I’ve realized recently that there are a lot of books, nutritional products and other such things that I think highly of. Because of that I’ve added to this blog a Recommended Products page. I’ll add to it periodically as I come across stuff that I think is worth owning and using. If you have suggestions for such items, please contact me and let me know.
Beating Obesity
StandardThe latest edition of the Atlantic features an excellent article on our nation’s struggle with obesity. Beating Obesity is written by Marc Ambinder and it’s a thoughtful, in-depth look at the political and social ramifications of this seemingly losing battle. We learn about the major players including First Lady Michelle Obama, the food industry and the insurance companies. (Ambinder himself struggled with obesity and eventually underwent bariatric surgery as a solution.) Ambinder does a very good job in discussing the issues of individual responsibility and the environmental challenges we face such as food at every checkout line (not just at the grocery store), ever growing portion sizes, and junk food that is cheaper than fresh fruits and vegetables.
Most importantly he examines the moral and demographic issues of obesity. He notes the following:
“Black children are more at peril of becoming obese than white children; black women are more than 50 percent more likely to be obese than white women. ‘At the current rate of increase,’ epidemiologists noted in a recent article in Obesity, ‘it will take less than 30 years for all black women to become overweight or obese.’ Obesity rates are above average among Mexican American boys, as they are among Hispanics generally. Obesity rates among young American Indians tend to be nearly twice the national average.
Please check out the article. It’s an excellent piece.
Personal Running Experiment: Brooks vs. Vibrams
StandardI’ve been dealing with Achilles pain since the end of last summer. (The Achilles pain is very likely the latest symptom of a variety of dysfunctions which seem to be rooted in foot and glute function.) This week I’ve gone on the first couple of what you might call “runs.” One day I wore my Brooks then the next day I ran in my Vibrams. There were very interesting and different results. Overall, I felt far more comfortable in the Vibrams. I experienced less shock and impact and I felt better at the end of the run. Running in the Brooks seemed to bother my left hamstring and my low back. Not everything was perfect in the Vibrams. I seem to have some irritation in part of the medial plantar nerve which results in a bit of burning/numbness type feelings in the big toe and 2nd/3rd toe area. It wasn’t too terrible though. I will continue to play around back and forth with footwear and see what happens.
Thus far, I love my Vibrams for work and gym exercise. I hiked in them this past weekend and I felt very good in them. I’m wearing them more and more and I encourage most exercise enthusiasts to experiment with wearing minimal footwear.
Cherries Aid Marathon Recovery
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Try cherries before and after your next long ride, run or grueling workout.
Here’s another weapon to add to your endurance training recovery arsenal: cherries. Marathon Runners Should Pick Cherries for a Speedy Recovery comes from Science Daily and it profiles a recent study out of Northumbria University in England. Marathoners who ran the London Marathon were split into two groups. Twenty marathon runners drank either a tart cherry blend juice or a placebo drink twice a day for five days before taking part in the London Marathon and for two days afterward. The story summarizes the research findings as follows:
“The findings indicated that the group who drank the cherry juice recovered their strength more rapidly than the control group over the 48-hour period following the marathon. Inflammation was also reduced in the cherry juice group, as was oxidative stress, a potentially damaging response that can be caused by strenuous physical activity, particularly long distance endurance exercise.”
It might be reasonable to conclude that cherries could aid cyclists, swimmers, cross-country skiers and maybe strength & power athletes as well. More research will be needed to confirm this guess. In any event, adding cherries to any or all of your recovery strategies may be a simple and tasty idea. (For more recovery methods, check out recovery nutrition, cold water immersion, and caffeine.)
Sounds like good news! However I can see it now… Sports nutrition stores will soon be stocking and promoting cherry juice extract–in a pill!! The stuff will cost more than cherries and probably won’t work. Warm weather is coming and cherries will soon be in the grocery stores. Buy ’em and eat ’em.
Compulsive Eating is Similar to Drug Addiction
StandardObesity-related eating issues are in the news again. This time new research indicates that the physiological dynamics of overeating are the same as drug addiction. Compulsive Eating Shares Addictive Biochemical Mechanism With Cocaine, Heroin Abuse, Study Shows comes from Science Daily. The article summarizes a Scripps Research Institute study that was published recently in the journal Nature Neuroscience.
The study examined the brain chemistry of rats that were fed high-fat, high-sugar diets similar to human junk food. The rats quickly became obese and at the same time their brain chemistry showed striking changes. Pleasure centers in their brains changed and became less responsive. The result was the rats had to eat more and more in order to stimulate these regions. These dynamics of food addiction mirror those of rats addicted to cocaine and heroin. Paul J. Kenny, one of the scientists who conducted the study said,
“It presents the most thorough and compelling evidence that drug addiction and obesity are based on the same underlying neurobiological mechanisms. In the study, the animals completely lost control over their eating behavior, the primary hallmark of addiction. They continued to overeat even when they anticipated receiving electric shocks, highlighting just how motivated they were to consume the palatable food.”
A fascinating development in the study came when researchers replaced the junk food with nutritious food: the rats refused to eat. They starved for nearly two weeks after the change.
What seems to be happening to these rats (and likely to obese humans) is that consumption of highly pleasurable food overstimulates and dulls the reward centers of the brain. More food (or drugs) are needed to stimulate feelings of reward and pleasure. Without getting too technical, the neurotransmitter dopamine and it’s receptors in the brain are the key elements here. Dopamine is released in the brain by pleasurable experiences such as drug or food consumption. Consume too much of either and the brain is flooded with dopamine which is essentially bad for dopamine receptors. Over time the brain actually undergoes physical changes and addictive behavior becomes normal and very difficult to change.
The big issue to me is that overeating and obesity are very complex and not at all simple matters of will power. Personal trainers and nutritionists must realize that the brain function of the obese person is very different from the non-obese person. Simply instructing someone to eat differently rarely works and now we know very specifically why.
To that point, I’m skeptical of our various efforts to educate the public on the caloric content in our food (first in NYC and most recently on a national level.) Similarly, it seems that small taxes on soda do little to curb consumption of the sugary junk. Simply putting the information in front of our eyes or enacting a slight monetary penalty isn’t enough and I don’t believe there are many ways government can affect our food choices. (I would be curious though to see the effects of eliminating subsidies for corn, wheat and soybeans. These subsidies keep the price of junk food–which is actually quite complex if you look at the ingredients–artificially low. So this addictive food is also dirt cheap. You and I are paying for this with our taxes!) That said, my hope is that those battling to lose weight won’t give up and resign themselves to poor health by saying “I’m addicted. There’s nothing I can do.”
From what I’ve seen of successful weight loss seems very similar to what I know of overcoming addiction. That is, the individual must decide to make a change for him or herself. Until the individual knowingly makes a firm decision to change no amount of preaching, pushing or cajoling by friends, a spouse, or parents will make the difference. And it is hard work. Perhaps now by recognizing the brain chemistry of over eating we can develop more effective strategies to slim down.
More Magical Fitness Nonsense: Part II
StandardThe first post of this series looked at a new weight loss pill being developed by General Nutrition Centers. It’s something containing caffeine, black pepper and an ingredient in hot peppers. Who knows? Maybe this thing actually is weight-loss in a pill. I doubt it though. Most likely this is just the latest version of fitness snake oil–and there’s plenty more out there.
If you’re any sort of follower of popular culture then you may know of the TV show the Biggest Loser. If so, then you know of Jillian Michaels, one of the show’s trainers. Michaels was sued in February by a fan of the show. The woman claims she bought a fat loss supplement sold by Michaels–and guess what!! It didn’t work. The suit further claims the product contains a tasty item called citrus aurantium (aka bitter orange). This substance contains amphetamine compounds which are similar to those found in ephedrine. These compounds are stimulants and they act to restrict blood vessels and to increase blood pressure and heart rate. This bitter orange stuff has been used to replace ephedra in many fat-loss products. Ephedra was linked to the 2003 death of Baltimore Orioles pitcher David Bechler.
More news on this topic came out in January of this year when the Abbott Laboratories’ weight-loss drug sibutramine was cited by European offiicials as being potentially harmful to heart disease patients. The F. D. A. added a warning to the drug, known as the products Reductil, Meridia and Sibutrex. (Wow, take a look at the contraindications and side effects of this stuff! Doesn’t look fun.)
What other kooky chemicals are in the news? The article F. D. A. Finds ‘Natural’ Diet Pills Laced With Drugs appeared in the New York Times Business section back in February of 2009. The story discusses a product called StarCaps. StarCaps were promoted by celebrities and touted as a “natural” weight loss product that used papaya as an active ingredient. Seems perhaps the true active ingredient was something called bumetanide, a diuretic that can cause all sorts of ugly side effects. The article further states:
“In a continuing investigation that has prompted consumer warnings and recalls by some distributors, the F.D.A. has determined that dozens of weight-loss supplements, most of them imported from China, contain hidden and potentially harmful drugs.”
These stories remind me of the Fen-phen episode of several years ago. Fen-phen was a combination of two weight-loss drugs marketed and sold by Wyeth. The drug combination was very popular and seemingly effective. Problem was Fen-phen caused heart conditions such as valvular heart disease, severe hypertension and even death in some users. The product is no longer available and as of 2005, there were about 50,000 liability cases still to be resolved with an estimated total of $14 billion in liability. Seems that we may be eager to repeat history.
So what is the big picture? Americans want to lose weight and there’s big money in that concept. We’re not too good at exercising and eating right though. If weight loss can come in a pill then a lot of us are very likely to spend plenty of cash on the product–nevermind the idea of “too-good-to-be-true” plays prominently in the background. Thanks to the supplement industry-friendly DSHEA act of 1994 these supplements live in a gray area between food and drugs, and they don’t undergo the same scrutiny. (Quackwatch gives a good commentary.) Therefore some supplements may be just as powerful and potentially dangerous to many users as any other prescription drug. (In fact, the risks posed by these weight-loss formulas may be more dangerous than simply being overweight!) As in the case of StarCaps, the ingredient label may not tell us everything that’s in a supplement. These are murky waters for the consumer.
Should these products be banned outright? I’m not sure. Can these products be used safely? Maybe. Clearly for some people these products are dangerous and possibly deadly. This stuff must be seen through the same lens as any other medication. Don’t let a label like “all-natural” fool you (BTW, black widow venom is all-natural too) and don’t let a celebrity face make you a sucker. A healthy lifestyle has yet to come in a pill and it never will. Get up, go walk around, and eat something that grew in the ground.
Pain: A Complex Matter
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When will this end?!
Anyone who’s experienced chronic pain knows it can be a very mysterious issue. Chronic pain presents very different characteristics and patterns when compared to acute pain such as a skinned knee or a sprained joint. It may start for no clear reason and progress with no clear pattern. A long-ago healed injury may continue to hurt even though the tissue is no longer damaged. Oddly enough even amputees and paraplegics may experience pain emanating from missing or non-working limbs. Chronic pain seems as if it’s driven by a very mysterious force.
The issue of hope–or hopelessness–can be a truly crushing burden in the quest to resolve long-term pain. Typical methods in addressing chronic pain may include drugs (ibuprofin, steroid shots, muscle relaxers), heat, ice, physical therapy, chiropractic adjustments, massage (Active Release Therapy, myofascial release, Rolfing, and others) and acupuncture, and then if none of the above works then we often resort to what certainly must be the final sure cure: surgery. These methods often provide temporary relief at best.
This past weekend I attended the first half of the Z-Health R-Phase certification. Pain and resolving pain was the overarching theme. I learned a tremendous amount about the issue. As many people have observed, pain doesn’t always equal an injury. Pain sometimes feels better with movement: someone with a slightly sore shoulder may feel better as he or she moves the arm around. In contrast, pain often does indicate an injury. If I break my leg and I continue to walk, then the pain will increase with every step.
A key issue we discussed is that the site of pain is rarely the site of the problem. Pain is often a symptom of dysfunction elsewhere in the body (Or sometimes even outside the body. More on that in a moment.) For instance, absent a blow or violent twist of the knee, knee pain is rarely a knee problem. Knee pain is often rooted in hip or foot dysfunction. Similarly, shoulder pain is often rooted in poor spine or hand movement. As the renowned neurologist Karel Lewitt said, “He who treats the site of pain is lost.”
Emotions are often overlooked when we deal with pain. Again we often think of pain as strictly a bodily thing. Still a lot of us have noticed that our pain increases during times of stress. This is an indication that we must consider our mind and our emotions when we’re trying to resolve long-term pain. It may be that our “physical” pain is rooted in the conditions that surround us. In fact what happens in many cases is that the pain itself causes us such distress that it becomes a self-perpetuating situation in which our fear of pain drives only more pain. It’s an enormously complex matter when we start to look inside our head in order to address pain; but if we’re not considering the inside of our skull then we’re probably missing the mark by a long shot.
One of the books Z-Health creator Eric Cobb suggested we read is David Butler’s Explain Pain. Butler is an Australian neurologist who specializes in pain research and treatment. His blog on pain is called Explain Pain. If you’re currently in pain or if you’re in the business of treating pain I highly suggest you look into it. Pain treatment professionals should also look into the Neuro Orthopedic Institute. The NOI site describes their mission as such:
“The nervous system is our prime focus, integrating neuroscience, neurodynamics and manual therapy into patient management. NOI’s core philosophy is to provide progressive, current material, always challenging existing management protocols, to promote professional reinvestment, and to ensure that course participants benefit from the most recent research in a fun way.”
Z-Health Day 1
StandardYesterday was the first day of the Z-Health R-Phase certification here in Denver and I found it very informative and enjoyable. We learned a tremendous amount about the nervous system and why doing joint mobility drills can relieve pain. (I started the day with some low back pain. We progressed through only a few drills: foot/ankle drills and knee drills. Soon after there was no back pain and I still am pain free this morning as I type this.) It sounds strange I know, but the ways of the body and nervous system are often less than obviously logical.
The class of about 20 students is the most diverse class I’ve seen at any sort of exercise course. In addition to personal trainers there’s a physical therapist and a PT school student in attendance, a yoga instructor, a school teacher, and a nurse. One man is a client of a Z-Health trainer who’s simply been impressed enough by the results that he wants to learn more. One woman has seen her elderly mother go through hip and knee surgeries with poor results. She said she didn’t want to get old in the same fashion.
I don’t want this to sound like some sort of a weird cult thing or blind devotion to some oddball system. Z-Health creator Eric Cobb has drawn on a wide variety of sources in developing the system. Much of what informs Z-Health is neurological research and an understanding of what pain is, how the brain views pain and they myriad ways we can address pain. Cobb urges students and Z-Health trainers to read a lot and learn as much as possible about these issues.
One criticism of Z-Health is that it’s hard to explain. People ask “What is Z-Health?” and those of us who’ve been exposed to it often can’t give as succinct an answer as we wish we could. I think the Z-Health web site should give a better explanation of what Z-Health is and how it works. The course I’m taking is called R-Phase. “R” stands for restore, rehab, and re-educate. There are other phases but R-Phase forms the basis for the other phases. I’ll do my best to give an explanation.
The driving concept is that the nervous system is the key driver of of every facet of the body. Absent an acute injury like a broken bone, cut or dislocation our pain is a movement problem. For example “My knee hurts when I climb stairs,” or “My shoulder hurts when I reach overhead.” Those are movement problems. The nervous system drives movement, not the muscles, not the bones, not connective tissue but the nervous system. Thus is if we want to eliminate pain then we must address the nervous system in order to improve movement. (Interestingly, if any movement pattern is compromised–ankle movement for example–then it may create pain and/or weakness in other regions such as the neck or a shoulder. It’s sort of similar to the way a storm in Seattle may impair air traffic in Miami.) The way we do this is by moving each joint one at a time through its full, pain-free range of motion. We do this very precisely under strict control. In this way we improve the brain’s map of the body (the homunculus). We increase the nervous system’s recognition of these joints and limbs thus we improve movement and control of the body.
That’s the brief, non-technical explanation! I wish I could put it more briefly. Medical and body work professionals may still prefer a more thorough explanation. Z-Health looks somewhat like tai chi. In fact Z-Health draws on martial arts, tai chi and dance for various mobility drills.
For anyone wanting more information I suggest you call the Z-Health offices. The people who work there are very much willing to discuss Z-Health and answer any questions. They’re a very helpful and well informed staff.
Achilles Tendon Issues: Help from Dr. Ivo at Summit Chiropractic
StandardMy wife and I just recently enjoyed a long weekend in the mountains full of skiing/snowboarding, sleeping in, and wishing we had a condo near the slopes. Part of that weekend included a visit with Dr. Ivo Waerlop at Summit Chiropractic in Dillon, CO. I went in hopes of 1) getting help with my sore left Achilles tendon that’s been bothering me for months, and 2) get some of his thoughts on barefoot running. The visit was very helpful and enlightening.
Dr. Waerlop was featured in a Denver Post article on barefoot running. My wife looked up his web site and it grabbed my interest. Dr. Waerlop is involved in the biomechanics of cycling, running and skiing (three things I love), and he’s involved in barefoot running. In fact, he’s a biomechanics advisor for Vibram. He’s also an accupunturist.
I won’t go into every detail but his asessment of my gait was very precise and his explanations very thorough. He assessed my feet, legs and trunk; observed my gait; and presecribed several exercises for me plus a sole lift for my shoe.
Most importantly we focused on attending to the causes of my problems (faulty biomechanics in the feet and toes) rather than the symptoms (pain in the Achilles–oh yeah, and my low back and my left shoulder).
He also advised me on barefoot running. I probably won’t ever be a full-on barefooter but I likely will be doing some barefoot running in the near future. (Gotta take it slow!)
There’s more. Dr. Waerlop is part of the Homonculus Group. (What is the homonculus? Excellent question. Click on the word to find out.) This is a group of physicians and sports performance/injury rehab professionals who are “committed and driven to better understand the problems of pain and movement impairment in this world (basically the aches and pains that ail individuals.)” The Homonculus site is rich with podcasts, articles and discussion threads (though it appears their discussion board has received a lot of spam which should be removed. Go to page 1 of the discussion board for legitimate information.) Finally, Dr. Waerlop is one of the Gait Guys whose lectures on gait assessment are found at Youtube.
I am very excited to dig into the articles and podcasts. If you’re a trainer, coach, or injury rehab professional–or if you’re just a fitness geek with some spare time, I highly recommend you investigate some of this material. I can’t get enough of this stuff!!!
Counterpoints to Barefoot Running
StandardI think it’s important to analyze any trend or issue from several viewpoints. In the world of fitness and nutrition we see all sorts of fads come and go. Today barefoot running is gaining in popularity. I’ve posted recently on some of the research that suggests barefoot running may be healthier for the joints than shod running. So, I believe it’s worth considering doing some barefoot work whether it be gym work such as weight training or agility work; or perhaps very short runs on a soft surface such as grass. It may in fact be beneficial to work toward a full transition from shod running to barefoot running. That said, it’s vital to consider other views.
First, the Science of Sport gives us Barefoot running – new evidence, same debate. One notable point the writers make is this:
“I guarantee that the media are going to be all over this and they are going to tell you that you should be running barefoot or in Vibrams. You will hear how science has proven that being barefoot will prevent injuries, and that those of you who are injured should blame your shoes as you lob them into the garbage bin.
(This sort of observation can go for just about every new study that’s reported in the press.) I think it’s entirely likely that runners may latch on to barefoot running thinking that it’s an instant magic cure for whatever is bothering them and the results may be disastrous. (Then what will the press, physical therapists, and podiatrists say? “Barefoot running is the worst thing in the world! No one should do it ever! Then we’ll have discarded a potentially helpful tool from our toolbox.)
The article goes on to give an example of what happens when the pendulum swings too far and runners adopt something very new and very different into their training:
“And I will illustrate this with our own insight into footstrike and injury. When the Pose research was done in Cape Town, athletes basically had their footstrike patterns changed through 2 weeks of training in the new method. The biomechanical analysis found lower impact forces (sound familiar? Same as the Nature paper), and even less work on the knee joint. This was hailed as a breakthrough against running injuries, because lower impact plus lower work on the knee meant less chance of injury. Jump ahead 2 weeks, and 19 out of 20 runners had broken down injured. Why? Because their calves and ankles were murdered by the sudden change. And the science showed this – the work on the ANKLE was significantly INCREASED during the forefoot landing.”
Thus we get the very clear point that barefoot work must be added gradually into your routine. A rapid switch in running technique is probably a very bad idea. DO NOT move rapidly to replace all your shod miles with barefoot miles.
Over at the Running World According to Dean you can read Another Barefoot Running Story. He seems a bit skeptical on the issue of barefoot running. Owen Anderson at Educated Runner has presented two posts on barefoot running: Barefoot, Nearly Barefoot and Bearfoot Running; and Barefoot Running: What the Harvard Study Really Said. Both articles are again somewhat skeptical of barefoot running and running in Vibrams. Anderson’s second post is most valuable I believe in that he points out some of the limitations of the study “Foot Strike Patterns and Collision Forces in Habitually Barefoot versus Shod Runners” that appeared recently in the journal Nature.
Anderson makes this point: “The Nature investigation did disclose some interesting information about the effective mass of the foot and shank (which we won’t discuss here), but it offered no other information about the potential links between barefoot running and either injury or performance.”
He’s correct. This study was not a long term study. The study indeed showed lower impact forces at the ankle, knee and hip during barefoot running when compared to shod running, however the runners were not observed over the long term. Thus we only know what happened during the short duration of the study. This situation is indicative of most barefoot running studies. Nor did the study investigate which method–barefoot or shod–results in the fastest performances.
Further studies should be conduced looking at several points. First, long-term studies should look at injury rates of shod runners compared to barefoot or minimally shod runners. Second, we need to move beyond injury issues and look at racing performance. In other words can we run faster barefoot/minimally shod or in shoes? Third, it might be interesting to see how many people have tried to convert from running shoes to barefoot running but were unsucessful. What happened to these people?
From my point of view, none of these other posts or viewpoints have changed my thinking that some degree of barefoot work is very likely healthy for a fair number of people. It’s not necessary for anyone to permanently discard their running shoes for bare feet, but perhaps it would be valuable to consider taking the shoes off from time to time and letting the feet behave like feet.