Return from Cozumel

Dolphins are in that pin, probably content to skip the bike and run.

This is my first post since returning a little over a week ago from Cozumel. We went from temperatures in the mid-80s with high humidity to highs in the single digits and wind chills in the negative double-digits. Quite a contrast. No mosquitos in Denver though, and the skiing is better.

The main reason my wife and I were there was a very generous invitation from Mike, a friend and former client from Virginia. He was competing in the Cozumel Ironman Triathlon. It was a fascinating experience and the ability of anyone to complete such a race (2.4 mi. open ocean swim/112 mi. bike/26.2 mi. run) is astonishing. Mike finished 32nd out of 100 in his age group and 135 overall out of nearly 2000 competitors. That’s a tremendous performance in a grueling race. It was hot, humid and about 1/3 of the bike course was into a stiff headwind.

The race is on!

There were competitors from all over the world. The local crowd support was very enthusiastic. I figure a race like this might be an interesting change from the typical staggering visits by drunken cruise line passengers. Much thanks to Mike, his girlfriend, and their families who were there as well. Here’s an excerpt from Mike’s race report:

“That Ironman is the most recognizable name in triathlon is no accident – the lead up to the start was nothing short of spectacular. The dolphins in the enclosures at the swim start were all performing various jumps, a helicopter raced in low and fast over the pier, and the music and emotions were amped up. The pros went first – down the pier and off the edge for the in-water start. It was easy to be envious both of their 15 minute head start and the fact that there were only 50 of them. At 7am, the other 1900 of us would all be in the same water, all swimming for the same buoy, all at the same time. Not for the faint of heart. I was able to position myself about two or three rows back once in the water, almost centered on the buoy. It was the first time we tested the current, as we had to swim in

place as the rest of the competitors made their way into the water.”

Aside from the big race, my wife and I got in some scuba diving and a healthy intake of margaritas, pina coladas and beer. The house where we all stayed was right on top of the edge of a reef so we could literally jump right into the Caribbean Sea at our leisure. Dunk your head under the water and there was a wide and varied crowd of fish, coral, sea urchins and other underwater creatures. Good livin’…

All in a day's work. Bravo.

No crowd support out here.

Artwork: St. Petersburg Times, FL

A day of severe gluttony is headed our way like a runaway chuck wagon. Therefore, how about a discussion of two articles on obesity? For the Overweight, Bad Advice by the Spoonful was published back in August of this year in the New York Times Health Guide. The other, Energy Gap Useful Tool for Successful Weight Loss Strategy is from early November in Science Daily. The two articles present very daunting insights into our fight against obesity. The Times piece tells us the following:

Weight control is not simply a matter of willpower. Genes help determine the body’s “set point,” which is defended by the brain.
Dieting alone is rarely successful, and relapse rates are high.
Moderate exercise, too, rarely results in substantive long-term weight loss, which requires intensive exercise.

The article further states:

“…the notion that Americans ever ate well is suspect. In 1966, when Americans were still comparatively thin, more than two billion hamburgers already had been sold in McDonald’s restaurants, noted Dr. Barry Glassner, a sociology professor at the University of Southern California. The recent rise in obesity may have more to do with our increasingly sedentary lifestyles than with the quality of our diets.”

Our bodies are remarkably stubborn in their ability to keep us at our current weight (discussed further here). We eat smart and healthy one day, a little less so the next. In contrast to the Times article, from everything I read and understand, the food component of weight loss is far more powerful than the exercise component (suggested here, and here). In fact the issue is poor eating plus a sedentary lifestyle that’s gotten our nation so heavy. Things like this are never isolated to one cause. (By the way, body weight isn’t the only measure of health. Look here for more on the issue of fit vs. fat.)

There are two things not mentioned in the Times article that we should consider. First regarding the way we ate decades ago vs. how we eat now is the presence of processed foods. I don’t have statistics but I think it’s safe to assume that in the 1960s we were eating more fresh, unprocessed food. We now eat gobs of food every day that is packed with calories but contains very little actual nutrition. For a sober, practical, in-depth look at our nation’s obsession with “nutritionism” you must read what Michael Pollan says in Unhappy Meals. Another comment on Pollan’s work is found at Disease Proof. (For truly fascinating insights into the American food system, you must read Pollan’s The Omnivore’s Dilemma and/or In Defense of Food.)

The second component of our eating we must consider is portion size. Portion size is a tremendous component of obesity. In recent decades past, our overall calorie intake was lower than it is now, thus there was far less obesity. The article notes the billions of McDonald’s hamburgers that were sold but do you know what those hamburgers looked like? You can still buy it today. If you look at a McDonald’s menu they actually have something simply called a hamburger; not a Big Mac, Quarter Pounder, Titanic Monster Burger, or whatever. It’s a small thing with one meat patty, pickles, onions and ketchup. A customer in the ’60s may have gotten fries and a soft drink, but the fries came in a small paper envelope, not a cardboard crate, and the soft drink was an eight ounce cup rather than an industrial drum.

For more on portion sizes and our consumption habits, the Centers for Disease Control provide a report called Do Increased Portion sizes Affect How Much We Eat? It’s amazing to see how we can unconsciously eat a lot more than we need to if it’s sitting there in front of us.

The Science Daily article tells us that once one is obese, the body fights extra hard to stay there. In contrast, one who never becomes obese seems far less likely to become obese. The article discusses the Energy Gap, a term used by the American Dietetic Association to estimate the change in energy balance (intake and expenditure) behaviors required to achieve and sustain reduced body weight outcomes in individuals and populations. We’re told that the energy gap to prevent weight gain is about 100 calories. That is, someone can prevent weight gain with a combination of reduced energy intake and increased physical activity that amounts to 100 calories. The news isn’t so good for those trying to lose significant amounts of weight. The energy gap may be 200-300 calories for someone looking to lose 10%-15% of their body weight. That means serious eating modification and quite a bit of time exercising.

According to James O. Hill, PhD,

“This analysis indicates that to create and maintain substantial weight loss (ie, obesity treatment), large behavioral changes are needed. This is in stark contrast to primary obesity prevention in which small behavioral changes can eliminate the small energy imbalance that occurs before the body has gained substantial weight. Because the body has not previously stored this ‘new’ excess energy, it does not defend against the behavioral strategies as happens when the body loses weight.”

What does all of this mean? First, obesity is much like any other disease in that preventing it is much easier than treating it once you’ve got it. (This makes the topic extremely relevant to the current health care debate. Preventing obesity will result in prevention of obesity related illnesses, and we’ll all spend less on health care.) Second, there’s much evidence to suggest that losing weight is a complex battle that is more than simply making a decision. We have a very tenacious system wired into us (likely rooted in some prehistoric survival strategy) that makes dropping pounds extremely difficult. It’s akin to telling the drug addict to just stop.

Just stopping–a conscious decision to change a behavior in other words–is still the heart of the issue. Weight loss still comes down to willful decisions to make changes. There’s no way around it. I learned a little bit about human psychology and behavior in graduate school. It seems that most of us adhere to changes if they’re made in small, gradual steps. Just one healthy decision made today is one more than was made yesterday. That’s a step toward whatever healthy goal we have in mind. Keep making healthier daily decisions and over the course of a year, two years, 10 years and you’ll have made a lot of them. Guess what’s around the corner though: the New Year’s Resolution.

We’re getting close to the time of year when many people will make the big decision to lose weight this year. Gyms will be packed with people exercising like they’ve never done before–at least not since the beginning of the previous year. They’ll make attempts to banish their favorite foods from their plates and replace it with food they’ve never much liked. Most of these noble attempts will be abandoned by the end of February. This is the perfect example of people making drastic lifestyle changes which cannot be maintained. As a personal trainer, I see this happen every year.

Speaking from personal experience, I look back to childhood, high school and college and see what I ate and/or drank–and in what amounts–and I’m amazed at the amounts of junk I once consumed. I’ve spent over a decade making changes here and there and I’ve found that it hasn’t been too terribly painful at all. Of course I can’t extrapolate my experience out to everyone else, but it seems to me a strategy of small changes in both eating and exercise made over time, plus the decision to stick with these changes is still the best strategy to lose weight and get healthy. If there’s a better strategy, please let me know.

Beyond that, here’s more to read on a variety of topics:

Are we Insane? Part II: the Cookie Diet. Does this even need any explanation? Cookies and dieting…. I think I’ll try breathing underwater later today, or maybe flapping my arms and flying. (Ever notice how everyone who was on a diet… WAS on a diet? No one stays on any of these things.)
To thrive longer, get stronger. The Washington Post discusses Consumer Reports’ findings on various clinical trials of strength training. Turns out picking up heavy objects is good for you in many ways.
Runners: Train less and be faster. OK, this will be controversial to some and I’m not saying this is true for everyone all the time. However the findings here help support some of the arguments made at Power Running that running fewer miles (low volume) while running faster (high intensity) may increase race performance. Science Daily profiles a report in the Journal of Applied Physiology on the topic of running less but running faster. Again, do not assume this is the be-all-end-all for everyone, but it might be exactly the strategy that will work for you.
Ice or Heat? The topic of icing or heating an injury is often debated. Like many issues of sports conditioning and rehabilitation, the jury is still out. The following is a reprint of a comment by the late Dr. Mell Siff from the Supertraining forum:
ICE OR HEAT?
by Dr. Mel C SiffThe use of ice treatment may not be universally superior to the use of heat
in enhancing recovery or rehabilitation.

THE PROBLEM

The use of localised or more extensive ice or cold treatment has been well
authenticated over the years and there is little doubt that, in many cases,
it is a highly effective and cheap method of restoration and rehabilitation.

However, any literature searches for definitive studies that compare the
effectiveness of ice cold versus very hot treatment of the same sort of injury are not as common as one would believe.

It seems as if we have all accepted that heat is contraindicated largely on
the basis of theoretical considerations or extrapolations form cases where
bleeding is apparent. We know that heat causes blood vessels dilatation,
temporary increase in inflammation and the decrease in blood viscosity, but
does this necessarily imply that it will be detrimental to the course of
restoration or rehabilitation of all sore, bruised and fatigued soft tissues?

Why I am saying this is because I have been experimenting, much against my
education and scientific traditions, with the use of very hot water as a
restorative means with myself and several other athletes, some of whom are
top pro footballers and basketballers.

Surprisingly, this seems to diminish muscle soreness and speeded up recovery
in many cases, especially if we use alternate hot and cold bathing. I have an
8 ft deep jacuzzi and long lap swimming pool and have my athletes alternate
between hot and cold immersion. Interestingly, I have found that the water
has to be almost unbearably hot (about 108 deg F or 41C) to be optimally
effective. Movement under these conditions also seems to be valuable
(‘cryokinetics’ for ice old immersion and ‘thermodynamics’ for hot
immersion).

Certainly my comments on this controversial topic merely constitute anecdotal
evidence at this stage, but I am curious to hear if anyone else has had
similar experiences or come across scientific research which legitimately
shows that dedicated ice treatment is significantly better than very hot
treatment or ice-heat contrast methods. Failing that, is there any evidence
that the use of heat is a general contraindication for musculoskeletal
recovery and rehabilitation, other than cases where there is obvious bleeding
or serious pathology?

Are we promoting ice therapy far too liberally to the exclusion of heat
therapy, when the latter may well also play a very helpful role in
musculoskeletal rehabilitation? Are we unfairly proclaiming that heat is
potentially harmful for treating any soft tissue repair? Does this attitude
go against our recent attestations to the value of ‘holistic’ treatment?

There have been a huge number of studies on the effect of stretching,
jogging, supplements, heat, cold, drugs, you name it …. and virtually
nothing has yet been found that appears to make some significant and
consistent difference to the dissipation of DOMS. Do a Medline search
and you will see what I mean. Many higher level weightlifters and
ppwerlifters rarely if ever suffer from DOMS even after very heavy
workouts, which afflicts mainly newcomers to a given exercise or
routine – or certain more susceptible individuals. For general recovery,
I have found it difficult to beat sensible program (or periodisation) design and
hot-cold contrast bathing, as I have written in previous letters. Your
recommendation to do some mild post-exercise activity probably is
a sound idea for general relaxation and recovery, but it has not been
shown to have any real effect on DOMS.

Benefiber??? Are we Insane?

My gym is currently handing out free samples of something called Benefiber. Sounds healthy, right? It’s got the word fiber in it and it even has the first part of the word beneficial in there too! Fantastic… (Also doesn’t sound much like real food, does it? This is a food-like substance.) What is Benefiber? The label tells us it’s a fiber supplement, and that it “Makes Taking Fiber Easier.” It’s a flavored sugar-free powder that comes in a small packet that’s emptied into a container of water, mixed, and drunk. For your troubles, you’ll get a whopping three grams of fiber for only 15 calories. Flavors include: kiwi strawberry, raspberry tea, citrus punch, cherry pomegranate, or unflavored.

So miracle of miracles, we have a fruit-flavored source of fiber that we can drink–thereby eliminating the titanic burden of actually eating a piece of fruit. We can now rest easier. (If this doesn’t yet sound a little koo-koo to you, then you might want to move along and find something else to occupy your time.)

Let’s back up just a little and figure out why we might be concerned with fiber at all. It’s fairly well known that food high in fiber helps confer good health. Fiber’s health benefits include the following: helps control blood sugar levels which probably reduces the risk of diabetes, reduces risk of heart disease, facilitates a healthy digestive tract, and fiber probably helps regulate the appetite. Nice stuff this fiber.

So Benefiber must be good for us right? What else is in this stuff? Well, that’s what’s really interesting. There are 11 ingredients, most of which are almost unpronounceable. They’re probably nothing you could cook up in your kitchen or reach for in your pantry. (Anyone ever brew up a hearty batch of acesulfame potassium?) These things are remarkably complex substances that were built by people in laboratories. This stuff is not found in food. Other animals don’t eat these things. I wonder how much time, effort, electricity and money went into concocting these magical items?

Is it food or Is it furniture varnish?

Look at the fourth ingredient, aspartame. It has two asterisks next to it. Down below the ingredient list in menacing bold print is PHENYLKETONURICS: CONTAINS PHENYLALANINE. Good lord what does that mean? I think we’re being warned. The issues associated with aspartame and other artificial sweeteners are more than I can go into here, but the point is there are more than a few concerns about the safety of these things. All this for three grams of fiber.

This seems like a product sold by Monty Python. Good nutrition in a powder is silly!

Meanwhile, I could eat actual cherries, strawberries, kiwis, oranges, or any number of other fruits and/or vegetables–real food in other words–and get the same amount of fiber plus untold amounts of various healthy molecules and none of the weird science-fiction chemicals. This whole thing seems absurd. It might be one part health to four parts poison. What are we doing here?

Drinkers More Physically Active Than Abstainers

Who’da thunk it?? Science Daily reports on a study in the September/October issue of the American Journal of Health Promotion indicates that drinkers exercised more than abstainers–and those who drank more exercised more!

“Among women, those currently using alcohol exercised 7.2 minutes more per week than those who abstained. Relative to abstainers, the more alcohol used, the longer the person exercised. Specifically, light, moderate and heavy drinkers exercised 5.7, 10.1 and 19.9 minutes more per week. Overall, drinking was associated with a 10.1 percent increase in the probability of engaging in vigorous physical activity. The results for men were similar.”

That outcome might be surprising to a lot of people. However, it’s interesting to note that for 2008 Colorado was the leanest state in the nation with an obesity rate of 18.4% yet a recent Men’s Health survey listed Denver as the most dangerously drunk city in the nation.

What does all this mean? It seems we might see parallels between alcohol and medicine. Too much of either will sicken and/or kill us but the right amount might be healthy. It certainly seems clear that some degree of alcohol consumption works well for a lot of people.

In my experience the drinking culture here in the Denver area is one that is strongly balanced with vigorous exercise. Hiking, skiing, kayaking, mountain biking, and/or running is often followed by a loosely reasonable amount of the region’s superb beer. Combine these habits and you get a fairly healthy and happy population.

Why do you exercise?

Do you have physique goals? Is sporting performance important to you? Do you exercise for the purpose of disease prevention? Maybe it’s all or some of the above.

For whatever reason, some of us simply enjoy picking up heavy steel objects and running/biking/climbing/jumping around to the point of exhaustion. We derive pleasure from discomfort: burning, aching muscles; lungs on fire; sweat in the eyes… What we do isn’t always fun like a birthday party but deeply fulfilling.

The fascinating thing to me about exercise is that it is clearly very simple in most regards. Pick up something heavy several times. Move fast enough and/or long enough to sweat and pant. That’s exercise for the most part. It ain’t Greek philosophy, trigonometry or neurosurgery. Yet look at how many smart, highly accomplished people simply cannot find a way to do something so simple—even though we recognize how vital exercise is to a long, healthy life. Think of a time when you’ve pushed yourself—or have been pushed—to extreme physical exertion. It doesn’t take complex mental skills but we all know these kinds of efforts take tremendous mental fortitude.

Gym Junk: Ditch the Machines and Get Fit

Boot camps and non-machine exercises are the gist of the New York Times Fitness Column for September 23, 2009. The article notes the growing popularity of fitness boot camps and group training. Frequent features of such classes are low-tech whole-body movements such as squatting, lunging, push-ups, pull-ups, jumping, running, crawling. These are the movements of life. Such movements are very effective for anyone wanting to improve not only their physique but also their ability to function in real life. The emphasis here is on movement and not on individual muscles. (Guess what, when you pull, you use your biceps, your back and shoulders. When you push, you use your triceps and/or your chest, and/or your shoulders. When you squat or lunge, you use your quads, glutes, hamstrings, and calves. There’s no need to think about all those little body parts when you move!)

In contrast, what do we typically see in gyms? Oceans of chrome coated weight-stack contraptions designed to work individual body parts. How do these machines work? First, typically you sit or lay down. (That’s nice and easy and very comfortable right? It’s also a great way to conserve energy—which is exactly what you don’t want to do when you exercise.) Then you have to figure out how to adjust any number of seats, back rests, chest rests, foot rests and/or handles. Confusing stuff. If you don’t adjust the machine properly then at a minimum you get a poor exercise; at worst you risk injury. So after sitting or laying down, adjusting a bunch of confusing pieces you then get to move one body part in one plane of motion only. Wow. A big, heavy, complex machine and you get one little exercise out of it… Meanwhile what does real life require of us? We must bend, reach, pick up, put up, throw, catch, pull, push, climb and sometimes even crawl. No gym machine really allows for much of this stuff.

In contrast, if you use your own trunk and limbs to run, lunge, crawl or climb—or if you get really wild and pick up a dumbbell, or a kettlebell, or a barbell, a medicine ball, a rock, a log, a sandbag, a chain or whatever in the world that’s heavy and just lying there—then a universe of movements is available to you. These movements look a lot more like real life. Through these types of movements the body is conditioned in an integrated fashion: arms working with legs and all of them working with the core while you stabilize yourself. You’ll use more energy. You won’t get the same workout twice and you’ll have a lot more fun. The article’s writer says it well:

“While such rough-hewn techniques and gear may look old-fashioned, they comport with a modern shift away from developing individual muscle groups and toward so-called functional fitness, which refers to overall strength and comfort in performing everyday activities, like lifting, walking and reaching, along with cardiovascular health.”

Exercise is Medicine

Exercise is medicine. Jake “Body by Jake” Steinfeld writing for the Huffington Post offers three points of advice to help improve the health of the nation. His advice goes to the point that above and beyond anything else, our personal choices have the greatest impact on our health. More than doctor visits, cutting edge disease treatments or the latest medicine we have the greatest power to either stay healthy or get sick. We decide what food to eat. We decide whether or not to exercise, and we decide whether or not to smoke. Those are the big three and that’s where health care begins.

Michael Pollan, author of the Omnivore’s Dilemma and In Defense of Food puts it very well in his op-ed piece for the NY Times:

“But so far, food system reform has not figured in the national conversation about health care reform. And so the government is poised to go on encouraging America’s fast-food diet with its farm policies even as it takes on added responsibilities for covering the medical costs of that diet. To put it more bluntly, the government is putting itself in the uncomfortable position of subsidizing both the costs of treating Type 2 diabetes and the consumption of high-fructose corn syrup.”

So there it is. We’re using tax dollars to subsidize a food industry that poisons us, while at the same time we’re looking to send our tax dollars to treat the resulting illnesses. Might it make sense to cut food subsidies so that we then can reduce spending on health care? And to the point of personal responsibility, if through our own actions we can avoid illnesses such as diabetes altogether–and thus never treat them at all–then isn’t that the best version of health care available?

(BTW, if you haven’t read Pollan’s In Defense of Food then you should go get it right now and start reading. As well, he was interviewed by Bill Moyers interviewed Pollan a few months ago. Go to PBS to watch it.)

Politicians very rarely suggest that we bear the most responsibility for our health. To do so would point out that we as a nation are failing miserably at controlling ourselves.

Denver Fitness Journal

All Things Health and Fitness by Kyle Norman, MS, CSCS, FMS, RRCA Running Coach

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