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Pandemic Proofing our Muscles

My first published article as a medical fitness pro (30+ years ago) was “Muscles…our True BFF (Best Friend Forever) in Life.” Fast forward over 30 years later in a global health pandemic, this is even more critical. Alas, our  muscles have not prospered as Netflix and liquor sales.

We all know that muscles exemplify  “use it our lose it.“ Fascinating study  August 2020:
“Exercise Induces Different Molecular Responses in Trained and Untrained Human Muscle”

Conclusion: “…several key regulatory genes and proteins involved in muscular adaptations to resistance exercise are influenced by previous training history. Although the relevance and mechanistic explanation for these findings need further investigation, they support the view of a molecular muscle memory in response to training.”   

Our “muscle memory” speeds the process by which we regain our former muscular strength and size. This merits the word “awesome”.

What an evolutionary advantage to regain muscle mass, for both physical and mental health.  Survival of the fittest in action.

Before the pandemic, studies showed 60% of US adults do not strength train. We are our own worst enemies.

During the COVID pandemic: Working from home, not getting up and going out to work — various factors have made us more sedentary. A study from eMarketer said TV viewing dramatically increased this year, ending a 9-year steady decrease in television viewership.  Studies show there’s been a 32% reduction in physical activity this year, and not surprisingly, another poll says 53% of people struggle with mental health issues due to the pandemic. 

Sitting truly is the new smoking.

I think gyms were closed more in 2020 than they were open. Many of us love the gym — a real adrenaline rush. Many people are dependant on the gym for exercise, whether it’s to see their trainer, attend a class, discipline, motivation. The fallout: this pandemic has been more of a sit down than a lock down!

If there is ONE thing, COVID has taught us: Adaptation, the ability to change to our environment, is truly paramount to survival. 

Exercising and working our muscles is a vital part of preventative health, even more so now. Muscle wasting is a product of aging, too much tush time and many diseases, including COVID.

Pop exercise advice always mentions get 10k steps per day”. And yes, “strength train 2-3 times per week”. Sadly, the perception of strength training is that it must be with heavy barbells and machinery at the gym. No gym, no strength.

May I suggest we encourage muscle mindfulness? Working our muscles is not just for “exercise time”. We can encourage muscle work in many forms, multiple times per day. Just like we eat, use the washroom, have screen time… let’s help people anchor some muscle time to daily activities. 

Example: cooking in the kitchen –  hang on to the counter and give me 10 squats.

Muscles are a key factor in our metabolic equation. Increasing our muscle mass boosts our resting metabolic rate,  burning more calories at rest, not just during exercise. Muscles help balance hormones such as leptin, insulin, estrogens, androgens and growth hormones. These are all imperative for appetite control, cravings, metabolism and body fat distribution and management. At the ripe old age of 30, we start to lose muscle mass (sarcopenia) unless we are mindful to nurture it. And yes, people over 90 can still build muscle mass. 

Amongst the many functions of our muscles is utilizing the glucose in our blood, therefore reducing blood glucose levels, irrelevant of the presence of insulin. 

Diabetes is an inflammatory disease. Type 2 diabetes causes the body to become less sensitive to insulin, and the insulin resistance leads to inflammation. A vicious cycle.

  • 1 in 3 people in the US are pre-diabetic
  • Most people are unaware of their diabetes
  • 13% of the population has diabetes
  • 42% of the population are obese

Diabetes is a gateway disease. It is a red flag for the potential to develop other diseases such as heart disease, cancers, kidney disease, eye issues. As I mentioned before, insulin resistance leads to greater levels of chronic inflammation, which greatly increases the risk of all of our plaguing chronic diseases. 

Lowering chronic inflammation has been the focus of my medical fitness journey, research, coaching and published work. Getting people to move “chronic inflammation” into their daily vernacular, permanently affix it to the top of their health wish list has been my professional raison d’être.

My last article here on MFN was all about chronic inflammation, how it is at the root of all of our chronic illnesses, mental & physical: diabetes, many cancers, mental health challenges, heart disease, arthritis, prostate issues, Alzheimer’s, neurodegenerative disorders… and yes, COVID-19. One line here: Please don’t get caught up in pop anti-inflammatory diets causing people to eliminate vital food groups.

The inflammatory response of COVID-19: The severe reactions to the virus happen more in seniors, and those with diabetes or obesity, or other preexisting inflammatory issues. No coincidence. COVID provokes an exaggerated immune response, excessive inflammation and inflammatory products called cytokines – the infamous cytokine storm. Exercise is a crucial factor in controlling inflammation – moderate cardio (NOT long high-intensity cardio, which actually can increase chronic inflammation) and preserving muscle. 

So just how important is it for us to encourage our clients to build muscle? Obviously, it is HUGE, and unfortunately, most people do not focus on muscle work.  It is our job as MedFit pros, friends and family, to demonstrate how to creatively and seamlessly incorporate muscle mania into their daily lives — yoga, Pilates, resistance bands, dancing…

The COVID pandemic is going to have far-reaching complications for many years to come. Adaptation is key. Integrating muscle work throughout the day along with other activity bodes well for lowering our levels of inflammation — helping to pandemic proof our bodies. Don’t just depend on a vaccine, we could have a new normal for a while. Preventative health is more important now than ever.  Our muscles are truly our BFF. 

Shira Litwack has been in chronic care management and prevention for 30 years, specializing in lifestyle habits including holistic nutrition, medical fitness and oxidative stress reduction. She is frequently called upon by the media, has her own podcast bringing current research to the public. She has created and provided oxidative stress assessments, to help clients identify potential health risks. From these, she provides guidance to lower inflammation. Shira is now a product specialist with a major COVID-19 test kit supplier, working with epidemiologists educating people on COVID testing, and setting up and designing protocol for COVID testing clinics

Infection of alimentary canal

The Cops & Robbers of Cancer

One of our favourite games as kids is now one of the most powerful determinants of sickness or health – the cops and robbers in our intestinal tract – better known as “good bacteria” or “bad bacteria”. Over the last ten years, the function of our “gut microbiome”, is finally gaining the research and respect that it so deserves.


COVID-19 New Normal in Fitness

The Challenges

We all know Darwin’s theory of survival of the fittest. During these COVID times, fitness professionals desperately need to evolve – for our own fiscal survival, a great deal of population health depends on us. 

A study released in June 2020 surveyed 10,824 people worldwide. Results showed 46.67% of gym members said they will not continue their gym membership after COVID. The number of people in the US not continuing membership is over 50%. 

We can encourage people to Zumba on Zoom, online exercise… but let’s have a reality check on what is really going on.

Forbes: “Americans Are Excessively Eating, Drinking, Smoking Pot, Playing Video Games And Watching Porn While Quarantined”

Obesity is associated with a more violent reaction to coronavirus – which is no surprise as fat cells are like millions of little endocrine engines spewing inflammatory factors. Smokers and vapers are at higher risk of serious illness and complications if they get COVID-19.

Everyone knows smoking tobacco, pot-smoking, and vaping affects the lungs. The damage done by smoke makes it easier to get many lung illnesses. People who smoke and vape – even younger people – are at higher risk of more severe illness and complications from COVID-19.

Isn’t it amazing alcohol sales were deemed as an essential service? According to Nielsen, studies show that “alcohol sales were up 55% in the week ending March 21.” Nielsen also found that amount of spirits sold, such as tequila, gin and pre-mixed cocktails, skyrocketed 75% compared to March 2019. Wine sales rose 66%, beer sales popped 42% and online alcohol sales grew by an astounding 243% from last year at this time. 

COVID Calamities

  • eating more junk
  • drinking more alcohol
  • exercising less
  • more stress
  • more TV/Screen time
  • Grand Canyon University Arizona study showed 22% of people surveyed reported weight gain during COVID crisis. That is just of those surveyed, and those who admitted to it! 

Their response to the findings:

“Get the recommended amount of sleep, do not snack after dinner, practice dietary restraint, alter stress coping mechanisms, and maintain an exercise regime.” People know this. They need help implementing these suggestions. 

The Balance of Exercise During COVID-19

If you haven’t read it yet – please refer to my article here on MFN on exercise and chronic inflammation. Reducing chronic inflammation and balancing our immune response is key during this pandemic.

Reducing chronic inflammation and balancing our immune response is key during this pandemic. 

In a number of studies, exercise has an important role in immune balance.

A large study showed that mild to moderate exercise, performed about three times a week, reduced the risk of dying during the Hong Kong flu outbreak in 1998. The Hong Kong study was performed on 24,656 Chinese adults who died during this outbreak. This study showed that people who did no exercise at all, or too much exercise — over five days of exercise per week — were at the greatest risk of dying compared with people who exercised moderately.

It is clear that both too much exercise, overexertion during exercise and exercising while sick increases the risk of medical complications and death. These cause excess production of inflammatory cytokines. In the COVID-19 pandemic, research is showing those who get very ill or succumb to the virus – a massive cytokine storm overwhelms the body. 

Secretory immunoglobulin A, or “sIgA” is an antibody protein used by the immune system to neutralize pathogens, including viruses. sigA has proven to be vital in upper respiratory tract infections. Over-exercising without adequate recovery has been shown to lower sigA, increasing susceptibility to respiratory tract infections. These infections are often what cause severe illness in COVID cases. 

Remember Physical Activity

Of course, physical activity is a necessity to keep all of us healthy. Even if it’s not an “exercise” day – we all must remind people to be vigilant about physical activity. 

Unfortunately “stay at home” was interpreted as sit on the couch and watch TV, or more screen time. 

According to the data from Comcast, the average household is watching TV at least 8 hours more per week. That’s a full workday more. The data shows a 40% increase in viewing during the late-night hours. Comcast says it has seen the largest increases happening between 11 p.m. and 2 a.m.

Netflix has added 16 million global customers since the pandemic started. 

Physical activity and moderate exercise are vital to our mental health, physical health & immune function. The immune system has no pump of its own. It depends on our pumping muscles for flow. 

There is no question this pandemic is increasing our stress levels. The psychological stress from feeling isolated, fear of catching the virus, the many unknowns, how long we will live like this, the hysteria.

It is our gift to be able to help people make better choices to deal with their stress levels. 

The increased stress, screen time, changed schedules are all contributing to sleep issues. Sleep is vital to immune balance and the control of inflammatory responses. 

We should encourage more passive exercise closer to bedtime, rather than trying to fall asleep to Netflix. Meditation, deep breathing, Tai Chi, yoga stretches, more passive exercise – incredible for stress reduction and muscle strength. Encourage some Pilates intermittently throughout the day for activity, calorie burn, muscle strength. And of course, walking. Remember there really isn’t a place now for the “no-time whine”. 

With our guidance as fit pros, we truly can make a massive contribution to how we come out of this pandemic. There is a new normal. This COVID crisis could be here for a while. Let’s take this as an opportunity to offer newer more innovative services. And yes – always welcome to contact me to brainstorm. We need to expand our services as health consultants. You are a wealth of information and creativity, and we can help calm the calamities. And please… educate all on wearing a mask!

Shira Litwack has been in chronic care management and prevention for 30 years, specializing in lifestyle habits including holistic nutrition, medical fitness and oxidative stress reduction. She is frequently called upon by the media, has her own podcast bringing current research to the public. She has created and provided oxidative stress assessments, to help clients identify potential health risks. From these, she provides guidance to lower inflammation. Shira is now a product specialist with a major COVID-19 test kit supplier, working with epidemiologists educating people on COVID testing, and setting up and designing protocol for COVID testing clinics


Paving the Road to Hell with Good Intentions

Going bigger is not necessarily better.

Many of us have the very best intentions with our health. We try to eat right, exercise, take supplements, make choices we deem to be healthy. However, we frequently think more is better: more restrictive with our food choices, more intense workouts, more supplements.

Let’s examine our choices from the perspective of inflammation.

What is Oxidative Stress?

Oxidative stress (OS) is an imbalance of free radicals and antioxidants in the body. Simply summarized, oxidative stress is electron thievery. Electrons are stable when coupled. Single electrons, called free radicals, scavenge the body to seek out other electrons to couple. It really is a wicked dating scene inside our cells!

Long-term oxidative stress damages the body’s cells, proteins, and DNA. OS strongly contributes to aging and is accepted to be the root of chronic conditions including diabetes, cancers, heart and vascular disease, depression, neurodegenerative disease, arthritis, Alzheimer’s, insulin resistance, IBD… more and more of our chronic issues are being linked to oxidative stress, as it can lead to chronic inflammation, to chronic illness.

Sources of Oxidative Stress

OS has both endogenous (from within) and exogenous (from our world) sources.

Endogenous: Cellular metabolism. Energy production happens in the mitochondria of our cells. Our currency or energy is ATP (adenosine triphosphate). OS is a natural by-product of ATP. When do we produce more ATP?

The body’s natural immune response can also trigger OS temporarily.

Fat cells create OS.

Exogenous: Exposures in our environment and lifestyle choices: alcohol, smoking, cell phone, EMF, environmental pollutants, many chemicals in our food and on our clothing, processed foods, sugar.

Chronic Diseases Continues to be on the Rise

Our inner antioxidant system was not designed to manage our current barrage of OS from our environment and lifestyle choices. According to the WHO, chronic disease is on the rise worldwide. Our levels of OS and chronic inflammation are also dramatically on the rise. An aging population and changes in our environment and our lifestyle choices are contributing to this steady increase. By lowering OS, we have a better chance of staving off illness.

Healthy Lifestyle?

From a perspective of inflammation, what is a healthy lifestyle?


Bottom line: Too much exercise in terms of intensity and duration is proven to increase oxidative stress. Yes, exercise and physical activity are a necessity for every aspect of health. Exercise has been proven to lower oxidative stress, cardiovascular risk, but the mechanisms of this are still being studied.

  • It has been proven that starting “on an exercise program”, then quitting abruptly, increases OS.
  • Nutrition plus exercise is far more effective in lowering OS, than exercise alone.
  • Exercise has better control on lowering oxidative stress in people who have higher levels of CRP (inflammatory marker).
  • Exhaustive and prolonged exercise promotes the generation of ROS, depletion of antioxidants and vitamins, induces oxidative stress, renal impairment and inflammation.
  • Prolonged aerobic exercise is linked to dramatic increases in oxidative stress.
  • Less studied thus far, intense hypertrophy training (heavy weight lifting) has been shown to increase oxidative stress. Muscle mass is imperative for healthy aging; balanced training is key.

More exercise in terms of duration and intensity could lose the beneficial effects of exercise. It is very important for those engaging in stressful exercise to support their antioxidant system. Passive exercise is a liberating and invigorating addition to our lives. We can benefit from adding some range of motion and stretching, emphasize our cool-downs, Qi Gong, meditation, and passive exercise.

Nutrient Restricting Diets

Our body needs a variety of amino acids to function efficiently. Bioavailability of these amino acids varies amongst food sources. We need to eat antioxidants to counteract oxidative stress.

Let’s look at some research on a few popular diets, with respect to oxidative stress

  • Keto diet: Ketogenic diets have shown to increase inflammatory markers.
  • Paleo diet: can be good in some respects by eliminating sugar, alcohol. If not done carefully Paleo-ers have been shown to be deficient in fiber and certain minerals and vitamins, which is hurtful to gut health, and yes pro-inflammatory.
  • Vegan diets: Again, proceed with intense caution. Vegan diets tend to be very carb-heavy. Our grains are not what they used to be. Genetic modification and toxins abound, and our soil is not what it used to be as a source of minerals. Meat and dairy are rich in bioavailable amino acids, and of course, moderation is key.
  • A 2018 study showed that long term diets excessively low, or high in carbohydrates are both linked with a shorter lifespan.

There is NO utopian diet. Examine lifestyle decisions from the perspective of inflammation. The scale is not the omnipotent indicator of health. We need to examine what we are identifying as our markers of health.  Maybe our good intentions weaken our inner defenses. Be healthy and balanced. Balance is strength!

Shira Litwack has been in chronic care management and prevention for 30 years, specializing in lifestyle habits including holistic nutrition, medical fitness and oxidative stress reduction. She is frequently called upon by the media, has her own podcast bringing current research to the public.

She has created and provided oxidative stress assessments, to help clients identify potential health risks. From these, she provides guidance to lower inflammation.


Senior Couple Exercising In Park

The Right Exercise

I have mentioned many times thus far, not just that exercise is the managing partner of integrative oncology, but I try to be really careful to say the right exercise. As much as exercise does hold the key to our magic kingdom of health within, there are contraindications, both in terms of prevention and recovery, and prevention of recurrence.

fresh green salad with arugula and beetsTo understand this, let me give you a very brief intro to oxidative stress. We have all read about the importance of eating our fruits and vegetables to provide much needed antioxidants. This is because we live a life where oxidative stress is in abundance. As exercise is the one and only Rx with no bad side effects, the truth is, we should always say “the right exercise”.

Unfortunately in our world of extremes and quick fixes, we think of exercise as bop till you drop. Pushing hard, sweating — and as some celebrity trainers like to take pride in — push till you
throw up.

OK… I will NEVER support the latter, under any circumstance, but for some people pushing to the point of sweaty, dirty, pumped, driven, is a great thing.

I do believe the fountain of youth is our own sweat! And yes, that level of intensity to achieve that state differs greatly amongst people.

The danger exists, when people exceed their optimal levels, which we can do unknowingly. Given the chronic illnesses, the data seems to support most people are not exerting themselves in terms of exercise or physical activity anywhere near that optimal level.

Medical staff with senior people at gymHowever, with people recovering from cancer, it is very important to work at the right level, and know that slow and steady wins the race. And just to throw in another caveat – yes this level of intensity will vary drastically, depending on the type of cancer and treatments utilized.

Oxidative stress occurs when the production of reactive oxygen species (ROS), often referred to as “free radicals,” exceeds antioxidant defence. There are many perpetrators in our world to the production of reactive oxygen species: alcohol, sugar, toxins, certain chemicals… a very long list, and the truth is we have to add exercise to this list if we are doing it beyond the appropriate point. Or if exercise is counterproductive to…

The balance between the ROS and antioxidants is out of whack, upsetting our inner ecosystem, creating an environment for cancer to survive and thrive. As always, its all about balance.

And this is yet another reason it is critical to have a well balanced, nutrition packed diet. The expression often used is “eat a rainbow”, because eating an assortment of colors (fruits and vegetables, not candy) is a great way to ensure getting a variety of antioxidants our bodies need to combat those free radicals. And by the way, the danger of an imbalance in this equation is a factor in not just cancer but many other diseases, including heart disease, Alzheimer’s, depression, macular degeneration, autoimmune disorders. Now, let’s think about the many possible side effects of treatments (medications) for these diseases… cancer. OK, let’s eat our antioxidants! (I promise, much more about antioxidants in another article)

Or as my chick flick heart insists: Exercise & Nutrition are the greatest love affair of all times. One just cannot live without the other.

The point is NOT don’t exercise because it might be a source of oxidative stress. The point is we must expand our view of what exercise is. The point is to understand physical activity vs. exercise, dynamic vs. static exercise. Exercise is NOT about pushing in misery until you drop in a gym you don’t like! The point is there are many types of exercise that can be performed multiple times through out the day to tweak our immune & circular systems, and to accomplish that flow of Qi, that inner ecosystem.

The other point we have to remember, in all of our wonderful forms of exercise: training, cardio respiratory, strength, yoga, pilates, Qi Gong Tai chi, they all have wonderful benefits and healing powers. However, there are boundaries & contraindications for all of them. There are a number of parameters involved when deciding on an exercise program for cancer recovery & beyond. To name a very few: the type of cancer, treatment, potential for lymphedema, other pre-existing medical conditions, level of conditioning, goals of the program, fat loss suggested, preservation of muscle mass, side effects of treatment. And every one of these categories opens up many
other considerations.

Couple bikingBut the most important factor of all is the F factor, FUN. What will we actually, enjoy, embrace, do, and want more. We learn very quickly in the fitness business, “no time” is an excuse. When we know the literally infinite possibilities for physical activity, no time is an excuse, or, a very limited knowledge of what exercise is.

But step one is MOVE. Whether we move and pump those muscles when seated or standing, get it moving and pumping. Please consult a trained professional in cancer exercise training.

Even if the professional tells you they have worked with many cancer patients, it does not mean he or she has been trained in cancer exercise, and knows the many forms of exercise available, not just their own platform, and is aware there are contraindications, and potentially could have an adverse effect on recovery.

There is no one Rx for each cancer. We cannot say, “For breast cancer do this, for prostate cancer do that.”

Cancer exercise is both art and science, supports a mind body connection and creates an environment within to optimize treatment outcomes. Yes, always get permission from the health care professionals, but don’t let them think you are considering training for Ironman, This is not what cancer exercise is all about.

In exercise, we follow the FITT formula: Frequency Intensity Type Time

For cancer exercise I have modified this formula. FFITTT: FUN Frequency Intensity Type Time Telomeres…. leaves you hanging for another blog!

For a constant supply on recent studies on cancer prevention and recovery, please join me on Facebook.

Shira Litwack is the Director of International Relations and Master Trainer at, Cancer Exercise Training Institute and creator of Best in Health Radio.