Half. Some 32,000 participants had a great time and we had a very successful day from a medical standpoint -- though it wasn't without incident. (More on that in a bit.)

You may remember that in a previous post I discussed Dr. Arthur Siegel’s theory about sudden cardiac death (SCD), which is what doctors call cardiac arrest even if it is resuscitated. Dr. Siegel theorizes that muscle breakdown from exertion (rhabdomyolysis) interacts with a plaque (even a small one), which activates platelets to form a small clot that causes enough of an ischemic area in the heart to result in an abnormal cardiac rhythm or arrest. This would not be seen on autopsy.

Dr. Siegel is on to something. In San Antonio, a 32-year-old man finished the half-marathon, then had a cardiac arrest. We successfully resuscitated him and performed cardiac catherization, only to find clean, clear coronary arteries. Because of Arthur’s work, we ordered a serum myoglobin (a marker for the muscle breakdown that Arthur speaks about). Levels were through the roof! This patient appeared to be a living example of Dr. Siegel's theory -- and further evidence of the need to take a preventive baby aspirin (81 mg dose) the morning of a race.

Now, it's true that one case doesn’t prove anything. The International Marathon Medical Directors Association is meeting in March 2010 to develop a multi-city, multi-country research project. It may be that all runners develop high serum myoglobins, since they clear quickly (sometime within one day) -- but they also interact in the body, creating a cascade of other inflammatory elevations that may be markers of risk and may help us to get a better handle on SCD.

As Dr. Siegel says: “Like the runner herein, these SCD victims during races can be saved. But wouldn't it make even more sense to try to prevent the SCD's in the first place? Taking aspirin may just do the trick."

You can help us make this research project "smarter."  If you happen to visit your doctor within 24 hours after finishing a full or half-marathon, please bring a copy of this post with you, record the information below, then e-mail  the results to us at IMMDANYC@aol.com. It will give us greater insight to develop the best research protocol we can.

Please record the following info:

• Your sex and age
• Date and time of last run
• Marathon or half-marathon
• Date and time of blood draw
• Height and weight
• Serum sodium level
• Serum myoglobin
• C-reactive protein level
• CK and tropinin levels
• How much you drank during the run and after the run
• What you drank during and after the run
• Your typical mileage you run per week
• Your typical pace

Anyone who does this will help us enormously.

Meantime, if your doctor says you have no contraindication to taking a baby aspirin the morning of your run, please do it. It may just be the healthiest thing to do.

Enjoy the ride.

Have a question for the Running Doc? E-mail him. NOTE: Due to the volume of mail, we regret that the Doc cannot answer every e-mail.

Why Is My Knee Stiff?

I experience stiffness in my left knee when I sit for a while. I stretch it out before I run, but it still doesn't go away. This is a problem almost every day. Any suggestions as to what it could be? Why my left leg? I am only 21, so arthritis is unlikely. - Brian

 
Thanks, Brian, for posting this question. Knee stiffness is a very common complaint but unfortunately, over the internet, it is impossible to give you a clear action to the cause.
 
Knee stiffness is a symptom, not a diagnosis. Similarly, if you twist your ankle, causing it to swell up, and  go to a doctor who examines it, x-rays it, then tells you that you have a “swollen ankle,” you wouldn’t be happy. It is a symptom that is caused by something and it is important to find out exactly the cause in order to come up with an appropriate treatment plan.
 

The knee is a closed space. If there's inflammation or a tear within that closed space, fluid builds up, causing it to feel stiff. Usually the weakest part of that space is in the back so it is common for patients to complain that the back of their knee has the pain or stiffness, but the stiffness can be global as well.

 
You will not resolve this until you find a good sports physician near you who can do a history and physical examination; an MRI may or may not be needed depending on what's found on your physical exam.
 
Please let us know what happens after you have a true diagnosis.
 
Enjoy the ride.

 
Attention, Readers!
Are you going to be in San Antonio this weekend? If so, come visit Dr. Lewis Maharam (our Running Doc, a.k.a. "Rock Doc) at the San Antonio Rock ‘n’ Roll Marathon and Half Marathon Heath and Fitness Expo. He will be giving lectures and available at a Medical Information Booth to answer personal questions and sign autographs.

Friday, November 13
1:30 p.m.  Rock Doc's Pre- and Post-Race Medical Tips
4 p.m.  Expert Panel: Frank Shorter, Rock Doc, John “the Penguin” Bingham
 
Saturday, November 14
noon  Expert Panel: Frank Shorter, Rock Doc, John “the Penguin” Bingham
2 p.m.  Rock Doc's Pre- and Post-Race Medical Tips

Location: Alamodome
100 Montana Street
San Antonio

The Health and Fitness Expo is free and open to the public.

* Note: Parking at the Alamodome costs $10 and will apply for the Expo on Friday and Saturday. This fee is issued by the Alamodome. There are alternate lots and parking meters available in downtown San Antonio.

Have a question for the Running Doc? E-mail him. NOTE: Due to the volume of mail, we regret that the Doc cannot answer every e-mail.