Are Barefoot Shoes Really Better?

Barefoot running may be trendy, but for scores of runners who train on urban streets or rocky trails, running without foot cover isn’t an option. As a result, many runners have switched to minimalist sports shoes that add a thin layer of protection without detracting from the feeling of running barefoot.

But do minimalist running shoes really reduce wear and tear on a runner’s body?

The American Council on Exercise, a nonprofit group that reports on fitness, recently sponsored a small study to learn more about the popular footwear. Researchers from the University of Wisconsin, La Crosse, asked 16 women, all healthy recreational joggers ages 19 to 25, to spend two weeks getting used to running in the Vibram FiveFingers, a snug, glovelike shoe that weighs less than five ounces. The women were advised to use the shoes, the best-selling brand of barefoot sports shoes, three times a week for up to 20 minutes a day.

Jodi Hilton for The New York Times

The women then returned to the lab, where researchers analyzed their form, foot-strike patterns and the force at which they hit the ground under three different running conditions — with regular running shoes, barefoot and while wearing the Vibram FiveFingers.

The researchers found that half of the women who switched to barefoot running or minimalist sports shoes failed to adjust their form, resulting in more wear and tear on their bodies, not less.

The study showed that when the women were wearing traditional running shoes, they all used a rear-foot strike, meaning they landed predominantly on their heels. But when the women switched to barefoot running or the Vibram FiveFingers, only half of them adjusted their form, as recommended, to a forefoot strike pattern, which entails landing mainly on the ball of the foot. The other half of the women kept the same form whether running barefoot, in Vibrams or in their cushy running shoes — landing first on their heels as they propelled themselves along.

Women who used the correct form experienced lower-impact forces on the foot while running barefoot or in Vibrams. But among the women who didn’t change their form and continued to land on their heels, the impact forces created by barefoot and Vibram running were nearly twice as high as in regular athletic shoes.

“People who run, they’ve run in shoes for so long, landing on their heels, that some of them are going to continue to do that,” said John P. Porcari, professor of exercise and sports science. “When you land on your feet, the force gets transmitted up the kinetic chain — to feet, to ankles, to knees, to hips, to back. That’s why runners can have injuries from their toenails to their belly button.”

Cedric Bryant, the chief science officer for the American Council on Exercise, said the study shows how important it is for new barefoot and Vibram runners to pay attention to form and slowly transition out of traditional shoes.

“Take the slow and steady approach,” he said. “Rather than going out and trying to run your typical distances at your typical speeds, give yourself ample time to adapt and adjust to this new style.”

The council recommends that runners who want to switch to barefoot or minimalist shoes begin with brisk walking. Once they start running, new barefoot and Vibram runners need to shorten their stride and focus on landing on the forefoot as opposed to the heel. Someone who has been running four or five times a week should try the minimalist shoes for only a portion of one of their runs until they adjust to the change, Dr. Bryant said.

“The key thing our study seems to suggest is that it’s really important you take some time to really adjust your running form or running style,” said Dr. Bryant.

In addition, the study found that all the runners bent less at the knee while running barefoot or in Vibrams, a change in form associated with fewer injuries. However, compared with barefoot runners, shod runners and those in Vibrams showed more pronation, which is the natural side-to-side movement of the foot during running. Excessive pronation is associated with more injuries.

While the research shows that runners who are able to change their form may benefit from going barefoot or wearing Vibrams, longtime runners who are doing fine may think twice about making the switch.

“If you’re not injured, I wouldn’t change anything,” said Dr. Porcari. “If you’re constantly getting injured, you may want to try these things. Maybe, biomechanically, shoes just aren’t for you.”

Jodi Hilton for The New York Times

Alzheimer's Disease Progression Predicted By Blood Test

By measuring ratios of two fatty compounds in blood, doctors are now better able to predict how rapidly somebody with Alzheimer's disease is likely to lose cognitive function, researchers from Johns Hopkins University School of Medicine reported in the Journal of Alzheimer's Disease. The authors explain that being able to predict cognitive decline could be useful for treatment targets, as well as providing loved ones and caregivers with vital data regarding what to expect and how to prepare.

Out of approximately 100 patients with newly diagnosed Alzheimer's, approximately 33 will experience virtual no cognitive decline during the first five years, 33 will lose cognitive function at a moderate rate, while the other 33 will deteriorate rapidly. An accurate prediction of what there is to come could help individuals with the disease as well as those who are likely to be caring for them to prepare. Doctors could also benefit by deciding which of their Alzheimer's patients would best benefit from aggressive treatment.

The authors explain that there are no current treatments that effectively prevent, stop or slow down AD (Alzheimer's disease),. They added that even in their present study, further tests are required before the blood fat test can be demonstrated as reliable.
Michelle Mielke, Ph.D., adjunct assistant professor of psychiatry, wrote:

"We're confident there's a relationship between these lipids and AD progression, but this work is not yet ready to be used clinically."

Michelle Mielke and team gathered and analyzed data from 120 patients with probable Alzheimer's at the Alzheimer's Disease Memory Disorder Center, Baylor College of Medicine, Texas. They measured a range of blood fat levels, and carried out cognitive assessments over a 2.3 year-period. Each patient was visited on average 4.2 times.

They found that a slower progression of dementia in Alzheimer's disease was linked to lower blood levels of ceramide and higher levels of plasma sphingomyelins. These are two kinds of fats found in cells throughout the human body.

The authors explained that ceramides play a role in cell death and inflammation. If there are fewer ceramides in the bloodstream, a small number of brain cells are being killed off, resulting in slower progression of the disease.

Mielke said that a prior study had demonstrated that ceramide blood levels were linked to faster shrinkage of the brain's memory center over a 12-month period in individuals with mild cognitive impairment. Some studies have also associated ceramide levels with amyloid beta levels. Amyloid beta is a protein which accumulates in patients with AD.

If this blood test is proven to be effective in further studies, the researchers believe there may be ways to slow down cognitive decline.

The researchers said:

"An enzyme known as sphingomyelinase metabolizes sphingomyelins into ceramides. It is possible, that if a sphingomyelinase inhibitor were used to slow down the process of breaking down sphingomyelins into ceramides, the progression of the disease could be interrupted.

Huge effort and a great deal of resources have gone into finding ways to stop Alzheimer's disease. To date, the only approved therapy helps cognitive decline symptoms in some individuals, and then for a short time only. No current treatment has had any effect on the course of the disease.

Mielke said:

"And none of the other compounds in clinical trials to date are showing any benefits. Perhaps we need to shift our focus. The answers could be in these lipids, which can be measured in the blood."

Written by Christian Nordqvist
Copyright: Medical News Today