Monday, December 30, 2013

Merrell Vapor Glove vs. Vivobarefoot The One..

The One on left, VG on right.
Nice review: "Barefoot Inclined: Minimalist Showdown: Merrell Vapor Glove vs. Vivobarefoot The One..."

The One looks appealing when compared side-by-side.

There's this, from another review:

"I've had no problems with this design, but the laminate strips near the big toe do wrinkle up a bit during plantar flexion (when you roll up onto your toes). A friend of mine picked up a pair and had some painful rubbing issues there as the "wrinkle" pushed down painfully on her big toe. I've had other shoes that do this at the flexpoint, and I can feel where it happens here but have no issue with it."

But I've had the same thing happen in the VG when worn sockless, so I don't know if this is the dreaded rubbing issue that plagued the early VB shoes...

And when I mentioned niche barefoot-style shoe producers, I forgot to mention VivoBarefoot. I'm wearing a pair of their loafers today. Love 'em.

Thanks to John.

Tuesday, December 24, 2013

"Paleo Diet Popular With Endurance Athletes"

Ah, journalists. The fact that three athletes are doing something does not make it "popular". In fact, paleo and low-carb dieting are far from popular in the athletic world, although they are on the increase. Zero is an easy place from which to increase.

Other than that, a neat article from

"What do professional cyclist Dave Zabriskie, ultramarathon runner Timothy Olson, and gold-medal triathlete Simon Whitfield have in common? All of these elite endurance athletes have pushed away the time-honored plate of pasta in favor of a "paleo" approach to nutrition. They've dialed down the carbohydrates and replaced them with copious amounts of healthy fat. And as multitudes of paleo converts claim (and anecdotal evidence suggests), this may be the key to optimizing performance and extending careers into the late thirties and beyond...."

Mark Sisson (interviewed in this article) mentioned Simon in a post a few years ago, and I completely forgot about him. Gold medal on a primal diet. Not bad. I've done a couple of posts about Tim Olson.

Zabriskie's an interesting story:

"...The results for Zabriskie were impressive, DeVore says. Over the course of their time together the 6-foot cyclist dropped his body weight from 168 pounds to 154 while improving his dead lift from 150 pounds to 245. This while increasing his power on the bike by about 15 percent."

I really do think that the only way this paleo/low-carb diet is going to make it big is if it turns out to be good for athletes. That does seem to be the case.

Wednesday, December 18, 2013

Barefoot Running In NYC and The State Of Barefoot Shoes


"Chris Hawson didn't run much in New York City until he took off his shoes. That was three years, and more than 9,000 miles, ago.

"You can blame Chris McDougall and Born to Run for that,” he says while sipping hot chocolate in a coffee shop near the Union Square Paragon Sports where he works as an outerwear buyer. “It was inspirational to me. I didn't treat it as a technique manual, but it set me off on a path.”

"A health scare in 2009 prompted Hawson, now in his mid-50s, to start running a couple of times a week, but he found his IT bands, knees, and shins started to hurt, forcing him to resort to inline skating. Then Hawson, who spent a decade leading bike and ski trips in Northern Scotland, discovered Vibram FiveFingers and ran a few hundred miles during the summer and fall, mixing them in with a couple other pairs of more traditional shoes. But winter came, so he packed the FiveFingers away because of the cold. That plan didn't last long, however, and pretty soon he had ditched conventional shoes entirely."

Read the whole thing.

I went to see In the High Country (a movie about ultra-runner Anton Krupicka) in NYC last night, and Chris was there. (Paragon organized the showing.)

Chris, as the Outdoor story makes clear, is the real deal. I've run with him a couple of time in various McDougall-organized "events". He really does do the bulk of his miles barefoot.

As a buyer at Paragon he had some interesting thoughts on the minimalist shoe market: it's fading. In large part because the minimalist shoes last so long. With no foam to break down, you replace your shoes when they tear, or when the sole wears through. Chis explained that he just tossed a pair of Altras that had 2,500 miles on them, because the sole wore through and he had torn the upper on a rock.

Given that the typical running shoe companies recommend that you replace their products every 300 miles, that's a major difference. He then mentioned that he probably had bought enough pairs of minimalist shoes to last the rest of his life, at that rate. I also have enough to last quite a long time.

Altra Torrin: not minimalist.
He explained that there are no new minimalist shoe designs coming out: even Altra's new line has a lot of cushion built in. We both wondered about the future of Merrell's Vapor Glove, one of my personal favorites. It was nice to see them in Merrell's winter catalog, but I wonder if they'll last through next summer. New Balance's Mimimus line does doesn't seem to be doing well (according to a New Balance store I visited recently), as the most minimal models are falling by the wayside.

Guess it's not too surprising... When Dr. Munson first invented the barefoot-style shoe after World War I, they put millions of them on the feet of American soldiers. They were very popular, but then the whole thing disappeared as generations turned over, and they were forgotten...

Hopefully a few companies will stick with the idea so folks like me and Chris can replace our shoes when we need to.

Luna, Russell, and Skora seem to be pretty committed to the minimalist idea. [P.S. And VivoBarefoot!]

But there's more research coming along showing the clear advantages of barefoot over shod foot-binding, so hopefully the idea will stick around.

After 10 miles running in the snow.
My running rotation has been barefoot, Luna Sandals, Vapor Gloves, and Vibram Fivefinger Speeds. None of them show much wear on the sole. If I do a trail race, I'll wear the Trail Glove, and I wore the Sonic Glove the other day when I did a 10-mile run in the snow. I can't really see any reason why I'd ever want to go back to the sort of sneaker I used to wear.

(Found the Outdoor story via Chris McDougall on Twitter.)

Barefoot 'Granny' Wins 3k Race In India

BBC News:

"Lata Bhagwan Kare [age 61] performed the feat wearing a nauvari - a traditional sari named after the term for a single nine-yard (8.2m) piece of cloth - Indian newspaper Daily News & Analysis reports. She started the race in the western town of Baramati wearing slippers. When one came off, she discarded the other too. Within minutes, she had apparently left all the other runners way behind.

"I used to go for morning walks daily, but I had never run. If I had even tried to run, people would have found it strange and they would have asked me uncomfortable questions," Kare says. She tells the paper she felt "a little awkward" at the starting line as the other participants were staring at her outfit. "However, when the race began and I started overtaking them one by one, I gained my energy." Throughout the... race, she kept telling herself she wanted to win - "And I did it." She says she'd like to take part in more races, but "only god knows whether I remain as strong then as I am today"."

This seems to be the original story, with the picture above.

No word on her finishing time.

P.S. File this one under "Too good to be true", or maybe "why journalists aren't to be trusted"...

The first commenter on this post provides a link to a more likely version of the story: that the lady in question won a 3k race held at a marathon, not the marathon itself. I looked around before posting this suspecting something like that was the case, but wasn't able to find any thing. So thanks to La Gazza Ladra (The Thieving Magpie) for setting me straight.

"61-year-old barefoot woman labourer wins 3-km race at Baramati marathon"

This story provides the most likely version of events, and the title ("Sixty-six-year-old granny runs 'marathon' in a saree in Maharashtra", with marathon in scare quotes) explains how the story changed from the facts:

"Kare's dress code was a traditional Maharashtrian saree, and no shoes at all! She won the senior citizen's category running 3 km and was awarded a cash prize of Rs 5000 and a certificate.

"Over 9500 people participated in the race in four categories but clearly the highlight was the 66-year-old farm worker. After running her first marathon Kare, who is a grandmother, now wants to run more races. With better footwear and running gear, you never know, she could just be another Fauja Singh in the making...."

"Better footwear". Dumb journalists...

So she won the senior category in a 3k race. At 66! Congratulations, nevertheless.

And a good lesson on how the press can twist a story, and how failing to check news reports adequately can lead to error...

Tuesday, December 17, 2013

Low-Carb Athletes: World-Record Ultra-Runner Zach Bitter

Hold your hats: World Record: ran 101.66 miles in 12 hours; American record: 100 miles in 11:47:13. The world record he broke was Greek God (that's not ironic, it's literal) Yiannis Kourus's* record.
That's a 7:04 pace (minutes per mile), for more than 100 miles. Wow.
And, just to make it extra cool, he did it wearing minimalist shoes and eating a low-carb paleoish diet.
He has a recent post on his blog describing his diet:
"My personalized OFM [Optimized Fat Metabolism] approach can be characterized as macronutrient cycling. While my protein intake fluctuates little (typically 100 to 150 grams per day), my carbohydrate intake can be anywhere from 5 percent of my total calories to 50 percent, depending on where I am in my training cycle. When I am in full recovery mode after a race, I drop my carbohydrate intake as low as possible. On the other hand, my carbohydrate intake is around 20-30 percent of my total calories when my training is ramping up in volume and intensity, and in the final 36 hours before a race I allow it to climb to 50 percent at most.
"All carbohydrates are not created equal. I don’t eat grains; I think the way grains have been engineered in the past several decades has made them hard on digestion and the likely cause of many of our broken guts. I also stay away from lactose, simply because my body doesn't seem to digest it very well. Commercial dairy producers have removed the enzymes in dairy that help our bodies break down lactose. Since our bodies cannot produce these enzymes on their own, this results in bloating and indigestion. I will drink raw milk if it's available, but I don't go out of my way to get it.
"My primary source of carbohydrates is vegetables. I usually opt for non-starchy vegetables, but when I am looking to raise my carbohydrate intake I do eat carbohydrates from starchy sources, such as potatoes, sweet potatoes, or rice. Another source of carbohydrates I use is fruit. I try to focus on melons and berries, as they are less apt to spike insulin, but I do eat things like apples, pears, and peaches from time to time.
[Tuck: I will note that "non-starchy vegetables" are metabolized into fats, basically: from a metabolic perspective they're not a carbohydrate. They will not enter the blood as glucose. P.S. See the first comment for a clarification from Zach.]
"After protein and carbohydrates, the rest of my calories, of course, come from fat—often more than half my daily calories. Just as with protein and carbohydrates, I pay close attention to the types of fats I consume. I take in approximately 50 percent of my fat as saturated fat.... The remaining 50 percent I try to make mostly monounsaturated fat, with very little coming from polyunsaturated fat sources. The polyunsaturated fat sources are a recipe for inflammation, especially when a diet is low in omega-3 fatty acids, so I avoid them for the exception of the occasional snack of mixed nuts or nut butters. A few go-to fat sources I enjoy include: coconut milk, coconut oil, butter, animal fat, avocado, extra virgin olive oil, and cheeses (full fat, to avoid lactose).
"One of my favorite dishes to eat is a mix of vegetables (mostly greens) with fresh calf liver, bacon, and sour cream..."

He never uses the phrase Paleo, but that's what it is. Robb Wolf or Mark Sisson would approve of his approach of cycling carbs up and down as required by training and racing: what's really interesting in the focus on lowering carbs for recovery.So by that standard, he's not strictly a low-carb athlete, as he's approaching this primarily from the perspective of maximizing fat metabolism, but I think that that's the right approach to take: it's not about which macronutrients you eat: the goal is maximizing health and performance. Minimizing carbs is a key part of that, but eliminating them isn't necessary for a healthy person. From an interview with Case Performance:

"...I would describe my intake as low carb, high fat, and moderate protein...."
"In terms of converting from a high carb to high fat based diet, there was probably a 2-3 week adjustment time period and I did feel "flat" during a couple of the workouts. However, it was well worth it. Since switching, I have found that a diet based on fats promotes quicker recovery, better sleep, and a more consistent level of energy throughout the day. My race times have consistently better since switching over as well."
He also discusses his approach to carb-loading:
"Basically, I begin to add more carbs 2-3 days out from the race. I focus on carb sources that are gluten free. Sources include: starches (potatoes/sweet potatoes), fruits, and raw honey. I decide how much carb based on the intensity of the race. If I would be heading into a 100 mile race I would add much less carb, as my body would be more apt to remain in a fat metabolic state."
And, in line with Wolverine's approach to hydration:
"If I am going out for a long steady paced run. I will do very little pre/during workout fueling. I will take in some amino acids in order to stave off any muscle catabolism, and water with some unrefined sea salt."
Skora Base
On the shoe front, he appears to have been wearing the Skora Base (on sale now!). Skora was a company that was started early in the minimalist shoe wave after Born to Run was published, and then went radio silent for a long time as they tried to get production started. Many of us figured that they wouldn't make it, and here they are, owning a world record. Congratulations to Skora!From their website:

"BASE is the ultimate, multi-purpose running shoe. Equally at home on the road, in the gym or racing a triathlon. BASE offers a stretch-mesh sockfit with an innovative adjustable X-strap system, elastic heel strap, reflective details and stitch-down construction with an Ortholite insole. Lightweight, quick-fit, and unique in design, BASE offers a lightweight cushioned ride with 13mm stack height (9mm without insole).
"BASE is built on the R01 platform composed developed to offer a unique anatomical fit that closely matches the foot’s shape. The R01 platform also features a zero-drop outsole/midsole with just enough cushioning and a curved section profile in both the forefoot and heel. This allows for optimal natural movement and performance.
While I've not tried Skora's products, they're a real minimalist shoe. A little beefier than a Vapor Glove (nearly twice the VG's feathery weight), but all the right features. Birthday Shoes did a nice review when they came out.Zach elaborates on how he adopted minimalist shoes:

"The practice of wearing shoes—with all their padding and support—regularly has weakened our foot muscles. Weak muscles need to be exercised with gradual incremental increases in order to avoid injury. It's the same reason why you don’t go from running 10 miles a week to running 100 miles a week without a build-up. Likewise, to effectively run with a minimalist shoe, one must slowly transition. If you're interested in learning about my transition to minimal footwear, keep on reading; I recently completed a 50-mile trail ultra in a pair of minimalist shoes."
And now he has a world record. Well done.Thanks to Sean for bringing this to my attention!
* If you don't know who Yiannis Kourus is, start here, but to sum he's the greatest distance runner in history, with no close second.
P.S. That's a 7:04 pace with bathroom breaks! Here's Zach's race report at iRunFar, and a couple of notes following up on what's above:

  • He was indeed wearing the Skora Base shoe.
  • His pre-race nutrition was pretty low-carb...
  • During the run he ate banana chips, potato chips, Mountain Dew, Gatorade, and had some M&M’s when he had a mini-bonk at mile 95.
  • He wore an iPod shuffle. Can you blame him? 100+ miles on a track? I'm amazed he could stay awake...
Read the whole thing, and congratulations, again.
P.P.S.: I listened to the Ultrarunner Podcast interview with Zach. Best line (discussing Kouros doing a 72-hour run in the near future):

"I think I'll stick to the short stuff..."
LOL.He's an interesting one, Zach is. He's minimalist and paleo solely for performance reasons, not because he thinks they're intrinsically better for health. He drinks beer, for instance, so he's not totally grain-free.
One other funny comment: one of the interviewers asked him about Achilles tendonosis, and Zach observed that he used to get it, but not since he went minimal. He also said that he'd use up to a 10-mm drop shoe, but all the shoes that he mentioned using (Skora and Altra) are zero-drop.
Additionally, as above, he made the point that (in essense) adapting to minimalist shoes is building up the muscles in your feet and lower leg. He noted that he doesn't (obviously) have any problems with strength in those muscles now.
I think this is a great point: a lot of people think that minimalist shoes "don't work" for them, when in fact their feet are still just really weak.
Oh, and thanks, Mark.

Friday, December 13, 2013

"The Nervous System and Metabolic Dysregulation: Emerging Evidence Converges on Ketogenic Diet Therapy"


"The KD might offer fewer chronic negative side effects than medication, and given that it has been in use for over 90 years, serious or systematic negative consequences would likely have surfaced by now."

Indeed. They make a strong case in this paper that epilepsy is effectively glucose poisoning...

"Converging lines of evidence suggest the utility of a KD for pain relief. First, it has long been known that reducing glucose metabolism influences pain. There is an overall increase in pain thresholds (and thus reduced pain) when glycolytic enzymes are inhibited..."

"...Thus, we predicted that the KD, which reduces glucose metabolism and is anticonvulsant, would reduce pain."

I've certainly noticed this effect since adopting a very-low-carb diet. I have a scar on my arm now from falling down steps. I didn't even notice the injury to my arm until I was in the shower many hours later. It's been a consistent reduction in pain from injury... And I get injured pretty frequently with the sports I do. ;)

"A better understanding of the relationship between metabolism and pain could help multiple and comorbid conditions, and the KD might prove uniquely useful against diabetes and diabetes-related neuropathy. Although work with rodents has produced mixed results (Al-Khalifa et al., 2009, 2011; Garbow et al., 2011; Park et al., 2011; Poplawski et al., 2011), clinical studies have found exclusively positive outcomes: after KD treatment, patients with type I or II diabetes had improved control of blood glucose, and many could have their medications reduced or eliminated (Gumbiner et al., 1996; Yancy et al., 2005; Westman et al., 2008; Dressler et al., 2010). In addition, type I diabetic patients (and, based on one report, children with epilepsy) prefer foods that are high in fat and low in carbohydrates (Amari et al., 2007; Snell-Bergeon et al., 2009), which might be attempted self-medication."

Only a doctor is dumb enough to prescribe more poison to a patient suffering from glucose poisoning...

Although polyunsaturated fatty acid content of the KD seems not to be important in the diet’s anticonvulsant effect (Dell et al., 2001; Dahlin et al., 2007), it might be a crucial characteristic for KD influence on inflammation.

It might seem ironic that the KD is discussed here as reducing inflammation, given that other high-fat diets and obesity are definitely linked to chronic inflammation (Thaler and Schwartz, 2010; Ding and Lund, 2011; Laugerette et al., 2011). Those high-fat diets that lead to obesity, including the so-called Western diet, include a high amount of fat along with normal amounts of carbohydrate, a crucial difference from the very low-carbohydrate KD which typically leads to weight loss (Gumbiner et al., 1996; Halyburton et al., 2007; Tendler et al., 2007; Westman et al., 2008). Thus, the high-fat-plus-carbohydrate diet promotes fat storage whereas the high fat, low-carbohydrate diet promotes fat metabolism.

This is fascinating. Not sure what they mean in the first paragraph. My bet would be that increased omega-6 polyunsaturated fat increases inflammation, even on a ketogenic diet, and is responsible in large part for the negative effects on obesity of the "Western diet".

A key part of my personal diet is avoiding omega-6 fats. The diet used to induce metabolic disruption in lab animals contains a large portion of omega-6 fat.

Wednesday, December 11, 2013

More On Resveratrol

"Resveratrol in mammals: effects on aging biomarkers, age-related diseases, and life span."
"Nevertheless, no study has demonstrated the prolongation of life span in healthy nonobese mammal models."
And none ever will.
"In our opinion, more studies should be performed..."
And you should pay us to do them!

Thanks to Bill Lagakos on Twitter for the link.

Friday, November 15, 2013

Persistance Hunt: Kenyans Run Down Cheetahs

Cheetah-hunting shoes?
From the BBC this morning:
"Mr Hassan, from a village near Wajir town, said the cheetahs were attacking his goat herd over several weeks.

""These cheetahs killed 15 of my goats - they were coming to my house daily to kill my goats," he said.

"He said he decided to return to his village to organise their capture at a time of day when cheetahs get very tired and usually rest in shade.

""I was sipping a cup of tea when I saw them killing another goat," he said, explaining that this was early in the morning.

"He said he waited until several hours later when the sun was high to go after them.

""I called some youths and we ran after them," he said.

""We caught them and we brought them to the local authorities.""
They were able to capture the cheetahs, alive, without the use of weapons.

Follow the link above for pictures of the festivities. Guess we know where all those Kenyan marathoners come from...

Thanks to Chris Bonner.

Wednesday, October 23, 2013

Follow-up to "Fat Adapted Horses"

Jimmy Moore posted this image today [scroll down]:

"This poster was actually on display at the Minnesota State Fair this year–pretty cool stuff!"

Indeed. This is the point John Durant makes in his new book, The Paleo Manifesto: we're not the only critters that have problems with a high-carb, non-ancestral diet.

[Original post]

Monday, October 21, 2013

Low-Carb Athletes: Jenson Button, 2009 Formula One World Champion

Jenson Button is one of the best race-car drivers in the world. Contrary to most people's expectations, driving a race car, especially an F1 car, is an athletically-demanding task. (And for all you Americans who are not familiar with F1, it's the most popular sport in the world with the highest-paid athletes.)
"His hobbies include mountain biking, competing in triathlons and body boarding..."
No slouch, then. This article ("Nigel Mansell: F1 weight limits for 2014 'disgraceful'") quotes Button:
"I love fitness training but there are things I can't do because I have to be a set weight - not eat carbohydrates, not build muscle. And next year it will be worse. I don't think any team will have ballast next year."
Interesting. Unlike Lindsey Vonn, who rarely mentions her diet, Button's pretty open about it.
Telegraph: "While Button said he was in no danger of developing an eating disorder, he admitted that he fasts before each race and “never” eats carbohydrates."
AskMen: "Keeping Jenson trim is a low-carb diet which, as he went on to tell us, was pretty tough to begin with, “When you grow up eating cereal, toast and fruit for breakfast like I did, it is initially very difficult to adjust. These days I’ll have a steak for breakfast with mushrooms and tomatoes, or I’ll have fish like salmon or haddock. Then I have the same thing at lunch – fish or meat with vegetables or salad – then the same for dinner. I’m not intolerant to carbs but if I eat too many I’d put weight on very quickly.”

"When pressed on what he missed eating the most he was quick to answer, “Desserts. I’ve got a very sweet tooth. I miss banoffee pie, sticky toffee pudding, that sort of thing. The worst thing is when I’m out for dinner over a Grand Prix weekend with Jessica (Michibata – Jenson’s Japanese girlfriend) and she orders dessert. I’m just like ‘How dare you? That’s so unfair!’”
Dehydration is a major concern in an F1 car, as you're often baking, fully dressed (including gloves and a helmet), in an open car on a hot track in the summer sun for hours:
"The two formulas created by Lucozade are specially balanced to aid with water retention and absorption into the blood stream. The hydration formula is used across the entire race weekend and is aimed at maintaining hydration especially in the hotter climes. Helen Cowie, the technical director, at GlaxoSmithKline Research & Development behind the drinks explained, “It’s low in carbs and a has a tightly maintained level of sodium within the drink that leaves it surprisingly salty in taste. Sodium speeds up the absorption of the liquid by your body, meaning that the drivers don’t sit there with a belly fluid of drinking sloshing around them, which can lead to stomach cramps.”"
Interesting, as it corresponds with Wolverine's experience with hydration: he also found that adding salt to the water aided in absorbtion.
SportsKeeda: "Jenson’s impressive physical condition can be attributed to two things: his fitness programme and his diet. He works out for up to five hours per day when he’s not at a racetrack and he follows a low-carb diet that has been tailored to his sport’s needs.

"To keep his competitive instincts razor-sharp, he competes regularly in triathlons (swimming, cycling and running). After the season-opening Australian Grand Prix he contested a triathlon in Hawaii and he’s maintained a strict nutritional programme.

"“I work out a lot,” says Jenson. “I need to be fit to do my job and a fit body results in a fit mind. However, I’ve benefited almost as much through improving my diet. It’s a cliché, but we are what we eat and I’ve worked hard with a nutritionist to ensure that I’m eating the right things at the right time of day.

"“I’ve lost three percent body fat by not eating carbohydrates for breakfast. No cereal or toast for Jenson Button! The benefits of eating the right things are huge; it’s something that I underestimated until quite recently.” [My emphasis.]

"The only potential snag during Sunday’s 56-lap Malaysian Grand Prix is the water bottle that Jenson will have strapped into the cockpit of his McLaren MP4-26. Even with his newfound levels of fitness, he’ll struggle in the race without a water bottle because he’ll be performing in cockpit temperatures of more than 50 degrees. [Centigrade, that's 122 F, for a two-hour race.]

"“It doesn’t matter how fit you are,” says Jenson. “If you get dehydrated, your physical performance drops off and your concentration is affected. A couple of years ago my water bottle stopped working on lap two at Sepang and by the end of the race I was suffering a lot.

"“The first thing that happened was that I got cold. Despite the excruciating heat I was shivering in the cockpit, which is a crazy thought. My eyesight then started to go and by the end of the race some things became blurred. That’s a horrible thing to happen in a racing car! As long as my water bottle works on Sunday, I’ll be fine.”
And if you ask Button for weight-loss tips, this is what he'll tell you:
This is an interview with Button's physiotherapist, Mike Collier:
On his diet and whether it is mostly pasta:

"No, the opposite, really. We try and avoid carbohydrates from Thursday through to Saturday evening. Saturday evening he will have carbohydrates. It's about making sure there is adequate protein there for recovery and repair, and that he eats reasonably regularly so that he maintains more of a constant blood sugar. People think about pastas and rice and all these carbohydrates being very good for you; they are, provided that you are exercising to be able to burn them. Otherwise it is just like eating too much fat: It will increase your weight. As driver weights are important, we play around with it a little bit to ensure that his weight is very good, that he has enough energy, that he is also repairing himself and recovering through protein. So his meal before the race will be a salad-based chicken dish. There is carbohydrate, but in his drink."
So he's got a bit to learn. Not yet a paleo diet, but a typical low-carb diet. Button would probably get even trimmer adding more fat and reducing protein, as Jimmy Moore demonstrated to the world. Eating fat does not make you fat. Maybe Button can consult with Dr. Noakes...

Tuesday, October 15, 2013

Seven Myths About Obesity

Myths, Presumptions, and Facts about Obesity — New England Journal of Medicine:


We review seven myths about obesity, along with the refuting evidence. Table 1 (Seven Myths about Obesity) provides anecdotal support that the beliefs are widely held or stated, in addition to reasons that support conjecture.

Small Sustained Changes in Energy Intake or Expenditure

Myth number 1:
Small sustained changes in energy intake or expenditure will produce large, long-term weight changes.

Predictions suggesting that large changes in weight will accumulate indefinitely in response to small sustained lifestyle modifications rely on the half-century-old 3500-kcal rule, which equates a weight alteration of 1 lb (0.45 kg) to a 3500-kcal cumulative deficit or increment.5,6 However, applying the 3500-kcal rule to cases in which small modifications are made for long periods violates the assumptions of the original model, which were derived from short-term experiments predominantly performed in men on very-low-energy diets (<800 kcal per day).5,7 Recent studies have shown that individual variability affects changes in body composition in response to changes in energy intake and expenditure,7 with analyses predicting substantially smaller changes in weight (often by an order of magnitude across extended periods) than the 3500-kcal rule does.5,7 For example, whereas the 3500-kcal rule predicts that a person who increases daily energy expenditure by 100 kcal by walking 1 mile (1.6 km) per day will lose more than 50 lb (22.7 kg) over a period of 5 years, the true weight loss is only about 10 lb (4.5 kg),6 assuming no compensatory increase in caloric intake, because changes in mass concomitantly alter the energy requirements of the body.

Setting Realistic Weight-Loss Goals

Myth number 2:
Setting realistic goals for weight loss is important, because otherwise patients will become frustrated and lose less weight.

Although this is a reasonable hypothesis, empirical data indicate no consistent negative association between ambitious goals and program completion or weight loss.8 Indeed, several studies have shown that more ambitious goals are sometimes associated with better weight-loss outcomes (see the Supplementary Appendix).8 Furthermore, two studies showed that interventions designed to improve weight-loss outcomes by altering unrealistic goals resulted in more realistic weight-loss expectations but did not improve outcomes.

Rate of Weight Loss

Myth number 3:
Large, rapid weight loss is associated with poorer long-term weight-loss outcomes, as compared with slow, gradual weight loss.

Within weight-loss trials, more rapid and greater initial weight loss has been associated with lower body weight at the end of long-term follow-up. 9,10 A meta-analysis of randomized, controlled trials that compared rapid weight loss (achieved with very-low-energy diets) with slower weight loss (achieved with low-energy diets — i.e., 800 to 1200 kcal per day) at the end of short-term follow-up (<1 yr) and long-term follow-up (≥1 year) showed that, despite the association of very-low-energy diets with significantly greater weight loss at the end of short-term follow-up (16.1% of body weight lost, vs. 9.7% with low-energy diets), there was no significant difference between the very-low-energy diets and low-energy diets with respect to weight loss at the end of long-term follow-up.10 Although it is not clear why some obese persons have a greater initial weight loss than others do, a recommendation to lose weight more slowly might interfere with the ultimate success of weight-loss efforts.

Diet Readiness

Myth number 4:
It is important to assess the stage of change or diet readiness in order to help patients who request weight-loss treatment.

Readiness does not predict the magnitude of weight loss or treatment adherence among persons who sign up for behavioral programs or who undergo obesity surgery.11 Five trials (involving 3910 participants; median study period, 9 months) specifically evaluated stages of change (not exclusively readiness) and showed an average weight loss of less than 1 kg and no conclusive evidence of sustained weight loss (see the Supplementary Appendix). The explanation may be simple — people voluntarily choosing to enter weight-loss programs are, by definition, at least minimally ready to engage in the behaviors required to lose weight.

Importance of Physical Education

Myth number 5:
Physical-education classes, in their current form, play an important role in reducing or preventing childhood obesity.

Physical education, as typically provided, has not been shown to reduce or prevent obesity. Findings in three studies that focused on expanded time in physical education12 indicated that even though there was an increase in the number of days children attended physical-education classes, the effects on body-mass index (BMI) were inconsistent across sexes and age groups. Two meta-analyses showed that even specialized school-based programs that promoted physical activity were ineffective in reducing BMI or the incidence or prevalence of obesity. 13 There is almost certainly a level of physical activity (a specific combination of frequency, intensity, and duration) that would be effective in reducing or preventing obesity. Whether that level is plausibly achievable in conventional school settings is unknown, although the dose–response relationship between physical activity and weight warrants investigation in clinical trials.

Breast-Feeding and Obesity

Myth number 6:
Breast-feeding is protective against obesity.

A World Health Organization (WHO) report states that persons who were breast-fed as infants are less likely to be obese later in life and that the association is “not likely to be due to publication bias or confounding.”14 Yet the WHO, using Egger's test and funnel plots, found clear evidence of publication bias in the published literature it synthesized.15 Moreover, studies with better control for confounding (e.g., studies including within-family sibling analyses) and a randomized, controlled trial involving more than 13,000 children who were followed for more than 6 years16 provided no compelling evidence of an effect of breast-feeding on obesity. On the basis of these findings, one long-term proponent of breast-feeding for the prevention of obesity wrote that breast-feeding status “no longer appears to be a major determinant” of obesity risk17; however, he speculated that breast-feeding may yet be shown to be modestly protective, current evidence to the contrary. Although existing data indicate that breast-feeding does not have important antiobesity effects in children, it has other important potential benefits for the infant and mother and should therefore be encouraged.

Sexual Activity and Energy Expenditure

Myth number 7:
A bout of sexual activity burns 100 to 300 kcal for each participant.

The energy expenditure of sexual intercourse can be estimated by taking the product of activity intensity in metabolic equivalents (METs),18 the body weight in kilograms, and time spent. For example, a man weighing 154 lb (70 kg) would, at 3 METs, expend approximately 3.5 kcal per minute (210 kcal per hour) during a stimulation and orgasm session. This level of expenditure is similar to that achieved by walking at a moderate pace (approximately 2.5 miles [4 km] per hour). Given that the average bout of sexual activity lasts about 6 minutes,19 a man in his early-to-mid-30s might expend approximately 21 kcal during sexual intercourse. Of course, he would have spent roughly one third that amount of energy just watching television, so the incremental benefit of one bout of sexual activity with respect to energy expended is plausibly on the order of 14 kcal.
They sum: "There is almost certainly a level of physical activity (a specific combination of frequency, intensity, and duration) that would be effective in reducing or preventing obesity."

Despite all evidence to the contrary.

Is there any bit of medical advice on exercise and obesity that's not covered above? LOL.

Monday, October 7, 2013

Interviews With Daniel Lieberman And Reviews Of His "The Story Of The Human Body"

Newest first:

Minds and Brains: Book Review: Daniel Lieberman’s The Story of the Human Body.

Lieberman argues that all of these diseases are in some sense a result of cultural evolution speeding ahead of natural evolution with the result that have humans manufactured a psychologically comfy and satisfying environment that is paradoxically unhealthy without fundamentally affecting our reproductive fitness. Lieberman calls this this paradoxical unhealthiness “dysevolution”.

The Colbert Show: Daniel Lieberman. Interview starts at about minute 14.

PaleoRunner: "The Story of the Human Body: Daniel Lieberman" (embedded below):

Food Navigator (this site is so annoying that I caution against clicking on the link, but include for completeness): "Type 2 diabetes a ‘mismatch disease’ for our Paleolithic bodies"

The Guardian: "The Story of the Human Body: Evolution, Health and Disease by Daniel Lieberman – Review"

National Public Radio: "How Our Stone Age Bodies Struggle To Stay Healthy In Modern Times"

Mail Tribune: "The Human Body Wasn't Built For Modern Life"

Boston Globe: "‘Human Body’ author talks ‘mismatch diseases’"

Everyday eBook: "The Story of the Human Body: Straight Answers to Big Questions"

Outside Online: "The Human Body has a Story to Tell"

Far North Endurance: "A review of The Story of the Human Body, by Daniel Lieberman"

Harvard Magazine: "Harvard professor Daniel Lieberman discusses health and human evolution"

Is Science Broken? Part 8: "Science’s Sokal moment"

An interesting experiment:

"John Bohannon, a biologist at Harvard with a side gig as a science journalist, wrote his own Sokalesque paper describing how a chemical extracted from lichen apparently slowed the growth of cancer cells. He then submitted the study, under a made-up name from a fictitious academic institution, to 304 peer-reviewed journals around the world."

But it doesn't really demonstrate that something is wrong with institutional Science, per se; unlike the other examples in this series.

"The publications Dr Bohannon selected for his sting operation were all open-access journals. These make papers available free, and cover their costs by charging authors a fee (typically $1,000-2,000). Policymakers have been keen on such periodicals of late. Since taxpayers already sponsor most academic research, the thinking goes, providing free access to its fruits does not seem unreasonable. But critics of the open-access model have long warned that making authors rather than readers their client risks skewing publishers’ incentives towards tolerating shoddy science."

Bohannan demonstrates that most of the "open-access" journals shouldn't exist, and that the policymakers, as usual, are doing more harm than good. I agree that science paid for by the public should be freely available to the public, but too many of these open-access journals seem to be simply viewing this as a gold-rush-style business opportunity; quality be damned.

Friday, September 27, 2013

"Seven Things I Wish I Knew When I Started Running"

Nice list, especially this part:
"Run in Less Shoe

"I used to wear bulky ASICS Kayano running shoes (I wonder why my achilles always hurt?) and never wore flats during workouts. Things have changed and the evidence is piling up that wearing a little bit less shoe and being strategic with barefoot running can really help your overall training.

"Just one session of barefoot strides per week and a good pair of minimalist running shoes can dramatically help you reduce your injury risk. You’ll strengthen your lower legs and feet and become a more efficient runner. It’s easier to run with better form in less shoe—and much easier barefoot.

"Ease into your new minimalist shoes. They can help you a lot—but only if you’re smart and gradually introduce them to your training program.

"...Jason Fitzgerald is a 2:39 marathoner..."

Thursday, September 19, 2013

The Ketogenic Diet In A Top Endurance Athlete

N=1. This is from Mike Morton's website. Read the whole thing, but I've excerpted the interesting (to me) bit below. (If you read this, Sgt. Morton, please add an RSS feed!):
"...Something that I have been getting questions on is the ketogenic diet. The questions are from one end of the spectrum to the other. Some general health to performance issues while in ketosis. I’m convinced that the diet is perfect for my athletic aspirations. Recovery is improved and I feel a level energy curve. I don’t ever “bonk” during races or training and my mental clarity is better. During Western States I consumed maybe 1200 calories through Coke, a couple gels, hard candy and food at aid stations. During races I don’t worry about consuming carbs; it is part of the “strategic carb use” of the diet. Peter Defty who helped me out with switching is the master mind behind what I’m doing. He has a lot of good info on his VESPA website. I use VESPA and I feel it is a big help, I take a concentrate every two hours during a race. Peter is very sincere about the diet from a health stand point but he sees great potential in endurance sports for a ketogenic diet.

"Another common question revolves around cholesterol and the effects of eating “all that fat”. I’m not a scientific guy so I trusted Peter and his accomplices when they told me if I was strict with eating low carb my cholesterol would go down. After years of eating a high carb, whole grain “healthy” diet I was scared to eat meat and cheese again! After nine months of eating bacon and eggs for breakfast, hard salami and cheese for lunch and a rib eye or porter house for dinner the blood tests are in!

"When I went in to finish my physical and go over my labs the first thing out of the doc’s mouth was “I’ve don’t see results like this often.” Part of her reaction was because of the heart rate being at 40 BPM but the cholesterol was not typical for a 41 year old soldier.

  • My good cholesterol (HDL) went from 43 to 89 MG/DL. The “normal” range is 35-55.
  • My bad cholesterol (triglyceride) went from 77 to 51 MG/DL. The “normal” range is 0-150.

"My cholesterol count was down from 184 to 174 MG/DL. Less than 200 is desirable.

"Another interesting experience I had was using getting a body scan to determine body fat and lean muscle mass of the body.

"I had a dexa scan a couple of weeks after winning the World 24 Hour Championship in Poland last year. This was after a nine month training block averaging about 140 miles per week on a high carb low fat diet. The results were:

  • 14.2% of my tissue was fat
  • Total mass was 126.9 pounds
  • 103.49 pounds of lean mass
  • 17.14 pounds of fat
  • 6.26 pounds of bone mass

"(Keep in mind this is measuring ALL the fat in the body to include organs and the Brain) [Moved this from above to make the list more readable -Tuck] At the end of March after three months of eating a ketogenic diet I repeated the scan. This scan took place after five weeks of ZERO running due to a torn tendon. I didn’t do any cross training either. I took advantage of the time and built a dog kennel/future chicken coup/ future horse stall. The results of the scan were:

  • 11.3% of my tissue was fat
  • Total mass was 124.4 pounds
  • 104.98 pounds of lean mass
  • 13.61 pounds of fat
  • 6.26 pounds of bone mass

"After five weeks of ZERO exercise I lost almost 3% of total fat mass and GAINED lean muscle mass. The human performance staff was amazed at this. 3% body fat loss in someone less than 130 pounds is a really big number.

"The Bottom line is the diet works for me in training, life and racing and so far the “side effects” are all positive…other than not being able to eat a jar of nutella. Again I feel compelled to state I know that no one diet works for everyone. I just want to share my experience with a ketogenic diet."
A few thoughts:
  1. We can put the notion that a ketogenic diet causes the body to cannibalize muscle to bed. There's no evidence for it, but, like a zombie, it keeps coming back.
  2. HDL going up and Triglycerides going down is what happens when you switch from a high-carb/low-fat diet to a low-carb/high-fat diet. This also happens to mean that one of the primary cardiovascular disease risk factors improves. That's a nice bonus, and one which I covered in this post. (As an aside, Morton says "My bad cholesterol (triglyceride)..." LDL, not triglycerides, are what is known as "bad cholesterol". He doesn't mention his LDL levels, but they must be low.)
  3. "Less than 200 is desirable." This is only correct from the perspective of the companies selling statin drugs. In epidemiologic terms, total cholesterol lower then 200 is where the risk profile starts rising again. If I had Morton's cholesterol numbers (especially the low LDL), and had spent as much time as he has in primitive conditions, I'd be worried about parasites being the cause of my low cholesterol numbers.
As a reminder, Morton's the current Masters' record-holder at the Western States 100-mile foot race.

I think we can safely say the ketogenic diet is, at worst, a reasonable option for an endurance athlete looking for top performance.

(Morton's post via Prof. Noakes on Twitter.)

Wednesday, September 18, 2013

Pacific Crest Trail FKT In Altra Lone Peak Shoes

Bravo to Heather Anderson for setting an unsupported record time [P.S. FKT is Fastest Known Time, an informal record.]:
"This summer, the 32-year-old, whose trail name is ‘Anish’ as a tribute to her Anishinaabeg heritage, set a truly obscene long-distance hiking record. She hiked the 2,663-mile Pacific Crest Trail (PCT) between the United States’s borders with Mexico and Canada and through Arizona, California, Oregon, and Washington. She did so in traditional thru-hiker style, meaning she carried all of her gear in a backpack, resupplied her food via personally sent mail drops at post offices and purchases from grocery stores on and near the trail, and received no planned assistance.

"Somehow, Heather managed to squeeze all of that into 60 days, 17 hours, 12 minutes. On the day she finished, her time was the fastest-ever for the PCT. Faster than all self-supported thru-hikers before her. Faster than the supported/crewed hikers, too. Faster than any woman. Faster than every man.

"Her record now has a qualification. The day after Heather finished, Josh Garrett finished his own PCT thru-hike in 59 days, 8 hours, 14 minutes. That’s 33 hours or so faster than Heather. But his hike was supported, meaning he had crew stationed occasionally along the trail for resupplying his food and other needs, and meaning he didn’t have to leave the trail to do so himself.

"Heather traveled an average of just under 44 miles per day...."
Emphasis mine. Read the whole thing. Pretty incredible.

Heather did this hike in a pair of "minimalist" shoes, although the Lone Peaks are one of the beefier "minimalist" shoes out there: they're designed for running ultra-marathons in really rocky areas.

Heather's blog includes a gear review post, which I'm guessing will now be quite popular. Her review of the Lone Peak is:
Altra Lone Peak
Grade: A-

Old and New
"I have been running ultras in these shoes for about a year. I love the roomy toe box and the neutral “Zero Drop” sole. These are a more minimal shoe however, and I noticed that on this hike my feet took a serious beating. A shoe with more cushion would have made them much happier, especially in the first 1,000 miles."

Pros: Roomy allowing plenty of space for swollen feet to expand
Neutral sole allowing a more natural, nimble foot movement

Cons: Not much cushioning
From another post:
"Once again, my Altra's took the terrain in stride. I've now run rooty, sloppy PNW trail; flat, loose, sandy desert; and now hard packed snowy trail. I have yet to be disappointed in them!"
The Barefoot Sisters, who I discussed in this post, were able to do about 35 miles per day on the Appalachian Trail in the eastern United States, and commented that they were unable to do much more because of fatigue in their feet. They also, however, hiked with packs that weighed up to 70 pounds, whereas Heather went so ultra-light that she didn't bring a stove.

There are a number of big variables here that I'm unable to quantify: I've not hiked the PCT myself, so I can't judge the relative difference in difficulty; it's hard to judge the difference the weight carried made, although it had to have been significant; and we can't underestimate the fact that Heather was alone, and had a lot of ultra-running experience. (The Barefoot Sisters had never done an over-night hike prior to hiking 2,100 miles on the AT. Heather is an incredibly experienced long-distance hiker and runner.)

For all those reasons, I think it's tough to attribute the 9 miles/day (25%) improvement over the Barefoot Sisters' daily hikes solely to shoes. But one can clearly understand that shoes weren't invented all over the world just for fashion. Correctly designed, they can provide a real boost to performance. But don't forget: the Barefoot Sisters hiked nearly 4,200 miles in their bare feet, with virtually no foot problems. In fact, their bare feet seem to have acclimated faster than Heather's shod feet did.

Altra has done a great job of creating well-designed footwear that add to your feet's capabilities. They deserve congratulations as well.

Friday, September 13, 2013

Science-Based Medicine on Gluten Sensitivity

Here we go.  A good article, overall.  Scott Gavura is one of the better contributors* to this group blog, but even he indulges in a bit of head-in-the-sand, blame-the-patient foolishness so typical of the medical profession:

"The current fad food “allergy” is gluten, a self-diagnosed condition in which gluten is believed to be some sort of dietary toxin – which must be distinguished from (1) the person with the documented anaphylactic wheat allergy and (2) those with celiac disease, an auto-immune response to gluten that requires absolute avoidance (but does not cause anaphylaxis if ingested)."
Well, there’s a third possibility, non-celiac gluten sensitivity, which has only recently been demonstrated to be a real condition.
Non-celiac Wheat Sensitivity Diagnosed by Double-Blind Placebo-Controlled Challenge: Exploring a New Clinical Entity.”

Gluten Causes Gastrointestinal Symptoms in Subjects Without Celiac Disease: A Double-Blind Randomized Placebo-Controlled Trial.

A Controlled Trial of Gluten-Free Diet in Patients With Irritable Bowel Syndrome-Diarrhea: Effects on Bowel Frequency and Intestinal Function.

Spectrum of Gluten-Related Disorders: Consensus on New Nomenclature and Classification.
Gluten clearly meets the definition of a “toxin” ("Toxins can be small molecules, peptides, or proteins that are capable of causing disease on contact with or absorption by body tissues interacting with biological macromolecules such as enzymes or cellular receptors.") in people who have one of the gluten-related disorders. Gluten is a protein that causes not one disease, but several.

The blog Science-Based Medicine exists, in practice, to defend the medical establishment against Complementary and Alternative Medicine.

They're relentless in this attack, and many times it's merited. However, the CAM community is often much more open-minded than the establishment medical community, and the topic of non-celiac gluten sensitivity has been one of those cases. After years of pooh-poohing claims by patients that they had such a problem, lo and behold the medical community has discovered that in some cases they're right. Meanwhile the CAM community has been correctly counseling people who have a gluten sensitivity that they should be avoiding wheat. They've been correct. Credit where it's due.

Mr. Gavura, sadly, does not seem to be familiar with this fact, and that lack of knowledge severely undercuts the thrust of this post. And I'll say again, it's a good post as far as it goes, and contains some terrific information (I did not know, for instance, that benedryl is useless in case of an anaphylactic reaction. And his list of bogus tests looks valid to me.)

I posted the list of links above as a comment, I'll be interested to see if he incorporates this research into his post.

* A great tip I got from the article linked to above (written by Gavura) was to get retested for my penicillin “allergy”. I’d had a reaction to it once, and was thus diagnosed. Sure enough, I did a challenge at my allergist’s office: no reaction. I’m “officially” not allergic to penicillin. Thanks.

Friday, September 6, 2013

Is Science Broken? Part 6: Most Medical "Advances" Are A Waste Of Time And Money

From Dr. Eades on Twitter:
"After 65 yrs of [Random Controlled Trial]s, ineffective, harmful, expensive med practices are being introduced more freq now than ever."
He links to "How Many Contemporary Medical Practices Are Worse Than Doing Nothing or Doing Less?" [PDF] which opens:
"How many contemporary medical practices are not any better than or are worse than doing nothing or doing something else that is simpler or less expensive? This is an important question, given the negative repercussions for patients and the health care system of continuing to endorse futile, inefficient, expensive, or harmful interventions, tests, or management strategies. In this issue of Mayo Clinic Proceedings, Prasad et al describe the frequency and spectrum of medical reversals determined from a review of all the articles published over a decade (2001-2010) in New England Journal of Medicine (NEJM). Their work extends a previous effort that had focused on data from a single year and had suggested that almost half of the established medical practices that are tested are found to be no better than a less expensive, simpler, or easier therapy or approach. The results from the current larger sample of articles are consistent with the earlier estimates: 27% of the original articles relevant to medical practices published in NEJM over this decade pertained to testing established practices. Among them, reversal and reaffirmation studies were approximately equally common (40.2% vs 38%). About two-thirds of the medical reversals were recommended on the basis of randomized trials. Even though no effort was made to evaluate systematically all evidence on the same topic (eg, meta-analyses including all studies published before and after the specific NEJM articles), the proportion of medical reversals seems alarmingly high. At aminimum, it poses major questions about the validity and clinical utility of a sizeable portion of everyday medical care....

"...Despite better laboratory science, fascinating technology, and theoretically mature designs after 65 years of randomized trials, ineffective, harmful, expensive medical practices are being introduced more frequently now than at any other time in the history of medicine. Under the current mode of evidence collection, most of these new practices may never be challenged."
Emphasis mine. Read the whole thing.

Doctors are notoriously prone to jumping on the latest treatment bandwagon without waiting for valid scientific confirmation of treatment, and without following up to see if the treatment is found to be ineffective, or fraudulent.

Of course patients assume that they do. The logical course to take, therefore, since new treatments are untrustworthy, is not to take any. Take treatments that have been around for a few generations, ideally, since the effectiveness and the side-effects should be well-known, and you can double-check what your doctor is telling you to confirm that he knows what he's talking about.

If it's a life-or-death situation and a you want to take a flyer on a new treatment, fine; but be aware that that's what you're doing. For most medicines and most situations, that's not the correct approach.

(See my series Is Science Broken? and You Are The Long-Term Test for more, if you have the stomach.)

Thursday, September 5, 2013

Is Science Broken? Part 4: Studies Often Aren't Reproducable

“Towards Better Papers, With Real Results in Them.”

What a radical notion.

“This has to be a good thing. From the latest issue of Nature comes news of an initiative to generate more reproducible papers:

“From next month, Nature and the Nature research journals will introduce editorial measures to address the problem by improving the consistency and quality of reporting in life-sciences articles. To ease the interpretation and improve the reliability of published results we will more systematically ensure that key methodological details are reported, and we will give more space to methods sections. We will examine statistics more closely and encourage authors to be transparent, for example by including their raw data. . .

“…I hope that Science, the Cell journals at Elsevier, and other other leading outlets for such results will follow through with something similar….”

Indeed.  Science has slipped pretty badly, as the need for an initiative like this demonstrates.  Reproducibility, not “statistical significance”, is the sine qua non of Science, after all. 

At least some are trying to fix the problem.

Thursday, August 29, 2013

What Does Sugary Water Do To Your Body? Thoughts On Racing With A Water Balloon.

I listened to this podcast interview with David “Wolverine” Smith the other day:

David "Wolverine" Smith – Survivor

It’s a remarkable, if completely infuriating, story about medical malpractice and human resilience.  In short, through a series of gross medical mishaps after a minor procedure, he wound up having his large and small intestines removed, and then replaced with a transplanted large and small intestine.

I discovered Wolverine’s site about 18 months ago, posted a comment, and engaged in a email dialog with him which was most interesting.

He eats basically a paleo diet:

“I eat mostly meat from grass fed animals (I own a small farm and raise my own cattle for meat).  I knew that I would have to eat very nutritionally dense foods, because the transplanted organ does not work at 100%.  I have to avoid sugary beverages, especially any containing caffeine, because they cause me to dehydrate.  I only have a total of about 22 inches of colon, so I can dehydrate easily.  I am the only member of the transplant patients from 2010 who does not require to have a port for hydration fluid infusions.  Because I only drink water (and [raw] milk).  I add a small amount of Himalayan sea salt to my water to add in minerals and electrolytes that I lose due to having a short colon.”

This was the part of the interview that I found particularly fascinating, as they apply directly to training.  I’d not read Dr. Tim Noakes’ Waterlogged when I first encountered Wolverine, and so really didn’t put two and two together.

One of the things I’ve noticed since going Paleo three-and-a-half years ago (post to come!) is that my hydration requirements are much lower than they used to be, and follow a particular pattern.  I used to get thirsty regularly, and pee regularly.  I’ve since learned that this is a symptom of diabetes, and since my doctor had informed me that I was pre-diabetic, I was happy to see it go.  But I didn’t understand why it happened.

The new pattern is that I drink some fluids, and then need to urinate within a short period of time.  Then nothing, until I drink more fluids.  It’s as if my body’s water sensor senses incoming fluids and feels free to release fluids.  It works quite well, and means that unscheduled potty breaks (or waking up at night) no longer occur.  

Wolverine, in the interview above, describes his experiences with dehydration, which are an elaboration of the quote above.

After having his intestines removed, but prior to his intestinal transplant, he had a short length of small intestine descending from his stomach which was routed out to a bag outside his body.  There was no connection to his colon. In the normal course of business, your colon absorbs most, if not all, of the water you consume.  In Wolverine’s case, since the colon was no longer having water routed through it, he needed IV hydration. 

What he discovered was that if he drank sugary water, his body reacted to it by flooding his stomach with water.  This flowed into what little bit of small intestine he had, and thence into the ostomy bag.  (The cause of his dehydration was revealed to him by a pharmacist, as the doctors, unsurprisingly, were clueless about how the body worked.)

Wolverine had already learned about toxicity of sugar to the body the hard way: he was being fed by having sugar and soybean oil pumped directly into his veins, and his veins would break down from sugar poisoning.  It seems that the stomach has a self-defense mechanism: flood the stomach with water to dilute the sugar.

Unfortunately in Wolverine’s case, this was a problem, since his body couldn’t reabsorb the water.  It turned out to really be a problem when he drank some sweetened ice tea.  His body reacted by dumping nearly three gallons of water into his stomach, and then into his ostomy bag.  Which required a great deal of IV replenishment, and put his life in jeopardy.  The combination of caffeine and sugar is a dangerous one, apparently.

In a person with a normal intestinal system, all of this water would be gradually absorbed back into the body, of course.  But in the meanwhile it sits in the intestines, doing nothing but protecting your body from sugar poisoning.

Two lights went on over my head on hearing this.  The first is that this explains diabetics’ frequent thirst and urination: they’re thirsty because diabetics consume a lot of sugar, which requires their bodies to dump water into their guts.  They need to replenish this water in their systems, and perhaps drinking the water helps in diluting the sugar in their guts.  Secondly, they’re peeing a lot because as their body reabsorbs all this water, they have too much in their blood, and the body starts dumping it the only way it can.  It’s a vicious cycle.

The second light was that if you’re running a race or training, the last thing in the world you want to do is cause your body to need to dump a lot of water into your gut, when it would be better off by maintaining a normal hydration balance.  The water in your gut does nothing to help you to keep cool through sweating, and only makes you more thirsty.  And what do runners love to drink?  Sugary water like Gatorade.  Back to the vicious cycle.  So the runner weighs more, needs to carry more water, and is going to wind up with a lot of water getting reabsorbed back into the blood stream, necessitating urination.  Moreover, having this load of water getting reabsorbed by your colon means that you’re at increased risk of hyponatremia (water poisoning), which is the topic of Waterlogged.

(I’ve often observed that runners in endurance races seem to be trying to induce diabetes.  This may be more true than I thought.)

Now as Noakes points out in his book, you’re at no risk of dehydration in a short race.  There’s no need, normally, for your body to drink.  And unless you’re a sugar-burner, there’s no requirement for sugar.  (If you are a sugar-burner, you can train your body not to be, and be healthier and faster for it.)  And, as Noakes also points out, losing water weight is a big advantage in a running race: if you want to find the most dehydrated runner in a race; the runner who’s lost the most weight, look to the top of the winner’s podium.  It certainly does you no good sloshing around in your gut; it’s dead weight.

Since reading Noakes’ book and going low-carb (not in that order); I’ve discovered that I can go hours and hours in warm temperatures with no water.  I’ve lost 8-10 pounds with no ill effects.  And I’ve gotten faster.

There’s an argument that really elite athletes may need some sugar for maximum performance, but non-elite athletes over-consume water and sugar.  To the detriment of their performance, I think.

The other comment Wolverine made above was about adding a smidge of salt to his water.  When you drink water, your body tries to normalize the salt content (blood is as salty as sea water).  I think this is a lot less important, as Noakes wrote, your body is normally pretty good at managing sodium balance, but it might explain why these athletes dumping sugar into their guts are craving salt; their bodies are trying to bring the salt content of the water they’re consuming up to normal.

I did a long run recently, and ate a couple of beef snack sticks in the middle of it, but no carbohydrates.  They were a lot saltier than I was expecting, and I think the salt was a big mistake: I immediately became madly thirsty, and started cramping at once.  Cramping in your feet for 10 miles ain’t fun.  I’ll not repeat that mistake…  But that said, I’ve never craved salt on a run.  Usually I’m dumping salt in sweat, which, as Noakes notes, is a normal state for an over-salted person. (This was a fine example of why you try experiments like those beef sticks on a training run.)

Do read Wolverine’s story on his site, and listen to the podcast above.  His story is incredibly informative, even if it does leave you shaking with anger, as it did me.  And Noakes’ book, as you may have gathered from my many references to it, is a fascinating read.

Thursday, August 15, 2013

You Are The Long-Term Test (Part 6): "Scientists Say Sugar At Levels Considered Safe Is Harmful"

No kidding:
"When mice were fed a diet that was 25% added sugars – an amount consumed by many humans – the females died at twice the normal rate and the males were less likely to reproduce and hold territory, scientists said in a study published Tuesday.

The study shows "that added sugar consumed at concentrations currently considered safe exerts dramatic impacts on mammalian health," the researchers said in the study, published in the journal Nature Communications. "Many researchers have already made calls for reevaluation of these safe levels of consumption."...
I've been avoiding sugar for decades. Anything that makes body parts rot away (teeth) can't be good for you. That should go under "Duh". For comic relief, we have the The Corn Refiners Assn., which:
"...questioned the use of mice in the study, saying in a statement that the only way to know the effect in people would be to test people. "Mice do not eat sugar as a part of their normal diet, so the authors are measuring a contrived overload effect that might not be present had the rodents adapted to sugar intake over time," the group said.
People don't eat sugar as part of their normal diet, either. And peoples' teeth don't rot out on their normal diet. But I imagine that the members of the Corn Refiners Assn. will volunteer for a follow-up test. We'll put 50% on the paleo diet, and 50% can eat the high-sugar diet. For a couple of generations. I know where my money is.
"The diet did not affect weight."
At least there's that... Unfortunately, there's also this:
“The mice tell us the level of health degradation is almost identical” from added-sugar and from cousin-level inbreeding.

"The study says the need for a sensitive toxicity test exists not only for components of our diet, but “is particularly strong for both pharmaceutical science, where 73 percent of drugs that pass preclinical trials fail due to safety concerns, and for toxicology, where shockingly few compounds receive critical or long-term toxicity testing.”...
From the press release announcing the study. Terrific.

“You have to ask why we didn’t discover them 20 years ago,” he adds. “The answer is that until now, we haven’t had a functional, broad and sensitive test to screen the potential toxic substances that are being released into the environment or in our drugs or our food supply.”
From Bill Lagakos on Twitter:

Friday, August 9, 2013

Barefoot Michael Sandler Injured

Just heard about this now:

'Barefoot Running' author Michael Sandler finds meaning in 2nd life-altering injury since 2006

"...Sandler had taken a swim in a natural pool beneath a waterfall, and because it was cold, he had put on leather-soled moccasins.

"All at once, while crossing a creek, Sandler slipped, flew up in the air and went down hard. He landed on a pyramid-shaped rock, causing his right femur to "explode" on impact, in the identical spot his left had shattered seven years earlier...."

"...Hours later, incredulous doctors at a hospital in Lake Tahoe called it a "one-in-infinity chance" of breaking both femurs in such an uncommon way.

"Sandler somehow left the hospital "balanced," according to doctors, with his leg length discrepancy gone and sporting "identical titanium hardware in both legs."..."
I don't know if they've got a fund to help them with the medical and evacuation bills...

Monday, July 8, 2013

Is Science Broken? Part 5: Retractions Of Fraudulent Work Are Near-Impossible


They have the guy on film tampering with lab samples at night, and that's not enough to get a retraction in Nature, supposedly the leading scientific journal. Nineteen years later, a letter retracting the original study gets published.

"The Nature paper has been cited 255 times, according to Thomson Scientific’s Web of Knowledge."
Careerism is the one universal scientific principle, apparently.

From one of the comments:
"You know what would make things like less a lot less painful? If you could simply publish negative results without all this ‘reluctance’ from journals to accept them. Honestly, if you were to take a survey of how many scientists out there have been unable to replicate experiments in high profile journals, and just ended up keeping that data in a file drawer and thinking to themselves ‘I’ve proven to myself that the findings of paper X are incorrect’, I bet it would be a disturbingly high number. We desperately need to change this!"
That would be bad for people's careers...

Wednesday, June 26, 2013

Evils of Peer Review

Interesting post:

“The most exciting period in science was, arguably, 1895-1945. It was marked by discoveries that changed the foundations of modern science: X-rays, quantum mechanics, superconductivity, relativity theory and nuclear energy. Then, compare this with the next 50 years in science. Incomparable. Nothing of that scale or impact. Yes, technology has advanced, but fundamental science – has come to a crawl. Have you ever wondered why? What changed as the 20th century grew older? Among other things, research budgets and the number of PhDs increased exponentially. This cannot be bad.

“Well, it can. All depends on the rules of the game. And they have changed. The change went largely unnoticed by the general public. In this article I will try to bring everyone up to speed. I will explain to non-scientists the “business model” of modern science. People may want to know. After all, scientists are burning public money, billions a year. And, I am quite sure, those who get my message will react with “you cannot be serious!” And leaders of organized crime will be pulling their hair out in despair: “why did not we think of this first?”…”

I think blaming all lack of progress in Science on peer review is a little extravagant.  Some fields, like physics, have essentially reached the limits of what we can learn with the technology available to us.  That doesn’t have anything to do with peer review.  In other fields, like human nutrition and climate science, I think the author’s spot-on.  As I recall, Steve Phinney mentioned that this problem was one of the reasons he moved out of academia and into industry in his book.

Monday, June 24, 2013

Master Sgt. Mike Morton: Ketogenic Ultrarunner

There’s been lots of speculation about how suitable a ketogenic diet really is for athletes.  Some folks (Robb Wolf) have gone back and forth, but my understanding of physiology leads me to think that it should be superior most of the time. 

Well, now we’ve got an interesting guinea pig:
  • “1994: Old Dominion 100 — 17 hours, 40 minutes — first place
  • “1995: Old Dominion 100 — 16 hours, 55 minutes — first place
  • “1995: Vermont 100 — 14 hours, 8 minutes — first place
  • “1996: Massanutten Mountain 100 — 20 hours, 21minutes — first place
  • “1997: Western States 100 — 15 hours, 40 minutes — first place [course record]”
That’s nice, of course, but what’s he done lately?

He won the famed Badwater 135 race, setting the course record last year.

Then he broke Scott Jurek’s record at the International Association of Ultrarunners Ninth Annual 24-Hour World and 18th European Championships, setting a new record for an American.

And now he’s done this:
“I have made some big changes in my fueling plan over the last five months. Prior to the changes, I was a high carb and low fat eater. I was consuming a large volume of food each day. Large volume in, means large volume out! At Badwater and the World 24 hour Championship, I spent too much time with natures [sic] business. Looking for efficiency, and a more stable energy curve, I researched several different options for fueling. Ultimately, I chose a high fat, moderate protein, low carb diet. This was a tough transition, since I rarely ate meat or fatty foods. I had been avoiding cheese and dairy for years... except for cottage cheese.
“I committed to myself and made the switch. After about four weeks of eating a high fat diet I was "keto adapted" meaning that my liver was making Ketones and the body was using them for fuel rather than glucose. Making that change was tough because I was addicted to sugar and grains! By being in Ketosis, I have made myself "bonk" proof  because I'm not using glucose for my primary fuel. Also, on race day, I can use carbs as a high octane fuel. I will list some reference material that explains the science behind a ketogenic diet. Since switching, I have ran two 100's and they went great; recovery is much easier on a high fat diet!”
He won the Rocky Racoon 100 race on a ketogenic diet, and soon he’ll be running Western States again:
iRunFar: According to your blog, you’ve been honing your diet in the recent year or so, and you now do a very low-carb regimen. What does this actually mean for WS100 fueling? What will you be eating and drinking during the race? 
Morton: The low-carb diet is working great for me. Really, the diet is more about eating high fat and being in ketosis. That does away with spikes in energy and reduces the volume of food that has to be physically eaten. Less in means less out and that equals efficiency during races. I will eat whatever looks appetizing during the race, including carbs. That is another benefit; I use carbs like a high-octane fuel during races. I’ll drink what is provided as well but avoid consuming huge amounts of sugar drinks to keep the stomach happy. My crew (wife Julie, daughter Bailey, and Eric and Noni) will have some of my favorite stuff so, when I’m feeling sorry for myself, I can cheer up looking forward to something.”
He’s racing against the current course record-holder Tim Olson, who also eats a low-carb paleo diet.
Obviously Morton has had most of his success on a high-carb, low-fat diet.  What’s interesting is if he’s able to continue his success with a high-fat, low carb diet.  He’s already noted that he recovers more quickly, we’ll see if he can set a few more records.

Interesting times.

Thanks to Sean.

P.S.  On the second-hottest Western States on record, Morton finished third, setting the Master's course record, Olson finished first, just failing to break his previous course record.