Is chocolate milk a good recovery drink after a workout? A dietitian reviews the evidence
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Whether you enjoy chocolate milk regularly, as a weekend treat, or as an occasional dose of childhood nostalgia, it probably wouldn’t be the first option you think of for post-workout recovery.
Unless you’re on TikTok, perhaps. According to many people on the social media platform, chocolate milk is not only delicious, but it offers benefits comparable to sports drinks after a workout.
So is there any evidence to support this? Let’s take a look.
Rehydrating after a workout is important
Water accounts for somewhere between 50% and 60% of our body weight. Water has many important functions in the body, including helping to keep our body at the right temperature through sweating.
We lose water naturally from our bodies when we sweat, as well as through our breathing and when we go to the toilet. So it’s important to stay hydrated to replenish the water we lose.
When we don’t, we become dehydrated, which can put a strain on our bodies. Signs and symptoms of dehydration can range from thirst and dizziness to low blood pressure and confusion.
Athletes, because of their higher levels of exertion, lose more water through sweating and from respiration (when their breathing rate gets faster). If they’re training or competing in hot or humid environments they will sweat even more.
Dehydration impacts athletes’ performance and like for all of us, can affect their health.
So finding ways to ensure athletes rehydrate quickly during and after they train or compete is important. Fortunately, sports scientists and dietitians have done research looking at the composition of different fluids to understand which ones rehydrate athletes most effectively.
The beverage hydration index
The best hydrating drinks are those the body retains the most of once they’ve been consumed. By doing studies where they give people different drinks in standardised conditions, scientists have been able to determine how various options stack up.
To this end, they’ve developed something called the beverage hydration index, which measures to what degree different fluids hydrate a person compared to still water.
According to this index beverages with similar fluid retention to still water include sparkling water, sports drinks, cola, diet cola, tea, coffee, and beer below 4% alcohol. That said, alcohol is probably best avoided when recovering from exercise.
Beverages with superior fluid retention to still water include milk (both full-fat and skim), soy milk, orange juice and oral rehydration solutions.
This body of research indicates that when it comes to rehydration after exercise, unflavoured milk (full fat, skim or soy) is better than sports drinks.
But what about chocolate milk?
A small study looked at the effects of chocolate milk compared to plain milk on rehydration and exercise performance in futsal players (futsal is similar to soccer but played on a court indoors). The researchers found no difference in rehydration between the two. There’s no other published research to my knowledge looking at how chocolate milk compares to regular milk for rehydration during or after exercise.
But rehydration isn’t the only thing athletes look for in sports drinks. In the same study, drinking chocolate milk after play (referred to as the recovery period) increased the time it took for the futsal players to become exhausted in further exercise (a shuttle run test) four hours later.
This was also shown in a review of several clinical trials. The analysis found that, compared to different placebos (such as water) or other drinks containing fat, protein and carbohydrates, chocolate milk lengthened the time to exhaustion during exercise.
What’s in chocolate milk?
Milk contains protein, carbohydrates and electrolytes, each of which can affect hydration, performance, or both.
Protein is important for building muscle, which is beneficial for performance. The electrolytes in milk (including sodium and potassium) help to replace electrolytes lost through sweating, so can also be good for performance, and aid hydration.
Compared to regular milk, chocolate milk contains added sugar. This provides extra carbohydrates, which are likewise beneficial for performance. Carbohydrates provide an immediate source of energy for athletes’ working muscles, where they’re stored as glycogen. This might contribute to the edge chocolate milk appears to have over plain milk in terms of athletic endurance.
Coffee-flavoured milk has an additional advantage. It contains caffeine, which can improve athletic performance by reducing the perceived effort that goes into exercise.
One study showed that a frappe-type drink prepared with filtered coffee, skim milk and sugar led to better muscle glycogen levels after exercise compared to plain milk with an equivalent amount of sugar added.
So what’s the verdict?
Evidence shows chocolate milk can rehydrate better than water or sports drinks after exercise. But there isn’t evidence to suggest it can rehydrate better than plain milk. Chocolate milk does appear to improve athletic endurance compared to plain milk though.
Ultimately, the best drink for athletes to consume to rehydrate is the one they’re most likely to drink.
While many TikTok trends are not based on evidence, it seems chocolate milk could actually be a good option for recovery from exercise. And it will be cheaper than specialised sports nutrition products. You can buy different brands from the supermarket or make your own at home with a drinking chocolate powder.
This doesn’t mean everyone should look to chocolate milk when they’re feeling thirsty. Chocolate milk does have more calories than plain milk and many other drinks because of the added sugar. For most of us, chocolate milk may be best enjoyed as an occasional treat.
Evangeline Mantzioris, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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What happens in my brain when I get a migraine? And what medications can I use to treat it?
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Migraine is many things, but one thing it’s not is “just a headache”.
“Migraine” comes from the Greek word “hemicrania”, referring to the common experience of migraine being predominantly one-sided.
Some people experience an “aura” preceding the headache phase – usually a visual or sensory experience that evolves over five to 60 minutes. Auras can also involve other domains such as language, smell and limb function.
Migraine is a disease with a huge personal and societal impact. Most people cannot function at their usual level during a migraine, and anticipation of the next attack can affect productivity, relationships and a person’s mental health.
What’s happening in my brain?
The biological basis of migraine is complex, and varies according to the phase of the migraine. Put simply:
The earliest phase is called the prodrome. This is associated with activation of a part of the brain called the hypothalamus which is thought to contribute to many symptoms such as nausea, changes in appetite and blurred vision.
Next is the aura phase, when a wave of neurochemical changes occur across the surface of the brain (the cortex) at a rate of 3–4 millimetres per minute. This explains how usually a person’s aura progresses over time. People often experience sensory disturbances such as flashes of light or tingling in their face or hands.
In the headache phase, the trigeminal nerve system is activated. This gives sensation to one side of the face, head and upper neck, leading to release of proteins such as CGRP (calcitonin gene-related peptide). This causes inflammation and dilation of blood vessels, which is the basis for the severe throbbing pain associated with the headache.
Finally, the postdromal phase occurs after the headache resolves and commonly involves changes in mood and energy.
What can you do about the acute attack?
A useful way to conceive of migraine treatment is to compare putting out campfires with bushfires. Medications are much more successful when applied at the earliest opportunity (the campfire). When the attack is fully evolved (into a bushfire), medications have a much more modest effect.
Aspirin
For people with mild migraine, non-specific anti-inflammatory medications such as high-dose aspirin, or standard dose non-steroidal medications (NSAIDS) can be very helpful. Their effectiveness is often enhanced with the use of an anti-nausea medication.
Triptans
For moderate to severe attacks, the mainstay of treatment is a class of medications called “triptans”. These act by reducing blood vessel dilation and reducing the release of inflammatory chemicals.
Triptans vary by their route of administration (tablets, wafers, injections, nasal sprays) and by their time to onset and duration of action.
The choice of a triptan depends on many factors including whether nausea and vomiting is prominent (consider a dissolving wafer or an injection) or patient tolerability (consider choosing one with a slower onset and offset of action).
As triptans constrict blood vessels, they should be used with caution (or not used) in patients with known heart disease or previous stroke.
Gepants
Some medications that block or modulate the release of CGRP, which are used for migraine prevention (which we’ll discuss in more detail below), also have evidence of benefit in treating the acute attack. This class of medication is known as the “gepants”.
Gepants come in the form of injectable proteins (monoclonal antibodies, used for migraine prevention) or as oral medication (for example, rimegepant) for the acute attack when a person has not responded adequately to previous trials of several triptans or is intolerant of them.
They do not cause blood vessel constriction and can be used in patients with heart disease or previous stroke.
Ditans
Another class of medication, the “ditans” (for example, lasmiditan) have been approved overseas for the acute treatment of migraine. Ditans work through changing a form of serotonin receptor involved in the brain chemical changes associated with the acute attack.
However, neither the gepants nor the ditans are available through the Pharmaceutical Benefits Scheme (PBS) for the acute attack, so users must pay out-of-pocket, at a cost of approximately A$300 for eight wafers.
What about preventing migraines?
The first step is to see if lifestyle changes can reduce migraine frequency. This can include improving sleep habits, routine meal schedules, regular exercise, limiting caffeine intake and avoiding triggers such as stress or alcohol.
Despite these efforts, many people continue to have frequent migraines that can’t be managed by acute therapies alone. The choice of when to start preventive treatment varies for each person and how inclined they are to taking regular medication. Those who suffer disabling symptoms or experience more than a few migraines a month benefit the most from starting preventives.
Almost all migraine preventives have existing roles in treating other medical conditions, and the physician would commonly recommend drugs that can also help manage any pre-existing conditions. First-line preventives include:
- tablets that lower blood pressure (candesartan, metoprolol, propranolol)
- antidepressants (amitriptyline, venlafaxine)
- anticonvulsants (sodium valproate, topiramate).
Some people have none of these other conditions and can safely start medications for migraine prophylaxis alone.
For all migraine preventives, a key principle is starting at a low dose and increasing gradually. This approach makes them more tolerable and it’s often several weeks or months until an effective dose (usually 2- to 3-times the starting dose) is reached.
It is rare for noticeable benefits to be seen immediately, but with time these drugs typically reduce migraine frequency by 50% or more.
‘Nothing works for me!’
In people who didn’t see any effect of (or couldn’t tolerate) first-line preventives, new medications have been available on the PBS since 2020. These medications block the action of CGRP.
The most common PBS-listed anti-CGRP medications are injectable proteins called monoclonal antibodies (for example, galcanezumab and fremanezumab), and are self-administered by monthly injections.
These drugs have quickly become a game-changer for those with intractable migraines. The convenience of these injectables contrast with botulinum toxin injections (also effective and PBS-listed for chronic migraine) which must be administered by a trained specialist.
Up to half of adolescents and one-third of young adults are needle-phobic. If this includes you, tablet-form CGRP antagonists for migraine prevention are hopefully not far away.
Data over the past five years suggest anti-CGRP medications are safe, effective and at least as well tolerated as traditional preventives.
Nonetheless, these are used only after a number of cheaper and more readily available first-line treatments (all which have decades of safety data) have failed, and this also a criterion for their use under the PBS.
Mark Slee, Associate Professor, Clinical Academic Neurologist, Flinders University and Anthony Khoo, Lecturer, Flinders University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Let’s Get Letting Go (Of These Three Things)
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Let It Go…
This is Dr. Mitika Kanabar. She’s triple board-certified in addiction medicine, lifestyle medicine, and family medicine.
What does she want us to know?
Let go of what’s not good for you
Take a moment to release any tension you were holding, perhaps in your shoulders or jaw.
Now release the breath you might have been holding while doing that.
Dr. Kanabar is a keen yoga practitioner, and recommends it for alleviating stress, as well as its more general somatic benefits. And yes, stress is in large part somatic too!
One method she recommends for de-stressing quickly is to imagine holding a pin-wheel (the kind that whirls around when blown), and imagine slowly blowing it. The slowness of the exhalation here not only means we exhale more (shallow breathing starts with the out-breath!), but also gives us time to focus on the present moment.
Having done that, she recommends to ask yourself:
- What can you change right now?
- What about next time?
- How can you do better?
And then the much more relaxing questions:
- What can you not change?
- What can you let go?
- Whom can you ask for help?
Why did we ask the first questions first? It’s a lot like a psychological version of the physical process of progressive relaxation, involving first a deliberate tensing up, and then a greater relaxation:
How To Deal With The Body’s “Wrong” Stress Response
The diet that’s not good for you
Dr. Kanabar also recommends letting go of the diet that’s not good for you, too. In particular, she recommends dropping alcohol, sugar, and animal products.
Note: from a purely health perspective, general scientific consensus is that fermented dairy products are healthy in small amounts, as are well-sourced fish and poultry in moderation, assuming they’re not ultraprocessed or fried. However, we’re reporting Dr. Kanabar’s advice as it is.
Dr. Kanabar recommends either doing a 21-day challenge of abstention (and likely finding after 21 days that, in fact, you’re fine without), or taking a slow-and-gentle approach.
Some things will be easier one way or the other, and in particular if you drink heavily or use some other substance that gives withdrawal symptoms if withdrawn, the slow-and-gentle approach will be best:
Which Addiction-Quitting Methods Work Best?
If it’s sugar you’re quitting, you might like to check out:
Food Addictions: When It’s More Than “Just” Cravings
If it’s meat, though (in particular, quitting red meat is a big win for your health), the following can help:
The Whys and Hows of Cutting Meats Out Of Your Diet
Want more from Dr. Kanabar?
There’s one more thing she advises to let go of, and that’s excessive use of technology (the kind with screens) in the evening, and not just because of the blue light thing.
With full appreciation of the irony of a one-hour video about too much screentime:
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Enjoy!
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The 4 Bad Habits That Cause The Most Falls While Walking
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The risk of falling becomes greater (both in probability and in severity of consequences) as we get older. But, many people who do fall do so for the same reasons, some of which are avoidable. Dr. Doug Weiss has advice based on extensive second-hand experience:
Best foot forward!
If any of these prompt a “surely nobody does that” response, then, good for you to not have that habit, but Dr. Weiss has seen many patients who thusly erred. And if any of these do describe how you walk, then well, you’re not alone—time to fix it, though!
- Walking with Stiff Legs: walking with a hyperextended (straight) knee instead of a slight bend (5-15°) makes it harder to adjust balance, increasing the risk of falls. This can also put extra pressure on the joints, potentially leading to osteoarthritis.
- Crossing Legs While Turning: turning by crossing one leg over the other is a common cause of falls, particularly in the elderly. To avoid this, when turning step first with the foot that is on the side you are going to go. If you have the bad habit, this may feel strange at first, but you will soon adapt.
- Looking Down While Walking: focusing only on the ground directly in front of you can cause you to miss obstacles ahead, leading to falls. Instead, practice “scanning”, alternating between looking down at the ground and looking up to maintain awareness of your surroundings.
- Shuffling Instead of Tandem Walking: shuffling with feet far apart, rather than walking with one foot in front of the other, reduces balance and increases the risk of tripping. Tandem walking, where one foot is placed directly in front of the other, is the safer and more balanced way to walk.
It also helps disguise your numbers.
For more details on all of these, plus visual demonstrations, enjoy:
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Want to learn more?
You might also like to read:
Fall Special (How To Not Fall, And How To Minimize Injury If You Do) ← this never seems like an urgent thing to learn, but trust us, it’s more fun to read it now, than from your hospital bed later
Take care!
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Smarter Tomorrow – by Elizabeth Ricker
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Based heavily in hard science, with more than 450 citations in over 300 pages, the exhortation is not just “trust me, lol”.
Instead, she encourages the reader to experiment. Not like “try this and see if it works”, but “here’s how to try this, using scientific method with good controls and good record-keeping”.
The book is divided into sections, each with a projection of time required at the start and a summary at the end. The reading style is easy-reading throughout, without sacrificing substance.
It proposes seven key interventions. If just one works for you, it’ll be worth having bought and read the book. More likely most if not all will… Because that’s how science works.
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Cleaning Up Your Mental Mess – by Dr. Caroline Leaf
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First of all, what mental mess is this? Well, that depends on you, but common items include:
- Anxiety
- Depression
- Stress
- Trauma
Dr. Caroline Leaf also includes the more nebulous item “toxic thoughts”, but this is mostly a catch-all term.
Given that it says “5 simple scientifically proven steps”, it would be fair if you are wondering:
“Is this going to be just basic CBT stuff?”
And… First, let’s not knock basic CBT stuff. It’s not a panacea, but it’s a great tool for a lot of things. However… Also, no, this book is not about just basic CBT stuff.
In fact, this book’s methods are presented in such a novel way that this reviewer was taken aback by how unlike it was to anything she’d read before.
And, it’s not that the components themselves are new—it’s just that they’re put together differently, in a much more organized comprehensive and systematic way, so that a lot less stuff falls through the cracks (a common problem with standalone psychological tools and techniques).
Bottom line: if you buy one mental health self-help book this year, we recommend that it be this one
Click here to check out Cleaning Up Your Mental Mess, and take a load off your mind!
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Xylitol vs Erythritol – Which is Healthier?
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Our Verdict
When comparing xylitol to erythritol, we picked the xylitol.
Why?
They’re both sugar alcohols, which so far as the body is concerned are neither sugars nor alcohols in the way those words are commonly understood; it’s just a chemical term. The sugars aren’t processed as such by the body and are passed as dietary fiber, and nor is there any intoxicating effect as one might expect from an alcohol.
In terms of macronutrients, while technically they both have carbs, for all functional purposes they don’t and just have a little fiber.
In terms of micronutrients, they don’t have any.
The one thing that sets them apart is their respective safety profiles. Xylitol is prothrombotic and associated with major adverse cardiac events (CI=95, adjusted hazard ratio=1.57, range=1.12-2.21), while erythritol is also prothrombotic and more strongly associated with major adverse cardiac events (CI=95, adjusted hazard ratio=2.21, range=1.20-4.07).
So, xylitol is bad and erythritol is worse, which means the relatively “healthier” is xylitol. We don’t recommend either, though.
Studies for both:
- Xylitol is prothrombotic and associated with cardiovascular risk
- The artificial sweetener erythritol and cardiovascular event risk
Links for the specific products we compared, in case our assessment hasn’t put you off them:
Want to learn more?
You might like to read:
- The WHO’s New View On Sugar-Free Sweeteners ← the WHO’s advice is “don’t”
- Stevia vs Acesulfame Potassium – Which is Healthier? ← stevia’s pretty much the healthiest artificial sweetener around, though, if you’re going to use one
- The Fascinating Truth About Aspartame, Cancer, & Neurotoxicity ← under the cold light of science, aspartame isn’t actually as bad as it was painted a few decades ago, mostly by a viral hoax letter. Per the WHO’s advice, it’s still good to avoid sweeteners in general, however.
Take care!
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