Last week when someone cut me off in the bike lane for no other reason than to cut me off (there was no turn he was going for, just me) I went to the police station to report him only to be told that unless he hit me or harmed me there is nothing they can do. Well karma came and got me because I was hit by a car on my bike yesterday on Jefferson Ave. and 16th Street in Miami Beach while riding in the bike lane. I flipped over my handlebars and landed on my shoulder and my head, but somehow I am completely fine and my bike was undamaged. I am very lucky, I know. The police were called, she was cited, and I rode off.
I am not satisfied with the officer's response when I tried to report the driver that tried but failed to hit me, and I certainly don't want to be hit again just so the police will respond. I could tell you many stories of all the close calls, near misses, and almost accidents as can anyone who rides around this city. While I enjoy critical mass and a big part of me relishes in the big F**K YOU message it sends to drivers, I have to agree with my urban planner friend that all it does is piss motorists off. If we want respect as cyclists we have to give it, and no amount of yelling, banging on trunks, and flipping off rude drivers will achieve that. (I am guilty of all of these things by the way.) In light of this, something needs to be done to make people aware of the bike lanes and the consequences of ignoring them without making them hate cycists.
Please join me next Saturday at 6pm in the bike lane on 16th Street in Miami Beach to create awareness of the rules of the lane. I cannot stress enough that this rally is meant to generate respect for cyclists (and skateboarders and rollerbladers for that matter) by showing respect for motorists as well. If you want to be belligerent towards drivers and block traffic, this event is not for you. I would like to create a single file human+bike barrier at the edge of the bike lane. Why single file? Because, as I said, I do not want to block traffic for motorists, and especially not cyclists. Cyclists and supporters are all welcome, bring your bike if you have one and come even if you don't. If you choose to attend, please adhere to the following guidelines:
respect traffic by not blocking intersections, driveways, or crosswalks
allow residents in and out of parking (it is a residential parking area)
be friendly to motorists
bring signs to create awareness (examples of what your sign could say: Share the road, respect bike lanes, RIP with name and birthday of a cyclist friend who has been killed by a motorist, We just want to be safe, etc. Please do not write anything accusatory towards drivers)
I personally will be at Jefferson and 16th where I was hit with a sign saying "This is where my head hit the pavement when a car hit me". Subtle, I know. I cannot stress it enough, I really want to shed a positive light on cyclists in Miami so please bring your good attitude. If we want respect we have to show it!
Myofascial Release Part 5
Now that we’ve reviewed so much research regarding the tissues affected by myofascial release and how, it’s time to get into how to actually perform self myofascial release (SMR) and when is the best time to do so. By the way, if you missed any of the other entries in the series just click on The Bio Mechanic above and it will link you to my blog history.
Since there’s no research on SMR and endurance sports and not much research in general on when is the best time to do SMR for most athletes, here’s my disclaimer about the recommendations I make. I’m considering what little research there is and making the best recommendations I can according to what we do know, combined with my and others’ experience using the foam roller and other SMR tools. As more research is done I may change my mind about some of this, but for now these are the best recommendations I can make.
The first step in SMR is tool selection. First of all, there are several different types of foam rollers, including eva foam, soft and hard molded foam, the grid, the rumble roller and the vibraroll. In addition to these rollers, you may also use Trigger Point Therapy tools (massage ball, quad roller, foot baller, baller block), cold roller, muscle trac massager, posture ball, and spikey ball. These items can be found in some sporting goods and running stores, and online at fitness product websites such as performbetter.com, power-systems.com, and spri.com. If you’re looking for a more economical option, SMR can easily be done with unopened 2 liter soda bottles as a substitute for the foam roller, frozen water bottles as a substitute for the cold roller, a rolling pin in place of the stick, tigertail, or muscle trac massager, and softball, baseball, tennis and golf balls instead of the myoball and foot baller. Since some SMR tools can be expensive, these alternatives are just as effective for a fraction of the price.
With all the options available, there are a couple things to consider when determining which tools will be most beneficial for you to use. One factor is to consider the area of the body on which you want to perform SMR. The size of the tool determines the surface area it will affect, and if you’re trying to release smaller muscles such as those in the lower leg, feet or shoulders it is best to use one of the smaller tools (myoball, tennis ball, etc.) Also, if you have tension deep within muscles, using one of the smaller tools can be more effective even on larger muscles. In general, the smaller the surface area the tool affects, the deeper the pressure and more effective the release will be. Another factor is the density of the tool you are using. Soft foam rollers have more give, which results in less pressure applied to the muscles. This could be good for people who are new to myofascial release and/or do not have high pain tolerance, or for use as something of a warm-up to help lightly release muscles before using a more aggressive form of release tool.
In my opinion, the best time to perform the roller can vary by the individual and the number of trigger points that are present. If you have muscles that are chronically tight or painful, I recommend at least doing SMR on these muscles on both sides of the body prior to training. For pre-training SMR, staying within the times used in the performance studies is probably best, so spending 1 minute per muscle group is sufficient. For athletes who are using SMR for treatment of tight muscles and for prevention of developing trigger points, I believe it would be beneficial to use the foam roller as a recovery tool. For recovery, you could use the roller after moderate workouts. I would be cautious rolling after really intense workouts that cause lots of soreness. In this case, there is a higher level of inflammation in the muscles (which causes the feelings of pain) and I’d be hesitant to apply too much pressure in this case. You could also use the roller in conjunction with your lower intensity or lower impact workouts such as swimming, yoga, or stretching, since there is less trauma to the muscles during these types of workouts. When using SMR as recovery, I would not hesitate to spend several minutes on areas that have lots of trigger points rather than limiting to one minute per muscle group.
There are already lots of resources for how to use the roller so rather than explain everything here I’m including links to some helpful videos to get you started. Once you get the idea of how it works, you will learn how to position your body to massage the muscles you want. As I mentioned before, for larger muscles you can try using smaller tools that will get deeper into the muscles. For example, I use a softball on my hamstrings.
You can use a golf ball for the SMR shown in this video. They mention rolling the forefoot but don’t demonstrate it. You can roll the ball between the bones in the ball of the foot, which is great relief for women who wear heels.
This video has good tips for using a small ball on the shoulders and other areas of the body. Although the video is described for seniors the tips are useful for anyone, especially if you’ve experienced tired shoulders while using the roller.
Enjoy your self massages!
One of the comments I got about the last post regarding the effects of self myofascial release (SMR) on performance was about how it affects recovery. As with studies on SMR and performance, the research on how it affects recovery are also quite limited. It also depends on what factors you consider when you think of recovery. Immediately after exercise, we have what you could consider general recovery when the heart rate, blood pressure, and internal body temperature are returning to resting levels. We also have muscle recovery, which can take much longer if you consider soreness, which occurs from high intensity or long duration exercise. Personally, I’m more concerned with if and how SMR can help my sore muscles after a week of intense training, but unfortunately I could find no research studies on this topic.
It’s not that there aren’t studies on SMR and pain, but the populations used in these studies have some kind of pathology-fibromyalgia, breast cancer, pelvic malalingments. At a glance, SMR seems to be helpful for these groups but as anyone in science knows we shouldn’t directly transfer results from one population to another. However, it would make sense that if SMR relieves pain in someone with a disease affecting their fascia, people with soreness due to exercise would likely experience some benefit too. So as I’m writing this, it gives me the idea to compare the study I reviewed earlier that measured inflammatory markers in muscles with painful trigger points and see how they compare to subjects with fibromyalgia. Fibromyalgia is a condition that causes generalized pain throughout the entire body because of its affects on myofascial tissue. Exploring this connection is not where I intended to go when I began writing this, but after reading a little bit it seems relevant so here we go. If you want a thorough refresher on what I discussed regarding inflammation in the muscles, review Myofascial Release Part 2. You can access previous entries by clicking on the blog title “The Biomechanic” at the top of the page.
One study on fibromyalgia measured several inflammatory markers, among other things. When I compared the results of this study to the previously mentioned study measuring biochemical markers in active trigger points I found a few similarities. Between the two studies, there were 3 inflammatory markers in common (cytokines IL-6, IL-8, and tumor necrosis factor alpha-don’t worry if you don’t know what these are, I just feel the need to specify for anyone who might). In both studies, the concentrations of these markers were compared to normal subjects and found that they were higher in subjects with both fibromyalgia and active trigger points. Although the causes are much different, this indicates that there could be some similarities in what causes pain in both conditions. If SMR helps relieve the symptoms of one it is possible to work for both. Considering the amount of research that is being done on fibromyalgia, this could potentially be helpful for research on myofascial release in athletic population.
Even without scientific research to explain how and why, athletes who use the foam roller and other SMR tools know they work. I’ll be getting into SMR tool selection and use next.
Bazzichi, L., Rossi, A., Massimetti, G., et al. Cytokine patterns in fibromyalgia and their correlation with clinical manifestations, Clinical and Experimental Rheumatology, 2007, 25: 225-230.
Shah, J.P., Danoff, J.V., Desai, M.J., et al. Biochemicals Associated With Pain and Inflammation are Elevated in Sites Near to and Remote From Active Myofascial Trigger Points. Arch Phys Med Rehabil, Vol 89, January 2008.
Myofascial Release Part 3
I got some feedback from readers that I’m writing a little too technically. Sorry everyone, when I get in science mode it’s hard to get out! This time around I’ll try my best to make things as understandable as possible, but feel free to comment with questions or requests for further explanation.
The next area I want to address regarding SMR is how it affects performance. After reading about what’s happening in the myofascial system to create painful trigger points it’s easy to see that doing SMR regularly is probably a good thing. However, as with any training method, it is important to know when and how to implement the foam roller to maximize the benefit.
In searching for scientific research on this topic I must admit there is little. I found only one study and one thesis that actually tested performance measures after using the foam roller. There were no studies to measure how it affects running or cycling, which I know is an area of interest for many of my readers. The studies that I did find measured multiple factors. In general, if I mention a difference occurring it means the effect of the foam roller was statistically significant, which means the effect was enough for us to care.
One study looked at quadriceps function without doing any SMR, and after doing 2 1-minute bouts of SMR on a PVC+foam roller. They measured isometric strength (strength of the muscle in a static position), range of motion, and other factors at 2 and 10 minutes after foam rolling. They found that the muscles were able to activate as well and produce similar amounts of force with and without performing SMR. When they measured range of motion, subjects’ ROM at the knee increased an average of 9 degrees after SMR. Another interesting result of the study was that for the control condition (no SMR) as range of motion increased, strength decreased. When the subjects performed SMR and were tested again, range of motion no longer affected strength. The researchers also noted that the increases in range of motion they measured were similar to studies measuring the effects of static stretching, with the difference that SMR did not decrease muscle strength production while static stretching did.
Another study compared a general warm-up only, general and dynamic warm-up, and general warm-up and SMR on plyometric power measured through jump height. The foam roller was done on the calves, hamstrings, quadriceps, and glutes for one minute per muscle group. Subjects were tested for performance after each type of warm-up on 3 different days with at least one day rest in-between. They were tested on three different jumps:
- squat jump-subjects held a 90 degree squat position for 2 seconds then jumped as high as possible
- countermovement jump-subjects squat down and immediately jump as high as possible with no pause
- depth jump-subjects stand on a .5m (~20 inch) box, step down to land on both feet and jump as high as possible upon landing
The analysis showed that the dynamic warm-up increased the height of the countermovement jump, but no other differences were found. In this study, the foam roller had no effect on power production.
For now, this is all we have to go on regarding foam rolling and performance. It’s not much, but what we can get from this is that range of motion is improved with no decrease in performance with the foam roller, at least in strength and power exercises. Although we cannot assume the outcome would be the same for endurance activities like running and cycling, we are at least one step closer in understanding how SMR affects muscle force production. In my next entry I’ll make my recommendations for what I believe is the best way to implement SMR into your training program, and how to do it. Thanks for reading!
MacDonald, G.Z., Penney, M.D.H., Mullaley, M.E., et al. An acute bout of self-myofascial release increases range of motion without a subsequent decrease in muscle activation or force. The Journal of Strength and Conditioning Research, 27(3), 812-821.
Fama, B.J., Bueti, D.R. The Acute Effect Of Self-Myofascial Release On Lower Extremity Plyometric Performance. (2011). Theses and Dissertations, Sacred Heart University.
In Myofascial Release Part 1 I reviewed in general the structure and function of the connective tissue that surrounds the muscles, which is the target structure of myofascial release. Now that we have a basic understanding of what the fascia is and what it does, let’s review some of the issues that myofascial release is meant to alleviate.
First of all, I would like to offer clarification on a statement I made in Part I regarding the innervation and circulation supplied to myofascia. I said that “While fascia does not contract on its own the way muscles do, or have direct connection with the circulatory system…”. I realize this implies that fascia does not contract or have circulation at all, and this is not the case. Researchers found that within the collagen fibers of fascial tissue are embedded smooth muscle cells and capillary systems. Smooth muscle fibers are those found in our internal organs that we do not voluntarily control, such as the stomach and intestines. As a result of the existence of these muscle fibers, when connective tissue was subjected to prolonged stretch, the tension of the tissue increased, indicating “contraction” of the fascia. These studies show that fascia is an active rather than passive tissue, as previously thought, and it can be extremely responsive to forces on the body, whether due to muscle contraction or stretch.
The painful areas usually targeted through myofascial release are called trigger points. When using the foam roller these spots are typically easy to find. As you roll the pressure often feels like strong massage, and when pressure is applied on or near the trigger points it is usually quite painful. The goal is to “release” these trigger points to alleviate the pain and improve function of the area. But what causes these trigger points and the pain associated with them?
Although fascia may not have large vessels directly supplying flow of blood or fluid, there are many points in the fascia where an artery, vein and nerve traveling together pass through, or perforate, the fascia. It was found that the majority of the 361 Chinese acupuncture points corresponded with one of these perforation points. Patients experiencing pain at these sites showed additional collagen buildup around the perforation described as “strangling” the vessels and nerves. This collagen buildup and subsequent pain is what is creates these trigger points.
In addition to the physical buildup of collagen associated with trigger points, there are also chemical differences. A study measuring the concentrations of a variety of chemical markers associated with pain and inflammation (inflammatory mediators, catecholamines, neuropeptides, cytokines) took samples from trigger point areas in the trapezius muscle (upper back) and unaffected gastrocmenius (calf) muscles. These chemical markers specifically indicate a decrease in fluid circulation, decreased ability to utilize oxygen and increased acidity. The increase in acidity also inhibits acetylcholinesterase activity at the motor end plate. This means that after the muscle fiber is stimulated to contract, the chemical that subsequently allows the muscle to relax is not able to function properly, causing the muscle to stay in a state of partial contraction. The results of these things are increased metabolic demand, muscle fiber shortening and muscle tension. It is easy to see how with these things occurring, muscle function would be affected along with the pain associated with trigger points.
This study also found that many of these biochemical markers were elevated in the trigger point areas as well as in unaffected muscles when compared to subjects with no trigger points. This indicates that the inflammation that occurs in areas of pain can affect the chemical balance of the fascia system of the entire body. There is debate whether the increased inflammation markers are the cause or effect of trigger points and more research is needed to determine this.
Now we have a better idea what is happening physically and chemically at the trigger point sites. Based on what we know so far, I think it is fair to say that in addition to just feeling better after doing myofascial release, there is probably some measurable physical and chemical improvement to the muscles. As with any therapy or training technique, there are questions about when and for how long we should perform foam rolling and other SMR techniques in order to increase performance rather than decrease it. Keep reading, as I will address this next!
Schleip, R. Fascial plasticity-a new neurobiological explanation: Part 2. Journal of Bodywork and Movement Therapies, 2003. 7(1) 11-19.
Shah, J.P., Danoff, J.V., Desai, M.J., et al. Biochemicals Associated With Pain and Inflammation are Elevated in Sites Near to and Remote From Active Myofascial Trigger Points. Arch Phys Med Rehabil, Vol 89, January 2008.
I constantly recommend the foam roller to clients, class participants, friends, and especially runners and cyclists. I use the roller and other self myofascial release tools often and I can feel a difference in pain and function afterwards. When people ask why or how it works, I have found my explanation to be a bit lacking. I’ve searched around and there isn’t a lot of scientific research done on the foam roller, but there is a decent amount on myofascial release in general. It’s much more complex than just saying massage relaxes your muscles and feels good (although it does!). In order to understand how and why myofascial release works, it is important to understand the structures involved. As always, I’ve tried to make it as easy to understand as possible.
Fascia is a connective tissue in the body, and the term myofascial refers specifically to the connective tissue that surrounds the muscles (myo). Each muscle is enclosed in its own fascial sheath, and the fascia of adjacent muscles are connected to one another. In addition, some groups of muscles that function together are surrounded by an addition fascial sheath. The fascia of these groups of muscles are then connected to other adjacent muscles or groups of muscles. This web of connection exists throughout the body. While fascia does not contract on its own the way muscles do, or have direct connection with the circulatory system, it is extremely important for transmission of force from one joint or body segment to another, shock absorption, joint stability, and muscle tone.
Fascia is comprised of collagen fibers that are orientated in a relatively parallel fashion. Trauma or dysfunction of the tissue can cause disturbances in its function, which will be addressed later. A liquid-gel type substance called ground substance fills in the space between collagen fibers. The ground substance varies somewhat depending on the tissue the fascia is surrounding, but is generally comprised of water and proteins.
Also within the fascia are a variety of receptors that sense mechanical (movement, tension or pressure related) and biochemical changes. One type of mechanoreceptor is the Golgi receptor. These are found all along the myofascia, but are commonly known for their presence in tendons as Golgi Tendon Organs. These receptors sense the force of contraction of the muscle. Other mechanoreceptors are called Ruffini and Pacini corpuscles. These receptors respond to short- and long-term pressure changes and vibration. A third group of mechanoreceptor is called interstitial myofascial receptors that are found within both muscle and fascia tissues. These receptors sense temperature, pressure, pain and chemical changes. This could explain how muscles can hurt even when they are not being moved. Pressure applied to the muscles will stimulate these mechanical receptors. Slow, steady pressure has been shown to decrease blood pressure, muscle tone/tension, and emotional arousal, while quick or sharp pressure has been shown to cause muscle contraction, most likely by stimulating a reflex response. If you’ve ever rolled quickly over a trigger point on the foam roller you probably experienced this kind of sharp contraction, rather than when moving slowly and allowing the muscles to release as you go.
So now that we have some understand of what the structures are, we are well equipped to next understand what problems can occur to cause excessive tightness, pain, and trigger points. Thanks for reading, there’s more to come!
Schleip, R. Fascial plasticity-a new neurobiological explanation: Part 1. Journal of Bodywork and Movement Therapies, 2003. 7(1) 11-19.
There are so many questions to ask about how soy affects our health. With all the products now made from soy from infant formula to milk substitues and ice cream, Americans are concerned about how consuming increasing amounts of soy protein will affect our health now and as we age, as well as the health of our children. Without getting too in-depth into any of the specific topics, here is a general summary of how soy can affect some of the major diseases present in the US. I have included links for additional studies that address more specific topics, and it is likely that I will write more more about the effects of soy. In defense of soy, I would like to point out that Eastern cultures have been eating large amounts of it for generations and they seem to be doing just fine, with the exception of increasing levels of lifestyle related diseases as they adopt a more Western diet.
Reader’s warning: this is a long one.
Phytochemicals are plant-based compounds that are biologically active, meaning that they affect chemical reactions in the human body. One group of these chemicals found in significant amounts in soy and flaxseed products is phytoestrogens. Of particular interest in nutrition research is the group of phytoestrogens called isoflavones. These phytoestrogens are non-steroids that can mimic the steroid estrogen’s behaviors. The amount of isoflavones soy products contain will depend on the species, environment where it is grown, and industrial processing, such as tofu compared to tempeh.
When comparing the steroid activity of estrogens to isoflavones the role of these phytoestrogens is very weak, however they are involved in many other nonhormonal actions. Effects of isoflavones seem to affect women in particular, due to the effects of estrogen on cancer risk, cardiovascular disease, and bone health. While some studies have been done on the health effects in men, more studies seems to be showing the effects of soy consumption on women. It is also recognized that the mechanism of effects of isoflavones on these diseases is not well-understood and seem to be multi-factorial.
Consumption of these compounds at normal dietary rates is associated with lower levels of hormone related diseases, and lower rates of these diseases in countries where high amounts of soy is consumed (i.e., China, Japan, Indonesia). Consumption of soy has been shown to affect cancer growth in several cases. Studies where breast cancer was induced showed that consumption of soy decreased tumor growth, and the effect was lost when consumption ceased. They have also been shown to decrease carcinogenic activity of compounds affecting DNA.
Soy protein is also associated with decreased levels of LDL (bad) cholesterol. After 1 month of consuming an average of 47g of soy protein per day, premenopausal women saw decreases of almost 10% of blood cholesterol levels. Part of the reason for this could be due to substituting soy protein, which contains no cholesterol or saturated fat, for animal proteins that contain varying levels of both. Consumption of pure isoflavones in pill form had no effect on cholesterol, indicating the complicated way these compounds function in the body when consumed as soy protein.
Rates of osteoporosis and hip fracture are also significantly lower in China and Japan than in Western women, indicating that there may be some connection to diet and consumption of soy. Estrogen is important for preventing bone breakdown, which explains why the risk of osteopenia and osteoporosis increases in postmenopausal women. Although the mechanism of isoflavaones in protecting from bone loss are not well understood, animal studies show positive effects on bone density. One study showed that soy protein was equally as effective as estradiol in maintaining bone density 1 month after ovariectomy.
Setchell, KDR. Phytoestrogens: the biochemistry, physiology and implications for human health of isoflavones. American Journal of Clinical Nutrition; 1998;68(suppl):1333S–46S
Zhan, S. & Ho, S. Meta analysis of the effects of soy protein containing isoflavones on the lipid profile. American Journal of Clinical Nutrition; Feb 2005. 81(2) 397-408.
Effects of soy protein and isoflavones on circulating hormone concentrations in pre- and post-menopausal women: a systematic review and meta-analysis
Meta-analysis of the effects of soy protein containing isoflavones on the lipid profile
META-ANALYSIS OF THE EFFECTS OF SOY PROTEIN INTAKE ON SERUM LIPIDS
Soy Protein Reduces Serum Cholesterol by Both Intrinsic and Food Displacement Mechanisms
Biological effects of a diet of soy protein rich in isoflavones on the menstrual cycle of premenopausal women
Ingestion of whey hydrolysate, casein, or soy protein isolate: effects on mixed muscle protein synthesis at rest and following resistance exercise in young men
Isoflavone-rich soy protein isolate attenuates bone loss in the lumbar spine of perimenopausal women
Some people think that vegetarian or vegan automatically makes a food, meal, or person healthier. I argue that this is not necessarily the case. A person who follows a vegan or vegetarian diet has many junk food options available to them. For example, potato chips and candy are vegan and I hope we all know that these things are not healthy. As with any diet or lifestyle choice, there is a spectrum of health and anyone can be as healthy or unhealthy as they want to within their diet/lifestyle.
I intended to write this post as an argument against processed foods, even vegan meat substitues. In general, I advocate for eating whole and unprocessed foods. If you look at a nutrition label and you can't buy all or most of the ingredients yourself you probably shouldn't be eating it. I was even somewhat opposed to vegan substitutes for meat, like Tofurky-type products. If you don't want to eat meat, why would you want to eat something that's been doctored up to look, feel, and taste like meat? And it is any healthier?
I did a little research (food label reading, to be exact) and I decided that meat substitutes aren't as bad as I thought. There are a few odd ingredients that I wouldn't be able to buy myself, but for the most part the ingredients are real and I don't think these items are too terrible. Because they are processed I still believe it's better to eat a "real" food and minimize how much of them you consume, but if you're craving something meaty and don't want to cheat I don't see anything wrong with these options.
One thing to note is that many Morningstar Farms items are NOT vegan (only vegetarian) and this brand is probably not the only vegetarian food brand that includes dairy/eggs, it's just the only one I looked at. If you are gluten-free, you might as well forget about it. Most of these items include wheat ingredients, probably for substance and texture.
Enjoy your veggie burgers!
There are so many topics I want to cover regarding a vegan diet, among other things, and I hope to answer many of your questions. One of the questions I got was regarding vitamin B12, and I hope to provide a decent summary here. It is somewhat technical but I tried to provide some translation for my non medical/research readers. Of course this is by no means an exhaustively researched paper and there’s much more to know. My references are included for those of you who would like to read more in depth about this topic.
Vitamin B12, also known as cobalamin, is the most complex of essential vitamins. B12 is important for DNA synthesis in the cells; repair of myelin (a component important for the function of nerve cells), energy synthesis in mitochondria, and production of blood cells in bone marrow. B12 is synthesized by microorganisms in the gut of animals, therefore it is not found in plants unless they have been fortified either through soil or in production. Low levels of B12 are associated with neurological decline/dementia, neural tube defects in fetus of pregnant women with deficiencies, cardiovascular disease, osteoporosis and macular degeneration. Some of these symptoms and conditions are irreversible, highlighting the importance of consuming appropriate levels of vitamin B12.
B12 is a water soluble vitamin, meaning that the body will absorb a limited amount of what you consume and the rest will be excreted in the urine. For example, studies show that after consuming a dose of 1 migrogram (mcg), 50% was absorbed (0.5 mcg) compared to 5% of a 25 mcg dose (1.25 mcg). Some research has shown that consumption of 1.5-2 mcg is enough to saturate the receptors, meaning that any additional consumption will result in excretion therefore is of no benefit. The amount an individual absorbs varies depending on factors including age, the source of B12, and it is assumed that 50% of dietary B12 is absorbed in adults with normal gastrointestinal function.
B12 serum levels can be an indicator of deficiency, and although no specific value is determined, a sufficient range of B12 serum levels has been defined as anywhere from 200-500 ng/L. Some believe that it takes decades to develop B12 deficiency with low dietary intake, however deficiency has been shown to develop within 2-4 years of adopting a vegan or vegetarian diet. A study of young adults and the elderly in several countries determined that 32% of vegetarians and 43% of vegans were deficient in serum B12. Even among those who took a B12 supplement, 31% of vegetarians and 88% of vegans were measured to be deficient. A different study found that in a group of vegans only 11% were deficient, and only 19% of the group was using a dietary supplement for B12. These differences could be attributed to how strictly they set the guidelines for what qualified as deficiency, but as you can see it may be difficult to determine.
Animal foods such as beef, chicken, liver, eggs and dairy tend to be very high in vitamin B12. Here is a short list of specific amounts of B12 in common foods (100g = about 4 oz.): eggs (mostly in the yolk): 0.9-1.4mcg/100g, milk: 0.3-0.4mcg/100g, salmon/sardine/trout/tuna: 3-8.9mcg/100g, tempeh (fermented soy): 0.7-8mcg/100g, nori (edible seaweed wrap about 0.3g each): 32-78mcg/100g, fortified breakfast cereals: varied. This a very short list, of course there are other plant sources that have been found to contain vitamin B12, but I didn’t find them to be realistic in the amounts you would have to consume to get a decent amount of the vitamin, which is why I didn’t list them here.
B12 absorption can be negatively affected by diseases and conditions such as Crohn’s disease, anemia, elderly, pregnancy, and certain medications. If you have any of these diseases or take medications it is extremely important to consult with your doctor or a clinical nutritionist to determine that you are getting enough B12 in your diet, particularly if you are interested in adopting a vegetarian or vegan diet.
I am supplementing with an Emergen-C dietary supplement that contains 25mcg of Vitamin B12 as cyanocobalamin, among other things. According to the studies that I read I believe this is sufficient to meet my needs. I also eat tempeh fairly regularly now, so between the two I am not too worried about my serum B12 levels. However, when I go for my annual checkup with my doctor I do plan on asking to have this parameter measured just to be sure.
Thanks for reading, and keep the questions coming!
O’Leary, F. & Samman, S. Vitamin B12 in Health and Disease; Nutrients 2010, 2, 299-316; doi:10.3390/nu2030299
Pawlak, R., Parrott, S., Raj, S., Cullum-Dugan, D., & Lucas, D. How prevalent is Vitamin B12 deficiency among vegetarians? Nutrition Reviews Vol. 71(2):110–117; doi:10.1111/nure.12001
Watanabe, F. Vitamin B12 Sources and Bioavailability. Experimental Biology and Medicine 2007, 232:1266-1274. doi: 10.3181/0703-MR-67
Someone recommended that I visit vegan restaurants in the Miami area and write about them, and I will, but to be honest I don't know if this is actually that helpful. Part of what I want to do with this blog topic is not only to help educate people on health and practicing veganism (or at least eating more plants than before), but how to do it in a practical way. Getting vegan food in a vegan restaurant is easy, getting vegan food in a restaurant where your carnivorous friends want to eat can be a different story! So far I've been to an Italian restaurant (Macchialina-in hindsight, a stupid choice for a gluten-free vegan) and 2 Japanese restaurants (Toni's and Doraku).
If you can't eat pasta, don't waste your time with Macchialina. I went there many months ago, and in my distorted memory they had a few dishes I thought I would be able to eat. Unfortunately, they use chicken broth to cook a lot of the menu items that might otherwise be adaptable, so that took my options down to 3 appetizers. After splitting a bottle of wine with my companion I left $70 poorer and with a practically empty stomach. Don't get me wrong, the items I ate were delicious, I just needed about 4 times more of them.
Toni's was the best so far. We started with edamame (you know, to get my PROTEIN), and I ordered a veggie sushi/sashimi dinner. It came with a veggie roll, and a few pieces of veggie "sashimi": 2 mushroom, wakame, avocado, and asparagus (I think...). The veggie roll could've used more diversity in contents; I only remember cucumber and mushroom being in there. Carrot, avocado, cabbage-anything else would've been nice. The mushrooms were the highlight of the meal for me. I believe they were pickled, they looked dark and purplish, and they had a meaty, chewy texture and sweet, tangy flavor. Delicious! The good side was I wasn't stuffed when I left like I usually am after eating sushi.
I hoped Doraku would have been as easy to find something to eat as Toni's, but unfortunately the vegan options are somewhat limited. I wanted something heartier and was hoping for tofu, but they didn't really have any tofu based dishes. I ended up getting vegetable fried rice with kimchee, which was good but not filling enough for how hungry I was.
The most important thing I've learned so far about ordering in a restaurant is to ask the waiter. They know what goes into the food, or can at least ask the chef, and can find out how they can modify existing items to fit into your dietary needs. You might find that some things that sound okay are actually not. For example, the waiter at Doraku disclosed that they add gluten to their white rice, which appears NOWHERE on the menu and explains why I usually feel so bloated after eating there.
P.S. I got a question about vitamin B12 and I'm doing some research before writing the post. It's coming soon! My research is also bringing up questions for me about folate, so I'll be addressing that soon too.
Enjoy your veggies!