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Wednesday, December 19, 2007

Medical Research and the Media

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"Research is what I'm doing when I don't know what I'm doing."
-Albert Einstein

I admit to being a bit of a fitness and health dork, so I read up a lot about different studies that come up in the news. Just because some new groundbreaking study comes out, doesn't mean that the results are all that meaningful. With a little research, you can quickly find out more about how the study was performed, what population was it done on, etc. Most of the time the media picks a small, controversial nugget of information from the result while leaving out the explanation.

The scientific process takes time to ensure that results of an experiment are repeatable. This explains why there is so much conflicting information in the media. Research studies have shown that high saturated fat intake is linked to a greater incidence of cardiovascular disease1, but other research shows that a diet high in saturated fat may diminish the risk of heart disease2. Both statements could be accurately stated based on two research studies that came to opposing conclusions. Which one is correct? Both deal with very specific populations.

Reference 1 is the landmark study by Ancel Keys that pinpointed saturated fat as a major contributor to cardiovascular disease. There are many articles suggesting that Keys "cherry-picked" the data from his seven countries to fit his hypotheses. The original data was from 22 countries, but the other countries were left out of his paper because the data from those countries didn't fit nicely with his hypothesis that saturated fat led to cardiovascular disease. I picked it as an example because it is a perfect example of "research" not necessarily being infallible.

The research suggesting that saturated fat decreased the likelihood of heart disease was done on a population of postmenopausal women who had symptoms of metabolic syndrome. Do those results apply to a 20 year old endurance athlete? Maybe or maybe not. More research needs to be done to get to the bottom of those results, but media deadlines waits for no such clarification.

I'm simply saying that just because we have easy access to lots of medical information and a media that is willing to subvert "fast-track" the scientific process doesn't eliminate the need for consumers to do their own research. As always, consumer beware.

1Keys A: "Seven Countries: A Multivariate Analysis of Death and Coronary Heart Disease." Cambridge, MA: Harvard University Press, 1980.

2Dariush Mozaffarian, Eric B Rimm, and David M Herrington: "Dietary fats, carbohydrate, and progression of coronary atherosclerosis in postmenopausal women." AJCN 2004 80: 1175-1184.

Monday, December 17, 2007

Find Thy Limiting Factor

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In the beginning of a training program, physical changes come quickly. Your body adapts at the fastest rate that you will ever see in the first six months of a training program. After that the rate of change begins to slow down as your body becomes accustomed to your new lifestyle. You can continue to improve for a long time, in the case of certain adaptations like aerobic capacity, for many years, but at some point you must become smarter about your training.

Once you have a foundation of consistency and adequate intensity, over time, progression will become more difficult. You must work on your limiting factor. You can get complicated in trying to determine what is holding you back, or you can do it the simple way: Figure out what you hate doing the most. Nine times out of ten, the thing that you hate doing the most is holding you back from further improvement.

You Squat Like a Girl...A Weak One!

So, using myself as a lab rat, I decided to see test that hypothesis. I run lots of miles weekly in order to train for ultra distance running events, but I also strength train as a form of cross training. I decided to test my strength levels on a few key lifts and compare them to other guys at my weight and level of training. I don't consider myself an advanced lifter, by any means, but I have been lifting weights seriously for several years and consider myself squarely in the middle of the "intermediate" category. To make a long story short, I fell pretty much in the intermediate category on all lifts...with one glaring exception, the squat. Now, I'm aware that lots of low-intensity running negatively effects leg strength so, it wasn't altogether a shock to see that when compared to other guys at my weight, I have the leg strength somewhere between the level of your grandmother and a 12 year old girl. And I should mention that I HATE SQUATS. Why? Because I suck at them, or at least I always thought I did. Now, my speculated squat suckage was confirmed.

For the last several months, I've forced myself to do squats at every strength session, with the goal of adding weight each time, even if only a little, and my strength has continued to increase. After 2 months of hard work, I think I'm approaching the leg strength level of a 14 year old girl. Woo Hoo! And the more I do them, the less I'm hating them.

While there isn't much carryover from the strength training to performance, or endurance, in my runs, I have noticed that my legs seem to handle the beating of the long runs a little better. Aches and pains in the smaller leg muscles, like the hip flexors and adductors, have all but disappeared. Coincidence? I really don't think so. Anecdotal evidence suggests that by strengthening the small muscles that oppose the strong running-related muscles, I've decreased the propensity for injury and decreased the discomfort on long runs. That translates indirectly into me running further which is definitely a goal.

The moral of the story is: Work on your weakest link, no matter how much you hate it.

OK, enough for today, I think I need to find some other exercise to hate.

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Friday, December 14, 2007

Dear Flabby

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Can cardio exercise kill you?

Is it possible? Yes, but it's very rare. I know Jim Fixx dropped dead while running, but it was a congenital heart defect...dammit! Actually, intense cardio is more likely to cause death because it exposes heart defects that may not be known. If you have concerns, schedule a treadmill stress test to determine if you have a heart issue that may cause problems with intense exercise. Many more people die each year from complications that could be avoided by doing cardio exercise (cardiovascular disease, Type II diabetes, etc.) than die from intense cardio.

Can you get fat eating salad?

Depends on what you put on it. Most vegetables are not very calorie dense and are okay, but watch out for the cheese and high calorie dressings. There is nothing magical about a salad that will make you lose weight if you load it with a cup of ranch dressing. And if you are going to wolf down 1000 calories, wouldn't you rather just eat a cheeseburger? If you hate salad and drown it in dressing to choke it down, you won't achieve your goal of losing weight. Deprivation doesn't equal weight loss. It is more sensible to cut down the portions of the foods that you like.

How many calories are in a tablespoon of honey?

About 64. Want to know how many calories are in almost any food, even some brand name foods? Try the USDA National Nutrient Database for Standard Reference.

How many times a week should I go to the gym to lose weight?

Weight loss is not a function of how many times you go to the gym. Spending 40 hours a week in the gym won't result in weight loss if you eat enough to feed a small family. You must balance the calories that you eat with your activities. Burn more calories than you consume and you will lose weight.

I want to lose muscle!

That's a new one. Okay, here's how you do it...create as large a calorie deficit as you can, as quickly as possible. Starving yourself is a great way to make your body start using the protein in muscles for fuel.

1. Eat as little as humanly possible. Think less than 1000 calories per day. Try one of those crazy, cleanse diets or live on grapefruit juice for a week or two.
2. You won't have much energy for cardio, but do it anyway. That should help create a larger calorie deficit.
3. Stay away from strength training or weights of any type. Those things preserve muscle.

Do these three things and you'll drop weight quickly. A large portion of that weight loss will be muscle. Good luck on the road to puny-ville!

What is the shortest, easiest workout ever?
You're doing it now.

Wednesday, December 12, 2007

The Process of Progress

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OK, let's get something straight, right now. Simply getting out there and doing the same thing, i.e. running the same speed/distance or lifting the same weights will not lead to improvement. If you always do what you've always done, you'll always get what you've always got! There is nothing wrong with lifting the same weights if maintenance is your goal, but don't spend the next two years lifting the exact same weights or running the same 3 mile loop and wonder why your squat or your 5k times haven't improved. The following three factors, in order, are essential for improvement.

Consistency Leads to Dedication

Consistency is the foundation on which a successful training program is built. The body requires a constant cycle of overreaching beyond your comfort level, followed by adequate rest and recovery to lead to supercompensation, i.e. your body becoming stronger, faster, etc. A good analogy is pushing someone on a swing. By consistently and repeatedly timing the small amount of force that is a single push, you can move the person much more than you could with only a single push. Randomly timing those nudges won't result in any significant movement. Focus first on consistency before mucking things up with complicated strategies to improve.

Intensity = Effort

If you are religious in your consistency to following a plan, next concentrate on intensity. Workouts must be done with the intensity necessary to force your body to adapt. Consistency may be the foundation, but without the proper intensity, you will never get off of the ground. Workouts should never be painful, but overreaching, or pushing a little beyond your current level of comfort, by definition will be uncomfortable. Your muscles may experience a burning feeling. Some soreness the next day may result. These effects are common if you are working out with the intensity needed to get stronger or faster. Again, if your goal is to maintain your current state of fitness, you don't need to cross the threshold into discomfort, but if your goal is to improve on your current level of fitness, you must push beyond your comfort zone.

Progression Requires Planning

Progression is at the top of the graph because it is not possible without the previous qualities. Consistency and intensity are required to make progress, but ironically, they don't guarantee it. Progression must be planned. If your goal is to run a half marathon and you can currently only run 3 miles, what steps must you take to increase the amount of distance that you can run? Running the same 3 mile loop will not magically result in the ability to run 13.1 miles on race day! You must slowly add to the distance that you can run increasing your maximum distance by small manageable amounts. If your goal is to get stronger, how can you expect to get stronger when you lift the exact same amount of weight for 6 weeks, or God forbid, 2 years. The answer: You can't!

By applying these to your workouts, given enough time, you can achieve your goals, whatever they may be. Never stop pushing!

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Monday, December 10, 2007

The Supplement Game

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In 2000, 17 billion dollars were spent on dietary supplements. The desire for a pill to solve all that ails us is pervasive in our culture. We want...no expect...some smart guy to provide the answer to all of our problems, for three small payments of only $19.99. To even begin to try to unravel all of the available supplements would be an monumental task. Instead, here are some supplements that seem to have a substantial amount of evidence that they can provide some benefit.


The common view of multivitamins is that they are a good "insurance" policy against vitamin deficiencies. As long as they contain vitamin and mineral amounts near the Recommended Daily Allowance, you should be OK. Again, these should only serve as a supplement to a healthy diet. If you are eating the recommended amounts of fruits and vegetables, you shouldn't need a multivitamin. If it makes you feel better, then take them.

Individual Vitamins

If you choose to take additional amounts of individual vitamins, be aware that you can have too much of a good thing. Your body can rid itself of excess water soluble vitamins (most of them) through sweat and urination. Be wary of excessive amounts of fat soluble vitamins (A, D, E, K), though. Large doses of these vitamins, especially Vitamin A, can accumulate in your body and cause headaches, vomiting, liver damage, coma, even death.

Fish Oil (Mayo Clinic)

Many claims have been made about the benefits of taking fish oil supplements. As with anything, these benefits are dose dependant...and remember, it the amount of the actual Omega-3 fats that cause the effect. Read the label on your fish oil supplement to make sure that you are taking enough to make a difference. Just because each capsule contains 1 gram of fish oil, doesn't mean that each capsule contains 1 gram of EHA/DHA. Read those labels! Here are some that "make the grade" according to the Mayo Clinic, as well as the dose of EHA/DHA needed to reproduce the effect in parentheses:

  • Reduces blood triglyceride levels (2 - 4 g per day)
  • Reduces risk of heart attack in those who have already had a heart attack (1 g per day)
  • Small reduction in blood pressure (2 - 5 mmHG) (>3 g per day)
The link to the Mayo Clinic also lists many other purported benefits of taking fish oil and details the strength of the evidence supporting those effects. Many things are listed, but the evidence is scant or non-existent for all but the ones that I've listed.


Very popular supplements to help with joint pain. Both supplements have been individually shown to help with osteoarthritis pain, especially of the knee. Glucosamine Sulfate is a component of cartilage and Chondrointin Sulfate is made from cartilage, so the popular reasoning is that they help rebuild cartilage. There is no evidence suggesting that taking these supplements will rebuild deteriorating cartilage. The effects seem to be related to these compounds having an anti-inflammatory effect.

Yeah, but this horny goat weed/siberian ginseng has cured my arthritis/bunions/irritable bowel syndrome? How do you explain that smart guy?

Well, is it the horny goat weed or the placebo effect? Would a sugar pill have had the same effect? Clinical trials use double blind studies where neither the researcher or test subject are aware of who gets the real medication or a sugar pill. In these cases, 30-50% of test subjects who receive the sugar pill report feeling better. Very few herbs, medicines, vitamins, or dietary supplements can do better than this. Medicines that can't outperform a placebo are shelved, but dietary supplements are not required to meet the same scrutiny. I guess if you can afford the supplement, it seems to help, and does no harm, it's okay for you, but that doesn't make it a panacea for everyone with your ailment.

If you choose to take supplements, remember that supplements are just that...SUPPLEMENTS. No supplement can undo the effects of a poor diet.

Wednesday, December 5, 2007

Top Nine Ways to Get Fat...Stat!

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Obesity...it's the new black. Thin is out! Fat...that's what it's about! A team of researchers at Johns Hopkins University predict that by 2015, 75% of adults in the U.S. will be clinically overweight or obese. Don't be left behind in the, ahem, stampede, to keep up with the Joneses. Here are my top ten tips for livin' la vida grande:

  • Skip breakfast - Cultivate your appetite and hunger by not eating anything for breakfast. Have no fear, you will make it up, and then some later in the day.
  • Eat lightly throughout the day...then pile it on at night - To pack on some prodigious poundage, you must have the appetite to eat vast amounts of food. By eating lightly throughout the day you can be ravenously hungry to get in as many calories as possible in the evening. Cookies and ice cream calling your name? Well, answer that call!
  • Pass on the Protein - Protein consumes too many precious calories in the digestion process and keeps your metabolism high by repairing muscle tissue. Does that sound like a recipe for success in largeness?
  • Supplement with Soft drinks - How can you get more calories in without curbing your appetite and hasten your way to becoming a fabulous fatty? It almost brings a tear to my eye to think what a gift soft drinks are to the world. Work as many of them into your day as possible. Starbuck's froo-froo drinks are a wonderful addition, as well, especially those Christmas-y drinks like the Peppermint Mocha and Eggnog Latte. Hell, have two! It'll get you to your goal of becoming lusciously large that much quicker.
  • Strength training...NOT! - leave the protein and the strength training to the meat heads and gym bunnies. Ripped, hard bodies? That's so 1982! In 2015, ripples rock! Hard bodies? More like, hardly able to move your body. That's what I'm talkin' about. Don't lift weights...those things are heavy. Lift Twinkies instead!
  • Forget the Fiber - Fiber is filling...not good for the future, formidably fat-alicious.
  • Cardio, shmardio! - Burn calories? What, are you crazy? That's for the losers in the 25% minority.
  • Vanquish the Veggies - Vegetables are too low calorie and high fiber. Drink ketchup instead...wouldn't want to negatively effect your health.
  • Can you say "refined carbohydrates"? - Say it, yes? Spell it, maybe not? Either way, a key to larding up is to consume as much sugar, flour, and white rice as possible. Stick with these foods and maybe, just maybe, you will claim the coveted moniker, morbidly obese.
Would have done a top ten list, but this...sugar...rush...is...making...it...hard...to...focus.

Excuse me, but I've got two bags of Cheese Doodles with my name on them.

Monday, December 3, 2007

Picking the Perfect MP3 Player

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Well, it's a fact, lots of people like to exercise with MP3 players. I have one, rarely use it on a run, but in the event that I find myself needing to workout in a gym, or need the distraction in a long race, it is an invaluable tool to mentally keep me going. There are lots of models available to choose from. Some of the basic features that you must consider:

Storage Space

All MP3 players have a certain amount of storage space to store songs. Using Apple's numbers (4 MB per song), you can get approximately 250 songs per GB of storage space on the device. Some models have small amounts of storage space and will need to be loaded frequently if you want to listen to new songs, but some models have space to store you entire music collection. I honestly don't think I could fill up anything more than 4 or 8 GB, much less a 160 GB IPod! Consider how much storage capacity you really need before you are seduced into buying a top-of-the-line model. The caveat to this is video. More and more of the new players are coming equipped with small video screens and the capability of playing videos and movies. If you get one of these models and want to store movies, then make sure you get one with plenty of storage space because movies really take up lots of space on the device.

Battery Type

  • Built-in Lithium Rechargeable
    • Pros: Very low on the hassle scale. Just plug the device into a computer and let it charge up.
    • Cons: What if you take your beloved MP3 player on a trip where you don't have access to a computer? You may need to buy an additional accessory to charge it up on the go. Another con is that those lithium batteries eventually begin to lose their charging ability and need to be replaced. You will need to send in your device to be "repaired" or try to replace it yourself.
  • Standard battery
    • Pros: Easy to replace the batteries, and they are available everywhere.
    • Cons: You will be replacing the battery very often, especially if it has an LCD screen. MP3 players tend to chew through batteries at a phenomenal rate. You can partially offset this disadvantage by using rechargeable batteries, which I recommend.
Accessory Availability

Without a doubt the Apple line of MP3 players has the most available accessories. It is the most popular MP3 player around and many companies are trying to sell products to users of the device. Everything from armbands and docking stations to...ahem...personal massage accessories. That might explain their popularity. Just make sure you investigate what accessories are available before you buy the device. You don't want to find out that you can't charge it up any other way than connecting to a computer once you've purchased it.


Consider how you will be getting music to fill your player. All players will allow you to "rip" your CD and put the resulting MP3 files on the player. Other options include buying your music online, or paying for a music subscription service.

Ripping CDs

For those unfamiliar with the MP3 "lingo", ripping CDs means copying music from a CD to your computer in a form that can be placed on the player. All players will have some facility to do this, and you will be able to put any music that you currently own onto the player.

Buying Songs Online

The undisputed king of online song sales is iTunes. But there are others, such as Wal-Mart, Amazon.com, Rhapsody and many others that also sell music online. Make sure that your player works with the service from which you intend to purchase songs.

Music Subscription Service

Another option for acquiring music is through a subscription service, such as Rhapsody or Napster. These services generally charge a set monthly fee, and you can download as many songs as you like as long as you continue to pay for the service. This option has the most potential for snags with certain MP3 players. If you intend on using a subscription service, make sure that the player you purchase works with your chosen service.