Along the way, we learn that the nutritional recommendation of the U.S. and many other governments: avoid dietary fat, is based on the results of a single study. The study had several problems including that it did not control for sugar consumption. Current evidence indicates that the negative health results are due to fructose consumption, not dietary fat.

Dr. Lustig emphasizes (starting at 1:12:53) that fruit is not equivalent to fructose: the natural fructose in fruit is packaged with fiber, which limits how much fructose you take in, plus gives you an essential nutrient. Fiber plays several essential roles in our metabolism, including increasing feelings of satiety. Note that fruit juice is not the same as fruit. Juice is essentially the same as pure fructose, and should be avoided, unless you’re trying to add body fat.

In this presentation, David Agus, oncologist and professor of medicine at the University of Southern California, describes a radically different strategy for dealing with cancer:

David Sinclair, Professor of Pathology at Harvard Medical School, is famous for his anti-aging research and his work with the “red wine molecule”, resveratrol. In this talk, he describes some technology in development which will treat many diseases at once:

Another very interesting area of research that takes a holistic approach to health, including the idea that disease emerges out of sub-optimal conditions within the complex system which is the human body, is the diet and nutritional findings of Loren Cordain, of the Department of Health and Exercise Science at Colorado State University. Dr. Cordain argues that since our bodies are almost wholly composed of molecules which we ingested, the conditions within our body are mostly created by our diets. The question of health is thus a question of optimal diet for the human body, and we can discover the optimal diet by examining the dietary conditions that existed during the millions of years in which we evolved.

Dr. Cordain and his research associates have published numerous papers and he has recorded several talks, which show that several common diseases likely have dietary causes. He argues that for millions of years humans evolved to eat meat, fish, fruit, and vegetables — but in the past 10,000 years, the common human staple has been grains, legumes, and dairy. It is disrupting bodily processes and causing disease and dysfunction.

This interview with Dr. Cordain on the radio show, Health Talk with Dr. Ronald Hoffman includes many key aspects of his developing theory of health:

This and other interviews with Dr. Cordain are available here.

Clinical trials for these and many other areas of health-related research are currently underway. As they come to completion in the near future, there should be a massive transformation in medicine. How fast will the medical establishment be able to adapt to the new information? Will doctors and patients who need solutions now wait for the official approval process? Interesting times!

Sam’s post muses on the possibility of expert systems (computer software with specialized databases) replacing doctors for the diagnosis of illness. I don’t think that doctors will become obsolete, because I don’t think that disease and injury will vanish, and someone needs to provide care for the sick in an informed and experienced way. However, I agree with Sam that IT can help, and that change is afoot.

The problem with the medical establishment right now, and the way that doctors work, is that the system is so completely focused on pathology. This is an unfortunate irony because if they were focused on preventative care instead, pathologies wouldn’t develop nearly as often in the first place, and we would all live longer and healthier lives.

Today doctor visits are designed to identify symptoms of illness, and to treat “primary complaints”. Diagnostic tests are done to check that your health is within normal parameters. As it turns out “normal” is the same as mediocre. If the goal were optimal health instead, surely fewer health problems would arise, and those that do could be spotted at an earlier stage, where treatment stands a much better chance of success.

Information technology (IT) could help health care in a number of ways. One way IT can help is by recording health and fitness data on an individual level, and making it easily and directly available, so people know exactly where they’re at and where they need to improve in order to reach optimal levels of health and fitness. By “available”, I mean available to the patient. I hate to use the word “patient” because it implies illness, but what I have in mind is a person who is not yet ill, and who wants to stay that way.

For an example of this idea applied to fitness data, see Wired’s articles on Nike and “personal metrics”, Living by the Numbers. The average person isn’t concerned enough with their fitness to get this geeky about it, and the sick-care system, with it’s focus on mediocrity, is in part to blame. As Ray Kurzweil and Terry Grossman ask in their new book Transcend, “when was the last time your doctor counted the number of push-ups and sit-ups that you can do?” Maybe they should.

The real power of fitness data would emerge when combined with clinical data such as cholesterol levels, blood glucose and blood pressure, homocysteine, C-reactive protein, etc., with dietary information including what drugs or supplements you take, and with illness and treatment histories. Family health history should be included, and eventually personal genomic data could also be added. All of this together could form an individuals health profile. The health profile could be anonymously fed into intelligent software that cross-references the data with everyone else’s health profiles to help spot problems and identify trends. This process is known as data mining. It’s value to health care and life sciences would be staggering.

Google and Microsoft have both begun projects that will move us in this direction. Google’s system is called Google Health, and Microsoft’s is HealthVault. (Given Microsoft’s history and culture, the choice for me is clear). The Personal Genome Project is explicitly about data mining, only it is focused entirely on personal genomic data. These efforts represent the beginnings of crowdsourcing for health care.

These technologies, if adopted by large enough numbers of motivated individuals, and taken up by a significant number of researchers and forward-thinking medical practitioners, could bring about the change that is needed to move health care out of it’s rut of pathology obsessiveness and into a era where health is optimized and disease is prevented.

However healthy we try to be, disease will always exist. Information technology can help with that, too. It can be used to reform the badly broken regulatory system, and by being a catalyst in bringing new treatments to medical practice.

A major problem with the medical establishment is that it adopts change at a glacial pace. It is decades behind in technology. For example, as noted in Transcend:

Consider ultrafast CT coronary artery calcium (CAC) scans of the heart. This technology has been available for over a decade and a half, and, even though multiple studies have shown that it is effective at detecting coronary artery disease very early in its course—at a time that effective preventative treatment can still be done—the American Heart Association still does not recommend its use for primary screening.

This sad situation is only going to get worse, since the pace of technology development continues to accelerate, and advances in medical research far outpace the regulatory approval process. The regulatory approval systems in place were conceived of and implemented in a much slower moving era, when major breakthroughs were seldom achieved. Now, science and technology breakthroughs are an almost daily occurrence.

Research is progressing so fast that individual scientific researchers in any given field are almost certainly not aware of all of the developments simultaneously taking place in his or her field. Thanks to amazing advances in communications technology, researchers are vastly more aware than they have been in the past, and many collaborate across the globe. However, the amount of new information is too verbose, diverse, and too fragmented across different systems and different languages that one person cannot keep track of it all. This problem is magnified by orders of magnitude when applied to the institutional level.

Information technology can help aggregate the fire-hose of research data and promote collaboration and communication between the research community and medical establishments. It could be used to streamline the regulatory process and promote more aggressive adoption of new technologies and therapies. The regulatory bodies could—and should—become more democratic, allowing more direct and open input from diverse sources including the research community, practicing doctors, and especially patients.

The hyper-intolerance to risk by the current regulatory bodies is completely out of touch with the reality that patients with real diseases are facing. I suspect that the litigation culture, born and nurtured in the United States, is largely at fault for this state of affairs. It is logically and ethically backwards: to have a fatal disease is itself a huge risk, and that risk should be balanced with the risk of experimental treatments. People suffering from fatal disease should be allowed the opportunity to possibly save themselves, and at the same time benefit science and medicine, whether the treatment works or not.

Encouraging all parties to participate in development and implementation of medical therapies would be to crowdsource medical research and practice. IT would be the medium through which the data would flow, the ideas exchanged, and results mined for further insight.

I enjoy that route in the evenings, because the trail runs east-west, providing spectacular scenery at dusk, when the skies turn purple, yellow, pink and sometimes even shades of green. Given the time that I was leaving for my run, I would have been treated to this during my return from the canyon, if it weren’t for one of my neighbours, her little dog, and an old dead tree.

I had just picked up speed, running down-hill on the trail from my house, when I spotted the little dog, connected to it’s owners by one of those ever-expanding retractable leashes.

This is a random photo of a dog from Google Images. It is not the actual dog that tripped me. I was too busy running and being stabbed to take photos.

There are a lot of wind storms here in the mountains, and as a result, fallen trees are very common. I don’t think twice about jumping over them while running, or bunny-hopping them on my mountain bike. So I was habitually unconcerned that there was a fallen tree crossing my path. It just so happened that at the exact moment my feet left the ground, as I hopped over the tree, the hyper little dog made a last-moment lunge for me. I cleared the dog, but not it’s leash, which snagged my foot, tripping me onto the downed tree. Which was covered in branches…

As the owner of the Heart Attack Grill explains the merits of lard-soaked buns and 4 ½-pound meat patties smothered in cheese and mayo in this interview, he remarks, “This is bad for you, and it’s going to kill you”. The dessert menu is composed of unfiltered cigarettes, and scantily clad girls in fantasy nurse costumes will push you to your car in a wheelchair.

I wonder if anyone has actually had a heart attack in the restaurant, half-way through a “triple bypass burger”…

The marketing angle here, and the fact that it is successful, is quite interesting. The tobacco industry could probably learn a thing or two from it. Let’s hope they don’t!

The Wikipedia article on resveratrol is filled with contradictions on its efficacy as a fountain-of-youth supplement. Some studies have it extending the life of some creatures by as much as 56%, while others showed no significant results at all. I had been convinced by Ray & Terry that it was a promising enough compound to add to my supplement regime. However, since some studies failed to show health benefits in mammals, and others showed that there is practically no evidence of efficacy in humans due to resveratrol’s lack of bioavailability, I grew skeptical and stopped buying it.

After researching this latest finding from Harvard, I was intrigued to discover that those in the know — namely, Dr. Sinclair and his team of Resveratrol researchers — personally supplement with the substance. The bioavailability problem can apparently be mitigated by microencapsulation, which protects resveratrol from oxidation and damage from heat and light, and allows it to by-pass the harsh digestive environment of the stomach so that it can be absorbed into the blood stream when it reaches the intestines. Including quercetin in the formulation also helps absorption.

There may be side-effects to supplementing with resveratrol, however. One of them may be ligament and tendon troubles:

It is possible that the anti-angiogenesis effect of resveratrol can cause ligament or tendon issues; those tissues are so poorly supplied with blood a reduction of angiogenesis could delay or prevent healing, and a series of micro-tears or other injuries would compound the situaton. Quercetin has a similar effect on agiogenesis.

That is from the sci.life-extension discussion group. If resveratrol slows exercise recovery time for tendons and ligaments, it is probably not a good thing for athletes to take. As a rock climber and distance runner, I’ve decided against it.

On another note, a recent study showed that, like resveratrol, endurance exercise can have similar SIRT1 effects! Note also that sweating is a natural iron chelator. The moral of this story is that intense exercise will do you much more good than resveratrol will, and will save you a lot of money too.

Here are some relevant links:

• http://en.wikipedia.org/wiki/Resveratrol
• http://www.fightaging.org/archives/001020.php
• http://science.slashdot.org/article.pl?sid=08/11/28/2315209
• http://www.sciencedaily.com/releases/2008/11/081126122203.htm
• http://scienceblogs.com/terrasig/2006…
• http://www.rayandterry.com/itemdesc.asp?ic=RESVER

Instead, athletes should do a short aerobic warm up, followed by dynamic stretching, which basically involves doing similar motions that will be involved in your actual work out. For running, do some squats and lunges, for example.

The embedded video on that page is worth watching. In it, manager of sports science for the U.S. Tennis Association Mark Kovacs says that the most important part of the warm up is — surprise — warming up, i.e. getting blood flowing to your muscles by doing a light jog, for example. After that, dynamic movement will further help your muscles warm up and get ready for action. It is also mentioned that static stretching is a good thing to do for cooling down. Damn, I too often skip that part.

An example of dynamic motion that makes for a good warm up is The Spiderman, which involves crawlng on hands & feet, bringing your foot up beside your hand while leaving the other way behind, sort of like a crouching lunge. Thankfully, Duke University’s Sports Medicine people have posted a helpful video on YouTube:

1. Lean forward, and don’t be afraid to stand up if you need to.
   Some experienced mountain bikers told me to remain seated on the uphills, at all time. I took this advice, but since then, I’ve found that in some circumstances, staying in a higher gear and standing up to pedal, while really leaning right over the handlebars to keep the front tire down, works better. Try not to wobble the bike back and forth when you do this. The trick is balancing your weight properly to give the back tire enough traction not to spin out (the higher gear helps with this), and not to let the front tire come off the ground.
2. Don’t rush.
   I used to find it amazing how I would be busting my lungs to get up long, steady hills, while more experienced riders didn’t seem to be working nearly as hard. They weren’t. For some reason, on hills, I felt the urge to pedal as fast as possible in the lowest gear. This is entirely inefficient: it causes the front tire to jump (too much torque on the rear tire), makes it more likely to spin-out the rear tire, and worst of all, makes you work way harder than you need to. Intentionally go slowly, pick the highest gear that you can “comfortably” pedal for that hill and your present physical state, and concentrate on a slow, steady cadence instead of how fast you’re moving. Relax and breathe easy.
3. Psychologically, use baby steps to get up those long, grueling hills.
   A huge hill can be intimidating, and that anxiety makes getting up it even more difficult. It’s best not to think about it. Pick a place on the ground a few metres in front of you and focus on getting to that spot. As you reach that spot, re-set your goal for another spot, further ahead. Climbing the hill in these increments makes it seem a lot easier.
4. Shift your weight forward on the seat.
   On most hills, you won’t be standing up, or at least not the whole time. When you’re in the saddle and pedaling uphill, move your weight forward so that you’re sitting as far ahead as possible on the front of the seat. Lean forward, moving your chest toward the handlebars. When you breathe, try to fill your chest with air, not your belly. Remember my second tip (don’t rush).
5. Steer around the bumps.
   If possible, go around those roots and rocks instead of over them. All you need is an inch of space for your tires; if there is room to go around a root, rock or trench — take it. Your front tire will be more likely to stay on the ground, and your back tire less likely to spin out.
6. Relax your upper body.
   Flexing the muscles in your chest, arms and shoulders uses a significant amount of energy, and your heart needs to pump blood into those muscles faster when you do. Reserve as much of your heart’s capacity for your legs as you can by keeping the rest of your body relaxed. Of course, you’ll need your arms to hang onto the handlebars, steer, and maybe pull yourself forward, but try to be aware of how much energy that you’re giving to your upper body. Your legs can use all of the O₂ that you can give them!

If you have any other tips, I’d love to hear them. Have a great summer!

1. Drink half your body weight in pounds, in ounces of water, per day. So if you weigh 180lbs (82kg), you should drink about 90oz (2.7L) of water per day. This does not include juice, soda, coffee or tea — just water. Water helps many bodily functions, and you will feel better if you drink enough of it.

2. Eliminate caffeine from your diet. Caffeine is a diuretic, causing you to dehydrate. It also causes the loss of essential calcium and potassium from your system.

3. Eliminate processed sugar from your diet. Consuming sugar causes your blood-glucose level to spike, which is inevitably followed by an energy-sapping low.

4. Eat plenty of natural, whole foods, such as meats, fruits and vegetables. These foods contain all the nutrients you need for lasting energy and stable blood-sugar.

5. Eat three meals per day, especially breakfast. I disagree that there is something magical about the number 3 — its probably better to have 5 small meals instead of 3 large ones — but I completely agree that a breakfast of high-quality food is especially important for energy throughout the day.

Number two, for me, is something to consider. I’ve been a coffee fiend for a long time, and failed to find much evidence of its negative effects. It is true that caffeine is a diuretic. If I over-dose on coffee in the morning and I’m training that day, I really notice it. I love coffee enough not to eliminate it from my diet, but I will definitely seek to moderate my caffeine intake. I may even switch to decaf…

Two more items that I would add to Nubella’s list are:

6. Exercise regularly. Old school: Low-intensity “base” training, where your heart rate is elevated to 60-70% of your max (not more) is a good place to start. Most people’s maximum heart rate is about 220 less their age. For example, an average 35 year old’s max is about 185, and so they would exercise with their heart rate between 111 and 129 beats per minute.

New school: short, intense exercise that science has shown gives all of the benefits of cardio, without the wear & tear that leads to injury, and in a small fraction of the time. Checkout a CrossFit gym near you, or start a “slow-burn” resistance training program such as the one described in Body by Science.

7. Get enough sleep! Duh! ;-) Sleep is very under-appreciated in modern society, but it is essential to our health and well-being. It is worth doing some research on, and taking steps in your life to ensure that you’re getting adequate amounts of it.

In my first race, my calves cramped in the final few kilometers, forcing me to slow down, continuing uncomfortably. A couple of people suggested that I was probably not well hydrated enough, prior to the race. So for the second race, I drank plenty of water in the days before, and in the morning before the race. I drank over a litre before the race started. I knew in the first 30 seconds of running that it was a mistake.

The course was 12km through a beautiful trail system at a place called Sibbald Flats. The weather was perfect for running: cool and moist, rain threatening at any moment. The sound of water sloshing around in my belly was mildly entertaining, but terribly uncomfortable. I felt like throwing up after about 10 minutes, and that feeling never left me. I managed to finish OK though, placing 8th in my category (out of 20), and 20th overall, out of 150.

For the 3rd race, I decided to get a jump on everyone and go out to the course for a practice run a few weeks before the race. The map provided by 5 Peaks sucked ass, but together with the map at Delta Lodge in K-country, I was able to discern the course. Although, I thought the website had said the course was 12-15km, but my GPS told me that it was only 11. It was easy running on wide road-like trails, nothing too steep, but the hills were super long. One section was about 2km of downhill, which just pounded my knees. So I thought the best preparation would be to work on power, so I trained on steep mountain trails, doing plenty of interval training.

The morning of the race, I didn’t over-hydrate, and arrived ready to run, with a strategy. A friend of mine who used to run a lot of cross-country races advised that its best to push hard at the beginning of the race, hold a good pace in the middle, then burn whatever you have left in the final bit. I knew that the beginning had about 1km of uphill followed by about 2km of down, and after that it was more or less flat for the rest of the race. So my strategy was to conserve energy up the big hill at the beginning, although keep a decent pace, and then burn really fast on the downhill, passing any ground that I lost.

That part worked like a charm, I was sprinting down the hill with huge bounding steps, and passed dozens of runners at twice their speed or more. At the bottom of the hill, the trail wound back to a fork in the trail, where I had taken a left during my practice run. To my surprise, the race course went right, instead. This worried me — suddenly I had no idea what was ahead, and I had just burned a substantial amount of energy. As it turned out, the course was indeed 15km, and there were plenty more big hills in the course. It was a major psychological struggle as I turned corner after corner to discover more and more climbs, and more and more distance. The sun was beating down, and it was around 30 °C. Normally for a 10-15k run, I would wear a hydration pack, but I thought it would be a quick 11k run at race pace. Ouch. In the end, I placed 8th in my category again, and 20th overall out of 150. Weird! I felt like death afterwards though, and it took days to recover.

My training between the 3rd and 4th race was sporadic and random. I did a few runs here and there, some short and fast, others long and easy, or long and grueling, and plenty of mountain biking. I did a few duathlon style runs, which I really enjoy. One of them was the most extreme run I’ve done, with about 10k of mountain biking, followed by around 20k of mountain trail running with around 1000m of elevation gain, followed again by another 10km of trail riding home. That was a week before the race, and I was worried that I wouldn’t have time to recover (my knees were aching from all the downhill). I did though, and even managed to do some speed work a couple of days before the race.

This morning I woke up a bit late — I stayed overnight at a friend’s place in Calgary — and rushed off to a late breakfast. I *hate* running before breakfast; it feels like I’m running in slow motion, on empty. So I ate a typical breakfast, hoping that two hours would be sufficient time to digest it before the race. It was and it wasn’t; when I was really pushing it, my guts were not happy at all. I could have used another hour to digest breakfast, but aside from some gross coffee-flavored burps and a pressing desire to visit a toilet, it wasn’t a huge problem.

My strategy this race, after some experimentation during training, was to pace myself for the first half so that I could really rip for the second half. In previous races, I found that the second half was always much, much slower, and I’d get passed by a dozen people. So I wore my heart-rate monitor, and tried to keep a pace that was as fast as possible while sustainable. There is a magic heart-rate, for me somewhere between 178 and 181 beats per minute, that is sustainable for a long time, probably hours. Above that, I’m running significantly faster, but I can only sustain it for 25 minutes or so before hitting a wall.

It was tough holding back for the first half of the race, watching people ahead of me that I knew I could pass if I just pushed it a bit harder. But then, after 5km or so, it was rewarding passing some of those people who had hit their wall, after passing me a few minutes earlier. It worked out well, but afterwards I felt that I could have pushed myself a lot harder than I did in the second half. I felt really good after the race, in contrast to the morbid pangs following the 3rd race. I even considered going mountain biking when I got home today, but opted for a hot bath and a movie instead. Strangely, I placed 8th in my category again, and 20th overall! This time there were 300 racers instead of 150, however, so I guess that it was relatively a better placing.

Hopefully I can break the mystical 8th-place barrier in the next race; placing in the top-5 would be great. The next one is in Canmore in September, and I’ve heard that its a gruesome course. I’m looking forward to it!

You can still improve your heart health by up to 90 percent by starting or increasing physical activity later in life, regardless of your age.

The article cites a study from German researcher Dr. Dietrich Rothenbacher. Thats good news for anyone who suffers from heart problems. Nubella has been on a role lately, as they also posted an article citing a different study on the benefits that exercise has on preventing dementia, Alzheimer’s disease, and general cognitive impairment. Notably:

Middle-aged people who were physically active at work and leisure more than twice a week enjoyed a 50-percent and 60-percent lower risk than sedentary people of developing dementia and Alzheimer’s respectively.

Nubella followed up with a few bits of advice, "10 Ways to Get Moving". It has some pointers for sedentary folks who would like to change their ways, but aren’t sure where to start.

All of these new studies on the benefits of exercise are interesting, in that the researchers have come up with numbers and facts to support the widely known common sense platitude, that exercise is a healthy thing to do. They’re finding out just how healthy it is. If one takes a moment to consider from where we came, how we evolved, it is no surprise that disease and illnesses often go hand in hand with lack of exercise. For millions of years, survival was a struggle. Movement was a prerequisite to staying alive. Had we evolved to sit around, our bodies would probably look more like plants. Potatoes, perhaps. However, thats not how we turned out — we are designed, via natural selection, to move, to use our muscles, to run, to sweat. To stop doing these things is to deny ourselves of that which makes us human, that which makes us alive.

The new recommendations include:

• * Do 30 minutes of physical activity each day.
• * Transfats should make up no more than 1% of total caloric intake.
• * Avoid exposure to tobacco products.
• * Cut back on sugary foods and drinks.

… among others.

The problem with the “30 minutes of activity” recommendation is that they add that the activity need not be all together. For example, 5 minutes of walking to the bus counts as part of that. This seems rather pathetically inadequate to me. It amounts to a recommendation against not moving all day, every day. Well duh. I admit that I don’t know how they came up with 30 minutes, but I doubt that the research that was used showed that any motion whatsoever, so long as together the amount of time in motion added up to 30 minutes, resulted in cardiovascular fitness.

If your aim is a strong heart, much better advice would be to exercise at least three times per week. By “exercise”, I mean an aerobic workout, where you significantly increase your heart rate and breathing for more than 20 continuous minutes. The heart rate should be sustained at 60 to 90% of the maximum (maximum is usually around 220 minus your age). And by “at least”, I mean it would be preferable to exercise five days per week, but you can get away with three days per week and still have cardiovascular fitness gains. (Assuming that three days per week isn’t less than your current activity level!)

I wonder how many people actually get less than 30 minutes of “physical activity” per day? It would seem that you’d never get out of bed. I suppose that if it only takes 2 minutes to get into the car, 2 minutes to get to a chair in the office and back, and 10 minutes of going back and forth to and from the toilet, one could get away with only 18 minutes of motion in a day. *Shudder* That is some serious abuse of the self.

I have no idea where the AHA came up with 1% of caloric intake as a safe upper limit on trans fats in the human diet. There have been conclusive studies showing that there is no safe upper limit for consuming trans fats.
Studies have shown that diets with even a small amount of trans fatty acids increases the level of LDL cholesterol (the bad kind) in the blood, while at the same time inhibit the heart’s ability to create HDL cholesterol (the good kind). It also increases the tendency for blood platelets to clot, and last but not least causes internal inflamation, increasing risk of stroke and heart attacks. Trans fats result in a four-pronged attack on the heart. These trans fats are the man-made type: oils that have been hydrogenated. They are poisonous to your health, and should be avoided at all costs short of starvation. This means that if you were stranded on a desert island with a huge supply of McDonald’s food, you should only eat it when you are on the verge of death by starvation trying to catch fish, have run out of seaweed and can’t swallow any more dirt. Its that bad.

AHA recommends that you avoid exposure to tobacco products. This means that if you smoke, stop, and regardless of whether you smoke, avoid second-hand smoke. This is sound advice, but I doubt that many smokers will get it. Smokers probably don’t care too much about their health in the first place, and are unlikely to be readers of health bulletins from Heart Associations. There is no lack of information about how bad cigarettes are for you, but I’d like to share this little tidbit, published in 1999, by Mike Stroud:

It is clearly so unnatural and likely to cause harm that it is hard to understand how smoking was ever accepted as a reasonable thing to do. Yet, while nobody believes the contorted arguments of the tobacco industry that try to dismiss the link between smoking and damage to the lungs in the form of bronchitis and cancer, many people do not realise that the danger from cigarette smoking does not stop there. By mechanisms not entirely clear, smoking markedly contributes to atherosclerosis in the coronary arteries, as well as the furring up of blood vessels elsewhere. Many smokers will therefore have heart attacks and strokes, and may even lose their limbs, well before their time. As a practicing hospital doctor, I can state without prejudice that I almost never see a patient under the age of 40 who has had a heart attack but who is not an avid proponent of the weed. For that matter, most of those I see in their 50s and 60s are also keenly addicted.

And last, but certainly not least, the AHA’s recommendation to “cut back on sugar”. Again, this is a major understatement. The sugar in the average North American diet is probably the number one contributor to the expanding obesity epidemic (excuse the pun), and certainly the type-2 diabetes epidemic. Fatty foods are likely a close second.

For millions of years, we evolved to digest naturally occurring sugars in fruits — processed sugar is only a recent luxury. Now we dump it down our gullets by the mouthfull, and it is added to most processed foods, exploiting our weakness for it. The empty calories do add up though, and the results can be devastating. I again draw on Mike Stroud’s work. This excerpt is a striking example of how a few extra calories can add up:

In 1995, newspapers in the United States reported the death of the fattest man in the world. He had come to weigh 465 kilogrammes, or around 1,000 pounds. On a visit to hospital he had to be transported by forklift truck, and after his death the wall of his bedroom had to be demolished in order to remove the body. Obviously he was an extreme example of the obesity problem, yet it would have required a weight gain of only 37 grammes per day to take him from a normal 70 killogrammes (155 pounds) at the age of sixteen up to the grotesque proportions of his death at just 45 years of age. This is the equivalent of eating an extra 250 calories per day — less than one small bar of chocolate.

I’m not suggesting that processed sugar needs to be entirely eliminated from the diet, and I’m sure that is what the American Heart Association has in mind when they choose conservative words such as “cut back”. However, it is clear that obesity, heart disease, diabetes and all of these related health problems which are reaching epidemic levels indicate that way too many people are gorging on sugars and fats, and do not exercise.

Extra calories gained by the odd sugar indulgence would be quickly burned off by active individuals — that is, people for whom exercise is part of their daily lifestyle. Of course there are always limits; if you take in more calories than you burn, you will inevitably gain body weight. Sugar and fat just happen to supply large amounts of calories, so if you’re going to consume them, you should also be spending a good deal of time doing hard physical work.

Note that this does not apply to trans fats! Consuming this man-made Frankenstein “food” will magically expand your waistline, regardless of the usual calorie physics. This disturbing fact was revealed in a six-year study using monkeys. The monkeys were fed minimal diets, with one group having 8% trans fats. That group somehow managed to add 30% more fat to their bellies than the other group. Waistline fat dramatically increases the risk of diabetes, and I have heard it said that the waistline is one of the best indicators of overall health. Eating something that by its very nature adds fat to this area is an unwise thing to do. Everyone should eliminate it from their diets, and join the effort to lobby for a ban on trans fats.

The race itself was a lot of fun. I got there an hour before the start time, and there were throngs of runners standing around stretching, there were sponsors setting up their tents, and merchandising their products. The Ski Patrol was there, loading their first-aid supplies onto mountain-bikes. Rock music bellowed from a sound system that was powered by a portable generator. The music, the sponsors and all of the anxious runners created an exciting atmosphere.

The registration line-up went fairly quickly, and I received my number sign, which I had to pin to my shirt. That really annoyed me — high performance, breathable sportswear isn’t cheap, and now my Arc’teryx base layer has 8 holes in it. The race didn’t start on schedule, which was also disappointing. It was quite windy out, and a bit chilly. I had been running around getting warmed up in preparation for a 10:00 start time, which was described on the schedule as, "10:00 sharp". We didn’t get started until about 10:20, and I had to go back to my vehicle, down the road, to get extra clothing to keep warm in the cool wind.

The 5km race started at around 10:10, only 10 minutes before the 10km race. This meant that fast runners in the 10km race had to deal with passing the slower runners in the 5km race. Not the best setup. They should have staggered the races by 30 minutes to avoid congestion, and probably discouragement for the 5km racers who were passed.

Having been my first race, I didn’t know where I stood, competitively, so I choose a spot in the middle of the pack of 141 competitors to start. The starting line, also the finish line in a 5km loop, was at the top of a big hill. This made for a cruel push right at the end of the race. After the starting gun, the pack of runners started on a slow pace, which increased only slightly as the path ran down into a forested valley. It was a very dry day, and the dust kicked up by the running crowds made it difficult to see and breath, until we got into the forest, where the path became narrow and covered in roots and rocks.

After a few minutes, I realized that the pace wasn’t going to pick up, and so I started passing people wherever I could. This proved to be a difficult task on the single-track trail. There were trees and rocks on both sides of the trail, making opportunities for passing scarce. Only a minute into the race, some people were standing in the woods off to the side of the trail, letting crowds of faster runners go by. I suppose that they choose to start at the beginning of the pack, realizing their mistake after dozens of faster runners were tripping over them trying to get by.

I had to constantly “brake”, keeping close eye on the heels of the person in front of me, for fear of tripping both them and myself, which in the tight line of runners, would have resulted in high-speed game of down-hill twister. The trail ran south-east into a valley bottom, where it crossed small streams over rocks. It then continued south, uphill out of the valley, and turned east again, on a gradual uphill slope. I found that the best places to pass were on the steeper uphill parts, where nearly everyone slows down, some to a walk. This required bursts of extra energy, but I could often pass 6 or 7 people in one short uphill distance, so it was an effective strategy, despite the required recovery period afterwards.

I also found that I had a big advantage over other runners on down-hill sections of trail. Throughout the entire 10km, I didn’t see anyone who ran as fast as I downhill. Perhaps it was my very active winter of aggressive downhill skiing that developed muscles well-suited to the task, or maybe it was a psychological thing, and people were afraid of twisting ankles or not being able to react fast enough when sprinting down trails. In some places though, my desire to accelerate down-hill was a disadvantage, where there was no room to pass, and those in front of me put on the brakes. I literally tripped over one of them, stumbling to the ground.

It took about 4km before I felt that I was “out of the crowd”, and I could run at my own pace. I probably made the most gains in the 3 or 4 km following that, over a gently sloping east-bound trail, that turned north, and then west again, into a much steeper climb for about 1000m, then down again, and then back up a final steep pitch. I crossed the 5km finish line after 21 minutes, and I was thinking at the time that had I been running the 5km race, I would have been very competitive. I was pacing myself for 10km though, thinking that the last few kilometers would probably make the biggest difference.

The second lap was much easier as far as crowds go. I think that I was far ahead of the slower runners, and gaining on the faster ones. Until my calves decided that they had had enough, and shot some searing pain signals up to my brain. I ignored them as much as I could, but eventually I had to stop and stretch, then resume at a much slower pace then I wanted. Numerous people passed me, and the minutes piled on.

I still had a respectable finish though, for a first-time race runner. I was in the top 3rd overall, at 41st place. I was 14th in my age & gender category, out of 42. My time was 48:23; the best time in my category was 39:17 and the worst was 1:09:12. I think I could have improved my time by at least 5 minutes, had I started near the beginning of the crowd, and had my calves held together for another couple of kilometers.

The official results are here.

My next race is this Saturday, at Sibbald Flats. It was sold out when I registered — there is a 150-person limit, because the course goes through an ecologically sensitive area — so I’m on the waiting list. Whether I run in the race depends on registered runners not showing up. They tell me it happens a lot, so I’m hoping to get in.

On race-day this time, I’ll do a few things differently. I’ll ask the organizers for an honest estimate of the start time, before I begin my warm up. I’ll get as close to the front of the pack at the start of the race as I can — although, I’m sure that I won’t be the only one vying for this position. I’ll push fairly hard right at the start of the race, to get out in front, and then try to keep pace with the faster runners throughout the race. I’ll also bring my own water bottle for after the race — it was difficult to find water at the race, and my cramping calves could have been due to dehydration. From now until Saturday, I’ll be drinking as much water as I can stand.

My resting heart rate right now is 56 bpm. :)

Dr. Ray earned her Ph.D. from Stanford Medical School, where she studied cellular physiology and biochemistry. From her personal experiences, she became motivated by an intense desire to understand health and disease, and now promotes a perspective that contradicts the approach of modern medicine. As opposed to “Health Care”, she says that modern medicine is closer to “Sick Care”. Dr. Ray details her perspective in her book, From Here to Longevity.

The problem with the modern medical approach, driven by the pharmaceutical industry, is that it tends to treat the symptoms of illness rather than the causes. It works against our genetics, in an effort to suppress the expression of our “bad genes”. A much more effective approach, she argues, is to help promote the expression of our “good genes” through healthy diet and lifestyle choices.

She argues that a central cause of illness of all sorts is the weakening of our cellular DNA by excessive free radicals in our bodies. These free radicals can be minimized by maintaining a healthy PH balance in our blood, achieved by a diet high in alkaline foods, namely, fruits and vegetables. Without this balance, our cells break down, and we effectively age faster. Studies of our DNA have shown that we should be able to live 120 years. Age 60 should be considered half way , but today it is considered near the end. Children are now dying from heart disease.

The health sciences have been too focused on vitamins and minerals, ignoring hundreds of thousands of other nutrients in fruits and vegetables. These other nutrients are collectively referred to as phytonutrients. Dr. Ray argues that phytonutrients are equally as important to our health as the common vitamins and minerals. It is for this reason that vitamin supplements are probably ineffective — they lack the companion nutrients that the body needs to absorb and make use of them. The only good source of phytonutrients is fruits and vegetables.

These are some tips that I picked up during the talk:

• Eliminate bread and pasta from your diet. According to Dr. Ray, our bodies have a natural reaction to stop eating when we’ve had enough food, but this reaction does not occur when we eat bread or pasta. This is why we tend to over-eat pizza, but we never over-eat broccoli. We haven’t evolved the same feeding shut-off mechanism for breads, but millions of years of evolution has given us this capability for fruits and vegetables. Furthermore, the benefits from grains and breads, such as dietary fiber, can be found in greater abundance in fresh vegetables anyways.

  Bread and pasta also cause a spike in your blood-sugar level, which stimulates the production of insulin. The result is that you’ll experience an energy crash, and also likely the carbohydrate from the bread or pasta will get converted to fat.

• Don’t eat for 3 or 4 hours before bed time. Eating late meals reduces the quality of your sleep. Sleep is essential for your bodies regeneration and repair of its cells. If you are digesting food, you won’t be regenerating. Dr. Ray actually claimed that your body can do only one thing at a time: digest or regenerate. I doubt that its so black-and-white, but I can imagine that less energy would go to regeneration if its being used on digestion.

• Fruit and vegetables should be your main staple. Dairy products, meats and other foods should be consumed in moderation.

• Use food supplements instead of vitamin pills. Supplementation is a good idea, because fruit and vegetables today have diminished concentrations of nutrients over a few decades ago. This is probably due to the overuse of soil and/or pesticides and/or genetic modifications to the plants themselves.

  Vitamin supplements have unnaturally high doses of vitamins, stripped of the phytonutrients that your body needs. They can actually be toxic to your body, and most of them will pass right through you. Dr. Ray actively promotes a food supplement product called “Juice+”, which she sells via MLM. Personally, I recommend Greens+, which you can order online from various sources or pick up at your local health-food store.

  Dr. Ray also advocated the use of Omega3 fatty acid supplements.

• Waistline measurement is the most effective indicator of overall health. Make a fist, and take a look at it. That is approximately the size of your stomach; your meal portions should never exceed this volume. Waistline body fat indicates that you are eating too much, not exercising enough, or both.

  Dr. Ray didn’t distinguish between men and women here though, which I think is a mistake. Men tend to accumulate fat on the waistline first, women, the hips. Either way, the point is that excess body fat, when there is no famine around the corner, is an indication that you’re doing something unhealthy.

• Look into Yoga. It is one of the healthiest forms of exercise that you can find.

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These studies come in the wake of a recent Harvard study that identified a coffee metabolizing gene that is apparently absent in some people. Those without it are at higher risk of heart disease when they drink coffee. Given the results of the 20-year, 120,000 person study, one could probably conclude that the absence of this gene is rare.

Previous studies show health benefits, rather than risks, of drinking coffee. These studies, however, fail to take into account the effects that coffee drinking may have on sleep, and the consequences of that.

The heart even prefers lactate as a fuel, Brooks found.

Mitochondria are the inter-cellular mechanisms that produce energy; the more of them you have, the more efficiently you’ll be able to oxidize lactate into energy. This study apparently links the process of anaerobic metabolism with aerobic metabolism – lactate is produced in the former, and burned off in the latter.

If I understand the results correctly, the implication of this study is that atheletes should be striving to maximize their mitochondria concentration instead of focusing on lactate reduction. Producing more lactate during training will encourage the body to produce more mitochondria to process it. So a focus on high-intensity workouts, followed by rest/recovery periods, would probably be optimal for acheiving maximum training benefit.